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Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is a bacterial infection of the female reproductive organs. It's often caused by the same bacteria responsible for several sexually transmitted diseases like gonorrhea and chlamydia, or in some cases, bacteria that has traveled through the vagina and cervix by way of an intrauterine device (IUD). PID can affect any of the reproductive organs such as the uterus, fallopian tubes or the ovaries causing pelvic adhesions and scar tissue, ongoing pelvic pain, the possibility of an ectopic pregnancy (the fertilized egg becomes implanted outside the uterus) or infertility.

One in 10 women with PID becomes infertile and, if left untreated, PID can also lead to chronic infection. If PID is not diagnosed early enough, peritonitis and inflammation of the walls of the abdominal and pelvic cavity may develop.

Who is at risk for pelvic inflammatory disease?

Although women of any age can develop PID, sexually active women under age 25, and those of childbearing age are at the greatest risk of acquiring the disease through sexually transmitted bacteria. Women who use intrauterine devices (IUDs) are also at an increased risk.

What are the symptoms of PID?

The following are the most common symptoms of PID. However, each individual may experience symptoms differently. Symptoms of PID include:

  • diffuse pain and tenderness in the lower abdomen
  • pelvic pain
  • increased foul-smelling vaginal discharge
  • fever and chills
  • vomiting and nausea
  • pain during urination
  • abdominal pain (upper right area)
  • pain during sexual intercourse

Symptoms may be mild enough that the condition may go undiagnosed.

The symptoms of pelvic inflammatory disease may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.

How is PID diagnosed?

In addition to a complete medical history and physical and pelvic examination, diagnostic procedures for PID may include the following:

  • Microscopic examination of samples from the vagina and cervix.
  • Blood tests.
  • Pap test: test that involves microscopic examination of cells collected from the cervix, used to detect changes that may be cancer or may lead to cancer, and to show noncancerous conditions, such as infection or inflammation.
  • Ultrasound : A diagnostic imaging technique which uses high-frequency sound waves to create an image of the internal organs.
  • Laparoscopy : A minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall. Using the laparoscope to see into the pelvic area, the physician can determine the locations, extent and size of the endometrial growths.
  • Culdocentesis: A procedure in which a needle is inserted into the pelvic cavity through the vaginal wall to obtain a sample of pus.

How can PID be treated?

Specific treatment for PID will be determined by your health care provider based on:

  • your age, overall health and medical history
  • extent of the disease
  • type and severity of the symptoms
  • your tolerance for specific medications, procedures or therapies
  • expectations for the course of the disease
  • your opinion or preference

Treatment for PID usually includes oral antibiotics, particularly if there is evidence of gonorrhea or chlamydia. In cases of severe infection, hospitalization may be required to administer intravenous antibiotics. Occasionally, surgery is necessary.