PID (Pelvic Inflammatory)
The most common and serious complication of Sexually transmitted Diseases/Infections (STDs/STIs) among women, next to AIDs, is Pelvic Inflammatory Disease (PID). PID can affect the uterus, ovaries, fallopian tubes, and other related structures. PID occurs when specific microorganisms migrate from the urethra and cervix into the upper genital tract. Many different microorganisms can cause PID, but most cases are associated with gonorrhea and chlamydia infections. Scientists have found that bacteria normally present in small numbers within the vagina and cervix may also play a role.
The most prevalent symptoms of PID are lower abdominal pain and abnormal vaginal discharge. Other potential symptoms are fever, pain in the right upper abdomen, painful intercourse, and irregular menstrual bleeding. PID, particularly when caused by chlamydial infection, may produce only minor symptoms or no symptoms at all, even though it can seriously damage the reproductive organs.
Most women with tubal infertility have no symptoms of PID. Organisms such as C. trachomatis silently invade the fallopian tubes and cause scarring. Tubal infertility can cause tubal pregnancy. This type of pregnancy is life threatening to the mother, and almost always fatal to her fetus. Infertility, chronic pelvic pain, and scarring occur in approximately one out of every five women who have had PID.
Another complication of PID is the risk of repeated attacks. As many as one-third of women who have had PID will have the disease at least one more time during their lifetime. With each episode of reinfection the risk of infertility, scarring, and chronic pelvic pain is increased.
PID is not always the result of a sexually transmitted infection — but in most cases it is. The sexually transmitted infections that most commonly cause PID are chlamydia and gonorrhea. They are spread by Vaginal, Anal and (rarely) Oral sex.
The more sexual partners and younger a woman is, the more likely she will contract PID. Women who douche monthly may be more likely to contract PID than those who douche less than once a month. Douching can push bacteria into the upper genital tract, resulting in PID. Also, douching can ease discharge caused by an infection, causing the woman to delay seeking a physician's diagnosis. To help avoid PID, always use a latex barrier method during intercourse with a partner who's sexual history you are unsure of.
PID can be difficult to diagnose and is sometimes overlooked. If symptoms such as lower abdominal pain are present, the doctor will likely perform a physical examination to determine the nature and location of the pain. The doctor should also check the patient for fever, abnormal vaginal or cervical discharge, and evidence of cervical Chlamydia infection or Gonorrhea. If the findings of this exam suggest that PID is likely, current guidelines advise doctors to begin treatment immediately.
If more information is necessary, the doctor may order other tests, such as a sonogram, endometrial biopsy, or laparoscopy to distinguish between PID and other serious problems that mimic it.
Because culture of specimens from the upper genital tract are difficult to obtain and because multiple organisms may be responsible for an episode of PID, especially if it is not the first one, the doctor will prescribe at least two antibiotics that are effective against a wide range of infectious agents. The symptoms may go away shortly after beginning treatment, but this does not mean you are cured; it means the medication is working and you must finish taking all of the prescribed medication. Two to three days after treatment has began, patients should be re-evaluated by their physician to be sure the antibiotics are curing the infection.
About one-fourth of women with suspected PID must be hospitalized. The doctor may recommend this if the patient is severely ill; if she cannot take oral medication and needs intravenous antibiotics; if she is pregnant or is an adolescent; if the diagnosis is uncertain and may include an abdominal emergency such as appendicitis; or if she is infected with HIV (human immunodeficiency virus - the virus that causes AIDS).
Many women with PID have sexual partners who have no symptoms themselves, but are infected with organisms that can cause PID. Because of the risk of re-infection, sexual partners should be treated even if they do not have symptoms. If you have contracted PID, anyone who you are having (or have had) sexual relations with up to a few months prior to contraction should be informed and examined by their physician.
If you believe you may have PID please see your physician immediately for a proper evaluation and diagnosis. If you are unhappy with your physician's assessment of your condition you should seek the opinion of a second doctor. Do not let any abnormal condition go unchecked. See a physician promptly if you believe you have PID or any other STD/STI.