Pelvic Inflammatory Disorder

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. Some sexually transmitted diseases, such as chlamydia and gonorrhea, can lead to this problem. PID can also be caused by other illnesses, not just those through sex.

Last Updated: February 24, 2024

In most cases, females between the ages of 15 and 25 are diagnosed with PID. The incidence of PID has been falling over the past decade. However, it is often seen in primary care and emergency rooms.

Various bacteria can cause PID, but gonorrhea and chlamydia infections are the most prevalent. The vast majority of cases of these germs can be traced back to unprotected sexual contact. Additionally, PID can also be acquired when:

  • Existing STD is not treated;
  • Have more than one sex partner; 
  • Have a sex partner who has other sex partners besides you;
  • Have had PID before;
  • Are sexually active and younger than 25 years old.

The following may indicate PID:

  • Pain in the lower abdomen; 
  • Fever; 
  • Unusual vaginal bleeding with a bad smell;
  • Pain and/or bleeding during coitus;
  • Having a burning feeling when you urinate;
  • Bleeding between periods.

Medical history, including questions about general health, sexual activity, and symptoms, is typically used to diagnose PID. The next step is a comprehensive pelvic exam to look for evidence of infection in the reproductive organs. Then doctors will collect a bacterial sample from the vagina. In addition, a doctor may recommend blood tests.

It is also possible to rule out a urinary tract infection (UTI), which can cause similar pelvic-area symptoms, by doing a urinalysis. Ultrasound can help to visualize the reproductive system better.

If necessary, doctors may suggest a biopsy of the endometrium, or uterine lining, to analyze the tissues in the uterus. It is also possible to perform a laparoscopy to inspect the reproductive organs closely. Finally, to extract vaginal fluid for testing, culdocentesis is another option.

 

Treatment

According to the Centers for Disease Control, the first treatment for outpatients is doxycycline plus ceftriaxone with probenecid for one dose or another parenteral third-generation cephalosporin. Metronidazole should be added if there is a concern about trichomonas. Hospitalization may be needed for women who are pregnant, who haven't gotten better with outpatient care, who have a severe illness, who have PID and have gotten a pelvic abscess, or who may need surgery. In the hospital, the recommended regimen is Cefotetan and doxycycline or Cefoxitin with doxycycline or clindamycin.

These steps can lower PID risk:

  • Engage in responsible sexual activity. Always use a condom. Limit the number of partners and ask about a potential partner's sexual history.
  • Discuss birth control options with a doctor. When it comes to preventing PID, several contraceptive methods fall short. The risk can be reduced using a condom or other barrier device or birth control tablets, especially with a new partner.
  • Get examined. Set up a routine screening regimen with a doctor if necessary. Early detection and treatment of sexually transmitted diseases can prevent 
  • The partner should be tested. If presently suffering from STI or pelvic inflammatory disease, the partner should be tested and treated. STIs and future episodes of PID are less likely to be transferred in this way
  • Don't douche. Douching disrupts the bacterial flora in the vagina.

 

References

Jennings LK, Krywko DM. Pelvic Inflammatory Disease. [Updated 2022 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499959/

Cleveland Clinic (2022). Pelvic Inflammatory Disease (PID). Retrieved November 4, 2022, from https://my.clevelandclinic.org/health/diseases/9129-pelvic-inflammatory-disease-pid

Mayo Clinic (2022). Pelvic Inflammatory Disease (PID). Retrieved November 4, 2022, from https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594

Centers for Disease and Control (2022). Pelvic Inflammatory Disease (PID) – CDC Basic Fact Sheet. Retrieved November 4, 2022, from https://www.cdc.gov/std/pid/stdfact-pid.htm#:~:text=What%20is%20PID%3F,transmitted%20can%20also%20cause%20PID.

 

Last Updated: February 24, 2024