Home. It’s such a warm and comforting word. Your home wherever it may be is composed of special yet equally cherished rooms such as the living room, where you spend time with your loved ones over an embarrassingly funny incident that happened years ago, the kitchen where you relieve all your worries with a spoonful of your moms cooking, the bedroom where you bath in solitude as you sink into your bed after a long day’s work. Now, imagine if intruders or thieves came into your house, made a huge mess, and even stole your belongings. Wouldn’t you be devastated?
This my dear friend is how PID is transmitted except the “home” is your vagina and the “special rooms “are different parts of the vagina like fallopian tubes, ovaries, and uterus. The “intruders and thieves “are the tiny germs that infect your vagina and damage your reproductive organs. Lastly the “Stolen things” are your dearly valued health assets such as fertility.
Pelvic inflammatory disease (PID) is an under-recognized infection that occurs in the upper genital tract of the female reproductive organ. It spreads from the lower genitalia tract up to the ovaries, fallopian tube, uterus, and contiguous pelvic structures. PID is intimately connected to sexual health and well-being. This article explores their relationship, causes, treatment, and prevention.
PID is not classified as a sexually transmitted disease however it is caused by sexually transmitted infections (STI), Therefore effective treatment and prevention of STIs is a foolproof method of reducing the risk of PID.
Sexually transmitted infections that cause PID :
Chlamydia: The most common sexually transmitted disease caused by Chlamydia trachomatis bacteria. It is less likely to cause any symptoms.
Symptoms of Chlamydia can include:
Painful urination.
Vaginal discharge.
Discharge from the penis.
Painful vaginal sex.
Vaginal bleeding between periods and after sex.
Testicular pain
Gonorrhea: Caused by the bacterium Neisseria gonorrhoeae. It is known to be more severe than other kinds of PID.
Symptoms of gonorrhea can include :
watery, creamy, or greenish vaginal discharge.
pain or burning while urinating.
an urge to urinate more frequently.
heavier periods or spotting between periods.
pain during penetrative vaginal sex.
sharp pain in your lower abdomen.
itching and soreness in your anus.
rectal bleeding or discharge.
Mycoplasma: Caused by the bacterium Mycoplasma genitalium
Symptoms of Mycoplasma can include:
a change in vaginal discharge
pain when passing urine
bleeding or spotting between periods or after having sex
pain during or after sex
pain in the lower abdomen.
a discharge from the penis
You may experience pain or irritation inside the anus and/or anal bleeding.
Ureaplasma: Caused by the bacterium Ureaplasma urealyticum
Symptoms of Ureaplasma urealyticum:
Burning sensation when passing urine
Urethral irritation
Unusual vaginal discharge in women
Urethral discharge in men
How does PID develop in your body?
Infection Entry and Initial Spread
Initial Infection: The bacteria first infect the lower genital tract, including the vagina and cervix.
Ascension to Upper Reproductive Tract: The bacteria can move up from the cervix into the uterus. The cervix is a key entry point where infections can travel upward if not treated. Once the bacteria have ascended, they infect the endometrium (lining of the uterus).
Inflammatory Response
Immune Response Activation: The body’s immune system recognizes the invading bacteria and activates an inflammatory response. White blood cells and other immune factors are sent to the site of infection to combat the bacteria.
Inflammation: This immune response results in inflammation, which is characterized by redness, swelling, heat, and pain. Inflammation is necessary to control the infection but can also cause tissue damage if excessive.
3. Spread of Infection to Fallopian Tubes and Ovaries: If the infection is not controlled, it can spread from the uterus to the fallopian tubes The fallopian tubes are particularly vulnerable because they are narrow and have a high risk of being obstructed by inflammatory processes. The infection can also spread to the ovaries leading to further inflammation and potential damage.
Symptoms of PID :
The majority of the patients diagnosed with PID are symptomless due to
Slow progression of PID which allows the body to adapt in a way that does not cause noticeable symptoms.
An effective immune system that controls the disease during its early stages.
If the infection is confined to the cervix the patient may remain symptomless as symptoms only become apparent when it spreads to the uterus, ovaries, and fallopian tube.
In some cases, symptoms come and go so it’s difficult to associate them with PID.
lack of awareness, people misattribute the symptoms to other health conditions such as menstrual irregularities rather than associating it with PID.
As PID is mainly symptomless it is not identified until it has reached later stages of infection. The delayed diagnosis may progress into infertility and Ectopic pregnancy.
Common symptoms of PID are as follows:
Pelvic pain
Painful intercourse
Abnormal vaginal discharge (color, consistency, odor)
Increased vaginal discharge
Irregular bleeding (spotting, heavy periods)
Delayed or missed periods
Painful urination
Painful bowel movements
Fever
Chills
Nausea and vomiting
Fatigue
Lower back pain
Abdominal swelling
Unexplained weight loss
Tenderness in the pelvic area
Foul-smelling discharge
Symptoms of ectopic pregnancy (severe abdominal pain, shoulder pain, dizziness)
Symptoms of abscess (severe pelvic pain, fever, nausea)
Complications due to delayed diagnosis :
As mentioned above the two main complications caused by PID are:
Infertility: Chronic inflammation caused by PID causes scarring and misconfiguration of fallopian tubes causing it to become blocked or narrow which prevents the egg from traveling through the tube. The ciliary epithelial cells are also damaged, which again impacts the motion and movement of the egg. Studies have shown a 5-fold increase in infertility in women with a history of PID. This complication is also most likely to occur if the Chlamydia bacterium is the cause of STI.
Ectopic pregnancy: It is a type of pregnancy where the fetus develops outside the uterus typically using a fallopian tube as an implantation site due to restrictive movement of the egg. The fallopian tube however is not equipped with nutritional support, adequate blood flow, and spatial environment which leads to miscarriage.
Diagnosis of PID:
Pelvic examination. Pelvic regions are checked for tenderness and swelling by inserting 2 gloved fingers inside the vagina. cotton swabs are also used to take samples of vaginal and cervical fluid which are tested in labs for the presence of infectious bacteria.
Urine and blood tests. They are taken to check for pregnancy, STIs such as HIV, white blood cell count, etc.
Ultrasound. To create images of reproductive organ
Endometrial biopsy. Where a small sample of endometrial tissue is removed and tested for signs of infection and inflammation.
Risk factors of PID:
Having a sexually active lifestyle
Women who are younger than 25
Having multiple sexual partners
Being in a sexual relationship with someone who has more than one sex partner
Having unprotected sex
Douching regularly, imbalances the ratio of good and harmful bacteria in the vagina and might mask symptoms
Invasive gynecological procedures can introduce bacteria into the reproductive tract.
Inadequate hygiene
Weakened immune system
Previous reproductive health issues such as endometriosis or fibroids can increase the risk of PID
Lack /negligence of regular STI screening
Preventative measures of PID:
use of condoms and protected sex
get regularly tested for STI with you and your partner
be monogamous (have only one sexual partner)
Do not douche
maintain good hygiene
do not abuse alcohol or drugs as it can lead to risky behavior
Consider hormonal contraceptives such as birth control pills (they minimize thinning of the endometrial lining reducing the spread of infection)
Educate yourself on sexual health and management
Address any preexisting reproductive health conditions
Takeaways:
Pelvic inflammatory disease is an often overlooked condition that arises due to infection in the female reproductive organ. The infection-causing bacteria are often associated with sexually transmitted infections. PID and sexual health are closely interconnected with each other which underscores the importance of maintaining a modest and healthy sexual lifestyle and being reproductively conscious. lastly Taking Preemptive measures for our sexual health is the best cure for such a precarious disease.
Written By: Tisa Tamala
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