Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease occurs when infection, such as gonorrhoea or chlamydia, travels from the lower reproductive tract (e.g., vagina) upwards through the cervix to the upper reproductive tract and causes infection in uterus, fallopian tubes and ovaries. If it is not treated promptly, inflammation can recur and lead to chronic pelvic inflammatory disease. In the long term, it can cause fallopian tube obstructive infertility. If the condition worsens, it can lead to pelvic abscesses and even a life-threatening condition – sepsis. 

Risk factors
  • Habit of vaginal douching 
  • Unprotected sex
  • Multiple sexual partners at the same time
  • Recent surgeries in the reproductive tract (e.g. pregnancy termination, or gynaecologic laparoscopy)
  • Inadequate vaginal hygiene

Women can remain asymptomatic. If symptoms do occur, they include:
  • Malodorous vaginal discharge that may be green or yellow 
  • Lower abdominal pain
  • Nausea and vomiting 
  • Lower back pain
  • Fever
  • Burning sensation when passing urine
  • Pain during sexual intercourse
  • Vaginal bleeding 

Diagnostic test

Doctor will collect sample of vaginal discharge for culture test, and access whether there are abscesses by performing abdominal ultrasound. 

Treatment

Two-week course of antibiotics is usually prescribed. Symptoms such as abdominal pain and fever should subside two to three days after the initiation of treatment. However, patients must complete the entire course of treatment. Premature termination of treatment can cause bacteria to become resistant to antibiotics.

During treatment, patients should stay hydrated and be well rested. Protection should be taken during sexual activities to prevent further infections. If symptoms do not subside after treatment and patients continue to experience abdominal pain and fever, then patients may be required to receive intravenous therapy and hospitalisation. In severe cases, laparoscopy have to be performed to clean up the abscesses.