Pelvic Inflammatory Disease - Medical Malpractice Lawyers - PIDLEGAL HELPLINE: ☎ 855 804 7125
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Pelvic Inflammatory Disease
Pelvic inflammatory disease or PID is a moderately severe infection of the female reproductive system. It is considered a sexually transmitted disease because the bacteria that cause PID are transmitted sexually and begin in the vagina before traveling up to the uterus and to the upper genital tract.
Women with pelvic inflammatory disease often have no or mild symptoms and don’t often seek medical treatment until they suffer from infertility or from chronic pelvic pain.
Symptoms of pelvic inflammatory disease include the following:
- Heavy vaginal bleeding that is malodorous
- Pain in the pelvis and abdomen
- Irregular bleeding
- Pain that occurs during intercourse
- Pain on urination
- Pain in the low back
- Fever or fatigue
- Diarrhea or vomiting
Many women with PID have minor symptoms or no symptoms at all. This is especially true if the infection is caused by Chlamydia.
If you have the following symptoms, you should see the doctor for evaluation of PID:
- Severe pelvic pain
- Fever with a temperature greater than 101 F
- Fainting or other sign of shock
Even if the symptoms aren’t bad but are persistent, see the doctor. Prompt treatment of a sexually transmitted disease can keep it from turning into a case of PID.
Causes of getting an STD that turns into a case of PID include unprotected sex, especially with more than one sexual partner, and failure to use a condom. An IUD can increase the chances of getting an STD; however a barrier method will decrease your chances of getting an STD. The birth control pill offers no protection whatsoever. It might protect somewhat against getting PID because you make thicker cervical mucus so the bacteria don’t travel into the upper genital tract.
Bacteria can get inside your upper genital tract because of an insertion of IUD, during childbirth, after an abortion or after an endometrial biopsy of the uterus.
Risk factors to getting pelvic inflammatory disease include the following:
- Having many sexual partners
- Being sexually active before age 25
- Being in a relationship with someone who has multiple sex partners
- Having unprotected sex
- Recently having an IUD placed
- Regularly douching, which upsets the balance of good and bad bacteria
- Having an STD or PID in the past.
There are several complications of having untreated pelvic inflammatory disease, which include the onset of scar tissue and the formation of abscesses in the pelvis. This can cause the following to happen:
- Getting an ectopic pregnancy. Pelvic inflammatory disease is a major reason behind getting an ectopic pregnancy. The scar tissue prevents the egg from passing through the fallopian tube and it gets fertilized and stuck there. This can be a life threatening condition. It can also require an emergency surgery.
- Chronic pelvic pain can be secondary to PID and many women don’t realize the connection for many years. This is when other side effects occur.
- Infertility is strongly related to having PID. The later your treatment for PID, the greater is the risk of getting infertility.
There are tests used to diagnose the disease of PID. It all starts with a good history and physical examination, including a pelvic examination. Cultures of the cervix are done, urinary tests are done and there is usually an analysis of the vaginal mucus. Swabs are taken from the vaginal area, and the cervical area. These can be paired with a pelvic ultrasound to check for scar tissue, an endometrial biopsy and possibly a laparoscopy to highlight the pelvic organs and tissues.
Antibiotics make up the major therapy for pelvic inflammatory disease. There may need to be many different antibiotics prescribed, depending on the organism or organisms involved. Pain medications are often prescribed. Your sexual partner may need to be treated so you don’t get the infection back again. You should avoid sexual activity until the infection has resolved itself in all sexual partners.
If cases are more serious, you might need to be in the hospital. This is true if you are sick, pregnant, and nonresponsive to oral antibiotics or HIV positive. Surgery isn’t needed unless there is an abscess that is about ready to rupture.
PID - Overview
Pelvic inflammatory disease is an infection of the uterus, fallopian disease and ovaries, resulting in abdominal pain and vaginal discharge, among other things. It is serious complication of certain sexually transmitted diseases such as gonorrhoea and chlamydia. It is also referred to as PID. It can damage the uterus, tubes and ovaries in such a way as to affect fertility. Other complications include ectopic pregnancy, chronic pelvic pain and abscess formation.
PID affects more than 750,000 women in the US each year and around 75,000 women become infertile each year as a result of having the disease. Many ectopic pregnancies occur as a result of the infection. The more sexual partners a woman has, the greater is her risk of developing pelvic inflammatory disease. If you have sex with someone who has had multiple sex partners, you have a higher risk of developing PID.
Women get PID from bacteria that come up inside the cervix during sex. There can be several organisms contributing to getting PID but many are associated with chlamydia and gonorrhoea, which are common bacterial sexually transmitted diseases. If you have had PID before, you are more likely to get it again, perhaps because of damage caused by previous infections. Those most at risk are sexually active women who are of childbearing age, especially those under the age of 25. This is mainly due to immaturity of the cervix in teen girls who get gonorrhoea and chlamydia more likely. Women who use douches have a higher chance of getting PID compared to those who do not douche. Douching affects the flora of the vagina adversely so that you get infections more readily.
Women with IUDs have a slightly higher risk of pelvic inflammatory disease especially around the time of insertion. Women receiving IUDs should be screened for STDs before insertion of the IUD.
The signs and symptoms of PID include pelvic pain, which can be mild or severe, abdominal pain, fever, foul-odoured vaginal discharge and painful urination. In rare cases, there can be pain in the right upper quadrant of the abdomen from liver inflammation.
PID requires appropriate treatment right away to prevent complications. There can be permanent damage to the reproductive organs if it is not treated promptly. Build up of scar tissue can affect fertility and can contribute to ectopic pregnancies. About one in ten women with PID go on to develop infertility and the rate of infertility goes up when the person has many episodes of PID. Scar tissue in the fallopian tubes or other parts of the pelvis can result in chronic pelvic pain that can last for many months or years. It is more common in those that have had many episodes of PID.
Pelvic inflammatory disease is not always easy to diagnose because the symptoms are subtle in some cases. Many cases go completely unnoticed. Tests for PID include cultures for Chlamydia and gonorrhoea, a pelvic examination that can detect uterine tenderness or abscess formation and a CBC, which may show elevation of the white blood cell count. An ultrasound can show inflammation of the fallopian tubes and possibly an abscess formation. Laparoscopy can show uterine and fallopian tube inflammation consistent with PID.
PID is treated primarily with antibiotics although surgery to remove abscesses might be necessary. The antibiotic of choice depends on the nature of the bacteria involved in the infection. Pain medications are used to treat pelvic pain. Broad spectrum antibiotics are used when the doctor cannot determine the exact bacteria involved in the PID infection. Treatment should be prompt as the longer it is delayed, the more likely it is to develop complications. Make sure the partner is treated as well so that you don't get the PID infection back again.
You need to be hospitalized if you are severely sick, are pregnant, have unresponsive infections and need IV antibiotics and or have an abscess that needs surgery or need monitoring of the infection until it heals due to other health problems.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here