Pelvic Inflammatory Disease

Pelvic Inflammatory Disease (PID) is not a single illness. It is a broad term covering a variety of infections of the internal reproductive organs - the ovaries, fallopian tubes, uterus, ligaments supporting the uterus, and even the abdominal lining.

PID is the most common, preventable cause of infertility in the United States. It can cause scarring of the fallopian tubes leading to blockage of the tubes.

PID is also the leading cause of ectopic pregnancy. If the fallopian tube is damaged from PID, the fertilized egg may attach to the inside wall of the tube instead of inside the uterus. An untreated ectopic pregnancy can lead to rupture of the tube, bleeding into the abdomen, and can result in death.

Sometimes PID is accompanied by symptoms - abdominal pain, fever, and vaginal discharge, but not always. Some women do not have symptoms at all.

When there are symptoms, the most common symptom is a dull abdominal ache. This pain may get worse with movement or sexual activity. Often the first symptom is a vaginal discharge. Other symptoms include abnormal uterine bleeding, fever and chills, and sometimes nausea and vomiting.

Cause
There are several bacteria that can cause PID. Neisseria gonorrhoeae and Chlamydia trachomatis are the most common. Both are sexually transmitted. The infection usually begins in the vagina, then travels up through the cervix to the rest of the reproductive organs.

Gonorrhea-associated infections generally begin quickly with severe symptoms. With Chlamydia, the symptoms may be mild and develop slowly over months or even years.

Another possible cause of PID is the introduction of organisms into the reproductive tract after an induced abortion, following the birth of a child, or by the insertion of an Intrauterine Device (IUD).

Risk Factors
Since the most common causes of PID are sexually transmitted, sexual activity is the largest risk factor for PID> Age is also a factor. Approximately 75% of all cases of PID occur in women under the age of 25. Younger women appear to be mor susceptible to Chlamydia and gonorrhea associated infection than older women.

There is a direct relationship between the number of sexual partners a woman has and her risk for PID. The more partners she has, the greater the risk.

Treatment
Because PID is generally caused by a mixture of bacteria, your physician will probably prescribe a combination of antibiotics. Since most cases are caused by sexually transmitted diseases, do not have intercourse with your partner until he has also completed his treatment. It is very important that you finish all the medication, even if the symptoms go away before treatment is finished.

It is important to see your doctor or midwife a few days after starting treatment to ensure the antibiotics are working. If your condition isn't improving, you may need to be hospitalized for IV antibiotics.

Resting as much as possible can help speed along your recovery. Pain medication, hot baths, or a heating pad applied to the lower back and abdomen may help relieve the discomfort of PID.

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