PID Full Form

PID is a common, serious condition affecting the female reproductive organs of non-pregnant women. It is a complication of sexually transmitted diseases such as gonorrhoea. In most cases, the spread of sexually transmitted bacteria from the vagina into other parts of the reproductive system such as the uterus, oviducts, and ovaries triggers PID development. The infection can also include neighbouring pelvic organs. PID symptoms can be mild, moderate, or severe, depending on the stage of the disease. Furthermore, a 2019 study uncovered that PID affects approximately 24-32% of women in India. Therefore, it is crucial to understand its symptoms, complications, prevention, and treatment.

Causes of PID

PID is a product of untreated bacterial infections. Its causative agents include Neisseria gonorrhoea and Chlamydia trachomatis. Some bacteria are commonly found in the female reproductive system and do not cause infection – flora. However, increasing these vaginal bacteria such as Gardnerella vaginalis causes PID.

The bacteria Mycoplasma genitalium causes upper genital tract infections and has also been linked to PID.  Genital tuberculosis also triggers PID. Furthermore, an intrauterine device (IUD) insertion can cause PID, especially in women with untreated gonorrhoea or chlamydia.

Risk factors of PID

PID involves the infection of reproductive organs in non-pregnant women. Therefore, young, menstruating women below 25 years have a higher chance of developing PID. Certain behaviours also increase risk, such as having multiple partners, practising poor menstrual hygiene, and unhygienic use of tampons. A medical history of bacterial vaginosis and STIs increases risk. Termination of pregnancy, insertion of an IUD, and in vitro fertilisation can cause PID.

Signs and symptoms of PID

These symptoms are considered during diagnosis of PID:

• Lower abdominal and pelvic pain
• Increased vaginal discharge
• Abnormal, foul-smelling vaginal discharge
• Pain during or after sexual intercourse
• Uterine bleeding during or after sexual intercourse or between menstrual cycles
• Painful and frequent urination
• Heavy menstrual periods with prolonged bleeding
• Painful periods or dysmenorrhea

PID can be symptomatic or asymptomatic. Women are advised to visit a gynaecologist as soon as possible. Some of these symptoms can indicate other STIs and require early treatment.

Diagnosis of PID

PID diagnosis involves several procedures such as transvaginal ultrasound, CT scan, endoscopy, and laparoscopy. Furthermore, extensive laboratory tests facilitate a definite diagnosis. Urine pregnancy tests rule out the possibility of an ectopic pregnancy. A complete blood count (CBC) indicating an increase in white blood cells indicates infection. Vaginal smears and culture of vaginal secretions confirm bacterial infections. Other tests for chlamydia, syphilis, HIV, and UTIs are carried out.

PID complications

The main complications of PID include the formation of abscesses in the upper reproductive tract and pelvic peritonitis. Pelvic peritonitis involves the inflammation of the peritoneum caused by infection of the fallopian tubes. Tubo-ovarian abscesses may cause permanent damage resulting in infertility. Lack of treatment increases the risk of developing infertility.

PID causes scarring in the reproductive organs causing pain during sex. Furthermore, PID is characterised by long-term pelvic pain. PID patients are at a higher risk of having ectopic pregnancies, requiring immediate medical attention and fatal.

PID preventive measures

Several practices can minimise the risk of developing PID, including practicing safe sex by using condoms and having one sexual partner. Using condoms is mandatory regardless of whether other contraception methods are used because contraceptives, injections, and IUDs do not protect women against STDs.

Furthermore, avoiding douching as it promotes the spread of bacteria internally. It is also important to undergo regular STI screening as early detection minimises PID risk. The patient’s partner should also be tested to prevent the spread of STIs and minimise the risk of recurring infections.

PID treatment measures

The treatment of PID involves the use of oral antibiotics. It is paramount that the prescription is completed even if the patient feels better as it averts the possibility of recurrent infection. However, if the medications do not work and symptoms persist, the medical practitioner may recommend intravenous medication. IV is prioritised in patients who have abscesses.

Surgery is rarely needed. This option is recommended for patients whose tubo-ovarian abscesses persist after taking antibiotics. The most important treatment step is to test the patient and their sexual partner regularly.

Conclusion:

PID is a serious condition that can result in infertility and ectopic pregnancies. Its symptoms can be acute, chronic, or unnoticeable. Some patients lack any physical signs but develop infertility. PID patients also suffer from chronic pelvic pain, which is mild and always present. On the brighter side, more research has been done on female reproductive health leading to improved treatment and preventive measures for PID. Women have condoms, treatment options, and extensive medical information that can help them prevent and treat PID. Solutions have also been provided for infertility, including fertility drugs that stimulate ovulation, surgeries to restore fertility, and adoption.