Pelvic Inflammatory disease is a common infection among women of childbearing age. Its onset depends on the causative agent, so does its treatment.
Mild cases can be easily treated by use of oral antibiotics while severe cases will require the involvement of other invasive medical procedures.
- Research shows that 1 in 9 women with a history of PID experiences difficulties in getting pregnant. Further studies agree that 18 percent of women with PID will develop chronic pain, while 20 percent of the rest will develop infertility as a result of tubal scarring.
What is PID?
Pelvic Inflammatory Disease is an infection of a woman’s reproductive organs. It is usually a result of some sexually transmitted Infections such as Chlamydia and Gonorrhea.
PID is usually categorized into acute or chronic depending on the presenting symptoms and its onset. Pictures illustrating how PID occurs usually show inflammation and blockages of the fallopian tubes in severe cases.
Pictures of PID
Signs and symptoms of Pelvic Inflammatory Disease
PID may present with one or all of the following symptoms:
- Pain in the lower abdomen and pelvis
- Heavy vaginal discharge with an odor
- Bleeding or pain during intercourse
- Episodes of fevers alternating with chills
- Painful urination
- Abnormal uterine bleeding especially in between menstrual cycles
What causes Pelvic Inflammatory Disease?
How do you get PID? You get PID when a bacterium enters the reproductive organs through the cervix.
When the cervix is infected, the bacteria can easily get into the uterus and fallopian tubes to cause damage. Pelvic inflammatory disease (PID) causes include:
1. Sexually transmitted infections (STIs)
STIs are the major pelvic inflammatory disease (PID) causes. STIs such as gonorrhea and chlamydia usually affects the lower genital tract.
Failure to treat the infection leads to its spread to the upper genital tract whereby it gets into the cervix and other organs. Chlamydia causes chronic PID while Gonorrhea leads to acute PID.
2. Bacterial Vaginosis (BV)
BV is as a result of bacteria imbalance in the vagina. There is a drop in the good (Lactobacillus) bacteria and increase in the bad (anaerobes) bacteria.
When this happens, the bad bacterium spreads to the uterus and other pelvic organs, and PID occurs as a result.
3. IUD
IUD insertion should be done after several tests and examinations to rule out STIs and PID. Inserting an IUD where there is an infection will cause spreading of the infection to the cervix.
IUD itself is not one the pelvic inflammatory disease (PID) causes. It only propels the micro-organisms upwards to the cervix.
Diagnoses and tests
Arriving at a pelvic inflammatory disease diagnosis is quite a process. These are the steps involved in diagnosing PID:
1. History taking
Your doctor will ask you various questions regarding your sexual behavior. It is advisable that you be honest while answering these questions because they form a base of correct diagnosis.
The questions mostly focus on:
- Signs and symptoms
- The number of sexual partners
- New or symptomatic sex partners
- Type of contraceptive on use, and for how long
- History of PID or sexually transmitted Infection
- History of douching
2. Physical examination
Your doctor will feel for fevers by placing their hands on your forehead. You will then be required to lie on your back. While on your back the doctor will palpate your abdomen in a circular motion to determine the nature and location of the pain.
Uterine tenderness is one of the symptoms that your doctor will be interested in, to make a diagnosis of PID.
3. Imaging tests
1. Laparoscopy
Laparoscopy is a surgical procedure in which a tiny, flexible tube with a lighted end is inserted through a small incision just below the navel. The procedure is done under some anesthesia so that you won’t feel any pain. Laparoscopy allows your doctor to view the internal organs, as well as take specimens for culture and sensitivity or microscopic studies if necessary.
2. Pelvic or transvaginal ultrasound
You will be asked to lie on your back with your abdomen exposed. Your doctor will then apply a gel-like substance on the lower and mid part of the abdomen. A small hand-held device is placed on the abdomen on a circular motion to show internal organs on a computer screen. The procedure can diagnose any cause of pain such as inflammation.
3. Magnetic Resonance Imaging (MRI) or Computer Tomographic (CT) scan
These diagnostic measures are only taken into consideration when the symptoms are not improving with treatment. They can also be done when an ultrasound has shown a possible growth or an abscess that needs further evaluations.
4. Laboratory tests
A pregnancy test is done to rule out the incidence of tubal pregnancy. Also, several blood tests are done to look for signs of inflammation.
The blood tests check on the sedimentation rate, full cells count and C-reactive protein. Blood or urine culture can be used to check for infections.
Acute or chronic Pelvic Inflammatory Disease
Acute PID occurs suddenly and tends to be more severe, whereas chronic PID is a low-grade infection that may cause mild pain and in other lower backache.
Women with PID may present with various symptoms. However, these are the most common ones with the acute subtype:
- Severe pain and tenderness in the lower abdomen
- Vaginal discharge
- Fevers
- Abdominal bleeding
Chronic PID, on the other hand, is accompanied by:
- Backache
- Mild, recurrent lower abdominal pain
- Infertility
- Unpleasant vaginal discharge.
Long-term effects of PID
Complications of PID may take many years to develop. The resulting long-term effects are often painful and can cause permanent damage to the reproductive organs.
The longer the woman has untreated or undiagnosed PID, the more chances that these long-term effects may occur:
1. Abscesses
There is a greater chance that the body’s immune system will form a pus-filled mass around the infected tissue in the tubes and ovaries. In most cases, an abscess forms immediately after the infection begins.
while in other instances the abscess is a long-term effect of untreated PID.It can be very painful and take some time to heal fully. If not properly treated, it might become a malignant ulcer, causing more pain.
2. Blocked fallopian tubes
The fallopian tubes may be blocked as a result of a scar, adhesion or abscess formation. The blockages hinder the sperm from meeting with the ovum for fertilization.
The slippery mucus known as cilia may also be damaged. Cilium propels the fertilized egg to the uterus for implantation. All these factors make pregnancy impossible.
3. Tubal pregnancy
Also known as ectopic pregnancy, tubal pregnancy occurs when the damaged fallopian tubes hinder the fertilized egg from moving to the uterus for implantation. In that case, the embryo begins to grow in the tube.
The tube bursts when the embryo grows to a certain size since it cannot stretch like the uterus. This is a life-threatening condition to the mother, and chances of embryo survival are nil.
4. Spread of infection
PID infection can spread to other parts of the body. Once the bacteria leave the pelvic cavity, it infects the abdomen and peritonitis occurs. All the organs surrounding the reproductive organs such as the bladder and bowel have high chances of being infected.
The spread of the infections is one of the long-term effects of PID that can hinder other organs from properly functioning, additionally making life unbearable. Spread of the bacteria in the bloodstream is very dangerous and fatal.
5. Chronic pelvic pain
PID that lasts for months or years eventually lead to scarring. Adhesions and scars in the fallopian tubes and other pelvic organs lead to unending pain during menstruation and sexual intercourse.
Chronic pelvic pain is one of the common long-term effects of PID in women.
Treatment
PID is treatable if diagnosed early and treatment schedule adhered to. However, it will not undo any damage such as scarring that has already occurred to the reproductive system. Treating PID is a process that must be adhered to avoid reinfection.
Treatment depends on the infectious agent and involves the use of antibiotic therapy. For most women, PID is often mild or moderate and is treatable with oral antibiotics. In severe cases parenteral and other oral therapies appear to be effective.
- Oral typical regimens include cefotaxime and doxycycline. Alternatively, a parenteral regimen of ampicillin and gentamycin can be used to treat PID. Erythromycin-based medications are effective in pregnancy.
Follow-up is another important factor; it ensures that the patient is responding to outpatient treatment. Clinical symptoms ought to improve within 72 hours of treatment.
Re-evaluation is advised if recovery signs are not visible within that period. Other patients may also require further tests to rule out other health problems.
- Male partners of women with PID are usually treated to avoid re-infection. Men tend to be more asymptomatic even when their female partners test positive for gonorrhea and chlamydia.
Counseling is also part of the treatment. It generally focuses on prevention of sexually transmitted infections and PID.This is because there is a high risk of re-infection even when partners have been treated.
Retesting for STIs is suggested three to six months after treatment. Testing for syphilis and Human Immunodeficiency Virus (HIV) should be done to rule out other related infections.
Natural treatments for PID
Natural treatments are also effective in treating and relieving symptoms of PID. Here are a few home remedies to try:
1. Turmeric
Turmeric contains an active ingredient known as curcumin, which has a powerful antibacterial as well as anti-inflammatory properties. These properties have illustrated efficiency in relieving symptoms related to PID as well as fight the infection.
Turmeric also boosts your immune system hence stronger immunity against invading micro-organisms
Procedure:
- Boil a teaspoon of turmeric powder in a glass of milk. Drink it once daily to relieve the symptoms
- Alternatively, you can take turmeric supplements of 500 mg daily.
2. Baking Soda
This is another ancient natural treatment for PID.This compound is alkaline, thus reducing the acidity of the large intestine. This factor makes it a powerful tool in the elimination of infection-causing bacteria. Additionally, it helps reduce the body’s overall pH.
Procedure:
- Add a tablespoon of baking powder to a glass of water
- Add one tablespoon of psyllium fiber
- Drink the mixture on an empty stomach, once daily for a few weeks
3. Sitz Baths
Constant sitz baths are an effective natural remedy in reducing symptoms of PID.It is advisable to use warm water to help relax the pelvic muscles.
Procedure:
- Fill two large bathtubs. One with warm water and the other cold water.
- Add a few drops of lavender essential oil and stir well
- Sit in the tub of cold water up to your waist for about 3 minutes
- Next, sit in the tub with cold water up to your waist for about a minute
- Repeat the same procedure twice daily, for several weeks to help treat PID.
4Probiotic Yogurt
Natural yogurt contains live cultures (good bacteria) that are a great natural treatment to fight infections related to the pelvic area. Apart from restoring good bacteria in the vagina, yogurt also helps balance its pH.
Procedure:
- Apply half a cup of probiotic yogurt to the vulva and vagina, wait a few hours and wash off with cold water. Use this treatment twice daily to relieve symptoms.
- Alternatively, you can consume two glasses of plain yogurt every day until symptoms subside, and preferably longer.
5. Garlic
Garlic is one of the most powerful treatments when it comes to PID treatment. It contains anti-bacterial compounds that help destroy harmful bacteria. It also helps balance the vaginal bacteria thus preventing recurrent infection.
Procedure:
- Fry 2 or 3 minced garlic cloves in a tablespoon of olive oil, until garlic turns brown.
- Strain the oil and allow it to cool
- Soak a clean cotton ball in this oil and insert into the vagina for a couple of hours and then wash off
- Alternatively increase your intake of garlic, by adding it to your meals or simply by taking a supplement after consultation with your doctor.
6. Echinacea
This is another effective remedy. This herb contains anti-microbial, anti-inflammatory and immune-stimulant properties that help fight infection, ease symptoms and promote fast recovery.
Preparation:
- Add a tablespoon of Echinacea tea into a glass of warm water
- Drink daily for a week, take a break for few days and continue again.
- Alternatively, you can take Echinacea supplements after consulting your doctor as people with autoimmune diseases are not recommended this herb.
Prevention of PID
The primary cause of PID is STIs. If you are sexually active, you can lower your risk of getting STI with the following steps:
1. Use condom
Because a man does not need to ejaculate to infect you with an STI, condoms are the best way to prevent you from serum contact with your vagina.Other methods of birth control like combined pills, diaphragms, implants and shots will not protect you from STIs
2 Get tested
Test when you have symptoms of STI or PID. Also, make sure you and your new partner get tested before engaging in sex
3. Have one sex partner
Being faithful to one sex partners can lower your risk for STIs. After being tested be faithful to each other, it means that you only have sex with the same partner.
4. Do not douche
Douching or excess cleaning of the vagina with chemical solutions depletes the good healthy bacteria that protect you from infections. Douching can also increase your risk of PID by pushing the bacteria to the upper genital tract.
SOURCES AND REFERENCES
- Sexually Transmitted Diseases Treatment (December 2010)
https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5912a1.htm
2. What is pelvic Inflammatory disease? (May 2014)
http://www.webmd.com/women/guide/what-is-pelvic-inflammatory-disease
- Pelvic Inflammatory Disease-Home treatments
http://www.webmd.com/women/tc/pelvic-inflammatory-disease-home-treatment
- Female Pelvic Laparoscopy (June 2014)
https://my.clevelandclinic.org/health/articles/female-pelvic-laparoscopy
- Sexually Transmitted Diseases (May 2013)