Apparently I am doing a bit of an “STD week” here, due to the rates of STD’s rising AND issues with long-term complications. One thing that people need to know more about is Pelvic Inflammatory Disease (PID).  PID is an infection of the uterus and fallopian tubes (the tubules that the eggs travel down to get fertilized).  The CDC estimates that 750,000 women get acute PID every year and because of this infection, 75,000 women become infertile every year.  With the rates of US infertility raising yearly, this is important to know about because it is a complication of STD’s, primarily Chlamydia and Gonorrhea, that goes unnoticed and can lead to severe long-term complications.

How do I get PID?
PID is a complication of STD’s, which is usually from unprotected sex.  If women have and STD that goes unnoticed and untreated for an extended period of time, and it is totally person dependent on that time period, the infection can spread up the uterus and into the fallopian tubes causing a wide spread infection.  The infection can lead to chronic uterine pain, abscesses in the uterus or fallopian tubes, and ectopic pregnancies (pregnancies in the fallopian tubes or in other places that where they should be).

What are risk factors?
Women who are sexually active, usually of childbearing years under the age of 25 are at highest risk of PID
People with prior PID infection
The higher the number of sexual partners, the higher your risk becomes
Using douche can increase your risk of PID by pushing bacteria higher up into your vagina, and causing an infection (such as PID)
IUD’s can increase the risk of PID UNLESS the women is tested before the IUD is placed and has concurrent STD testing.

What are the symptoms?
The scary thing is that you can have absolutely no symptoms or pretty severe symptoms.  Usually with Chlamydia, there are very very few symptoms, as most often the women don’t know they have an infection.  But, some of the noticeable symptoms are lower abdominal pain ( I know, who doesn’t get that on occasion?), fever, unusual discharge, painful sex, pain with peeing, and irregular menstrual bleeding.  One very rare but VERY serious complication is called Fitz-Hugh-Curtis syndrome which causes right upper quadrant pain (under the right side of the rib cage on your stomach); it causes your liver to adhere to lungs and can cause respiratory problems….there is no real treatment and no treatment unless is causes other issues.  Also, of note, the fevers and abdominal pain can mimic that of appendicitis/a ruptured appendix, so it can be an emergency and require emergent surgery and at least an overnight hospital stay.

Testing:
There are no precise tests for PID because it is a complication from other STD’s, so the best tests are getting regularly STD tested.  And it is also based upon the clinical findings of your HCP in your abdominal exam.  Also, an ultrasound may be performed to rule out abscesses or other problems that may mimic PID.

Are there any treatments?
Usually PID is treated with two antibiotics (orally) to ensure that the bacteria is being treated and preventing it from doing further damage to your reproductive system.  In cases where a women is pregnant, or having severe symptoms, they may be admitted to the hospital for IV antibiotics for treatment and for monitoring of the baby.  And, as stated above, the symptoms may mimic a ruptured appendix requiring emergent surgery, which is why any abdominal pain symptoms in a women require an abdominal exam in the Emergency Room.

How do I prevent PID?
Use protection with every sexual partner unless you are in a monogamous relationship and you are both getting tested.  Get tested regularly regardless of your use of protection or not, it is your body and you need to make sure that you are safe and healthy.  If you have ANY of the symptoms above, go get tested and talk to your HCP. Also, regular Gynecological exams are a way to prevent the infection from getting  to far and having your HCP notice any changes that you might have in your cervix that you did not know of.

So, please spread the word, be safe, get tested, and go talk to your HCP if you have any inkling that you might have PID.  Infertility is such a horrible price to pay for a mistake of having sex with the wrong person, getting an STD, and not getting it treated…there is no excuse these days with free/low cost STD clinics in every city!  (Go to your local Department of Public Healths website to find where the low cost/free clinics are)

Yours in Good Health
B