Pelvic inflammatory disease (PID) is an infection of the upper genital tract, including the cervix, uterus, ovaries and fallopian tubes, and spreading over a large pelvic area, causing symptoms such as pain in the belly or lower abdomen, bleeding outside the menstrual period or fever.
PID is caused by sexually transmitted infections (STIs) that begin in the vagina, mainly chlamydia or gonorrhea that are not adequately treated, and is more common in young women aged 15 to 25.
The treatment of pelvic inflammatory disease is carried out by a gynecologist and involves the use of antibiotics to eliminate bacteria and avoid complications, such as the formation of abscesses, ectopic pregnancy, infertility or chronic pelvic pain, for example.
PID symptoms
The main symptoms of PID are:
- Abdominal or pelvic pain, in the foot of the belly or in the lower abdomen;
- Yellowish or greenish vaginal discharge with a bad smell;
- Vaginal bleeding outside the menstrual period or after sexual intercourse;
- Pain during intimate contact;
- Burning sensation when urinating;
- Fever equal to or greater than 38ºC or chills.
In most cases, pelvic inflammatory disease can be very subtle, and women are not always able to notice its symptoms, favoring the proliferation of microorganisms and resulting in greater inflammation of the genital region. Know how to identify all the symptoms of PID.
It is important to consult a gynecologist whenever symptoms of PID or STIs appear, so that the most appropriate treatment can be diagnosed and initiated.
Read too: STIs in women: 11 symptoms, causes (and what to do)
When is PID serious?
PID can become serious when treatment is not carried out properly, with guidance from a gynecologist, as it can cause complications, such as serious abdominal infection, called peritonitis, formation of abscesses, blockage of the fallopian tubes, ectopic pregnancy or infertility.
Read too: Peritonitis: what it is, symptoms, causes and treatment
How to confirm the diagnosis
The diagnosis of pelvic inflammatory disease is made by the gynecologist based on the evaluation of symptoms, as well as when they started, health and sexual history, gynecological and pelvic examination, and imaging and laboratory tests.
Make an appointment with your nearest gynecologist to investigate the possibility of PID:
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Which test detects pelvic inflammatory disease?
The main tests that detect pelvic inflammatory disease are:
- Pregnancy test, to rule out ectopic pregnancy;
- Analysis of vaginal secretion;
- Urine tests;
- Blood tests, such as complete blood count, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR);
- Pelvic or transvaginal ultrasound;
- Computed tomography or magnetic resonance imaging;
- Laparoscopy and endometrial biopsy.
In addition, the doctor may also recommend tests for other sexually transmitted infections, such as syphilis or HIV, for example.
Read too: 10 STI tests: what they are, what they detect (and when to do them)
How do you know if you have PID?
To find out if you have PID, you should consult your gynecologist as soon as symptoms of pelvic inflammatory disease or STIs appear, to carry out diagnostic tests, confirm the infection and the stage of the disease and, thus, begin the most appropriate treatment. .
DIP stages
Based on the results of the diagnostic tests carried out, the doctor is able to verify the stage of the disease, which are:
- Stadium 1: inflammation of the endometrium and tubes, but without infection of the peritoneum;
- Stadium 2: inflammation of the tubes with infection of the peritoneum;
- Stadium 3: inflammation of the tubes with tubal obstruction or tubo-ovarian abscess;
- Stadium 4: rupture of the tubo-ovarian abscess, or purulent secretion in the cavity.
Therefore, by identifying the severity of PID and the infectious agent responsible, it is possible that the most appropriate treatment will be indicated.
Possible causes
Pelvic inflammatory disease is mainly caused by sexually transmitted infections (STIs), such as chlamydia and gonorrhea, or Mycoplasma genitalium.
Other infections can also cause PID, such as bacterial vaginosis, trichomoniasis, ureaplasma or herpes simplex type 2, for example.
Additionally, bacteria from the intestinal, urethral or vaginal tract, such as Escherichia coli, Bacteroides fragilis or Streptococci group B, can also cause PID.
Risk factors for PID
The main factors that can increase the risk of pelvic inflammatory disease are:
- Previous history of pelvic inflammatory disease or STIs;
- Do not use a condom during intimate contact;
- Multiple sexual partners;
- Having an STI that is not adequately treated;
- Contamination by some bacteria at the time of birth;
- Make frequent use of vaginal douches;
- IUD placement less than 3 weeks ago;
- Pelvic surgery or tubal ligation.
Women who are most likely to develop this type of inflammation are those between 15 and 25 years of age and who do not use condoms during all sexual relations.
How the treatment is carried out
Treatment for pelvic inflammatory disease must be guided by a gynecologist, and aims to eliminate the infection, alleviate symptoms and avoid complications.
The main treatments for pelvic inflammatory disease are:
1. Use of medicines
Remedies for PID are antibiotics taken orally or intramuscularly for about 14 days. See the main remedies for PID.
Some antibiotics that may be recommended by the gynecologist are ceftriaxone, metronidazole, doxycycline or azithromycin, for example, which should be used for the time indicated by the doctor, even if the symptoms disappear quickly.
It is recommended that the sexual partner is also treated even if they do not have symptoms to avoid recontamination.
Furthermore, it is also important to rest and avoid sexual intercourse during treatment to give the tissues time to heal.
2. Withdraw or DIU
If the inflammatory disease was caused by the placement of the IUD, the doctor must recommend the removal of the IUD, in addition to the use of antibiotics.
3. Surgery
Surgery may be indicated when there is a serious infection, or when the infection has not improved with the use of antibiotics.
Furthermore, surgery is indicated to treat inflammation of the fallopian tubes, to drain abscesses or to treat ectopic pregnancy.
Read too: Ectopic pregnancy: what it is, symptoms, treatment and risks
Is there a cure for PID?
Pelvic inflammatory disease can be cured if diagnosed in time. However, if the disease has caused any damage, it will be permanent.
Furthermore, if adequate treatment is not carried out, complications may arise.
Possible complications
Pelvic inflammatory disease can cause complications such as:
- Abscess in the ovaries and fallopian tubes;
- Severe abdominal infection, called peritonitis;
- Perihepatitis which is inflammation of the capsule surrounding the liver, called Fitz-Hugh-Curtis syndrome;
- Blockage of the uterine tubes;
- Salpingite;
- Chronic pelvic pain.
Additionally, pelvic inflammatory disease can increase the risk of ectopic pregnancy and infertility.
How to prevent
Pelvic inflammatory disease can be prevented by using a condom in all sexual relations, in addition to adequate treatment for STIs, such as chlamydia and gonorrhea. The treatment must also be carried out by the partner.
Furthermore, women with an active sex life should have periodic consultations with the gynecologist and routine exams, including tests that detect STIs.
It is also important to avoid using vaginal douches, as this can unbalance the vaginal microbiota and increase the risk of PID.
