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Pelvic inflammatory disease

What is pelvic inflammatory disease (PID)?

Pelvic inflammatory disease describes any infection of the reproductive organs of a woman. It occurs when microbes (germs) travel up through the cervix and uterus (womb) and then spread inwards to the Fallopian tubes, ovaries and surrounding tissues in the pelvis. The commonest serious infection is that of the tubes-this is called salpingitis.

A pelvic infection can be either acute, which causes sudden severe symptoms, or chronic, which gradually produces milder symptoms.

What are the facts?

Here are some basic facts about the disease:

Sexual intercourse causes up to 75 per cent of cases.

Minor operations [such as the insertion of an intra-uterine device (IUD)] or procedures of pregnancy (such as a miscarriage, an abortion or even a delivery) can cause PID.

Up to 10 per cent of young women normally have the microbes, which include chlamydia and gonorrhoea, on their cervix. These women are at special risk of getting PID.

The commonest cause of infertility in Australia is PID-it affects about 5000 Australian women each year.

PID is a preventable disease and it is best diagnosed by laparoscopy (where a tube is passed through the abdomen).

Who are the women most at risk?

The women most at risk are those who:

are under 25 years of age

have abnormal Pap smears when aged between 15 and 35

have multiple sexual partners

have steady partners who have sex with others

do not use barrier methods of contraception (eg. condoms)

have operations needing the opening of the cervix (eg. dilation and curettage, and placement of an IUD)

What are the symptoms?

Some patients may feel no symptoms, but others may have symptoms that vary from mild to very severe.

Acute PID

fever

severe abdominal pain

Chronic PID

ache in the lower back

mild lower abdominal pain

Both acute and chronic

painful intercourse

menstrual problems (eg. painful, heavy or irregular periods)

unusual, perhaps smelly, vaginal discharge

painful or frequency of urination

What are the risks?

The main serious risks are subsequent sterility, ectopic pregnancies and further episodes of PID. Occasionally an acute infection may cause a pelvic abscess or cause peritonitis or even blood poisoning by spreading.

How can it be prevented?

Safe sex is most important. Insist that a partner with a possible sexually transmitted disease (STD) uses a condom.

Avoid IUDs if you have a history of PID or have a number of sexual partners.

It is advisable to have antibiotic treatment if a partner has or gets an STD even if you have no symptoms.

If you get PID, your partner or partners should be treated.

Those at risk for PID should have regular checkups.

What is the treatment?

A course of antibiotics is given, usually by mouth. Avoid sexual intercourse or manipulation of your vagina (eg. with hands or tampons) until the infection is cleared. This may take 2 weeks.

If you have an IUD, it should be removed.