WHAT IS PELVIC INFLAMMATORY DISEASE (PID)?
Pelvic inflammatory disease describes any infection of the reproductive organs of a woman. It occurs when microbes (germs) travel up through the cervix and uterus (womb) and then spread inwards to the fallopian tubes, ovaries, and surrounding tissues in the pelvis. The most common serious infection is that of the tubes—this is called salpingitis. Pelvic infection can be either acute, which causes sudden severe symptoms, or chronic, which gradually produces milder symptoms
WHAT ARE FACTS?
Here are some basic facts about the disease:
• Unprotected sex with someone who has been infected causes up to 75% of cases.
• Minor operations (such as the insertion of an intrauterine device [IUD]) or procedures of pregnancy (such as a miscarriage, an abortion, or even a delivery) can cause PID.
• Up to 10% of young women normally have the microbes, which include chlamydia and gonorrhea, on their cervix. These women are at special risk of getting PID.
Chlamydia is the most common cause of PID.
• The most common cause of infertility is PID
• PID is a preventable disease and it is best diagnosed by laparoscopy (where a tube is passed through the abdomen).
WHO ARE THE WOMEN AT MOST RISK?
The women most at risk are those who:
• are between 20 and 29 years
• have abnormal Pap tests when aged between 15 and 35 years
• have multiple sexual partners
• have steady partners who have sex with others
• do not use barrier methods of contraception (e.g. condoms)
have operations needing the opening of the cervix (e.g. dilation and curettage, and placement of an IUD).
WHAT ARE SYMPTOMS
Many patients may feel no symptoms (PID is often called the ‘silent epidemic’), but others may have symptoms that vary from mild to very severe.
ACUTE PID
• Fever
• Severe abdominal pain
CHRONIC PID
• Ache in the lower back
• Mild lower abdominal pain
BOTH ACUTE AND CHRONIC
• Painful intercourse
• Menstrual problems (e.g. painful, heavy, or irregular periods)
• Unusual, perhaps smelly, vaginal discharge
• Painful or frequent urination
WHAT ARE THE RISKS?
PID can lead to scarring of the reproductive system. The main serious risks of this are subsequent sterility, ectopic
pregnancies, and further episodes of PID. Occasionally an acute infection may cause a pelvic abscess or cause peritonitis or even blood poisoning by spreading.
HOW IT CAN BE PREVENTED?
• Safe sex is most important. Insist on condoms with all sexual partners.
• Avoid IUDs if you have a history of PID or have several sexual partners.
• It is advisable to have antibiotic treatment if a partner has or gets an STI even if you have no symptoms.
• If you get PID, your partner or partners should be treated.
• Those at risk for PID should have regular check-ups.
NOTE:
It is your responsibility to inform your partner or partners that you have PID.
WHAT IS THE TREATMENT?
A course of antibiotics is given, usually by mouth. Avoid sexual intercourse or manipulation of your vagina (e.g. with hands or tampons) until the infection is cleared. This may take 2 to 4 weeks. If you have an IUD, it should be removed