Pelvic inflammatory disease (PID) is an infection of a woman’s reproductive organs such as the uterus, fallopian tubes, and ovaries. Left untreated, PID can lead to lasting damage and even become life-threatening in the worst cases. It is a key issue affecting women’s reproductive health. Each year in the United States, more than 750,000 women experience an episode of acute PID.

Read on to learn more about pelvic inflammatory disease.

What causes PID?

PID is caused by the spread of bacteria from the lower genital tract (vagina) to the upper genital tract(the uterus, ovaries, or fallopian tubes).
In 85% of cases, PID is caused by sexually transmitted bacteria. The most common ones are the bacteria Neisseria Gonorrhoeae or Chlamydia Trachomatis. According to data, about 10% to 15% of women with endocervical Neisseria Gonorrhea or Chlamydia Trachomatis will develop PID. (1)
It can take anywhere from a few days to a few weeks after an untreated infection to develop PID. Gonorrhea typically causes more severe PID than other infections.
Less commonly, PID can be caused by other microorganisms such as genital mycoplasmas, aerobic streptococci, and endogenous vaginal flora bacteria implicated in bacterial vaginosis.

What are the symptoms of PID?

Women with PID may experience a variety of symptoms that can be subtle and difficult to recognize. Some women don’t display any signs.
For others, the symptoms may be mild and include one or many of the following:

  • Pain in your lower abdomen. It is the most common symptom. The pain can range from mild to severe.
  • Abnormal vaginal discharge with foul-smelling
  • Pain during sex
  • Abnormal vaginal bleeding during or after sex
  • Bleeding between periods
  • Burning during urination
  • Fever (100.4° F or higher), sometimes with chills

What are the risk factors of PID?

Several factors have been identified to increase the risk of PID. The factors that can heighten the risk of PID include :

  • Having a previous PID
  • Being sexually active before 25 years old
  • Having multiple sexual partners
  • Smoking
  • Having unprotected sex
  • Being in a sexual relationship with someone who has sex with other people than you
  • Having an STD and not getting treatment

The insertion procedure of an intrauterine device (IUD) can also increase the risk of PID slightly. Research has shown that the instrument used for the insertion can facilitate the introduction of vaginal and cervical bacteria into the uterus. (2) However, the risk is very low and limited to the first three weeks after insertion.

Some studies also suggest that frequent douching increases the risk of PID for many reasons. Douching destroys the good bacteria( lactobacilli) and facilitates the overgrowth of bacteria that cause PID. It also makes it easier for the bacteria to travel from the vagina to the upper genital tract. (3)

What is the treatment for PID?

Your healthcare provider will prescribe two or more antibiotics that you will take by mouth. You must take all of your antibiotics, even if your symptoms improve. Your doctor may schedule a follow-up visit a few days after starting the medicine to ensure the treatment is working. If your symptoms don’t improve despite the treatment, you may need to be treated in the hospital with IV medications.
A hospital stay may also be necessary if you:

  • are pregnant
  • have a high fever
  • are severely ill
  • have an abscess in your fallopian tube or ovary.

Sometimes PID may require surgery. Unfortunately, treating the PID cannot reverse any scarring that the infection has already caused.

What are the complications of PID?

The longer a woman has untreated PID, the greater the risk for long-term sequelae. PID can cause complications whether you experience symptoms or not. The complications of PID include:

  • Tubo-ovarian abscess_ It is a collection of pus in the fallopian tubes and the ovaries. The abscess may form soon after the beginning of the infection. It can take months to heal. HIV-positive women may be at higher risk of a tubo-ovarian abscess (4)
  • Infertility_It is estimated that 15% of women may become infertile as a result of PID. The inflammation due to the infection can lead to scar tissue formation and adhesions (band of scar tissue binding the organs) that may create a blockage within fallopian tubes. This makes it difficult for the sperm to meet and fertilize an egg. PID is more likely to lead to infertility if it is related to chlamydia, or there is a delay in treatment, or it is a severe case.
  • Ectopic pregnancy_ Many cases of ectopic pregnancies occurring every year are the result of PID. An ectopic pregnancy occurs when the scars in the fallopian tube prevent a fertilized egg from moving into the uterus. Instead, the fertilized egg settles in the fallopian tubes and bursts as the pregnancy grows. It can lead to life-threatening bleeding in the abdomen and pelvis.
  • Long-term pelvic pain_ A large proportion of women with PID will develop chronic pelvic pain that might last for years. The pain is also related to the scarring, tissue damage, and adhesions resulting from the inflammation.
  • Ovarian cancer_Few studies have also linked PID to an increased risk of ovarian cancer, especially among women with multiple episodes of PID. (5)

credit: Shutterstock

How can you prevent PID?

The following steps can help you reduce your risk of pelvic inflammatory disease:

  • Avoid STDs. The best way to avoid STDs is abstinence. If you decide to have sex, always practice safe sex using a condom or being in an exclusive relationship.
  • Get tested regularly for STD if you have multiple partners.
  • Make sure you get treatment as soon as possible when you have an STD. Your partners should get treatment, as well.
  • Avoid douching
  • Always wipes front to back after using the bathroom to keeps bacteria in the rectal area from entering the vagina.
  • Go to your doctor if you experience any of the symptoms we described earlier.




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About the Author

Hermione M.

My name is Hermione. I am the founder of WomenH and I write about women's health, wellness, mental health, and personal growth. I created this platform to inspire women to take care of themselves mentally, physically, and emotionally to become their best selves. Thank you for stopping by.

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