October 18th, 2016
Pelvic Inflammatory Disease (PID) refers to inflammatory damage and destruction of pelvic reproductive organs of the females (such as uterus, fallopian tubes and the ovaries). The women who have a history of sexually transmitted infections are at highest risk. If not treated in time, PID can lead to formation of strictures (obliteration or obstruction of genital tubes) and may lead to infertility.
PID mostly affect women in their teens. In the US, approximately 1 million females are diagnosed with PID each year. On an average, about 100,000 of these females develop infertility and other related complications. In addition, a large number of ectopic pregnancies also results in the US strictly due to PID.
Two Sexually Transmitted Infections (STIs), namely Gonorrhea and Chlamydia accounts for the majority of cases of PID. In most cases, infection and inflammation process starts from the vagina and cervix. If no treatment is sought, the cervix loses its protective function and allows the bacteria to ascend and infect the internal reproductive organs. According to latest statistics reported by Centers for Disease Control and Prevention (1), investigators suggested that each year more than 1.5 million cases of Chlamydia are reported in the US making it the most frequently reported sexually transmitted infection. Gonorrhea is the second most common infection, with each year more than 301,174 reported cases in reproductive-aged women (15-45 years).
Besides sexually transmitted infections, other causes of PID include; complicated childbirths that are performed in unhygienic conditions, pelvic surgeries and unclean (septic) abortions.
As PID is mainly caused by sexually transmitted infections, following factors can make a woman more susceptible to develop PID:
PID can be asymptomatic or present with mild, non-specific symptoms. If a woman has any of the predisposing factors mentioned above, she should consult a gynecologist for screening and monitoring of the disease.
Following symptoms are frequently reported in patients with PID:
Women under 25 years of age, who are at higher risk of getting an infection, should visit a doctor on an annual basis. In case of unprotected sex, report to the doctor and follow the advice.
There is no specific test to diagnose PID. Following procedures or tests can be undertaken:
Further testing may be required under special circumstances, if necessary:
After diagnosis, treatment should be started immediately to prevent complications. It includes the use of antibiotics. The treatment should be completed even after the symptoms have been resolved. The sexual partner should also get a full course of treatment even if he doesn’t show any symptoms.
In case, medical treatment doesn’t work and an abscess (a localized collection of pus) has been formed, surgery may be necessary to remove it, either through laparoscopy or laparotomy.
Following precautions should be taken to prevent PID:
1. Rekart, M. L., Gilbert, M., Meza, R., Kim, P. H., Chang, M., Money, D. M., & Brunham, R. C. (2013). Chlamydia public health programs and the epidemiology of pelvic inflammatory disease and ectopic pregnancy. Journal of Infectious Diseases, 207(1), 30-38.
2. Gottlieb, S. L., Xu, F., & Brunham, R. C. (2013). Screening and treating Chlamydia trachomatis genital infection to prevent pelvic inflammatory disease: interpretation of findings from randomized controlled trials. Sexually transmitted diseases, 40(2), 97-102.
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