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Pelvic Inflammatory Disease (PID)
In addition, a partially blocked or slightly damaged fallopian tube may cause a
fertilized egg to remain in the fallopian tube. If this fertilized egg begins to grow in the tube as if it were
in the uterus, it is called an ectopic pregnancy. As it grows, an ectopic pregnancy can rupture the fallopian
tube causing severe pain, internal bleeding, and even death.
Scarring in the fallopian tubes and other pelvic structures can also cause
chronic pelvic pain (pain that lasts for months or even years). Women with repeated episodes of PID are more
likely to suffer infertility, ectopic pregnancy, or chronic pelvic pain.
How is Pelvic Inflammatory Disease
(PID) diagnosed?
PID is difficult to diagnose because the symptoms are often subtle and mild.
Many episodes of PID go undetected because the woman or her health care provider fails to recognize the
implications of mild or nonspecific symptoms. Because there are no precise tests for PID, a diagnosis is usually
based on clinical findings. If symptoms such as lower abdominal pain are present, a health care provider should
perform a physical examination to determine the nature and location of the pain and check for fever, abnormal
vaginal or cervical discharge, and for evidence of gonorrheal or chlamydial infection. If the findings suggest
PID, treatment is necessary.
The health care provider may also order tests to identify the infection-causing
organism (e.g., chlamydial or gonorrheal infection) or to distinguish between PID and other problems with
similar symptoms. A pelvic ultrasound is a helpful procedure for diagnosing PID. An ultrasound can view the
pelvic area to see whether the fallopian tubes are enlarged or whether an abscess is present. In some cases, a
laparoscopy may be necessary to confirm the diagnosis. A laparoscopy is a surgical procedure in which a thin,
rigid tube with a lighted end and camera (laparoscope) is inserted through a small incision in the abdomen. This
procedure enables the doctor to view the internal pelvic organs and to take specimens for laboratory studies, if
needed.
What is the treatment for Pelvic Inflammatory Disease (PID)?
PID can be cured with several types of antibiotics. A health care provider will
determine and prescribe the best therapy. However, antibiotic treatment does not reverse any damage that has
already occurred to the reproductive organs. If a woman has pelvic pain and other symptoms of PID, it is
critical that she seek care immediately. Prompt antibiotic treatment can prevent severe damage to reproductive
organs. The longer a woman delays treatment for PID, the more likely she is to become infertile or to have a
future ectopic pregnancy because of damage to the fallopian tubes.
Because of the difficulty in identifying organisms infecting the internal
reproductive organs and because more than one organism may be responsible for an episode of PID, PID is usually
treated with at least two antibiotics that are effective against a wide range of infectious agents. These
antibiotics can be given by mouth or by injection. The symptoms may go away before the infection is cured. Even
if symptoms go away, the woman should finish taking all of the prescribed medicine. This will help prevent the
infection from returning. Women being treated for PID should be re-evaluated by their health care provider two
to three days after starting treatment to be sure the antibiotics are working to cure the infection. In
addition, a woman’s sex partner(s) should be treated to decrease the risk of re-infection, even if the
partner(s) has no symptoms. Although sex partners may have no symptoms, they may still be infected with the
organisms that can cause PID.
Hospitalization to treat PID may be recommended if the woman (1) is severely
ill (e.g., nausea, vomiting, and high fever); (2) is pregnant; (3) does not respond to or cannot take oral
medication and needs intravenous antibiotics; (4) has an abscess in the fallopian tube or ovary (tubo-ovarian
abscess); or (5) needs to be monitored to be sure that her symptoms are not due to another condition that would
require emergency surgery (e.g., appendicitis). If symptoms continue or if an abscess does not go away, surgery
may be needed. Complications of PID, such as chronic pelvic pain and scarring are difficult to treat, but
sometimes they improve with surgery.
How can Pelvic Inflammatory Disease
(PID) be prevented?
Women can protect themselves from PID by taking action to prevent STDs or by
getting early treatment if they do get an STD.
The surest way to avoid transmission of STDs is to abstain from sexual
intercourse, or to be in a long-term mutually monogamous relationship with a partner who has
been tested and is known to be uninfected.
Latex male condoms, when used consistently and correctly, can reduce the risk
of transmission of Chlamydia and gonorrhea.
CDC recommends yearly Chlamydia testing of all sexually active women age 25 or
younger, older women with risk factors for chlamydial infections (those who have a new sex
partner or multiple sex partners), and all pregnant women. An appropriate sexual risk assessment by a health
care provider should always be conducted and may indicate more frequent screening for some women.
Any genital symptoms such as an unusual sore, discharge with
odor, burning during urination, or bleeding between menstrual cycles could mean an STD
infection. If a woman has any of these symptoms, she should stop having sex and consult a health care
provider immediately. Treating STDs early can prevent PID. Women who are told they have an STD and are treated
for it should notify all of their recent sex partners so they can see a health care provider and be evaluated
for STDs. Sexual activity should not resume until all sex partners have been examined and, if necessary,
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Gonorrhea Symptoms
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