How common is Pelvic Inflammatory Disease?

  • What is Pelvic Inflammatory Disease?
  • How is it diagnosed?
  • What are the symptoms?
  • Are there long-term effects of it?
  • What are the causes?
  • Who is at risk?
  • How is it treated?
  • Can it be prevented?

What is Pelvic Inflammatory Disease?

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It is a common illness. PID is diagnosed in more than 1 million women each year in the United States.

PID occurs when bacteria move from the vagina and cervix upward into the uterus, ovaries, or fallopian tubes. The bacteria can lead to an abscess in a fallopian tube or ovary. Long-term problems can occur if PID is not treated promptly.

What are the causes?

Two sexually transmitted infections (STIs)—gonorrhea and chlamydia—are the main causes of PID. Gonorrhea and chlamydia may cause vague symptoms or even no symptoms in a woman. When a woman is infected with gonorrhea or chlamydia and does not receive treatment, it can take anywhere from a few days to a few weeks before she develops PID. PID also can be caused by infections that are not sexually transmitted, such as bacterial vaginosis (BV).

How is it diagnosed?

To learn if you have PID, your gynecologist or other health care professional will start by asking about your medical history, including your sexual habits, birth control method, and symptoms. If you have PID symptoms, you will need to have a pelvic exam. This exam can show if your reproductive organs are tender. A sample of fluid from your cervix will be taken and tested for gonorrhea and chlamydia. Blood tests may be done.

Your gynecologist or other health care professional may order other tests or procedures:

Other tests may include?

  • Ultrasonography
  • Endometrial biopsy
  • Laparoscopy

Who is at risk?

PID can occur at any age in women who are sexually active. It is most common among young women. Those younger than age 25 years are more likely to develop PID. Women with the following risk factors also are more likely to have PID:

  • Infection with an STI, most often gonorrhea or chlamydia
  • Multiple sex partners (the more partners, the greater the risk)
  • A sex partner who has sex with others
  • Past PID

Some research suggests that women who douche frequently are at increased risk of PID. Douching may make it easier for the bacteria that cause PID to grow. It also may push the bacteria upward to the uterus and fallopian tubes from the vagina. For this and other reasons, douching is not recommended.

What are the symptoms?

Some women with PID have only mild symptoms or have no symptoms at all. Because the symptoms can be vague, many cases are not recognized by women or their gynecologists or other health care professionals. Listed are the most common signs and symptoms of PID:

  • Abnormal vaginal discharge
  • Pain in the lower abdomen (often a mild ache)
  • Pain in the upper right abdomen
  • Abnormal menstrual bleeding
  • Fever and chills
  • Painful urination
  • Nausea and vomiting
  • Painful sexual intercourse

Having one of these signs or symptoms does not mean that you have PID. It could be a sign of another serious problem, such as appendicitis or ectopic pregnancy. You should contact your gynecologist or other health care professional if you have any of these signs or symptoms.

Source: ACOG.ORG

How is it treated?

PID can be treated. However, treatment of PID cannot reverse the scarring caused by the infection. The longer the infection goes untreated, the greater the risk for long-term problems, such as infertility.

PID is treated first with antibiotics. Antibiotics alone usually can get rid of the infection. Two or more antibiotics may be prescribed. They can be given as pills, through a tube inserted in a vein (intravenous line), or by injection. A member of your health care team may schedule a follow-up visit 2–3 days after treatment to check your progress. Sometimes the symptoms go away before the infection is cured. If they do, you still should take all of the medicine for as long as it is prescribed.

Some women may need to be treated in a hospital. A hospital stay may be recommended for women who do not have a clear diagnosis, are pregnant, must take IV antibiotics, are severely ill, have nausea and vomiting, have a high fever and/or have an abscess in a fallopian tube or ovary.  In certain situations, such as when an abscess is found, surgery may be needed.

A woman’s sex partners must be treated. Women with PID may have partners who have gonorrhea or chlamydia. A person can have these STIs even if there are no signs of illness.

What are the long-term effects?

PID can lead to serious, long-term problems:

  • Infertility—One in 10 women with PID becomes infertile. PID can cause scarring of the fallopian tubes. This scarring can block the tubes and prevent an egg from being fertilized.
  • Ectopic pregnancy—Scarring from PID also can prevent a fertilized egg from moving into the uterus. Instead, it can begin to grow in the fallopian tube. The tube may rupture (break) and cause life-threatening bleeding into the abdomen and pelvis. Emergency surgery may be needed if the ectopic pregnancy is not diagnosed early.
  • Chronic pelvic pain—PID may lead to long-lasting pelvic pain.

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Can it be prevented?

To help prevent PID, take the following steps to avoid STIs:

  • Use condoms every time you have sex to prevent STIs. Use condoms even if you use other methods of birth control.
  • Have sex only with a partner who does not have an STI and who only has sex with you.
  • Limit your number of sex partners. If you or your partner has had previous partners, your risk of getting an STI is increased.

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