The morning sun poured through the clinic windows as I reviewed the day’s appointments. The waiting room was filling up with the familiar hum of quiet conversations, nervous glances, and the occasional cough. Among the list of patients was Amanda, a 26-year-old college student I’d seen a few times before. She was here for persistent abdominal pain, a concern she’d mentioned during a previous visit.
When I called her name, she walked in slowly, her expression a mix of discomfort and worry.
“Good morning, Amanda,” I greeted with a warm smile. “What brings you in today?”
She sighed and took a seat, her hands clasped tightly together. “Dr. Priya, the pain in my lower belly just won’t go away. It gets worse after sex, and sometimes I feel feverish. I thought it might just be a bad period, but it’s been weeks.”
My heart sank. The symptoms Amanda described were all too familiar. It was time to talk about a condition that’s more common than many women realize: Pelvic Inflammatory Disease (PID).
What is Pelvic Inflammatory Disease (PID)?
Pelvic Inflammatory Disease (PID) is an infection of the reproductive organs in women, including the uterus, fallopian tubes, and ovaries. It happens when bacteria travel up through the cervix and into the pelvic cavity. This condition can be either acute (sudden and severe) or chronic (long-lasting with milder symptoms).
According to the Centers for Disease Control and Prevention (CDC), over 1 million women in the United States are diagnosed with PID each year. Of these cases, approximately 100,000 experience infertility as a direct result of the condition (CDC, 2021).
Amanda’s symptoms pointed to a possible case of PID. It was important to act quickly to prevent any long-term complications.
Causes of PID
I explained to Amanda that PID usually results from sexually transmitted infections (STIs), like chlamydia or gonorrhea, but it can also be caused by other types of bacteria. Here are some key facts:
- Unprotected sex with an infected partner causes up to 75% of PID cases (National Health Service, UK).
- Minor medical procedures like IUD insertion, miscarriages, or abortions can introduce bacteria into the uterus.
- Having multiple sexual partners or a partner with multiple partners increases the risk.
- Young women between the ages of 15 and 35 are most at risk.
- Not using barrier methods like condoms increases susceptibility.
A study published in the Journal of the American Medical Association (JAMA) in 2020 found that up to 10% of women with untreated chlamydia infections develop PID within a year (JAMA, 2020).
As I explained this, Amanda nodded slowly, taking in the information.
Symptoms of PID
The symptoms of PID vary from mild to severe. Some women may not have any symptoms at all, which is why PID is sometimes called the “silent epidemic.”
I went through the checklist of common symptoms with Amanda:
- Fever (often over 38°C or 100.4°F).
- Severe lower abdominal pain or pelvic pain.
- Pain during intercourse.
- Unusual vaginal discharge with a foul odor.
- Irregular menstrual bleeding, such as bleeding between periods.
- Painful or frequent urination.
- Nausea and vomiting in severe cases.
Amanda confirmed she had experienced several of these symptoms. It was time to discuss the risks and the importance of immediate treatment.
Risks of Untreated PID
I leaned forward gently. “Amanda, PID is treatable, but if left untreated, it can lead to serious complications, such as:”
- Scarring of the reproductive organs, which can cause infertility.
- Ectopic pregnancy (where a fertilized egg implants outside the uterus).
- Chronic pelvic pain that lasts for months or years.
- Abscesses (pus-filled pockets) in the fallopian tubes or ovaries.
Research from the American Journal of Obstetrics and Gynecology shows that 20% of women with PID develop chronic pelvic pain, and 15% experience infertility due to damage to their fallopian tubes (AJOG, 2019).
Diagnosis of PID
Amanda’s next step was a thorough diagnosis. I explained the process to her:
- Pelvic Examination – To check for tenderness, swelling, and abnormal discharge.
- Blood Tests – To check for signs of infection and inflammation.
- Vaginal and Cervical Swabs – To identify the bacteria causing the infection.
- Ultrasound – To view the reproductive organs and check for abscesses.
- Laparoscopy – In some cases, a small tube with a camera may be used to get a closer look inside the abdomen.
A comprehensive review in the British Medical Journal (BMJ) highlighted that laparoscopy remains the gold standard for PID diagnosis when clinical findings are unclear (BMJ, 2020).
Treatment for PID
Once PID is diagnosed, treatment typically involves:
- Antibiotics – A course of oral or intravenous antibiotics to clear the infection. Completing the full course is crucial.
- Pain Relief – Over-the-counter painkillers like ibuprofen or paracetamol.
- Rest and Hydration – To support the body’s healing process.
A 2018 study in The Lancet Infectious Diseases reported that early antibiotic intervention reduces the risk of complications by up to 50% when started within 3 days of symptom onset (The Lancet, 2018).
I stressed the importance of treating Amanda’s partner as well. “If your partner isn’t treated, you could get reinfected,” I explained. “Abstinence during treatment is also necessary.”
Prevention of PID
Before Amanda left, we talked about prevention strategies:
- Consistent use of condoms during sex.
- Regular STI screenings, especially with new partners.
- Avoiding douching, which can push bacteria into the uterus.
- Seeking immediate treatment for any vaginal infections or unusual symptoms.
I also reminded her that if she had an IUD, it might need to be removed during treatment.
FAQs About PID
1. Can PID be cured?
Yes, with prompt antibiotic treatment. However, damage already done to the reproductive organs cannot always be reversed.
2. Can I get PID again after treatment?
Yes. Having PID once increases the risk of getting it again. Practicing safe sex and regular screenings are essential.
3. Does PID always cause infertility?
Not always. Early treatment reduces the risk of infertility significantly.
4. Is PID only caused by STIs?
No. It can also result from bacterial infections after childbirth, miscarriage, abortion, or other pelvic procedures.
5. How can I tell if I have PID?
Lower abdominal pain, unusual discharge, fever, and pain during sex are key symptoms. If you experience these, seek medical help promptly.