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Pelvic Inflammatory Disease: Causes, Symptoms, Treatments, Risk Factors, Complications, Prevention

What is Pelvic Inflammatory Disease?

Pelvic inflammatory disease or pelvic inflammatory disorder (PID) is an infection of the upper part of the female reproductive system. The pelvis is in the lower abdomen and includes the fallopian tubes, the ovaries, the cervix, and the uterus.

Several different types of bacteria can cause PID, including the same bacteria that cause the sexually transmitted infections (STIs) gonorrhea and chlamydia. What commonly occurs is that bacteria first enter the vagina and cause an infection. As time passes, this infection can move into the pelvic organs.

PID can become extremely dangerous, even life-threatening, if the infection spreads to your blood. If you suspect that you may have an infection, see your doctor as soon as possible.

Symptoms of Pelvic Inflammatory Disease

Some women with pelvic inflammatory disease don’t have symptoms. For the women who do have symptoms, these can include:

  • pain in the lower abdomen (the most common symptom)
  • pain in the upper abdomen
  • fever
  • painful sex
  • painful urination
  • irregular bleeding
  • increased or foul-smelling vaginal discharge
  • tiredness

Pelvic inflammatory disease can cause mild or moderate pain. However, some women have severe pain and symptoms, such as:

  • sharp pain in the abdomen
  • vomiting
  • fainting
  • a high fever (greater than 101°F)

If you have severe symptoms, call your doctor immediately or go to the emergency room. The infection may have spread to your bloodstream or other parts of your body. Once again, this can be a life-threatening condition.

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Tests for Pelvic Inflammatory Disease

Diagnosing PID

Your doctor may be able to diagnose PID after hearing your symptoms. In most cases, your doctor will run tests to confirm the diagnosis. Tests include:

  • cervical culture to check your cervix for infections
  • urine test to check your urine for signs of blood, cancer, and other diseases
  • pelvic exam to check your pelvic organs

After collecting samples, your doctor sends these samples to a laboratory.

Assessing damage

If your doctor determines that you have pelvic inflammatory disease, they may run more tests and check your pelvic area for damage. PID can cause scarring on your fallopian tubes and permanent damage to your reproductive organs. Additional tests include:

  • pelvic ultrasound: imaging test that uses sound waves to create pictures of your internal organs
  • endometrial biopsy: outpatient procedure where a doctor removes and examines a small sample from the lining of your uterus
  • laparoscopy: outpatient procedure where a doctor inserts a flexible instrument through an incision in your abdomen and takes pictures of your pelvic organs

Treatment for Pelvic Inflammatory Disease

Your doctor will likely have you take antibiotics to treat PID. Because your doctor may not know the type of bacteria that caused your infection, they may give you two different types of antibiotics to treat a variety of bacteria.

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Within a few days of starting treatment, your symptoms may improve or go away. However, you should finish your medication, even if you are feeling better. Stopping your medication early may cause the infection to return.

If you are sick or pregnant, can’t swallow pills, or have an abscess (pocket of pus caused by the infection) in your pelvis, your doctor may send you to the hospital for treatment.

Pelvic inflammatory disease may require surgery. This is rare and only necessary if an abscess in your pelvis ruptures or your doctor suspects that an abscess will rupture. It can also be necessary if the infection does not respond to treatment.

The bacteria that cause PID can spread through sexual contact. If you are sexually active, your partner should also get treated for PID. Men may be silent carriers of bacteria that cause pelvic inflammatory disease. Your infection can recur if your partner doesn’t receive treatment. You may be asked to abstain from sexual intercourse until the infection has been resolved.

Pelvic Inflammatory Disease Prevention

You can lower your risk of PID by:

  • avoiding douches
  • wiping from front to back after using the bathroom to stop bacteria from entering your vagina
  • practicing safe sex
  • getting tested for sexually transmitted infections

Complications of Pelvic Inflammatory Disease

Make a doctor’s appointment if you think that you have PID. Other conditions, such as a urinary tract infection, can feel like pelvic inflammatory disease. However, your doctor can test for PID and rule out other conditions.

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If you don’t treat your PID, your symptoms can worsen and lead to problems, such as:

  • chronic pelvic pain: pain in the lower abdomen caused by scarring of the fallopian tubes and other pelvic organs
  • infertility: inability to conceive a child
  • ectopic pregnancy: pregnancy that occurs outside the womb

The infection can also spread to other parts of your body. If it spreads to your blood, it can become life-threatening.

Risk factors for Pelvic Inflammatory Disease

Your risk of pelvic inflammatory disease increases if you have gonorrhea or chlamydia. However, you can develop PID without ever having an STI. Other factors that can cause pelvic inflammatory disease include:

  • having sex without a condom
  • using an intrauterine device (IUD) to prevent a pregnancy
  • having sex with different people
  • douching
  • having a history of pelvic inflammatory disease
  • having sex and being under the age of 25

Long-term Outlook for Pelvic Inflammatory Disease

Pelvic inflammatory disease is a very treatable condition and most women make a full recovery. However, according to the Centers for Disease Control and Prevention, about 10 to 15 percent of women with PID will have difficulty getting pregnant. Pregnancy is still possible for most women.

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