PELVIC INFLAMMATORY DISEASE (PID)

General Information

DEFINITION--Infection of the female internal reproductive organs. This is contagious if it is caused by a sexually transmitted organism.

BODY PARTS INVOLVED--Fallopian tubes; cervix; uterus; ovaries; urinary bladder.

SEX OR AGE MOST AFFECTED--Sexually active females after puberty. The peak incidence occurs in late teens and early 20s.

SIGNS & SYMPTOMS

Early symptoms (up to 1 week):

• Pain in the lower pelvis on one or both sides, especially during menstrual periods. Menstrual flow may be heavy.
• Pain with intercourse.
• Bad-smelling vaginal discharge.
• General ill feeling; low fever.
• Frequent, painful urination.

Later symptoms (1 to 3 weeks later):

• Severe pain and tenderness in the lower abdomen; high fever.
• Increased bad-smelling, vaginal discharge.

CAUSES

• Bacterial infection (chlamydia, gonorrhea or mycoplasma) or a virus. This may be transmitted by an infected sexual partner.
• Childbirth; abortion; pelvic surgery.

RISK INCREASES WITH

• Many sexual partners.
• Use of an intrauterine contraceptive device (IUD).
• Previous history of PID or cervicitis.

HOW TO PREVENT

• Use latex condoms, spermicidal creams or sponges to help prevent sexually transmitted infections.
• Oral contraceptives appear to decrease risk.
• Seek routine medical check-ups for sexually transmitted diseases if you have multiple sexual partners. Have your sexual partner evaluated and treated if necessary.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory blood studies and culture of the vaginal discharge.
• Surgical diagnostic procedures, such as laparoscopy or culdocentesis (See Glossary).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• You may receive treatment as as outpatient if infection is mild. You must adhere to treatment and medication schedule. Close medical follow up care is necessary.
• Hospitalization may be required for severe illness, further diagnostic studies, suspected abscess or appendicitis, failure to comply or failure to respond to outpatient therapy, or pregnancy.
• Surgery to drain a pelvic abscess (sometimes).
• Hysterectomy may be recommended for older patients who desire no more children.
• Psychotherapy or counseling, if infertility occurs.

POSSIBLE COMPLICATIONS

• Pelvic abscess and rupture. This can be life-threatening.
• Adhesions (bands of scar tissue) inside the pelvis.
• Infertility; ectopic pregnancy.
• Recurrence.

PROBABLE OUTCOME--Usually curable with early treatment and avoidance of further infection. The illness lasts from 1 to 6 weeks, depending on its severity. Poorer prognosis if treated late and unsafe lifestyle continues.

How To Treat

GENERAL MEASURES--

• Use heat such as warm baths to relieve pain. This may reduce the bad odor of the vaginal discharge, as well as relax muscles and relieve discomfort. Sit in a tub of hot water for 10 to 15 minutes as often as needed.
• Use sanitary pads to absorb the discharge or menstrual flow.
• Don't douche during treatment.

MEDICATION--Your doctor may prescribe:

• Intravenous antibiotics to fight infection if hospitalization is required. Oral antibiotics may be necessary for about 1 month following hospitalization.
• Oral antibiotics for early or mild PID.
• Pain relievers.

ACTIVITY--Avoid sexual intercourse until you are well. Rest in bed until the fever subsides. Sit and lie in different positions until you find one that is comfortable for you. Allow several weeks for recovery.

DIET--No special diet.

Call Your Doctor If

• Symptoms recur after treatment.
• New, unexplained symptoms develop.