Dr. MJ Bazos MD,
What is pelvic inflammatory disease
Pelvic inflammatory disease (PID) is an
infection in the female reproductive organs. Normally, the cervix prevents
bacteria in the vagina from spreading up into the internal organs. If the cervix
is exposed to a sexually transmitted disease (STD) such as gonorrhea or
chlamydia, the cervix becomes infected. If the disease travels up through the
internal organs, they can also become inflamed and infected. It can damage the
fallopian tubes and make it difficult to become pregnant.
How does a woman get
There are several ways women can get PID. The
most common way is to have sex with a person who has gonorrhea or chlamydia.
These diseases are carried in the semen and other body fluids of infected
people. During sexual contact, the germs spread to the woman's cervix. The germs
can also infect the glands at the opening of the vagina, the urethra (passageway
for urine) or the anus. When the cervix is infected with gonorrhea or chlamydia,
normal vaginal bacteria can spread through the cervix and into the uterus,
fallopian tubes, ovaries and abdomen.
Sometimes women get PID without being exposed to
gonorrhea or chlamydia. Doctors aren't sure why this happens, but sometimes
normal bacteria in the vagina spread into the uterus, fallopian tubes and
abdomen, causing PID.
PID can also occur after certain surgical
procedures on the female organs. PID can occur after the insertion of an
intrauterine device (IUD), but this isn't common. PID may occur after an
abortion or after procedures that take a sample from the inside of the womb,
such as a dilatation and curettage (D & C). Sometimes PID can occur after
the cervix is treated because of an abnormal Pap smear.
How do I know if I have
PID causes different symptoms in different
women. Most women have a "stomachache," or dull pain and tenderness in the
stomach. During a pelvic examination, it's common to feel pain or abdominal
tenderness when your doctor touches or moves the cervix.
PID may also cause a vaginal discharge. The
discharge usually has a yellow or green color to it and may have an unusual
odor. Some women have irregular periods, such as extra long periods, spotting or
cramps throughout the month. Other women become very sick, with chills, high
fever, nausea and vomiting. Some women have pain during sex. Unfortunately, some
women have PID without these symptoms and don't know they have it. If you have
PID, follow all your doctor's instructions and finish all the medicine you are
given, even if you feel better after a few doses. If you have any questions,
talk with your doctor.
What should I do if I have symptoms
Women who have these symptoms or who think they
have been exposed to an STD should see their doctor right away. There is no
over-the-counter treatment for PID. Your doctor can only diagnose PID with a
pelvic exam and cultures (swabbing the area and having the sample tested). The
sooner you see your family doctor, the better! Waiting even 1 or 2 days can
allow the infection to spread farther into your body and cause more pain and
What are the risk factors for
The same things that put you at risk for STDs
put you at risk for PID. Risk factors for PID include sexual contact with
multiple partners and unsafe sexual habits. Both men and women can carry STDs
and not have any symptoms. They can expose their sex partners to a disease
without knowing it.
How do I practice safe
Avoid sexual contact with people who are at risk
of infection. If you decide to have sex, ask your partner first if he or she has
any risks for infection. A male partner should always wear a condom. Even though
the condom will not prevent 100% of STDs or PID, it will greatly reduce your
chances of getting infected.
Remember, birth control pills, the birth control
shot and birth control implants (brand name: Norplant) can't prevent you from
getting PID or an STD. Only a condom can provide some protection against
How is PID
Treatment begins with an exam. Depending on how
sick you are, the treatment can be done either in the hospital or on an
outpatient basis. If you are very sick with PID, or if you are pregnant, are
under the age of 18 or have the HIV virus, hospitalization is usually
If you are treated as an outpatient, you must
take your medicine just the way your doctor tells you. If you don't take all the
pills, your symptoms will get worse and you may have to go to the hospital. A
few days after you start taking the medicine, you'll have to see your doctor
What can happen to my body if I get
Early and complete treatment can help prevent
complications of PID. Unfortunately, if PID isn't treated it can cause permanent
damage to your internal organs. Scar tissue can form in the fallopian tubes and
around the abdomen. These scars can prevent pregnancy or cause the pregnancy to
form in the fallopian tube (called a tubal or ectopic pregnancy). Scarring can
cause pain that lasts for months or even years. Occasionally, the effects of PID
can be so severe that surgery is required to remove pus, get rid of scar tissue
or remove damaged organs. Finally, PID is more likely to come back if you are
exposed to STDs again. Each episode of PID causes more damage and a greater
possibility of complications.
Should my partner be treated if I
If you are treated for PID, especially if an STD
is found, your partner must also be treated. Unless your partner is treated, you
may be infected again. Making good choices about sexual contact is important. If
you think you might have PID, check with your family doctor.