Pelvic Inflammatory Disease (P.I.D.)

What is pelvic inflammatory disease?

Pelvic Inflammatory Disease (P.I.D.) is an infection which occurs when bacteria enters the cervix and spreads upwards into the pelvic organs, including the uterus, fallopian tubes and the ovaries. Apart from H.I.V., P.I.D. is the most common and serious complication of sexually transmitted diseases.

What causes pelvic inflammatory disease?

There is a variety of bacteria that can cause P.I.D., but the bacteria that causes the sexually transmitted diseases gonorrhoea and chlamydia are responsible for most P.I.D. infections. Sometimes the exact cause of P.I.D.is unknown, bacteria that lives harmlessly in the vagina can get passed the cervix and into the reproductive organs, this bacteria can then cause infection. The bacteria is more likely to enter the body after the insertion of an I.U.D. (Intra-Uterine contraceptive Device), childbirth, miscarriage or abortion.

What are the signs or symptoms for pelvic inflammatory disease?

The symptoms of P.I.D. can vary in different women and this can make it very difficult for a doctor to diagnose.  It can be an acute (short and severe) or a chronic (long term) infection. P.I.D., particularly when caused by chlamydia infection, may produce only minor symptoms or none at all.

Symptoms that are associated with acute P.I.D. include:

• Lower abdominal pain and around the pelvis..
• Heavy, bad smelling vaginal discharge that might be yellow or green in colour.
• High temperature or chills.
• Nausea.
• Fast pulse.
• Pain or discomfort during sex.

Symptoms that are associated with chronic P.I.D. include:

• Constant and more severe abdominal pain or tenderness.
• Weakness and tiredness.
• Heavy, painful periods.
• Pain or discomfort during sex.
• Bleeding between periods.
• Back pain.

If you are worried about P.I.D. you should make an appointment to see your doctor or visit your local G.U.M. clinic.

How can I avoid getting pelvic inflammatory disease?

Infection with P.I.D. can be prevented by avoiding risky sexual behaviour (unsafe sex). If condoms are used correctly and consistently you are protecting yourself against infection from gonorrhoea and chlamydia, the two main causes of P.I.D.

Other procedures you can follow to avoid the spread of bacteria include:

• Not having vaginal intercourse directly after anal intercourse.
• Avoiding sexual intercourse for 6 weeks after childbirth, or for one week after abortion or miscarriage.
• Avoiding douching, as this may push bacteria upwards.

How is pelvic inflammatory disease diagnosed?

P.I.D. can be hard to diagnose. Your doctor may begin by asking you about your sexual history, they may then be able to diagnose P.I.D. by examining your pelvic area for swollen and painful areas. If the doctor suspects P.I.D. he/she may take a swab of the inside of your cervix and vagina this will be sent away to look for the presence of a bacteria infection. Your doctor may also carry out a urine and blood tests. Your doctor may then refer you to a specialist for examinations, these may include an ultrasound and a laparoscopy. A laparoscopy is a minor operation in which a small telescopic camera is inserted (through a small cut under your naval) to look at your pelvic organs.

How is pelvic inflammatory disease treated?

P.I.D. is treated with antibiotics, bed rest and painkillers. In severe cases a stay in hospital may be necessary so that the antibiotics can be given directly into the veins. A follow-up appointment is usually required to ensure that the infection is gone. It is also very important that your partner has a full check-up, to make sure you are both clear of all infections.

How will pelvic inflammatory disease affect me in the future?

Early treatment of P.I.D. can help prevent any complications developing, however, If P.I.D. is left untreated it can cause infertility. This is because the infection scars the tissues of the fallopian tubes, causing them to narrow. If the fallopian tubes become blocked, sperm are unable to pass to fertilize the egg.

A woman who has had P.I.D. is also at risk of having a tubal or ectopic pregnancy, in which the egg can become fertilized but can’t pass into the uterus to grow. Instead, the egg usually attaches in the fallopian tubes,where it is unable to grow normally. This type of pregnancy is life threatening to the mother and almost always fatal to her fetus.

Women with recurrent episodes of P.I.D. are more likely to suffer scarring of the tubes, than women with a single episode.