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Pelvic Inflammatory Disease

Inflammation of the female reproductive organs, most often due to a sexually transmitted infection

  • Most common between the ages of 15 and 24; rare before puberty
  • Lifestyle as a risk factor depends on the cause
  • Genetics is not a significant factor

Pelvic inflammatory disease (PID) is a common cause of pain in the pelvic region in women. In this condition, some of the female reproductive organs become inflamed, usually as a result of an infection. Young and sexually active women are most likely to be affected. PID may have no obvious symptoms, and some women are unaware that they have had the condition until, years later, they are investigated for infertility (see Female infertility).

PID is usually caused by a sexually transmitted infection (STI), such as gonorrhoea or chlamydial infection. PID may also be caused by an infection developing after a termination of pregnancy or after childbirth. In rare cases, PID can occur as a result of tuberculosis developing in the pelvis or from the spread of a severe infection from the large intestine.

The infection spreads upwards from the vagina to the uterus and fallopian tubes. The ovaries may also be affected. An intra-uterine contraceptive device (IUD) makes this spread of infection more likely if an infection is present at the time the IUD is inserted. If you think you may have an infection, tests will usually be performed so that you can be treated before PID develops. When PID is discovered during investigations for infertility, the original cause may remain unknown.

What are the symptoms?

PID may have no obvious symptoms, especially when caused by chlamydia. If there are symptoms, they may include:

  • Pain in the pelvic region.

  • Fever.

  • An abnormal vaginal discharge.

  • Heavy or prolonged periods (see Menorrhagia).

  • Pain during sexual intercourse.

  • Tiredness.

If PID develops suddenly, you may have severe pain, nausea, and vomiting, and urgent hospital attention is required.

If the condition is not treated, the fallopian tubes may be damaged. The infection may also spread to other organs in the pelvis and the abdomen.

What might be done?

If your doctor suspects that you have PID, he or she will carry out a pelvic examination. Swabs may be taken from both the cervix and the vagina to identify the organisms causing the infection. Ultrasound scanning of the pelvis may also be performed. If you have severe symptoms, you will be admitted to hospital, and a laparoscopy may be performed to view the abdominal and pelvic cavities.

Your doctor will probably prescribe antibiotics, which may be given intravenously in some cases. You may also be given painkillers.

You should not have sexual intercourse until your recovery is complete. Your sexual partners should have tests to look for sexually transmitted infections and should be treated if necessary to prevent a reinfection (see Preventing STIs). If you use an IUD, you may be advised to change to a different method of contraception.

If PID is detected and treated early, you should make a complete recovery. If PID is not treated, damage to the fallopian tubes can increase the risk of having an ectopic pregnancy or may lead to infertility.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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