Acute pelvic inflammatory disease (PID) is the name given to severe inflammation of the womb, fallopian tubes, ovaries and surrounding areas in the lower abdomen. It is usually caused by an infection that travels up through the entrance of your womb and spreads into your reproductive organs or pelvic area.
The original infection may be a sexually transmitted infection such as chlamydia or gonorrhoea or a vaginal infection.
Chlamydia is a common cause of PID, but PID may not develop until some time after you catch chlamydia. You may not realise you have chlamydia, because it often does not produce noticeable symptoms.
Occasionally PID can develop after a miscarriage , an abortion, giving birth , a gynecological operation.
PID shows up as:
-----------inflammation of the lining of the womb (endometritis)
-----------inflammation of the fallopian tubes (salpingitis)
-----------inflammation of the ovaries (oophoritis)
-----------inflammation of the internal lining of the abdomen (peritonitis).
Acute PID is not easy to diagnose. The symptoms can include:
-----abnormal vaginal discharge
-----pain in your lower abdomen
-----pain deep inside when you have sex
-----bleeding between your periods or after sex
-----a high fever
-----general feeling of being unwell.
These symptoms can be caused by other conditions, so your doctor will need to examine you and do a number of tests to decide whether you have PID.
If your doctor thinks you might have PID he /she may:
---give you an internal vaginal examination
---check for infections by taking samples from your vagina and the entrance of your womb with a swab
Your doctor may give you other tests to help confirm that you have PID.
You may have:
---an ultrasound scan through your vagina or abdomen
---blood tests. Your doctor may advise you to have a pregnancy test.
You may be offered a laparoscopic examination. This is a ‘keyhole’ operation, done under general anaesthetic. The doctor makes two small cuts (one below your navel and one just above your bikini line) and then inserts a small telescope (called a laparoscope). This enables him or her to examine your fallopian tubes and pelvic area more closely. It can help to show how severe the PID is or exclude other causes of pain.
Because PID is so difficult to diagnose, and because it can cause serious problems if it is not treated, your doctor may offer you treatment even if he or she is not completely sure you have PID. The benefits of this are greater than the risks. If you are diagnosed as having PID you should be treated as soon as possible.
You should usually be given a combination of two antibiotics to take by mouth to begin with. If your symptoms have not improved after three days, you may need further tests or treatment. The antibiotics your doctor prescribes should be effective for treating sexually transmitted infections, If your PID is severe or if you do not respond to or cannot take antibiotic tablets, you may have to go into hospital. You will have injections of antibiotics at first. After you start to improve, you will switch to antibiotic tablets. You will be allowed home once you are feeling better. You must finish the full course of antibiotics, which will usually
last for 14 days, even if you are feeling much better. The antibiotics will not work effectively if you do not take the full course. If you stop taking them early the infection and inflammation will return.
You may be asked to go back to see a doctor or nurse after four weeks, to check that your symptoms have not reappeared and that you have completed the full course of antibiotics.
If your PID is very severe you will feel very ill and will need to go into hospital. If you have a pelvic abscess (a collection of infected fluid, or pus, in your lower abdomen), you may need an operation to drain the abscess and clear the affected area. Your doctor or nurse will explain the exact procedure to you.
You should avoid having sex or, if this is not possible, use condoms until you and your partner have finished the course of treatment.
Short courses of antibiotics can make oral contraceptives less effective, so if you are on the combined Pill you should use additional contraception, such as condoms, while you are taking antibiotics and for seven days after you have finished the treatment.
If you use an IUD for contraception it may need to be taken out if you have severe PID. If your IUD needs to be removed and you have had sexual intercourse within the last seven days, you should ask your doctor whether you need to use emergency contraception.
If you have vaginal bleeding between your periods for no obvious reason when you are taking the contraceptive pill, you should be tested for infections, especially chlamydia.
Your current sexual partner should be offered advice and be tested for sexually transmitted infections. Your doctor may do this by referring you both to a sexual health clinic. If your partner has an infection, he or she may need to take antibiotics. If you or your partner have had other sexual partners within the last six months the clinic will recommend that those people are contacted and offered tests.
If you are HIV positive you should be given the same antibiotic treatment as women who are HIV negative. Your doctor should take into account any other medication you are receiving.
Pelvic inflammatory disease (PID) is not easy to diagnose. The symptoms
can include:
------abnormal vaginal discharge
------pain in your lower abdomen
----- deep pain inside when you have sex
------bleeding between your periods or after sex
------and fever.
_If it is not treated straight away, PID can cause infertility, ectopic
pregnancy, period problems and chronic pelvic pain.
_If you are diagnosed as having PID, you should be treated with antibiotics.
_If you have severe PID, you may have to go into hospital. If your PID is
particularly bad, you may need an operation.
_Your current sexual partner should be offered advice and be tested
for sexually transmitted infections. He or she may need to take antibiotics.
_Avoid having sex until both you and your partner (or partners) have finished
any course of treatment.
