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  • Pelvic Inflammatory Disease

    (PID; Salpingitis)

    Definition

    Pelvic inflammatory disease (PID) is a serious infection of the female reproductive organs. This includes the uterus, ovaries, and fallopian tubes. PID can cause scar tissue to form in the pelvis and fallopian tubes. This damage may result in infertility, a future tubal pregnancy, or chronic pelvic pain.
    Female Reproductive Organs
    Fallopian Tube, Ovary, and Uterus
    Copyright © Nucleus Medical Media, Inc.

    Causes

    PID is caused by bacteria that travel to the reproductive organs. A single bacteria or mixture of several bacteria may cause the infection. The most common bacteria that initiate PID are gonorrhea and chlamydia.

    Risk Factors

    A risk factor is something that increases your chance of getting a disease or condition. Factors that increase your risk include:
    • Current or previous sexually-transmitted disease (STD)
    • Multiple sex partners
    • Sexual intercourse with a partner who has an STD
    • Intercourse without the protection of a condom
    • Age: 15-24 years old
    • Use of an intrauterine device (IUD) for birth control (The device does not increase the risk of getting an STD, but it can accelerate the course of PID)

    Symptoms

    Women with PID do not always have symptoms. However, if symptoms do occur, they may include:
    • Pain in the lower abdomen
    • Vaginal discharge with a foul odor
    • Fatigue
    • Fever
    • Nausea or vomiting
    • Painful intercourse
    • Painful urination
    • Irregular menstrual bleeding
    If you suspect PID, or have any symptoms, see your doctor immediately.

    Diagnosis

    Because symptoms are often subtle or nonexistent, PID can be difficult to diagnose. There are no specific tests for PID.
    If PID is suspected, the doctor will ask about your symptoms, as well as your sexual history, partners, and birth control methods. The doctor may perform a general physical exam, as well as a pelvic exam. The pelvic exam is key to making the diagnosis. Samples from the vagina or cervix may be taken to help diagnose the problem.
    Tests may include:
    • Cultures of the cervix to test for STD organisms
    • A blood test to check pregnancy status and to check for infection
    • Ultrasound—a test that uses sound waves to visualize the inside of the body
    • Laparoscopy—insertion of a thin, lighted telescopic tube through a small incision in the abdomen to look at the reproductive organs

    Treatment

    The primary treatment for PID is antibiotics. Your doctor may prescribe more than one type of antibiotic to treat the problem. Finish the entire dose of each medication, even if your symptoms disappear during treatment. Rest is also an essential part of the treatment for PID.
    You may be hospitalized if the diagnosis is uncertain, you do not improve, or your symptoms are severe. In the hospital, antibiotics can be given by IV. In certain situations, surgery may be required to remove infected or damaged tissue.
    If you are diagnosed with PID, follow your doctor's instructions.

    Prevention

    To help prevent PID:
    • Use a latex condom each time you have sexual intercourse.
    • Discuss birth control options with your doctor. Ask which methods may increase or decrease your risk of PID.
    • Seek immediate treatment for symptoms, such as unusual vaginal discharge or bleeding.
    • Limit the number of sexual partners.
    • Have regular screening tests for STDs.
    If you are diagnosed with PID or another STD:
    • Do not have sexual intercourse until after the treatment is complete.
    • Notify all sexual partners. They will also need to be treated.

    RESOURCES

    American Congress of Obstetricians and Gynecologists http://www.acog.org/For%5FPatients

    National Institute of Allergy and Infectious Diseases http://www3.niaid.nih.gov

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org/index%5Fe.asp

    Women's Health Matters http://www.womenshealthmatters.ca

    References

    Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR 2010;59(No. RR-12):1-110.

    Pelvic inflammatory disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 2012. Accessed October 9, 2012.

    Pelvic inflammatory disease. National Institute of Allergy and Infectious Diseases, NIH website. Available at: http://www3.niaid.nih.gov/topics/pelvicInflammatoryDisease. Updated November 29, 2011. Accessed October 9, 2012.

    Centers for Disease Control and Prevention (CDC). Pelvic inflammatory disease. In: Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 2010 Dec 17;59(RR-12):63-7.

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