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Understanding Pelvic Inflammatory Disease (PID): Symptoms, Causes and Treatment

UNDERSTANDING PELVIC INFLAMMATORY DISEASE (PID)

Table of Contents

The word PID or pelvic inflammatory disease signifies inflammation and infection of the female reproductive organs like the uterus; fallopian tubes and ovaries and also pelvic lining; that’s called pelvic peritoneum.; which are primarily situated in the pelvis.

Though this is a very well treatable condition; if neglected; it can lead to serious long term health complications in a woman s life.

So in this blog; we will go into the details about the causes; symptoms; complications or long term side effects and treatment for PID.

 

MECHANISM OF PID  

PID develops when the infection causing organisms; mostly bacteria; from vagina and cervix ascend inside the pelvis to affect the productive organs like uterus; fallopian tubes and ovaries.

This involves the following steps:

  1. Entry of organisms into the vagina and cervix ; which may include some bacteria from normal vaginal flora overgrowth or STI s like gonorrhoea and chlamydia.
  2. Breaking the cervix barrier; uterine cervix has a mucus plug which guards against the bacterial entry in to the pelvis; and this barrier breaks due to STIs; child birth; copper T insertion; vaginal douching and gynec procedures like abortions and D and C
  3. Spread to the uterus; causing endometrial inflammation; pain; irregular bleeding and discharge.
  4. Spread to the fallopian tubes; causing its inflammation; leading to swelling; scarring of the tube with adhesions.
  5. Spread to the ovaries and surrounding structures causing oophoritis or inflammation of the ovaries ; which may grows to form tuboovarian abscess or tuboovarian mass. Also called adnexal mass.
  6. Spread to the pelvic peritoneum which is the inner lining of the pelvis. This can lead to fluid collection n pelvis; sticking of intestines to pelvic organs giving rise to frozen pelvis.

Through the pelvis; the infection can also affect the intestines leading to adhesions which may cause obstruction in future. 

 

RISK FACTORS FOR PID DEVELOPMENT.

  1. Multiple sexual partners; sexually transmitted infection
  2. Unprotected sex
  3. Invasive procedures like D and C; Copper t insertion; abortion or childbirth.
  4. If anyone has past history of PID attack; the chances of recurrence are more if the treatment is incomplete or if the partner is still infected and not treated.   
  5. Vigorous vaginal cleaning and douching
  6. Immunity suppression due to disease like HIV; tuberculosis

 

SYMPTOMS OF PID

  1. Pelvic or abdominal pain which can worsen during activity or sexual intercourse.
  2. Abnormal vaginal discharge with foul smell.
  3. Fever and chills
  4. Irregular bleeding; spotting between periods or heavy periods.
  5. Painful sexual intercourse
  6. Painful urination
  7. Nausea and vomiting
  8. Lower back ache

 

COMPLICATIONS DUE TO PID

  1. Chronic pelvic pain
  2. Infertility
  3. Ectopic pregnancy
  4. Intestinal adhesions; which may lead to obstruction
  5. Development of TO mass or adnexal mass or hydrosalpinx
  6. Fitz-hugh-Curtis syndrome when it affects the liver.

 

DIAGNOSIS OF PID

  1. PID is diagnosed based on symptoms; examination and lab tests to assess infection levels.
  2. Pelvis ultrasonography and
  3. Vaginal swabs may be done

 

TREATMENT OF PID

  1. Antibiotics like cefotaxime; ceftriaxone; azithromycin ; doxycycline; metronidazole are given according to the doctor s advice and usually continued for 2 to 3 weeks.
  2. Hospitalisation may be needed if fever and severe symptoms
  3. Avoiding sexual activities until the infection is fully treated.
  4. Partner may need treatment to prevent recurrence.

 

PREVENTION OF PID

  1. Safe sexual practices; avoiding multiple partners.
  2. Using condoms everytime.
  3. Avoid vaginal overcleaning and douching
  4. Get regular STI screening especially if one has multiple partners.

 

CONCLUSION

Pelvic Inflammatory Disease is a serious yet preventable condition. Early detection and treatment are crucial in avoiding long-term complications such as infertility and chronic pain. Practicing safe sex, getting routine check-ups, and seeking immediate medical attention for symptoms can help protect reproductive health.