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Pelvic Inflammatory Disease
Pelvic Inflammatory Disease is a severe syndrome affecting the reproductive organs of

the female affecting young and sexually active ladies. It often occurs when bacteria is sexually

transmitted to the uterus, ovaries or the fallopian tubes from the vagina. PID is a weighty

healthcare issue that can be addressed significantly through healthcare promotion activities.

Sexually transmitted infections, such as gonorrhoea and chlamydia, can cause PID. A generous

percentage of women with chlamydia tend to develop acute Pelvic Inflammatory Disease after

six months of an initial infection if not treated in time. PID, in many cases, can be prevented,

although it remains an expensive threat to public health. If left untreated, it can eventually cause

ectopic pregnancy or infertility.

The process and stages of Pelvic Inflammatory Disease

Most sexually active women contract PID by engaging in unprotected sex; however, a

small percentage of the disease prevalence may not have been sexually transmitted. Sex lets

bacteria into the reproductive system, after which they affect the reproductive organs. The well-

known cases of PID occur in two distinct stages. One stage is vaginal infection acquisition. This

often occurs through sexual transmission and can be asymptomatic or presented with other

vaginal complications such as itching, vague lower abdominal pain, dyspareunia, dysuria and

mucopurulent vaginal discharge. The other stage includes a direct mounting of microorganisms
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to the upper genital tract from the cervix or the vagina. It causes an infection which leads to

inflammation of these organs (Simmons).

Endogenous microorganisms like the gram-negative and positive anaerobic organisms and

aerobic negative and positive cocci and rods presented in high heights in females who have

bacterial vaginosis have also been concerned with the causes of Pelvic Inflammatory Disease.

Mycoplasma genitalium also causes PID, although it is associated with mild symptoms. The

microorganisms associated with PID manifests and spreads through the following ways;

 Intra- abdominally, which involves travelling of microorganisms from the vagina to the

endometrium wall of the uterus, via the salpinx to the peritoneal cavity hence causing

salpingitis, tubal-ovarian abscess or endometritis.

 They can also spread via the lymphatic systems, like the parametrium's infection caused

by an intrauterine device, initially used for birth control. IUDs have been cited to be the

cause of PID, which can cause tubal infertility. The risk of getting PID is high within a

few weeks after the IUD insertion, and it can be prevented by testing for STI just around

the time of the IUD placement.

 Hematogenous routes, like the ones related to tuberculosis, can also be a channel to the

microorganisms.

Untreated PID can cause damages to the reproductive organs, and these complications can be

permanent. They include;

 Infertility: the more times one has had PID, the greater the chance of infertility. Delayed

treatment for PID damages the reproductive organs hence increasing the risks of

infertility.
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 Ectopic pregnancy: an ectopic or tubal pregnancy can occur due to failure to treat PID.

Scar tissues develop in the fallopian tubes and prevent the fertilized egg's movement to

the uterine wall for implantation, causing the egg to implant in the fallopian tube. Ectopic

pregnancies are hazardous and life-threatening, hence the need for immediate medical

attention.

 Tubo- ovarian abscess: PID can lead to the formation of pus in the reproductive tract.

The abscesses affect the ovaries and the fallopian tubes and, if not treated, can cause the

development of life-threatening infections.

 Chronic pelvic pain: PID can cause prolonged-lasting pelvic pain, and scarring in the

fallopian tubes can be the source of pain during ovulation and intercourse.

Signs and symptoms of Pelvic Inflammatory Disease

One may not realize that she has pelvic Inflammatory Disease since the symptoms can

sometimes be are unnoticeable. Other symptoms can, however, commence suddenly and quickly.

The signs of PID include;

 Mild to severe pelvic pain

 Lower abdominal pain

 Irregular menstrual bleeding as well as abnormal uterine bleeding, especially during or

after sexual intercourse

 Abnormal or increased vaginal discharge that an unpleasant odour may characterize

 Pain during sexual intercourse

 Inflammation

 Fever, sometimes with chills

 Frequent and painful urination

 Pelvic, abdominal, uterine, adnexal and cervical motion tenderness (Haggerty et al.).

If one displays these signs and symptoms of PID, however mild or severe, she should

immediately seek medical attention. Vaginal discharge with a foul smell, bleeding between

menstrual cycles, and painful urination can be signs of sexually transmitted infections. Prompt

management and treatment of STI's help with the PID’s prevention.

Diagnostic interventions and treatments of Pelvic Inflammatory Disease

The diagnosis of PID is based on clinical evaluations. The diversity of signs and

symptoms of PID can make its diagnosis quite challenging. There are no specific physical,

historical or laboratory findings that are specific for the PID diagnosis. When sexually active

women experience lower abdominal and pelvic pain, and no there is no likely cause of the

disorder other than PID, preventive treatment should be immediately initiated. Also, if cervical

motion, uterine, or adnexal tenderness, which are the minimum clinical criteria for diagnosing

PID, prevails, treatment should be encouraged (Vanthuyne and Pittrof). One does not have to

wait for all three symptoms to administer treatment since a wait can result in insufficient

diagnostic sensitivity.

Medical practitioners should also consider the risk profile tied to STIs after deciding on

empirical treatment for PID. Frequent elaborate diagnostic evaluations on PID are required since

wrong diagnosis can cause unnecessary outcomes. Oral temperature, elevated c- reactive protein,

elevated rate of erythrocyte sedimentation, cervical infection laboratory documentation and

abnormal cervical mucopurulent discharge add to the criteria that can enhance specificity

towards the diagnosis of PID. The specific diagnostic interventions for PID are; laparoscopic
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findings consistent with PID, endometrial biopsy with evidence of endometritis and transvaginal

sonography that displays fluid-filled tubes with pelvic fluids or tubo- ovarian complexities.

Endometrial biopsy is carried out on women going through laparoscopy and do not show any

trace of salpingitis since endometritis can be the only sign of PID in specific women. Testing for

HIV is also a method of diagnostic intervention for PID. Pregnancy tests can also be carried out

to trace the chances of ectopic or tubal pregnancy.

Treatment for PID is done by the use of antibiotics which act by covering the pathogens.

The antibiotics, however, do not reverse scarring already caused by the disorder. An infected

person should immediately seek medical attention before it gets to the point of scarring since

antibiotics' treatment could avert further damage to the reproductive organs. Clinicians should

encourage their patients that although the symptoms may cease to exist even before the infection

is fully cured, they should ensure that they complete their prescribed dosage. Their sexual

partners as well have to be treated to limit the chances of re-infection since they can have PID-

causing pathogens even though they do not display the symptoms. More severe cases call for

hospitalization for close monitoring.

The medications for PID involve different types of antibiotics that work together towards

treating the illness. One of the antibiotics used is azithromycin, which can act against PID

pathogens hence is fit for monotherapy. It is proven to be beneficial since it is cost-effective.

Azithromycin, however, has side effects such as allergic reactions like swelling of the throat and

face, hives and difficulty in breathing. Another side effect is severe skin reactions like skin pain,

reddening of the skin, burning sensation in the eyes, sore throat and fever. One should seek

immediate medical attention in case of the emergence of side effects. The drugs should be

continuously taken for a period of two weeks, even after immediately feeling better. If the
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symptoms do not improve within three days of taking the drugs, one should visit the doctor one

more time to find out which medication can work best towards eliminating the illness.

In summary, Pelvic Inflammatory Disease can be effectively prevented to avoid the risks

associated with its infection. Early diagnosis and treatment help in the long run as it prevents

further complications of the disorder. Since PID can be unnoticed by women and healthcare

providers as well, if the symptoms are insignificant, strategies to minimize the incidences and the

outcomes of both gonorrhoea and chlamydia should be emphasized. Educational initiatives

targeted at the populations which are at risk of this complication are also cost-effective in the

management of the disease.

Works cited

Haggerty, Catherine L., et al. “Predictors of Chronic Pelvic Pain in an Urban Population of

Women with Symptoms and Signs of Pelvic Inflammatory Disease.” Sexually

Transmitted Diseases, vol. 32, no. 5, May 2005, pp. 293–299,

10.1097/01.olq.0000162361.69041.a5.

Simmons, Susan. “Understanding Pelvic Inflammatory Disease.” Nursing, vol. 45, no. 2, Feb.

2015, pp. 65–66, 10.1097/01.nurse.0000458943.04114.6e.

Vanthuyne, An, and Rudiger Pittrof. “Diagnosis and Treatment of Pelvic Inflammatory Disease.”

Prescriber, vol. 27, no. 10, Oct. 2016, pp. 47–50, 10.1002/psb.1507.