Understanding Sexually Transmitted Diseases (STD): A Guidebook to Better Sexual Health (Women) by Dr Tan and Partners - HTML preview

Pelvic Inflammatory Disease (PID) & STIs

PID is caused by infection of the upper female genital tract, including the womb, fallopian tubes, ovaries and nearby pelvic structures.

The importance of diagnosing and treating PID early is related to its complications which can have major detrimental effects on a woman’s fertility and health.

What causes PID?

PID is caused by infection that moves upward from the vagina and cervix into the upper genital tract. Commonly the infection is sexually transmitted and the woman may or may not have any symptoms suggestive of an infection. The most common sexually transmitted organisms associated with PID is chlamydia trachomatis and neisseria gonorrhoea.

Other organisms that is linked to PID include gardnerella vaginalis, mycoplasma hominis, ureaplasma urealyticum, herpes simplex virus 2, trichomonas vaginalis, haemophilus influenza, cytomegalovirus, etc.

PID can be caused by both sexually transmitted and non sexually transmitted infections. Studies have shown that up to one third of PID cases is caused by >1 organism. Approximately 20% of untreated chlamydia or gonorrhoea infection progresses to PID.

Risk factors:

• Multiple sexual partners
• History of sexually transmitted infections (STI)
• Current untreated sexually transmitted infections (STI)
• Previous history of PID
• Previous gynaecological surgical procedures – eg: endometrial biopsy, curettage, etc
• Recent abortion
• Having an intrauterine device (IUD) – risk is highest during the first 6 months after insertion
• Douching

Symptoms:

With PID, the severity of symptoms may vary in each individual and may take weeks or months for symptoms to present after being infected.

Symptoms include:

• Fever
• Nausea/vomiting
• Pelvic/lower abdominal pain (ranges from mild to severe)
• Abnormal vaginal discharge
• Abnormal vaginal bleeding

Treatment:

PID can be treated with antibiotics if diagnosed early. However, treatment would not reverse any damage that has already occurred to your reproductive system. Hence, it is important to seek treatment early as the longer you wait, the more likely you will develop complications from PID.

While being treated for PID, it is advisable to abstain from sexual activity until your symptoms have fully resolved and you have completed your antibiotic regimen. It is important for your sexual partner to be tested and treated for STI if necessary so that you do not re-infect each other. Even after treatment, you can still contract PID again if you get infected again. If you have had PID before, the chances of getting it again increases.