What are the treatment options for Pelvic Inflammation

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs, specifically ascending from the endocervix. Infection usually starts in the vagina and spreads to the uterus, fallopian tubes or ovaries.  Delay in treatment might cause an increased risk of infertility, ectopic pregnancy and chronic pelvic pain. Even though it is commonly a sequela of unprotected sex, it can also be due to a break in the normal barrier created by the cervix. This can happen after childbirth, miscarriage or abortion. Hence, get yourself educated and checked at your nearest Obstetrician & Gynaecologist in Kuala Lumpur with DoctoronCall.

How do I get PID?

PID can be a polymicrobial disease. The most commonly isolated bacteria are N.gonorrhoeae and C.trachomatis. However, other probable causative organisms are Mycoplasma genitalium, Gardnerella vaginalis Streptococcus agalactiae, Enteric gram-negative rods (eg, Escherichia coli), Enterococcus and anaerobes. These organisms can be contracted from:

• Having an untreated STD and do not get treated
• Having multiple sexual partners
• Having a sex partner who has a number of other sex partners
• Having a past medical history of PID
• Being sexually active and are at age 25 years old or younger;
• Practising vaginal douching
• Using an intrauterine device (IUD) for birth control. However, the small increased risk is mostly limited to the first three weeks of usage.

What are the symptoms and signs of PID?

PID can be acquired via unprotected sex but because the STD produces no symptoms, the untreated infection then progresses into PID. By then the patient would have developed symptoms:

• Pain in the lower abdomen.
• High fever.
• An unusual vaginal discharge with a bad odour from your vagina.
• Pain during sex particularly felt deep inside the pelvis.
• Bleeding from vagina especially after sex.
• Painful or burning sensation during urination.
• Bleeding between periods.
• Nausea and vomiting.

Is PID curable?

Yes, if it’s treated earlier. It is important to take note that the sexual partner(s) may need to be screened and treated as well. Patients should be provided with a detailed explanation of their condition, with emphasis on the long-term implications for the health of themselves and their partner. Treatment options for mild to moderate infection is a cocktail of antibiotics either in the form of oral tablets and/or injection for 14 days with a scheduled follow up in between.

Intravenous antibiotic treatment is warranted in patients with criteria below:

1. Clinically severe disease including complication of tubo-ovarian abscess
2. PID in pregnancy
3. Lack of response to oral therapy
4. Intolerance to oral therapy.

It is then followed up with treatment via the oral route. For patients who have developed tubo- ovarian abscess, surgical treatment with ultrasound guidance is vital to ensure complete recovery.

How do I reduce my chances of pelvic inflammatory disease?

• Practice safe sex by using a condom and avoid high-risk behaviour such as involving in the promiscuous activity. If possible, ask about a potential partner’s sexual history.
• Talk to your doctor about contraception. Not all forms of contraception provide protection against the development of PID. Using barrier methods, such as a condom, might help to reduce your risk.
• Get tested. If you’re at risk of an STI, arrange an appointment with your doctor for a screening test. Early treatment of an STI gives you the best chance of avoiding PID.
• Request that your partner be tested. If you have a pelvic inflammatory disease or an STI, advise your partner to be tested and treated. Thus, preventing the spread of STIs and possible recurrence of PID.
• Don’t douche. Douching upsets the normal flora of the vagina. Do you know the vagina is a self- cleaning organ with its own defence mechanism?