Pelvic inflammatory disease (PID) affects a woman’s reproductive organs and can have potentially life-threatening complications. The most common cause of PID is a sexually transmitted infection (STI), particularly chlamydia and gonorrhea (although non-STI related causes are also possible). The World Health Organisation estimates that the numbers of chlamydia and gonorrhea are increasing, meaning that PID will continue to be a significant medical problem.
PID arises from leaving STIs untreated. This allows the initial infection to progress from the genital area to the pelvic area, which contains the uterus and ovaries. Leaving STIs untreated is unfortunately common, because many STIs do not produce any symptoms at all, or the symptoms are easily confused with those of other diseases.
How quickly PID develops after getting an STI is highly variable from person to person, ranging from a few days to weeks, sometimes even months.
Symptoms of chlamydia and gonorrhea are more difficult to detect particularly in women. Inflammation of the cervix (cervicitis) is common in these STIs, but because of the internal location of the cervix, any changes resulting from infection is not visible at all. However, infection can result in other signs such as painful urination or pain during sexual intercourse, as well as abnormal vaginal discharge (which may be yellow or greenish, accompanied by a bad smell).
You are at risk of chlamydia or gonorrhea infection (and consequently PID) if you:
- Are sexually active and under 25 years old
- Have unprotected sex
- Have multiple sexual partners
- In a sexual relationship with someone who has multiple sexual partners
What are the complications of PID?
PID causes damage to the reproductive organs through the formation of scar tissue. This scarring is the cause of some of the complications arising from PID. Ectopic pregnancy: In a normal pregnancy, the fertilised egg (embryo) travels from the ovary to the uterus, where the embryo implants and attaches to the uterine wall. When PID is present, scar tissue can block the pathway between the ovary and the uterus (this pathway is called the Fallopian tube). When this happens, the embryo implants in the narrow Fallopian tube, rather than in the uterus. When the embryo develops past a certain size, the tube ruptures, resulting in massive internal bleeding (hemorrhage). Death from hemorrhage is a leading cause of death during early stages of an ectopic pregnancy.
Peritonitis: The peritoneum is a membrane that lines the inside of the abdomen, covering the internal organs. It is possible for the underlying infection that causes PID to progress past the boundaries of the pelvic organs (e.g. uterus and ovaries) when left untreated. In this case, the infection reaches the peritoneum, leading to inflammation. If left untreated, peritonitis can lead to life-threatening infection throughout your body (systemic infection).
Tubo-ovarian abscess: This is a collection of pus in the ovaries and Fallopian tubes. The abscess can rupture and lead to a systemic infection.
Infertility: Depending on the amount of scarring, there may be such extensive blockage of the uterus and Fallopian tubes that sperm and egg cannot meet, so fertilisation cannot occur.
Chronic pelvic pain: Scarring in pelvic organs can cause pain during sexual intercourse and ovulation, which can last from months to years.
How is PID diagnosed and treated?
Because STIs are the most common cause of PID (particularly chlamydia and gonorrhea), PID diagnosis begins with STI screening, which can be done with swabs and blood tests, and sometimes an ultrasound scan as well.
PID can be treated with antibiotics. However, it is not possible to reverse any scar tissue formation, which becomes more likely the longer the infection is untreated. For this reason, getting yourself checked early if you suspect you have PID is important.
If you test positive for an STI, your partner will also need to be treated to avoid re-infection. Having a previous chlamydia or gonorrhea infection does not protect you from getting infected again. Your former partners will also need to be notified so that they can get tested and obtain treatment, if needed, in order to prevent further transmission.
Can PID be prevented?
Since the leading cause of PID is an existing untreated STI, preventing STIs is a key step towards protecting yourself from PID. Preventing STIs can be achieved by practicing abstinence, or ensuring that you only engage in protected sex.
However, precautions can fail. If you are worried that your protective measures have been compromised, make sure that you get yourself tested for STIs, so that you can obtain treatment early and avoid any complications from STIs.
Our range of STD Rapid Test Kits for chlamydia and gonorrhea are quick, safe, accurate, and easy to use. Please keep in mind that testing is only the first step to protecting yourself from the ill effects of STIs. If you test positive, you must be sure to follow up on the result by seeking advice from a physician and obtaining the appropriate treatment.