[Effie_drine]

What is pelvic inflammatory disease (PID)?

Pelvic inflammatory disease (PID) is an infection in the female reproductive organs. Normally, the cervix prevents bacteria in the vagina from spreading up into the internal organs. If the cervix is exposed to a sexually transmitted disease (STD) such as gonorrhea or chlamydia, the cervix becomes infected. If the disease travels up through the internal organs, they can also become inflamed and infected. It can damage the fallopian tubes and make it difficult to become pregnant.

How does a woman get PID?
There are several ways women can get PID. The most common way is to have sex with a person who has gonorrhea or chlamydia. These diseases are carried in the semen and other body fluids of infected people. During sexual contact, the germs spread to the woman's cervix. The germs can also infect the glands at the opening of the vagina, the urethra (passageway for urine) or the anus. When the cervix is infected with gonorrhea or chlamydia, normal vaginal bacteria can spread through the cervix and into the uterus, fallopian tubes, ovaries and abdomen.

Sometimes women get PID without being exposed to gonorrhea or chlamydia. Doctors aren't sure why this happens, but sometimes normal bacteria in the vagina spread into the uterus, fallopian tubes and abdomen, causing PID.

PID can also occur after certain surgical procedures on the female organs. PID can occur after the insertion of an intrauterine device (IUD), but this isn't common. PID may occur after an abortion or after procedures that take a sample from the inside of the womb, such as a dilatation and curettage (D & C). Sometimes PID can occur after the cervix is treated because of an abnormal Pap smear.

How do I know if I have PID?
PID causes different symptoms in different women. Most women have a "stomachache," or dull pain and tenderness in the stomach. During a pelvic examination, it's common to feel pain or abdominal tenderness when your doctor touches or moves the cervix.

PID may also cause a vaginal discharge. The discharge usually has a yellow or green color to it and may have an unusual odor. Some women have irregular periods, such as extra long periods, spotting or cramps throughout the month. Other women become very sick, with chills, high fever, nausea and vomiting. Some women have pain during sex. Unfortunately, some women have PID without these symptoms and don't know they have it. If you have PID, follow all your doctor's instructions and finish all the medicine you are given, even if you feel better after a few doses. If you have any questions, talk with your doctor.

What should I do if I have symptoms of PID?
Women who have these symptoms or who think they have been exposed to an STD should see their doctor right away. There is no over-the-counter treatment for PID. Your doctor can only diagnose PID with a pelvic exam and cultures (swabbing the area and having the sample tested). The sooner you see your family doctor, the better! Waiting even 1 or 2 days can allow the infection to spread farther into your body and cause more pain and damage.

What are the risk factors for PID?
The same things that put you at risk for STDs put you at risk for PID. Risk factors for PID include sexual contact with multiple partners and unsafe sexual habits. Both men and women can carry STDs and not have any symptoms. They can expose their sex partners to a disease without knowing it.
How do I practice safe sex?
Avoid sexual contact with people who are at risk of infection. If you decide to have sex, ask your partner first if he or she has any risks for infection. A male partner should always wear a condom. Even though the condom will not prevent 100% of STDs or PID, it will greatly reduce your chances of getting infected.

Remember, birth control pills, the birth control shot and birth control implants (brand name: Norplant) can't prevent you from getting PID or an STD. Only a condom can provide some protection against infections.

How is PID treated?
Treatment begins with an exam. Depending on how sick you are, the treatment can be done either in the hospital or on an outpatient basis. If you are very sick with PID, or if you are pregnant, are under the age of 18 or have the HIV virus, hospitalization is usually recommended.

If you are treated as an outpatient, you must take your medicine just the way your doctor tells you. If you don't take all the pills, your symptoms will get worse and you may have to go to the hospital. A few days after you start taking the medicine, you'll have to see your doctor again.

What can happen to my body if I get PID?
Early and complete treatment can help prevent complications of PID. Unfortunately, if PID isn't treated it can cause permanent damage to your internal organs. Scar tissue can form in the fallopian tubes and around the abdomen. These scars can prevent pregnancy or cause the pregnancy to form in the fallopian tube (called a tubal or ectopic pregnancy). Scarring can cause pain that lasts for months or even years. Occasionally, the effects of PID can be so severe that surgery is required to remove pus, get rid of scar tissue or remove damaged organs. Finally, PID is more likely to come back if you are exposed to STDs again. Each episode of PID causes more damage and a greater possibility of complications.

Should my partner be treated if I have PID?
If you are treated for PID, especially if an STD is found, your partner must also be treated. Unless your partner is treated, you may be infected again. Making good choices about sexual contact is important. If you think you might have PID, check with your family doctor.

American Academy of Family Physicians
Permission is granted to print and photocopy this material for nonprofit educational uses.

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