Certain medical conditions related to the sex organs are not intrinsically sexually transmitted infections as such. These often appear due to complications if STIs go untreated, and have severe consequences.
This is Pelvic inflammatory disease's case, also known as (PID), a disease that affects women all over the world, that causes severe complications including infertility and even cancer. In this article, we will describe what PID is, its causes, signs and symptoms, and treatment.
What is pelvic inflammatory disease?
Pelvic inflammatory disease, also known as pelvic inflammatory disorder (PID), is a condition that affects the upper feminine reproductive system, which includes the uterus, fallopian tubes, ovaries, and the inside of the pelvis.
Most cases of PID are the result of STI complications. Gonorrhea and chlamydia are two sexually transmitted infections that often result in pelvic inflammatory disease. However, other bacteria exist that can also provoke this condition.
Those affected by this disease often do not show any signs. This increases the risk of the appearance of problems such as chronic pelvic pain, infertility, ectopic pregnancy, or cancer. If any of these appear, the symptoms can include abdominal pain, fever, a burning sensation upon urination, or dyspareunia (pain during sex).
All women of childbearing age that experience lower abdominal pain without any apparent cause should consult a gynecological professional for relevant testing to rule out PID. Ultrasound testing or pus present in the fallopian tubes reflect a positive diagnosis.
There were approximately 100 million cases of chlamydia reported in 2008, and 100 million more cases of gonorrhea, across the world. Although the amount of incidents that ends up leading to pelvic inflammatory disease is unclear, in total, around 1.5% of young women are affected by this condition yearly.
Signs and symptoms
Pelvic inflammatory disease can be asymptomatic in its first phases, meaning that it may not provoke visible signs, or they may be very mild. Some of the main symptoms of pelvic inflammatory disease are the following:
- Pain in the lower abdomen and pelvis
- Abundant vaginal discharge with a strong odor
- Abnormal uterine bleeding, especially during or after sex, or between menstrual cycles
- Pain during sexual relations
- Fever with or without chills
- Pain and difficulties urinating
When the disease progresses, and the symptoms become more serious, high fevers, severe lower abdominal or pelvic pain, and intestinal discomfort may occur.
If mild signs and symptoms become persistent, a doctor should be consulted as soon as possible, even if this does not seem serious. Vaginal secretions, difficulty urinating, or bleeding between menstrual cycles, could all be signs of a sexually transmitted infection (STI).
If these symptoms appear, it is best to discontinue sexual relations until you receive a diagnosis and treatment takes place. Early intervention in cases of sexually transmitted infections is critical for PID prevention.
What causes inflammation?
Many different types of bacteria could cause pelvic inflammatory disease. However, sexually transmitted infections such as gonorrhea and chlamydia are the most common causes.
Both of these sexually transmitted infections are bacterial; so, the leading causes of pelvic inflammatory disease are two different types of bacteria. Also, gonorrhea, as well as chlamydia, tend to be transmitted through sexual relations, especially without proper protection.
Another less common cause is the entry of the bacteria in the reproductive tract when the natural barrier created by the cervix is disturbed. This disruption can happen after birth or an abortion, whether it was induced or spontaneous.
Risk factors
Besides the direct causes of pelvic inflammatory disorder, there are many risk factors that can increase the probability of contracting this disease. These include:
- Women younger than 25 that are sexually active
- Taking part in unprotected sex
- Having sexual relations with a partner that does not get treated
- Regular carrying out vaginal cleanses
- A history of pelvic inflammatory disease or STIs
PID treatment
There are many different treatments for pelvic inflammatory disease. Administering antibiotics, treating sexual partners, temporary abstinence and, on rare occasions, surgery, to name a few.
Antibiotics
After diagnosis, the doctor immediately administers a combination of antibiotics to treat PID. Treatment gets rid of the disease, but it cannot reverse any of its harmful effects.
After some tests, the doctor may modify the treatment to adapt it to the needs of the patient more appropriately.
Hospitalization may be necessary if the patient is seriously ill, pregnant, or does not respond to the medication.
Treating sexual partners
Sexual partners should also be tested and treated if need be, to prevent reinfection.
Sexual abstinence
Abstaining from sexual relations of any kind is necessary until treatment is through and tests indicate that the infection is no longer present in the primary patient or any sexual partners.
Other procedures
Although it is uncommon, abscesses may need to be drained if they burst or are at risk of doing so. Likewise, if the person does not respond to treatment with antibiotics, surgery could be necessary.
References
Burnham, R. C., Gottlieb, S. L. & Paavonen, J. (2015). Pelvic inflammatory disease. The New England Journal of Medicine, 372(21): 2039–2048.