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Pelvic Inflammatory Disease

Pelvic Inflammatory Disease (PID)

What is Pelvic Inflammatory Disease?

  • Pelvic Inflammatory Disease is usually shortened to PID.
  • It means infection of a woman’s reproductive organs including the uterus (womb), fallopian tubes (tubes that carry eggs from ovary to womb) and ovaries.
  • PID is usually caused by sexually transmitted infections such as chlamydia or gonorrhoea.
  • Early signs of PID include bleeding between periods and lower abdominal pain – particularly during sex.
  • If left untreated PID can lead to serious problems such as infertility, ectopic pregnancy (baby in the tube), abscess formation and chronic pelvic pain.
  • If you have PID we recommend that you should have a full STI screen including an HIV test.

How common is PID?

  • It occurs most frequently in young sexually active women and is a common problem of untreated chlamydia or gonorrhoea.

How do you catch PID?

  • PID is caused by a bacterial infection that spreads from the cervix (neck of the womb) up into the uterus (womb), fallopian tubes and ovaries.
  • The most common cause is a sexually transmitted infection such as chlamydia or gonorrhoea.
  • Sometimes PID is caused by bacterial infections spreading from other abdominal organs e.g. during acute appendicitis.
  • Very occasionally fitting a coil may lead to PID – but this is only if there is an existing infection in the neck of the womb – so best to test for STIs before having a coil fitted.
  • A previous episode of PID increases the risk of getting another one – you don’t need to catch another infection for this to happen.

What would I notice if I had PID?

  • Two thirds of women may not notice much at all – it is possible to get PID and associated tubal damage without realising it.
  • Some women get severe lower abdominal pain, fever and nausea / vomiting which needs treatment in hospital.
  • Most women get mild symptoms that may include the following:
  • Lower abdominal pain, aching or bloating – a bit like a period pain
  • Pain deep inside during sex
  • Bleeding in-between periods or after sex
  • Unusual vaginal discharge

How do I get tested for PID?

  • It is often difficult to tell if a woman has PID as there is no precise test.
  • A woman needs a full assessment by a doctor who will perform an internal examination as well as some other tests including a STI screen.
  • Often the STI screen is negative – but it is still possible to have PID.
  • If there is any suggestion of PID you will be given immediate treatment in the clinic.

How is PID treated?

  • PID is treated with a mixture of antibiotics to cover all possible infections.
  • At the Wolverton you will usually be given:
    • CEFTRIAXONE 250mg as a single injection

AND

  • DOXYCYCLINE 100mg capsule twice daily for 2 weeks

AND

  • METRONIDAZOLE 400mg tablet twice daily for 2 weeks
  • Avoid alcohol whilst taking metronidazole and for 48 hours following completion.
  • All treatments at the Wolverton are free and are given to you in the clinic.
  • Do not take doxycycline on an empty stomach as it will make you feel sick and avoid sunbathing as you may get a rash.
  • The antibiotics may interfere with the contraceptive pill and make it less effective – use condoms for 7 days after finishing the antibiotics and when you finish your current pack of pills immediately start the next pack i.e. omit the 7 day break
  • You will be advised to rest, drink plenty of fluids and take pain killers such as ibuprofen or paracetamol.
  • All women will be advised to attend the clinic for review in 1-2 weeks to check that the treatment is working.
  • Taking your treatment and resting will minimise your risk of developing the serious complications of PID.
  • If your symptoms (pain/ fever/ sickness) get worse you should come back to the clinic, see your GP or attend A&E.

What about my partner?

  • PID is usually caused by a sexually transmitted infection so it is important that all current partners are tested and treated with antibiotics.
  • Sometimes ex-partners will need to be tested too – the nurse will advise about this.
  • Make sure that both you and your partner complete your courses of antibiotics before having sex again.

What problems can untreated PID lead to?

  • Multiple episodes of PID can lead to scarred and blocked fallopian tubes.
  •  This can cause:
    • an ectopic pregnancy (baby in a tube)
    • infertility
    • chronic or recurrent bouts of pelvic pain
    • pelvic abscess
  • Prompt treatment of PID can minimise these risks.
  • For this reason we take PID very seriously and treat immediately if there is any suspicion of PID.

Will PID come back again after treatment?

  • Women who have had one bout of PID are at higher risk of another bout because damaged tissues are more susceptible to re-infection.
  • Recurrent infections may be due to a wide range of bacterial infections – some may be sexually transmitted and others may not be.
  • It is important that recurrent episodes of PID are treated promptly with antibiotics.
  • To prevent getting PID again it is important to use condoms with new partners and both get tested for STIs before having sex without a condom.
  • We advise women to be tested for STIs prior to coil fitting.

More information

http://www.bashh.org/

http://www.nhs.uk/Livewell/STIs/Pages/STIs-hub.aspx