Pelvic Inflammatory Disease

Author: Alexander Salerno, MD
December 23, 2019

Pelvic pain and pelvic diseases can often take longer to diagnose and the pain is usually chronic, experienced over a period of six months or longer. Women are found to suffer more often from pelvic disorders; one such disease is pelvic inflammatory disease, commonly referred to as PID. Mainly females are prone to this reproductive organ infection. When bacteria (sexually transmitted) spreads to the fallopian tubes, ovaries, and uterus from the vagina, the disease occurs. The disease can often go undetected because it does not have any immediate signs as such, thus delaying the treatment.

Causes of PID and risk factors
There are probably a number of causative bacteria responsible for PID, but gonorrhea and chlamydia infections are most common. These enter the body during unprotected intercourse. During miscarriage, childbirth, or abortion, the bacteria can cross the barrier of the cervix and enter the vagina too.

The risk for PID increases if one is sexually active before turning 25, has multiple partners, is not using a condom, or is douching regularly. The risk also increases if one has a partner who has sex with more than one person or has a previous history of the disease.

The disease can further lead to conditions such as ectopic pregnancy, chronic pelvic pain, infertility, and tubo-ovarian abscess if untreated.

Signs and symptoms
The signs of PID include heavy vaginal discharge accompanied by a foul odor, pelvic pain along with pain experienced in the lower abdomen, and abnormal uterine bleeding between menstrual cycles and after or during sexual intercourse. Symptoms also include difficulty during urination along with pain and fever accompanied by chills and painful intercourse along with bleeding.

When the pain in the lower abdomen turns severe, or there is heavy vaginal discharge, fever accompanied by a high temperature, or vomiting and nausea with an inability to keep anything down, it is time to visit the doctor.

Diagnosis, Treatment, and Prevention
Diagnosis includes carrying out a pelvic exam plus urine tests and analysis of the cervical culture and vaginal discharge by taking a sample using a cotton swab. Blood and urine tests are conducted to check the white blood cell count, which can further indicate the presence of an infection. Tests to look for HIV can also be carried out. Ultrasound and laparoscopy are further ways to diagnose the disease.

Treatment includes antibiotics to help with the infection and prevent any further complications. Abstinence and treatment of the partner are also suggested by doctors. The treatment is usually outpatient, unless the abscess has ruptured or the infection is further complicated. Pregnant or seriously ill patients might require hospitalization along with those who do not show improvement post antibiotic treatment.

The disease can be prevented, primarily by opting for safe sex, using protection during intercourse, discussing ways of contraception with the doctor, and using the most suitable one. Other elements of prevention include avoiding douching as it disrupts the balance of bacteria in the body, and getting regularly tested along with one’s partner for sexually transmitted infections.

Dr. Alexander G. Salerno

About Alexander Salerno, MD

Salerno Medical Associates medical practice & founder of Urban Healthcare Initiative Program (UHIP) and Community Healthcare Outreach Program (CHOP)