Pelvic Inflammatory Disease

Pelvic inflammatory disease is an inflammation of the female reproductive organs. It can lead to scar formations with fibrous bands that form between tissues and organs. It can affect the uterus, or womb, the fallopian tubes, the ovaries, or a combination. Complications include chronic, persistent, pelvic pain, ectopic pregnancy, and infertility.

Symptoms​

Pelvic inflammatory disease can cause pain and lead to infertility. Many women with PID have no symptoms. If symptoms appear, they can vary from mild to severe. However, untreated PID can have serious consequences.

Possible symptoms include:

  • pain, possibly severe, especially in the pelvic area

  • fever

  • fatigue

  • bleeding or spotting between periods

  • irregular menstruation

  • pain in the lower back and the rectum

  • pain during sexual intercourse

  • unusual vaginal discharge

  • frequent urination

  • vomiting

Complications

Complications that can arise if PID is not treated include:

  • scarring that can lead to fertility problems

  • recurring PID

  • severe pelvic pain

  • a tubo-ovarian abscess

Many women do not realize they have had a PID until they seek medical advice for infertility problems.

Diagnosis

Your doctor will ask about symptoms and carry out a pelvic exam to check for tenderness. Also, a test for chlamydia and gonorrhea will be asked to be performed. A swab may be taken from the cervix, and maybe from the urethra, the tube from the bladder through which urine flows. There may be blood and urine tests. An ultrasound scan may be used to check for inflammation in the fallopian tubes. Sometimes, a laparoscope is used to view the area. If necessary, tissue samples can be taken through it.

Treatment

Early treatment decreases the likelihood of developing complications, such as infertility. 

  • Antibiotic treatment

The first kind of treatment is with antibiotic. It is important to follow the doctor's instructions and complete all of the prescription. A course usually lasts 14 days. PID often involves more than one type of bacteria, so the patient may take two antibiotics together. If tests show which bacteria are causing the disease, more targeted therapy is possible.

  • Hospitalization and surgery

Hospitalization: If a woman with PID is pregnant or has very severe symptoms, she may need to remain in the hospital. In the hospital, intravenous medication may be given.

Surgery: This is rarely needed, but it may be needed if there is scarring on the fallopian tubes or if an abscess needs draining. This may be keyhole surgery, or it may involve removal of one or both fallopian tubes.

The woman's sexual partner may need to seek treatment for an STI. If the partner has an STI, there is a serious risk of recurrence if it goes untreated. The patient should refrain from sex until the treatment is completed.