Pelvic inflammatory disease explained

Some women’s health matters don’t get the attention they deserve – often because there’s a general lack of awareness about the condition. This can even occur for fairly common conditions such as pelvic inflammatory disease (PID).

Haven’t heard of PID? You’re not alone.

But every year in Australia, around 10,000 women are treated for PID in hospital and anywhere between 100,000 and 300,000 women are treated as outpatients by their GP or gynaecologist. PID is most common among sexually active women aged 20–29.

Read on to learn about this potentially devastating condition and how you can protect yourself from the long-term complications.

What is pelvic inflammatory disease?

As its name suggests, PID refers to inflammation of the organs and tissues in the pelvis. This includes the uterus, fallopian tubes and cervix.

The inflammation is caused by a bacterial infection. In most cases, the infection enters the body through the vagina and make its way up the cervix to organs in the pelvic region. Over time, the inflammation damages the tissue and causes scarring.

What causes pelvic inflammatory disease?

The most common causes of PID are the sexually transmitted infections (STIs) chlamydia, gonnorhoea and Mycoplasma genitalium. Infection of the female reproductive tract can also occur during an abortion, insertion of a contraceptive intrauterine device (IUD) or following childbirth. Other causes of PID include a ruptured appendix or bowel infection (gastroenteritis).

What are the symptoms of pelvic inflammatory disease?

PID is often referred to as a ‘silent epidemic’ because in many cases women can have an infection without having any signs or symptoms – we refer to this as being asymptomatic. The trouble is that even if you don’t have any symptoms, tissue damage is still occuring and this can cause serious health consequences in the long term.

When symptoms do occur, they can include any or all of the following:

• Abnormal vaginal discharge
• Unusual bleeding
• Pain in the pelvis or lower abdomen
• Pain during or after sex
• Bleeding after sex
• Increased period pain
• Abnormal periods
• Fever.

How is pelvic inflammatory disease diagnosed and treated?

A diagnosis of PID can be difficult to confirm. Diagnosis may involve testing for the presence of bacteria that cause PID and/or looking for evidence of inflammation in the pelvic region.

We can check whether certain bacteria (e.g. chlamydia) are present in the vagina and cervix by taking a swab from these areas or testing a urine sample – this is standard practice for the common STIs. If either test comes back positive, prompt treatment with antibiotics will clear up the infection. However, antibiotics cannot reverse any damage already done to the tissue. For this reason, early diagnosis and treatment is very important to minimise the long-term effects of PID.

Further testing may be required for some patients. This can involve blood tests, a pelvic exam and/or a pelvic ultrasound. Sometimes a laparoscopy is necessary. During this keyhole surgical procedure, a camera is used to examine inside the pelvis. This allows your doctor to detect the presence and severity of PID and is generally reserved for women who have more severe symptoms.

Remember that not everyone will develop symptoms from PID, which is why it is so important to have routine STI tests if you are sexually active and also if you have a new sexual partner. Regular testing can ensure that an infection is detected and treated early.

What happens if pelvic inflammatory disease goes untreated?

It is very important that PID is treated early to prevent long-term complications, including fertility issues and chronic pelvic pain.

In order to fall pregnant, an egg needs to travel from the ovary to the uterus via the fallopian tubes. PID can lead to scarring of the fallopian tubes, which blocks this path and causes subfertility.

PID not only reduces fertility, it can also be dangerous to your health because it greatly increases the risk of an ectopic pregnancy (where a pregnancy develops in the fallopian tube). Ectopic pregnancy can lead to a ruptured fallopian tube, which is a medical emergency.

The risk of long-term complications depends on how long the condition has gone untreated and the number of times you develop PID – repeated bouts significantly increase your risk.

How can I avoid getting pelvic inflammatory disease?

The best way to protect yourself from developing PID is to ALWAYS practise safe sex and have regular STI checks. If you have been diagnosed with an STI, your male partner should be treated as well to make sure you don’t get re-infected.

Also have any medical procedures (e.g. IUD insertion) performed at a reputable clinic with good hygiene and safety standards.

If you have symptoms, don’t ignore them!

In addition to having routine STI tests, it’s important that you always seek medical help if you have any symptoms related to your reproductive health (e.g. abnormal bleeding or pain). Don’t hesitate to call my rooms on (03) 9418 8299 or book online to make an appointment if you need a specialist opinion on any women’s health matters.