Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) occurs when an infection spreads from the vagina to the cervix, the endometrium (lining of the uterus) and the fallopian tubes. The infection is usually sexually transmitted. It can also occur after a ruptured (burst) appendix or a bowel infection.
Some surgical procedures, such as abortion, curette or insertion of an intrauterine device (IUD), can lead to PID. The infection usually occurs in three stages – the cervix is infected first, followed by the endometrium and then the fallopian tubes.
PID is often called the ‘silent epidemic’ because it is common among sexually active women, but does not always cause symptoms. About 10,000 women in Australia are treated for PID in hospital each year and many more are treated as outpatients. Women aged 20 to 29 have the highest reported incidence of PID.
Signs and symptoms of PID include:
lower abdominal pain or tenderness
a change in smell, colour or amount of vaginal discharge
deep pain during sexual intercourse
Causes of PID
The most common causes of PID are the sexually transmissible bacterial infections, chlamydia and gonorrhoea. Chlamydia is responsible for 50 per cent of sexually acquired PID cases, while gonorrhoea is the cause in 25 per cent of cases. Mycoplasma genitalium has recently been recognised as another sexually transmissible infection associated with PID. The risk of fallopian tube blockage is slightly higher for PID caused by gonorrhoea.
Treatment of PID
Chronic pain and, sometimes, severe disability can occur if PID is not treated. This is usually due to extensive scarring. Early treatment of PID may minimise the risk of complications.
Treatment usually involves:
taking a combination of antibiotics that are active against a broad range of organisms, usually taken for two weeks
testing male partners and treating them – symptoms may be mild or non-existent in men, however, for STI-related PID, all partners should be treated, regardless of test results
avoiding genital sexual contact until the treatment is complete and a negative test result is obtained.
Women with severe episodes of PID must be hospitalised for treatment