“PID can cause scarring or damage to the Fallopian tubes”

Emobileclinic Trending Topic: Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection of the female upper genital tract, including the womb, fallopian tubes and ovaries. PID is a common condition, although it is not clear how many women are affected. It mostly affects sexually active women aged 15 to 24.

Symptoms

Most women have mild symptoms that may include one or more of the following:

pain around the pelvis or lower abdomen (tummy)

discomfort or pain during sex that’s felt deep inside the pelvis

pain during urination

bleeding between periods and after sex

heavy periods

painful periods 

unusual vaginal discharge, especially if it’s yellow or green

A few women become very ill with:

severe lower abdominal pain

a high temperature (fever)

nausea and vomiting

When to seek medical advice

It is important to visit your GP or a sexual health clinic if you experience any of the above symptoms.

If you have severe pain, you should seek urgent medical attention from your GP or local A&E department. Delaying treatment for PID or having repeated episodes of PID can increase your risk of serious and long-term complications.

Diagnosis

Diagnosis is based on your symptoms and the finding of tenderness on a vaginal (internal) examination. Swabs will be taken from your vagina and cervix (neck of the womb).

Causes

The major cause of PID is bacterial infection which is spread from the vagina or the cervix to the reproductive organs higher up.

In about one in four cases, it is caused by a sexually transmitted infection (STI) such aschlamydia or gonorrhoea. Some cases of PID are not due to a sexually transmitted infection. The vagina normally contains many different bacteria. These are usually harmless and are not passed on by sexual contact. However, these bacteria sometimes cause PID. This is more of a risk after having a baby, or after a procedure such as inserting a contraceptive coil.

Treatment

If diagnosed at an early stage, PID can be treated with a course of antibiotics, which usually lasts for 14 days. 

It is important to complete the whole course and avoid having sexual intercourse during this time to help ensure the infection clears.

Your recent sexual partners also need to be tested and treated to stop the infection recurring or being spread to others.

Complications

Complications may not develop in most cases if pelvic inflammatory disease (PID) is diagnosed and treated early. Possible complications include one or more of the following:

Difficulty becoming pregnant (infertility). PID can cause scarring or damage to the Fallopian tubes. This can occur whether or not the PID caused symptoms.

An increased risk of a pregnancy developing in a Fallopian tube (an ectopic pregnancy) if you become pregnant. This is due to damage to the Fallopian tube by the infection. If you have had PID and become pregnant, you have about a 1 in 10 chance that it will be ectopic.

Persistent pain may develop. This often includes pain during sex.

The risks of developing some complications of pregnancy (such as miscarriage, premature birth and stillbirth) are increased in pregnant women with untreated PID.

Reiter’s syndrome. This is an uncommon cause of arthritis and eye inflammation. It is an uncommon complication of PID. It is thought to be due to the immune system ‘over-reacting’ to pelvic infection in some cases.

A collection of pus (an abscess) sometimes develops next to the womb (uterus) if the infection is severe.

You are less likely to develop complications if you begin treatment within 2-3 days of symptoms starting. This may be possible if symptoms develop quickly. However, some women with PID have mild symptoms or no symptoms at all. The infection may progress for quite some time before it is diagnosed or treated.

Treatment of pelvic inflammatory disease (PID)

The usual treatment is a course of antibiotics for at least two weeks. This is advisable if your temperature is very high (higher than 38°C) or there are signs of a collection of pus (an abscess).

Prevention

Wearing a condom during sex helps to protect you from sexually transmitted infections. The risk of infection increases with the number of changes of sexual partner. If you are sexually active and under 25 years old, you should be tested for chlamydia every year or when you change your sexual partner.

Can PID resurface after treatment?

About 1 in 5 women who have pelvic inflammatory disease (PID) have a further episode. This is usually within two years. Reasons why this may occur include:

If the sexual partner was not treated. You are then likely to get the infection back again.

If you did not take the antibiotics properly, or for long enough. The infection may then not clear completely, and may flare up again later.

If you change your sexual partner and do not practise ‘safer sex’ by using condoms.

Some women are more prone to infection once their womb (uterus) or tubes have been damaged by a previous episode of PID.

The risk of developing complications such as infertility or persistent pelvic pain is greatly increased with repeated episodes of PID.