About Pelvic Inflammatory Disease (PID)

 PID is an infection of the female reproductive organs—most often the uterus, fallopian tubes, and ovaries—typically caused by untreated STIs such as chlamydia or gonorrhea. If left unaddressed, PID can result in chronic pelvic pain, infertility, or ectopic pregnancy. Its symptoms can be mild or absent, making early detection difficult. PID is most prevalent among women aged 15–24 and globally affects around one in eight sexually active young women.

What is Pelvic Inflammatory Disease (PID)?

Pelvic inflammatory disease is a bacterial infection of the upper reproductive tract, commonly caused by Chlamydia trachomatis or Neisseria gonorrhoeae, which ascend from the cervix or vagina into the uterus, tubes, and ovaries. Symptoms may include lower abdominal or pelvic pain, unusual vaginal discharge, discomfort during intercourse, fever, and irregular menstrual bleeding.

However, many cases are asymptomatic, which delays diagnosis. If untreated, PID may lead to severe complications, including infertility, ectopic pregnancies, chronic pelvic discomfort, and pelvic abscesses. Diagnosis is clinical—based on history and exam—with support from ultrasound or lab tests. Treatment relies on early broad-spectrum antibiotics; surgery may be required in complicated cases. Preventive strategies include safe sex, routine STI testing, and early treatment.

Types of Pelvic Inflammatory Disease (PID)

• Acute PID: A sudden, severe infection of reproductive organs.
• Chronic PID: Persistent or recurrent inflammation that may cause long-term damage.

Signs and Symptoms of Pelvic Inflammatory Disease (PID)

 Typical PID symptoms often include:

• Lower pelvic or abdominal pain
• Abnormal vaginal discharge (yellow, green, or foul-smelling)
• Irregular bleeding
• Pain during intercourse (dyspareunia)
• Fever
• Pain or burning while urinating
• Spotting after sex - In untreated cases, particularly gonorrhea-related, symptoms can escalate to high fever and severe pain. Rarely, there may be right-upper abdominal discomfort (Fitz-Hugh-Curtis syndrome). Regular reproductive health check-ups are crucial given the often silent nature of PID.

Pelvic Inflammatory Disease (PID) Causes

Pelvic Inflammatory Disease (PID) arises when bacteria spread upward from the vagina or cervix. This typically involves:

• Neisseria gonorrhoeae
• Chlamydia trachomatis

Other contributors include:

• Mycoplasma genitalium
• Imbalance of normal vaginal flora (e.g., bacterial vaginosis)
• GI tract infections such as appendicitis
• Medical procedures like D&C, IUD placement, or abortion

Pelvic Inflammatory Disease (PID) Risk Factors

 You may be at higher risk if you:

• Are sexually active, especially ages 15–25
• Have multiple partners
• Have had STIs or past PID
• Practice douching
• Recently had an IUD placed
• Underwent tubal ligation
• Have GI or cervical procedures

Complications for Pelvic Inflammatory Disease (PID)

Left untreated or recurrent, PID can result in:

• Infertility due to blocked or scarred fallopian tubes
• Elevated risk of ectopic pregnancy
• Persistent pelvic pain
• Formation of tubo-ovarian abscesses
• Fitz‑Hugh‑Curtis syndrome — inflammation of the liver capsule

Diagnosis of Pelvic Inflammatory Disease (PID)

• Pelvic Exam: Checks for cervical motion, uterine, or adnexal tenderness and unusual discharge
• Lab Tests: Swabs test for STIs; blood tests detect inflammation (WBC, CRP, ESR)
• Pregnancy Test: To rule out ectopic pregnancy
• Imaging: Ultrasound identifies abscess or hydrosalpinx; CT may be used in complex cases.
• Laparoscopy: Used when diagnosis is unclear or surgery is needed

Treatment of Pelvic Inflammatory Disease (PID)

1. Medical Management

Prompt broad-spectrum antibiotics targeting gonorrhea, chlamydia, and anaerobic bacteria are essential. Standard therapy includes ceftriaxone, doxycycline, and metronidazole. Severe cases or abscesses may require hospitalization.

2. Minimally Invasive Surgical Intervention

• Laparoscopic Abscess Drainage: Targets tubo-ovarian abscess using high-precision tools for rapid recovery and minimal scarring.

Partners should also receive treatment to prevent reinfection. Medication only advised under medical supervision.