Pelvic Inflammatory Disease

Pelvic infections (also known as the pelvic inflammatory disease) is one of the most serious complications of sexually transmitted infections (STIs), that affects the upper reproductive organs, including the uterus, ovaries and fallopian tubes

In North America, pelvic infections affect over 1 million women each year. Pelvic inflammatory disease is the leading cause of tubal infertility in young women; however, this disorder can usually be prevented if the STI is detected early and treated promptly.

Causes Of Pelvic Disease

Pelvic infections are caused by a bacterium that infects the upper part of the female genital tract, especially the fallopian tube, ovary, and uterus. The most common bacteria are Neisseria gonorrhoea and Chlamydia trachomatis, but bacteria that are normally found in the vagina and cervix can also be involved.

Naturally, the female reproductive system contains a cervix mucus secretion which neutralises the effect of harmful bacteria. This defence mechanism stops bacteria from moving further up the tract. However, bacteria are given free passage during the menstrual and ovulation period when the cervix fails to secrete this mucus.

From studies, the number of bacteria which contributes to Pelvic disease is not one. Different categories of bacteria can cause pelvic inflammatory disease. And usually, many are present in the body of the patient who has developed the disease. However, C. trachomatis (the bacterium responsible for genital chlamydia) and Neisseria gonorrhoeae (responsible for gonorrhoea) are the most frequently implicated.

From most research, One-quarter of cases result from untreated chlamydia or gonorrhoea. Some studies suggest that this percentage is even higher, with 33 to 50% of cases directly linked to these two sexually transmitted disease.

Other bacteria that affect the vagina and spread from the cervix to the upper genital tract may also cause pelvic inflammatory disease. The bacteria can be harmless if it is in the vagina but cause health problems when it comes in contact with other parts of the body.

Also, Pelvic Infections can develop if the cervix is damaged following the birth or after a miscarriage, or during surgical procedures such as the placement of an IUD.

Hygiene conditions can also be involved, especially if the patient is accustomed to practising douches. This practice can thwart the bacterial balance of the vagina. Hence, it becomes even more important to maintain proper hygiene during ovulation as well as when menstruating.

Risk Factors For PID

The main risk factor for PID is infection with a sexually transmitted disease, particularly chlamydia and gonorrhoea.

The risk factors for these STDs include:

  • Having multiple sex partners
  • Unprotected sex without the use of a latex condom
  • Having a sexual partner who has multiple sexual partners.

How can I protect myself against PIM?

  • Pelvic infection can be prevented by avoiding dangerous sexual behaviour.
  • Use latex or polyurethane condoms during sex.
  • Stay faithful to one sexual partner

If you have symptoms that indicate an STD or think you have been exposed to an STD, see a health care provider right away.

However, If you have recently been treated or are currently receiving treatment for an STD, you must ensure that your sexual partner is also treated to prevent reinfection and this should be done even when the partner shows no sign.

Symptoms of PID

Lower abdominal pain or pelvic pain is the main symptom of PID. In mild cases, there may be mild cramps. In severe cases, the pain is constant and very intense. Physical activity, especially sex, greatly increases pain. Other symptoms of PID include:

  • abnormal vaginal discharge
  • abnormal or abundant vaginal bleeding
  • bleeding between the rules
  • fever/chills
  • nausea/vomiting.

However, It is possible that women with PID do not show any of the symptoms above and neither should you automatically assume that you have this disease if you notice one or two of the symptoms mentioned above. The only way to be sure is to go for a medical check-up.

Complications

Complications resulting from PID can be very serious and cause death.

  • Tubo-ovarian or pelvic abscess: In severe cases of PID, local accumulation of pus occurs in the ovaries and fallopian tubes or the pelvis. Hospitalisation and intravenous antibiotic therapy, as well as surgeries, may be required.
  • Sterility: After pelvic disease infection, scar tissue forms around the pelvic organs. These tissues cause the blockage and distortion of the fallopian tubes so that the egg can not pass through the tube to reach the uterus. After a period of PID, a woman's risk of infertility is estimated to increase by 15%. After two periods, this risk is approximately 35%. After the third period, the risk is almost 75%.
  • Chronic pelvic pain: Not only does the scar tissue associated with PID cause infertility, but it also causes pelvic pain or discomfort due to distortion of the pelvic organs. Surgery is necessary in severe cases.
  • Ectopic pregnancy: This is a type of pregnancy that occurs outside the womb, most commonly in the fallopian tubes. Since PID causes partial blockage or tubal distortion, the risk of ectopic pregnancy is increased. Ectopic pregnancy is a very serious condition that requires surgery.

What is the effect of PID on pregnancy?

A woman with a history of PID can have difficulty conceiving. Previous PID also increases the risk of ectopic pregnancy in women (a pregnancy that occurs outside the uterine cavity with a common occurrence in the fallopian tubes). Ectopic pregnancy can cause serious complications, including death. Therefore, Surgery should be carried out as soon as ectopic pregnancy is detected.

How To Prevent Pelvic Infection Disease

When you're diagnosed with Pelvic disease at the early stage,  it can be treated with antibiotics and analgesic and anti-inflammatory drugs to reduce the intensity of pain. Applying ice to painful areas can also help reduce pain. Also, the sexual partner must be treated.

In cases of advanced pelvic disease, hospitalisation is required to take intravenous antibiotics and to perform surgery, if necessary (removal of the tubes, ovaries.)

Prevention of Pelvic Disease

  • The systematic use of condoms during vaginal/anal sex, a dental dam during oral sex
  • Go for constant medical check-up to detect any risk of STI’s
  • Avoid having sex with partners diagnosed with STI’s
  • Maintain good hygiene during your period

Conclusion

Pelvic infections are common among women. Unfortunately, few women know about this, which increases the risk even higher. Early detection makes it easy to cure without surgery. To be on the safer side, it's important to maintain proper hygiene and also use a condom during sex.