Pelvic Inflammatory Diseases (PID)

This is a broad term encompassing infections of the female reproductive organs, including the ovary, fallopian tubes, uterus, cervix or the vagina.

The infection is in the pelvic region of the female, hence the term.

Most infections are transferred upwards during sexual activities via the vaginal canal. Therefore, many STDs are covered under the broader class, PID.

Common Modes of Catching a PID

  • Most infection are encountered during unprotected sex from an infected partner.
  • During procedures like IUD insertion.
  • During surgical abortions or child birth.
  • Douching, which may push the bacteria upwards into the vaginal tract
  • Poor hygiene in the groin area

Common culprits of pelvic infection include chlamydia and gonorrhea, there are many other organisms associated with it.

Symptoms

  • Pain in lower abdominal area. The pain is usually dull and constant. It may be tender to touch. Sometimes, the pain is an the upper abdomen, typically on the right side.
  • Pain or burning while urinating
  • Painful intercourse
  • Fever. This may be accompanied with shivering
  • Foul smelling discharge form the vagina. The discharge may be altered in its smell, color and consistency.
  • Low back ache
  • Sometimes, there are no overt signs or symptoms of the condition. The couple may report infertility.

Complications

PID is a common cause of infertility now a days. Due to infection in the tubes, inflammation occurs, occluding the fallopian tubes with products of inflammation. Sometimes, thick fibrous bands are formed, which may block the tube for ever.

In a normal course, the egg released from the ovary, travels through the fallopian tube to reach the uterus. When tubes are occluded, the egg is not able to complete its journey.

Also, occluded tubes prevent the sperm from traveling upwards to fertilize with the egg.

PID are culprits in several cases of abortions. They do not let the fetus grow in a healthy way.

Many cases of low back pain are actually due to chronic PID.

Diagnosis

Diagnosis is made on the basis of symptoms. Vaginal discharge may be analyzed. A swab may be taken from the vagina or the cervix and send for culture.

In some cases, ultrasound pelvis is required. Endometrial biopsy may be taken.

Treatment

  • Cleaner sex practices are recommended.
  • Avoid multiple sexual partners.
  • Using clean condoms would prevent most of the infections of that area.
  • A course of appropriate antibiotics is given. PID is usually a mixed infection. So a combination regimen of antibiotics may be recommended.

Commonly used medications include doxycycline, ceftriaxone or cefoxitin. Metronidazole may be given to cover the anaerobic bacteria.

Medical Advice (Q&As) on “Pelvic Inflammatory Diseases (PID)

    1. Buddy M.D. Post author

      Fluid in pouch of Douglas needs to be investigated further. This may be an indication of some infection, PID or even malignancy.

      What are your symptoms? Do you have any pain, fever etc.?

      Reply
  1. Janet

    I have had 4 miscarriage and I am 30 yrs. My scan said my endometrial plate is thin and there is much fluid in my pod. I am afraid can I still be pregnant again.

    Reply
    1. Buddy M.D. Post author

      It’s not normal to be having fluid in the pouch of douglas. This may be due to some pelvic infection or hidden malignancy.

      Before conceiving again, you need to get evaluated by a doctor and investigate the cause of having excess fluid in the POD.

      Reply
  2. Janet

    Thank you for your answer sir. I will go and see my Doctor right now. My endometrial plate is thin what is the meaning and is there an problem with me?

    Reply
    1. Buddy M.D. Post author

      Yes, endometriosis may cause infertility, though it’s temporary. You recover after treatment.

      Pelvic infections may be due to sexual indulgence with an infected partner. This is the commonest cause.

      Reply
  3. fynna

    Hi. Plz, I have delay in my menses for days now, abdominal pain which is on right side of my abdomen. Fever, diarrhea today, went and had a pregnancy test. It was negative. Also had a scan and every time seemed normal but saw a little accumulation of fluid in the cul-de-sac. Have been scheduled to see a gynecologist but want to know what’s wrong with me. Will I be able to have kids in future? I am 23 yrs.

    Reply
  4. Name

    I had a scan today and was diagnosed with hemorrhagic right ovarian cyst.
    Minimal POD FLUID – To R/O P.I.D

    Reply
    1. Buddy M.D. Post author

      Management would depend upon your clinical symptoms. If the hemorrhage is substantial, surgical drainage is usually done. For smaller amounts, pills may be given and it resolves on its own.

      Reply
  5. bee

    My scan says: bulky uterus, minimal fluid seen in cul-de-sac and in endometrial cavity. PID suggested, both ovaries are normal in size. ( 8 months after normal delivery) treatment?

    Reply
  6. Remi

    The result of my pelvic scan shows a retroverted uterus. Is it possible to give birth? I am also experiencing sperm leakage. How can I overcome that? Thank you doctor.

    Reply
    1. Buddy M.D. Post author

      You may conceive, there should be no problem due to the retroverted position.

      How much is the sperm leakage? This needs to be assessed. If it’s too much, your cervix needs to be tightened.

      Reply
  7. Andy

    I did scan I was told I have pid for fluid in the pouch of Douglas and I have not seen my period for this month and am having pain in my lower abdomen

    Reply
    1. Buddy M.D. Post author

      Kindly elaborate your symptoms. Since when do you have pain lower abdomen, any evident swelling there, fever or fatigue, irregularity of menses, backache, discharge from vagina, if yes, smell and color of the discharge?

      Reply
    1. Buddy M.D. Post author

      You need to check up with your gyne. Your doctor would correlate this finding with clinical symptoms. He would check if you have any pain in lower abdomen, fever, problem urination or any other symptoms suggesting PID.

      Furthermore, there can be other causes, besides PID, for getting fluid there. They need to be ruled out at the earliest.

      Reply
    1. Buddy M.D. Post author

      Pouch of douglas is a sort of pocket or groove between your urinary bladder and the uterus. It is formed by folding of internal covering layers of skin over these organs.

      In healthy conditions, it doesn’t have any fluid. Fluid collected in it is usually indicative that some nearby organ is sick and is oozing out fluid.

      In most cases, it is the uterus, which is either infected or has some other cause of inflammation, and is oozing fluid.

      You need to be checked up by a gyne to know your cause.

      Reply
    1. Buddy M.D. Post author

      Infection in the uterus are commonly transmitted via sexual intercourse. However, there are other causes too.

      You may get it via infected commodes, bath tubs or swimming pools. You are also likely to develop an infection there if there’s poor hygiene down there, easpecially after defecation or when you don’t change tampons for long hours.

      Reply

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