Pelvic Inflammatory Disease
PID: Infection That Causes Infertility


How PID Affects The Reproductive Organs

Pelvic Inflammatory Disease


What Is PID?
How Do You Get PID?
What Causes PID?
What Are The Risk Factors?
What Are The Symptoms Of PID?
What Complications Can It Cause?
How Is It Diagnosed?
What Is The Treatment For PID?
How Is PID Prevented?

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Female Reproductive System

What Is PID?

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs that can damage the uterus (womb), fallopian tubes and ovaries. It is caused by bacterial infection. There are 40 different types of bacteria that can cause PID but about 50 percent of cases are caused by the sexually transmitted diseases (STD) gonorrhea and chlamydia. PID can cause pain in the abdominal region and without treatment can lead to infertility, ectopic pregnancy and debilitating pelvic pain. Nearly one million American women develop PID every year. Countless others probably have it but remain undiagnosed.

How Do You Get PID?

PID occurs when certain bacteria move up through the vagina and cervix and into the reproductive organs. Many different types of bacteria can cause PID, but most cases are associated with the bacteria that cause chlamydia and gonorrhea. These enter the woman's body by having sexual intercourse with an infected male. Less commonly PID is acquired by other bacteria which travel into the womb via an intrauterine device (IUD), endometrial biopsy, during an abortion procedure, miscarriage or childbirth.

What Causes PID?

Causes of pelvic inflammatory disease: In the United States and western world most cases of PID are the result of catching an STD. However it is still possible to have PID without having an STD. Normal bacteria found in the vagina and on the cervix can sometimes cause the condition, doctors are not sure why this happens. And rarely the bacteria can enter the body, as previously mentioned, due to IUDs, biopsy, abortions and so on.

What Are The Risk Factors?

Any woman can develop PID but her risks are higher if:

• She has multiple sexual partners. The more people she has sexual relations with, the higher her risk of STD exposure.
• Sexually active women under 25 are more at risk, partly because their cervix is not fully matured.
• Previous bouts of PID damage the reproductive organs making them more prone to future infections.
Douching may force harmful bacteria further up the reproductive tract.
• An IUD slightly increases your risk. This is greatly reduced if you undergo STD testing before having the IUD inserted.
• A virgin cannot develop PID. If the hymen is intact, bacteria cannot go beyond the cervix.

What Are The Symptoms Of PID?

Because symptoms of pelvic inflammatory disease are so mild they often go unnoticed and undiagnosed. Where signs do appear they include:

1. Diffuse pain and tenderness in the lower abdomen.
2. Back Pain.
3. Heavy/foul smelling vaginal discharge.
4. Heavy periods (metrorrhagia) and severe menstrual cramps.
5. Painful sexual intercourse.
6. Painful urination.
7. Pain on one side of the abdomen if one fallopian tube develops an abscess.
8. Constant fatigue.

In severe cases:
1. Fever.
2. Nausea and vomiting.

What Complications Can It Cause?

It not treated promptly; PID can cause permanent damage to the female reproductive organs. The bacteria silently invade the fallopian tubes turning normal tissue into scar tissue. This scarred tissue then prevents the normal movement of eggs into the womb and blocks sperm from fertilizing eggs. Up to 15 percent of women with PID become infertile. The more bouts of PID you have, the higher your risk of infertility (read about causes of infertility in women). Another risk is that scar tissue will partially block a fertilized egg from leaving the fallopian tubes. This egg then begins to grow in the fallopian tubes, causing a life threatening condition called ectopic pregnancy. Ectopic pregnancy is 6 times more common in women with PID than those without infection. Finally, scar tissue can cause chronic pelvic pain that lasts for months and even years.

How Is It Diagnosed?

Pelvic inflammatory disease diagnosis: There is no specific test for PID and it often goes undetected because women and their doctors fail to recognize the signs of mild cases. To begin with your doctor will perform a pelvic examination. He will check for areas of tenderness and possible masses. He may also order chlamydial or gonorrheal tests (alternatively you may go to an STD clinic for testing). PID must be distinguished from other causes of severe pelvic pain, which can include miscarriage, ectopic pregnancy, ovarian cysts and interstitial cystitis. A pelvic ultrasound can help in ruling out some of these conditions, as well as help to diagnose PID (the doctor will check to see if the fallopian tubes are enlarged of if an abscess is present). In some cases laparoscopic surgery may be necessary to investigate the cause, if needed.

What Is The Treatment For PID?

Treatment for pelvic inflammatory disease: If there is evidence of either chlamydia or gonorrhea you will be started on oral antibiotics immediately - even before the test results come back. Your partner will also need to be treated to prevent the infection passing back and forth (even if he displays no symptoms). As it is not always possible to identify which organism is causing the infection (there may be more than one), you are likely to be given at least two types of antibiotics, one of which may be injected. The antibiotics will not reverse any damage already done to the reproductive organs, so the sooner PID is treated the better. Women who suffer infertility problems may need surgery to reduce scaring (see infertility treatments). Severe infections, with vomiting and fever, may require hospitalization.

How Is PID Prevented?

Prevention of pelvic inflammatory disease: The only way to prevent PID is to keep the bacteria that cause the condition out of the vagina. This is particularly important at times when the cervix is partially open - such as after an abortion, miscarriage or childbirth. At such times, intercourse and tampons should be avoided until the cervix has closed. In addition, STD prevention advice needs to be implemented. It should be noted, while condoms and spermicides can help prevent infection they are no guarantee. Women who have an IUD should be routinely checked for PID. Additionally, all sexually active women should undergo regular health screenings as a preventative measure.

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