Pelvic Inflammatory Disease (PID)

What is pelvic inflammatory disease (PID)?
Pelvic inflammatory disease (PID) is an infection in the female reproductive organs (uterus, fallopian tubes and ovaries). Normally, the cervix (opening to the womb) prevents bacteria in the vagina from spreading up into these organs. However, if the cervix is exposed to a sexually transmitted disease (STD) such as gonorrhea or chlamydia, it becomes infected. This can allow
bacteria to travel up into the internal organs, making them inflamed and infected. If this occurs, the woman's fallopian tubes may be damaged, making it difficult for her to become pregnant.

How does a woman get PID?
There are several ways women can get PID. The most common way is by having sex with a person who has gonorrhea or chlamydia. These diseases are carried in the semen and other body fluids of infected people. During sexual contact, the germs spread to the woman's cervix. The germs can also infect the glands at the opening of the vagina, the urethra (passageway for urine) or the anus.
Sometimes women get PID without being exposed to gonorrhea or chlamydia. In these cases, doctors aren't sure why the bacteria in the vagina spread into the uterus, fallopian tubes and abdomen, causing PID. PID can also occur if bacteria infect your internal organs as a result of
giving birth, or having a miscarriage, an abortion or a procedure to take a sample from the inside of the womb for laboratory testing. Sometimes PID can occur after the cervix is treated because of an abnormal Pap smear or after the insertion of an intrauterine device (IUD). However, this isn't common.

How do I know if I have PID?
PID causes different symptoms in different women. These may include the following:

• A "stomachache, " or dull pain and tenderness in the lower abdomen.
• Vaginal discharge that is usually yellow or green and may have an unpleasant smell.
• Irregular menstrual periods, such as extra long periods, spotting or cramps throughout the month.
• Severe illness, including chills, high fever, nausea and vomiting.
• Pain during sex.
  

Some women who have PID do not have any of these symptoms and don't know they have it.

What should I do if I have symptoms of PID?
Women who have these symptoms or who think they have been exposed to an STD should see their doctor right away. Your doctor can only diagnose PID by doing a pelvic exam, and swabbing the area and having the sample tested. The sooner you see your family doctor, the better. Waiting even 1 or 2 days can allow the infection to spread and cause more pain and damage.

How is PID treated?
There is no over-the-counter treatment for PID. Usually, PID can be cured with antibiotics. Most women can have outpatient treatment. If you are treated as an outpatient, you must take your medicine just the way your doctor tells you to. If you don't take all the pills, your symptoms will get worse and you may have to go to the hospital. A few days after you start
taking the medicine, your doctor will want to see you for a checkup. Hospitalization may be recommended if you are very sick with PID, or if you are pregnant, under the age of 18 or have the human immunodeficiency virus (HIV).

Should my partner be treated if I have PID?
If you are treated for PID, especially if it's caused by an STD, your partner must also be treated. Unless your partner is treated, you may be infected again. Making good choices about sexual contact is important. If you think you might have PID, talk to your family doctor right away.

What are the risk factors for PID?
The same things that put you at risk for STDs put you at risk for PID. Risk factors for PID include sexual contact with multiple partners and unsafe sexual habits. Both men and women can carry STDs and not have any symptoms. They can expose their sex partners to a disease without knowing it.

How do I practice safe sex?
Avoid sexual contact with people who are at risk of infection. If you decide to have sex, first ask your partner if he or she has any risks for infection. A male partner should always wear a condom. Even though the condom will not prevent 100% of STDs, it will greatly reduce your chances of getting infected. Remember, only a condom can provide some protection against STDs. Other forms of birth control don't provide this protection.

What can happen to my body if I get PID?
Early and complete treatment can help prevent complications of PID. However, if PID isn't treated, it can cause permanent damage to your internal organs. Scar tissue can form in the fallopian tubes and around the abdomen. This tissue can prevent pregnancy or cause the pregnancy to form in the fallopian tube (called a tubal or ectopic pregnancy). Scarring can cause pain that lasts for months, or even years. Occasionally, the effects of PID can be so severe that surgery is required to remove pus, get rid of scar tissue or remove damaged organs.
PID is more likely to come back if you are exposed to STDs again. Each time you have PID causes more damage and a greater possibility of complications. (AAFP)