Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs. It most commonly occurs when sexually transmitted bacteria spread from the vagina to the uterus, fallopian tubes, or ovaries. Although often presenting with mild symptoms or even asymptomatically, in more severe cases, it can directly affect female reproductive organs. Today, we discuss this disease, its treatment, and how it can impact pregnancy or fertility.

Definition of Pelvic Inflammatory Disease

As mentioned, Pelvic Inflammatory Disease (PID) is an infection caused by bacteria derived from a sexually transmitted disease. There are many pathogenic bacteria responsible for causing PID, but infections from gonorrhea or chlamydia are the most common. Typically, the infection is contracted through unprotected sexual intercourse. It can also occur when the protective barrier of the cervix is disrupted, which happens during menstruation, childbirth, or abortion.

Symptoms of Pelvic Inflammatory Disease

Symptoms can be very subtle, and some women may not experience anything. In such cases, the patient may not realize until having difficulty getting pregnant. Chronic pelvic pain may also develop. Some of the most frequent symptoms of PID include:

• Pain, ranging from mild to intense, in the lower abdomen and pelvis
• Unusual or abundant vaginal discharge, possibly accompanied by an unpleasant odor
• Unusual vaginal bleeding, especially during or after intercourse, or between periods
• Dyspareunia or pain during intercourse
• Fever, sometimes accompanied by chills
• Painful, frequent, or difficult urination

When to Consult a Specialist?

Even if the symptoms you experience are not apparently severe or intense, it is advisable to consult a doctor as soon as possible. Timely treatment of a sexually transmitted disease can help prevent pelvic inflammatory disease. In summary, you should seek specialist care if you experience:

• Intense pain in the lower abdomen
• Nausea and vomiting
• Fever over 38.5°C
• Unpleasant vaginal discharge

Among the risk factors for pelvic inflammatory disease are:

• Having multiple sexual partners
• Engaging in unprotected sexual intercourse
• Having a history of pelvic inflammatory disease or sexually transmitted diseases

Causes of Pelvic Inflammatory Disease

As mentioned earlier, PID is often caused by an invasion of bacteria from the vagina to the cervix, colonizing other regions of the upper female genital tract. Internal organs undergo various changes, and fluid forms that affect the mucosa. The most common causes of PID include:

• Having multiple sexual partners and being under 25 years old
• Sexually transmitted diseases (STDs)
• Changes in vaginal flora
• Insertion of intrauterine devices (IUDs)
• Endometrial biopsy
• Voluntary or spontaneous abortion
• Childbirth
• Other infections

Treatment of Pelvic Inflammatory Disease

The longer the delay in starting PID treatment, the more lesions and chances of complications arising. Therefore, it is essential to consult a specialist who can diagnose and determine the appropriate treatment. The goals will be to eliminate the infection, relieve PID symptoms, and prevent possible complications.

Antibiotic Treatment

This is outpatient treatment prescribed when PID appears mild (grade I). Administering this medication helps eliminate the infection causing inflammation in the female reproductive system. In addition to antibiotics, incorporating sexual hygiene practices and condom use during intercourse is recommended.

Hospitalization

When antibiotic treatment fails or is not tolerated, hospitalization may be necessary. In this case, antibiotics would be administered intravenously, supplemented with antipyretics for fever and analgesics for pain. In cases where the patient has an intrauterine device (IUD), it will need to be removed when starting antibiotic treatment. Furthermore, other cases of PID that may require hospitalization include:

• Pregnant women
• Cases of PID grade II or III
• Uncertain diagnoses of PID, ectopic pregnancy, or appendicitis
• History of uterine abnormalities

Surgery

Surgical intervention is only indicated when all previous treatments have failed or serious complications arise. However, it is rare for a PID patient to require surgery. In cases where there is a risk of abscess rupture, the specialist will perform drainage by inserting a small needle, all under ultrasound control.

Pelvic Inflammatory Disease and Pregnancy: is that possible at all?

We emphasize the importance of consulting a specialist for any of the detailed symptoms. Untreated PID can have very negative consequences on reproductive organs. Ultimately, this could affect the chances of getting pregnant or carrying a pregnancy to term correctly.

Specifically, PID can lead to scar tissue development and/or abscesses in the reproductive tract, which can cause permanent damage. Some complications arising from pelvic inflammatory disease include:

• Risk of ectopic pregnancy. PID is a major cause of tubal pregnancy. This can occur with untreated PID where scar tissue has developed in the fallopian tubes, preventing the fertilized egg from traveling through the tube to the uterus and instead implanting at the tubal level.
• Damage to reproductive organs increases the difficulty of getting pregnant.
• Chronic pelvic pain, lasting for months or years, felt during intercourse and ovulation.
• Tubo-ovarian abscess. This must be treated urgently, as it is possible to develop a potentially life-threatening infection.

Can you prevent pelvic inflammatory disease?

Since PID stems from bacteria generated by an STD, practicing safe sex is important. Consult your specialist about the most suitable contraceptive method, as not all protect against PID. The most advisable methods are barrier methods like condoms. Additionally, if you are at risk of contracting an STD, it is necessary to undergo periodic screening tests to prevent compromising your fertility. Remember, if you want to have a child but are having trouble conceiving, IVI is here to help. We have a series of clinics where a team can assist you in your own language and accompany you through all stages of your journey to motherhood. Call us or fill out our contact form, and together we will take the first step to make your dream of having a child a reality.