Pelvic Inflammatory Disease
What is Pelvic Inflammatory Disease (P.I.D)?
P.I.D is the name given to a group of infections which can affect the lining of the womb and/or the fallopian tubes (which connect the ovaries to the womb) and surrounding tissues. P.I.D is often so mild that it produces no symptoms, but it can occasionally cause quite severe pelvic symptoms.
What Causes P.I.D?
There are two main groups of germs which cause P.I.D – those which are normally found in some parts of your body and those which can be passed on during sexual intercourse. When these germs get through the cervix (neck of the womb), P.I.D can sometimes occur.
Your body normally protects you from P.I.D by creating a tough layer of “antiseptic” mucus across the entrance to the cervix. Anything which upsets this (such as having a minor gynaecological procedure, e.g. fitting of an intrauterine coil device) can make some women more prone to P.I.D. P.I.D is much more likely if there is an infection already present in the vagina or cervix.
What are the Symptoms of P.I.D?
Very often symptoms are mild and may go unnoticed. If present, they may include pelvic discomfort, bleeding at times other than your period or deep pain during penetrative sex. Your partner may also have symptoms, but even if this is not the case, examination and treatment for both of you is usually recommended to minimise the risk of P.I.D happening again.
What is the Risk of Fertility Problems after P.I.D?
P.I.D can sometimes lead to blockage of the fallopian tubes and women then having problems having a baby – this is naturally a concern for women. However, it is important to say that this risk is quite small. Generally it depends on how many times you have P.I.D. The risk is probably well below 5% (1 in 20 women with P.I.D) if you have one mild episode; if you have three or more episodes of P.I.D, some research studies suggest that the chance of having difficulty having a baby may be as high as 50% (1 in 2 women).
So it is important that you and your partner receive the right treatment to prevent recurrent P.I.D.
How do I know if I have P.I.D?
The diagnosis of P.I.D is usually made by a doctor, based on your symptoms and a pelvic examination. Swab tests are taken for several different infections from both you and, if applicable, your partner. Occasionally (especially if your symptoms are not settling with treatment) the doctor may recommend a more accurate way of assessing the pelvic organs – this is called “laparoscopy”. Under general anaesthetic, a thin camera is passed through the muscle layers below the navel (tummy button) and this lets the doctor look around the whole abdomen to see why you are still getting discomfort and/or bleeding.
Most women will not need this test.
How is P.I.D treated?
Treatment usually involves a 1-2 week course of antibiotics – make sure that you take the tablets at regular intervals and finish the course. Even if your partner has no symptoms, it is very important that you both complete the course of antibiotics. This is important in minimising the chance of recurrent episodes of P.I.D.