Insights into pelvic inflammatory disease

Pelvic inflammatory disease (PID) is a serious medical condition characterised by an infection affecting the upper female genital tract, including the womb, fallopian tubes, and ovaries. Predominantly observed in sexually active women aged 15 to 24, PID can have significant repercussions on reproductive health if not promptly addressed.

In her latest online article, Dr Irfana Koita gives us her insights into pelvic inflammatory disease. She talks about the causes, symptoms, complications, treatment and prevention.

Causes:

PID predominantly results from a bacterial infection that ascends from the lower genital tract to the upper reproductive organs. Various bacteria can contribute to PID, and in about 25% of cases, sexually transmitted infections (STIs) such as chlamydia or gonorrhoea play a pivotal role in its development.

Symptoms:

PID often operates stealthily, with many affected women exhibiting no apparent symptoms. When present, mild symptoms may include abdominal pain, discomfort during sexual intercourse or urination, intermenstrual bleeding, heavy or painful periods, and unusual vaginal discharge, particularly if it displays yellow or green hues. Severe cases may manifest with intense abdominal pain, elevated body temperature, nausea, and vomiting.

Complications:

One of the potential complications of PID is tubal occlusion, leading to blocked fallopian tubes. This, in turn, can result in infertility due to the inability of an ovulated egg to be fertilised or reach the endometrial cavity. Additionally, women with PID have an increased risk of ectopic pregnancies. Approximately 1 in 10 women with PID may experience infertility, particularly those who undergo delayed treatment or recurrent episodes of PID.

Treatment:

Timely diagnosis and intervention are crucial in managing PID. In the early stages, PID responds well to a 14-day course of antibiotics. Completing the entire antibiotic regimen is essential to ensure the eradication of the infection. During the treatment period, abstaining from sexual intercourse is advised. Equally important is the testing and treatment of recent sexual partners to prevent the recurrence or spread of the infection.

In instances where both fallopian tubes are blocked, in vitro fertilisation (IVF) becomes a necessary reproductive intervention. If a tube is blocked and filled with fluid (known as a hydrosalpinx), minimally invasive surgical procedures such as laparoscopy or hysteroscopy are recommended. These procedures can either remove the affected tube or block/separate it from the uterus before embarking on fertility treatments.

Prevention:

Taking proactive steps to minimise the risk of PID involves consistently using condoms with new sexual partners until they undergo a comprehensive sexual health check. This precautionary measure significantly reduces the likelihood of contracting or spreading bacterial infections that can lead to PID. Regular screenings and practicing safe sexual behaviours contribute to overall reproductive health and well-being.

Dr Irfana Koita is an esteemed fertility specialist with over 15 years of experience. You can schedule an appointment with Dr Koita on her Top Doctors profile.