Pelvic inflammatory disease (PID)
pelvic; inflammatory; disease; PID; safer; sex; STD; sexually; transmitted; chlamydia; gonorrhoea; infertility; ectopic; infection; condoms.;
Contents
Pelvic Inflammatory Disease (PID) is a serious health problem for women. It can cause infertility (inability to get pregnant) due to scarring of the fallopian tubes (the tubes leading from the ovary to the uterus). It is estimated that even one attack of PID will lead to about a 1 in 5 chance of having a blocked tube, and more than one infection causes an even higher risk of a blocked tube.
Warning!
If you suspect you have a Sexually Transmitted Disease (STD) don't give it to others. Get tested and treated quickly.
Pelvic Inflammatory Disease (PID) is caused by the spread of infection into the upper part of a woman's reproductive system (the cervix, uterus, and fallopian tubes). It has been estimated that over 100,000 women in Australia experience PID, and around 4,000 need treatment in hospital for PID each year.
Causes of PID
PID is mainly caused by chlamydia (about 50% of the time) and gonorrhoea (about 25% of the time). These infections are sexually transmitted. Not every one who has these infections will get PID. If a young woman has a chlamydia infection in the lower part of the reproductive tract (vagina), she has about a one in 12 risk of getting PID, and about a one in 10 risk if she has gonorrhoea. (See Chlamydia and Gonorrhoea for more information about these infections).
PID can also be triggered (rarely) by surgery such as a caesarean section, childbirth or using an IUD (an intra-uterine contraceptive device), or very rarely by termination of pregnancy (abortion). Most women who have these procedures do not develop PID.
Young women (under 24 years), women who have several sexual partners, and women who have sex often are more likely to get PID, but other sexually active women can also get it.
Using a barrier contraceptive such as a condom or diaphragm can be protective.
Signs and symptoms
Signs of PID can include the following:
- A change in vaginal discharge - can vary from white to yellow to brown to greenish and can have an offensive smell.
- Changes to periods - they could be longer or heavier or there may be spotting in between periods.
- Pain and tenderness in the lower abdomen.
- Pain deep inside during sexual intercourse.
- Pain when passing urine.
- Fever.
- Nausea (feeling sick) and vomiting.
About 60% of women do not notice any symptoms of PID, and it might be found for other reasons, such as when a woman is being tested for infertility or when a sexually transmitted disease (STD) is found in a contact. A woman can still have complications of PID (such as infertility) when she did not have symptoms.
Complications
PID can cause very serious problems. Scarring of the fallopian tubes is the most frequent one. This scarring can block an egg (ovum) passing from the ovary to the uterus, causing infertility. It has been estimated that one episode of PID doubles the chances of a woman being infertile because of a blocked tube, and after three episodes of PID, up to 40% of women will be infertile for this reason.
Scarring of the tubes can also lead to an ectopic pregnancy, where the fertilised egg attaches to the tube or other area around the tube rather than inside the uterus. It is very rare for a baby to develop normally outside of the uterus and often there is a sudden loss of blood from the ectopic pregnancy, putting the woman's life at risk. The risk of an ectopic pregnancy is increased by 7 times with just one episode of PID.
Untreated PID can also cause chronic pain.
Testing for PID
If symptoms such as pain, tenderness and discharge are present, a doctor will take a swab of the discharge from the cervix of the uterus. Sometimes it will be necessary to use ultrasound (where sound waves are used to 'see' inside the uterus and tubes) or laparoscopy (where a thin tube is inserted through the wall of the abdomen, and the doctor can see the tubes and ovaries and surrounding tissue).
PID will be diagnosed by finding signs of infection, and being able to work out which 'bug' is causing the infection.
Treatment
Treatment is usually started before the 'bug' is identified so that the infection can be eliminated as quickly as possible, so there is less chance of scarring.
This treatment may be in the form of tablets, capsules or an injection. For some women, the infection and inflammation can be severe enough that they need a hospital stay.
Even with the best treatment, it may not be possible to prevent all of the complications.
It is very important that male sexual partners are treated at the same time. They may have a discharge from the penis, but many will have the infection and not have signs of it, but they could still pass it on.
Prevention
Safer sex is one way to help avoid getting PID. Using a condom will help to protect you from most of the infections that cause PID. Using a condom even when an IUD is in place will lower the risks.
Sex in a permanent relationship where you are both faithful to each other is another way to prevent PID. Even then you can never be totally sure about what the other person might do when you are not with them. Before you have sex with your partner, ask him or her to have an STD check that includes testing for chlamydia and gonorrhoea. Ask to see the test results. This may seem like you are not trusting the person but it is your body and your health that we are talking about. You are the one who might become unwell, and might become infertile.
It is important to get early treatment for gonorrhoea and chlamydia because they can both lead to PID.
Resources
South Australia
- The Second Story Youth Health Service (TSS)
- Central: 57 Hyde St, Adelaide
- South: 50a Beach Rd, Christies Beach
- North: 6 Gillingham Rd, Elizabeth
Contact TSS via the Youth Healthline on 1300 13 17 19
or for mobile phone callers (08) 8303 1691 - normal rates apply.
- SHine SA - Sexual Health information network education
Sexual Healthline: Monday to Friday 9am to 1 pm (08) 364 0444
Country callers 1800 188 171
http://www.shinesa.org.au/
- Clinic 275 (Sexually Transmitted Diseases Clinic)
275 North Terrace Ph: (08) 8222 5075
Country callers 1800 806 490
http://www.stdservices.on.net/
References
Clinic 275 'Pelvic inflammatory disease':
http://www.stdservices.on.net
Dayan L 'Pelvic Inflamatory disease' Australian Family Physician, Vol 35, No 11 November 2006 http://www.racgp.org.au/afp/200611/12508
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Youth Healthline on 1300 13 17 19 (local call cost from anywhere in South Australia).