Pelvic inflammatory disease, sometimes called PID, is an
infection of the fallopian tubes, uterus, cervix, or ovaries. Most
girls develop PID as a result of sexually transmitted diseases
(STDs), such as chlamydia or gonorrhea.
In the United States, each year more than a million women will
develop PID. Most of those infected will be teenagers and young
women. Girls with multiple partners and those who don't use
condoms are most likely to get STDs and are at risk for PID. If PID
goes untreated, it can lead to internal scarring that can result in
chronic pelvic pain, infertility, or an ectopic pregnancy.
What Are the Symptoms of PID?
PID can cause severe symptoms or very mild to no symptoms. Girls
who do have symptoms may notice:
- pain and tenderness in the lower abdomen
- foul-smelling or abnormally colored discharge
- pain during sexual intercourse
- spotting between periods
- chills or fever
- nausea and vomiting
- loss of appetite
- backache and perhaps even difficulty walking
- painful or more frequent urination
- pain in the upper abdomen on the right
What Can Happen?
Any girl with symptoms of an STD should get medical care as soon
as possible. An untreated STD has a greater chance of becoming
PID.
If PID is not treated or goes unrecognized, it can continue to
spread through a girl's reproductive organs. Untreated PID may
lead to long-term reproductive problems, including:
-
Scarring in the ovaries, fallopian tubes, and
uterus.
Widespread scarring may lead to infertility (the inability to
have a baby). A teen girl or woman who has had PID multiple times
has more of a chance of being infertile.
-
Ectopic pregnancy.
If a girl who has PID does get pregnant, scarring of the
fallopian tubes may cause the fertilized egg to implant in one of
the fallopian tubes rather than in the uterus. The fetus would
then begin to develop in the tube, where there is no room for it
to keep growing. This is called an ectopic pregnancy. An
untreated ectopic pregnancy could cause the fallopian tube to
burst suddenly, which might lead to life-threatening
bleeding.
-
Tubo-ovarian abscess (TOA).
A TOA is a collection of bacteria, pus, and fluid that occurs in
the ovary and fallopian tube. It is most often seen in teens. (A
TOA is also more likely to happen to teens or adult women who use
intrauterine devices [IUDs] as birth control.) A teen girl with a
TOA often looks sick and has a fever and pain that makes it
difficult to walk. The abscess will be treated in the hospital
with antibiotics, and surgery may be needed to remove it.
How Is PID Diagnosed and Treated?
If you think you may have PID, see your gynecological health
care provider (your family doctor or nurse practitioner,
gynecologist, or adolescent doctor) immediately. The longer a girl
waits before getting treatment, the more likely it is that she will
have problems like the ones listed above.
If a doctor thinks a girl has PID, he or she will do a physical
exam, including a
pelvic exam
. The exam can reveal when someone has a painful cervix, abnormal
discharge from the cervix, or pain over one or both ovaries.
THe doctor may also take swabs of fluid from the cervix and
vagina, and this fluid will then be tested for STDs. He or she may
also do a pregnancy test. Sometimes health providers take blood or
urine tests to look for signs of infection, including STDs like
chlamydia and gonorrhea.
Sometimes doctors need an ultrasound or CAT scan of the
lower abdomen to see what's going on with a girl's
reproductive organs. Ultrasounds and CAT scans are often used to
diagnose a TOA or ectopic pregnancy.
If it's found that a girl has PID, the doctor will
prescribe antibiotics to take for a couple of weeks. It's vital
to take every dose of the medication to completely treat the
infection, even if symptoms go away before finishing the medicine.
It's also important that girls with PID get rechecked 2-3 days
after beginning treatment to make sure that they are improving.
Girls who have more severe cases of PID - for example, if they
have a fever, vomiting, or are not responding to medicines by mouth
- are often treated in the hospital for a few days with antibiotics
given directly into a vein through an IV. Surgery is sometimes
needed for cases of PID that do not get better with antibiotics or
if a girl has an abscess. Ectopic pregnancies can require emergency
surgery.
If a girl has taken all her medication for PID but still
isn't feeling better, she should follow up with her doctor. If
a girl has PID, her sexual partners should be checked for STDs
right away so they can get treatment. An untreated partner is
likely to reinfect a girl with the same STD again.
Can PID Be Prevented?
The best way to prevent STDs or PID is to not have sex
(abstinence). For those who choose to have sex, it's important
to use protection and to have as few sexual partners as possible.
Using a latex
condom
effectively and consistently helps protect against most STDs.
However, it's very important to have regular checkups with your
doctor.
So when you're making choices about sex, be smart and be
safe.
Reviewed by:
Larissa Hirsch, MD
Date reviewed: March 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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