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Pelvic Inflammatory Disease: Causes, Symptoms, Diagnosis, Treatment, and Prevention

The pelvic inflammatory disease (PID) can cause pelvic pain, vaginal discharge, abnormal bleeding, fever, and infertility in women. It affects the uterus, fallopian tubes, ovaries, and cervix. Sexually transmitted bacteria, such as chlamydia and gonorrhea, cause PID, but other bacteria that normally live in the vaginal area can also cause it. By practicing safe sex, getting tested and treated for STDs, and avoiding douching, PID can be prevented.

Causes of PID

It occurs when bacteria enter the upper reproductive tract through the vagina or cervix. Chlamydia and gonorrhea are the most common STIs that cause PID. PID can also be caused by bacteria that are normally found in the vagina, such as those associated with bacterial vaginosis. Some factors that can make you more likely to contract PID include:

• Having unprotected sex with multiple partners or a partner who has an STI

• Having a history of STIs or PID

• Having an intrauterine device (IUD) inserted

• Having a recent abortion, miscarriage, or childbirth

• Douching or using vaginal products that can alter the normal balance of bacteria

Symptoms of PID

Women with PID may not recognize they have it until they experience difficulty conceiving or have chronic pelvic pain. When symptoms are present, they may include:

• Pain in the lower abdomen or pelvis

• Unusual or heavy vaginal discharge that may have an unpleasant odor

• Abnormal bleeding from the vagina, especially during or after sex, or between periods

• Pain during sex

• Fever and chills

• Difficulty or pain when urinating

Medical attention should be sought if you experience severe symptoms, such as high fever, nausea, vomiting, or abdominal pain. A tube-ovarian abscess (a pus-filled mass in the fallopian tube or ovary) or an ectopic pregnancy (a pregnancy outside of the uterus) might be signs of a serious PID complication.

Diagnosis of PID

The symptoms of PID are similar to those of other conditions, so they can be difficult to diagnose. Your doctor will ask about your medical history, sexual history, and symptoms, as well as perform a physical examination of your abdomen and pelvis. In order to confirm the diagnosis and rule out other causes of your symptoms, they may also perform some tests.

• A pelvic exam to check for signs of inflammation and infection in your cervix, uterus, fallopian tubes, and ovaries

• A swab test to collect samples of fluid from your cervix or vagina to test for chlamydia, gonorrhea, and other bacteria

• A urine test to check for signs of infection in your urinary tract

• A blood test to check for signs of inflammation and infection in your body

• An ultrasound to get a clear view of your reproductive organs and look for any abnormalities or complications

• A laparoscopy to insert a thin tube with a camera through a small incision in your abdomen to examine your pelvic organs directly

Treatment of PID

You may need to take more than one type of antibiotic for several days or weeks to treat PID. Antibiotics can kill the bacteria that cause the infection. In addition to taking all prescribed medications as directed, you should not stop taking them without consulting your doctor. Additionally, you should refrain from having sex until you and your partner have completed the treatment and are cured of any STIs.

A severe case of PID or complications such as a tube-ovarian abscess or ectopic pregnancy may require hospitalization and surgery, which may involve draining the abscess or removing the affected fallopian tube or ovary.

Prevention of PID

PID can be prevented by taking steps to protect yourself from STIs and maintaining a healthy vaginal environment. Some ways to prevent PID are:

• Practicing safe sex by using condoms every time you have sex

• Getting tested and treated for STIs regularly and asking your partner to do the same

• Limiting the number of sexual partners you have

• Choosing contraception methods that protect against PID, such as hormonal birth control pills or implants

• Avoiding douching or using vaginal products that can alter the normal balance of bacteria

• Seeking medical attention as soon as possible if you have any symptoms of PID or an STI