View source for Pelvic inflammatory disease (patient information)

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{{Pelvic inflammatory disease (patient information)}}

{{CMG}}; '''Assistant Editor(s)-in-Chief:''' Alexandra M. Palmer

==Overview==
[[Pelvic inflammatory disease]] ([[PID]]) is a general term for [[infection]] of the [[uterus]] lining, [[fallopian tubes]], or [[ovaries]].

==What are the symptoms of Pelvic inflammatory disease?==
The most common symptoms of [[PID]] include:
*[[Fever]] (not always present; may come and go)
*[[Pain]] or [[tenderness]] in the [[pelvis]], lower [[abdomen]], or sometimes the [[lower back]]
*[[Vaginal discharge]] with abnormal color, texture, or smell
Other symptoms that may occur with [[PID]]:
*[[Bleeding]] after [[intercourse]]
*[[Chills]]
*[[Fatigue]]
*Frequent or painful [[urination]]
*Increased [[menstrual]] [[cramping]]
*Irregular [[menstrual bleeding]] or spotting
*[[Lack of appetite]]
*[[Nausea]], with or without [[vomiting]]
*No [[menstruation]]
*Painful [[sexual intercourse]]
Note: There may be no symptoms. People who experience an [[ectopic pregnancy]] or [[infertility]] often have had silent [[PID]], which is usually caused by [[chlamydia infection]].

==What causes Pelvic inflammatory disease?==
Most cases of [[pelvic inflammatory disease]] are caused by [[bacteria]] that move from the [[vagina]] or [[cervix]] into the [[uterus]], [[fallopian tubes]], [[ovaries]], or [[pelvis]].
The most common cause of [[PID]] is sexual contact without using a [[condom]] or other protection. This is called a [[sexually transmitted disease]] ([[STD]]). [[Chlamydia]] and [[gonorrhea]] are the two [[bacteria]] that cause most cases of [[PID]].
However, [[bacteria]] may also enter the body during some [[surgical]] or office procedures, such as:
*[[Childbirth]]
*[[Endometrial biopsy]]
*Insertion of an [[intrauterine device]] ([[IUD]])
*[[Miscarriage]]
*Therapeutic or elective [[abortion]]
In the United States, nearly 1 million women develop [[PID]] each year. About 1 in 8 [[sexually active]] adolescent girls will develop [[PID]] before age 20.

==Who is at highest risk?==
[[Risk factors]] include:
*Male sexual partner with [[gonorrhea]] or [[chlamydia]]
*Multiple sexual partners
*Past history of any [[sexually transmitted disease]]
*Past history of [[PID]]
*Recent insertion of an [[IUD]]
*Sexual activity during adolescence

==When to seek urgent medical care?==
Call your [[health care provider]] if:
*You have symptoms of [[PID]]
*You think you have been exposed to a [[sexually transmitted disease]]
*Treatment for a current [[STD]] does not seem to be working

==Diagnosis==
You may have a [[fever]] and [[abdominal tenderness]]. A [[pelvic examination]] may show:
*A [[cervix]] that bleeds easily
*[[Cervical]] discharge
*[[Pain]] with movement of the [[cervix]]
*[[Tenderness]] in the [[uterus]] or [[ovaries]]
Lab tests that look for signs of [[infection]] are:
*[[C-reactive protein]] ([[CRP]])
*[[Erythrocyte sedimentation rate]] ([[ESR]])
*[[WBC]] count
Other tests include:
*Culture of your [[vagina]] or [[cervix]] to look for [[gonorrhea]], [[chlamydia]], or other causes of [[PID]]
*[[Pelvic ultrasound]] or [[CT scan]] to look for other causes of your symptoms, such as [[appendicitis]] or [[pregnancy]], and to look for [[abscesses]] or pockets of [[infection]] around the tubes and [[ovaries]]
*[[Serum]] [[HCG]] ([[pregnancy test]])

==Treatment options==
Your doctor will often start you on [[antibiotics]] while waiting for your test results.
If you are diagnosed with milder [[PID]], you will usually be given an [[antibiotic]] [[injection]] or shot, and then sent home with [[antibiotic]] pills to take for up to 2 weeks. You will need to closely follow-up with your [[health care provider]].
More severe cases of [[PID]] may require you to stay in the hospital. [[Antibiotics]] are first given by [[IV]], and then later by mouth. Which [[antibiotic]] is used depends on the type of [[infection]].
A number of different [[antibiotics]] may be used for treating this type of [[infection]]. Some are safe in [[pregnant]] women. 
Sexual partners must be treated to prevent passing the [[infection]] back and forth. You and your partner(s) must finish all of the [[antibiotics]]. Use [[condoms]] until you both have finished taking your [[antibiotics]].
Complicated cases that do not improve with [[antibiotics]] may need [[surgery]].

==Where to find medical care for Pelvic inflammatory disease?==
[http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Pelvic inflammatory disease}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating Pelvic inflammatory disease]

==What to expect (Outlook/Prognosis)?==
Prompt treatment can prevent complications and have a good prognosis.

==Possible complications==
[[PID]] [[infections]] can cause [[scarring]] of the [[pelvic]] [[organs]], possibly leading to:
*[[Chronic]] [[pelvic]] [[pain]]
*[[Ectopic pregnancy]]
*[[Infertility]]

==Prevention==
Preventive measures include:
*Get prompt treatment for [[sexually transmitted diseases]].
*Practice safer sex behaviors. The only absolute way to prevent an [[STD]] is to not have sex ([[abstinence]]). Having a sexual relationship with only one person (monogamous) can reduce the risk. Use a [[condom]] every time you have sex.
You can reduce the risk of [[PID]] by getting regular [[STD]] screening exams. Couples can be tested for [[STDs]] before starting to have sex. Testing can detect [[STDs]] that may not be producing symptoms yet.
All sexually active women ages 20 - 25 and younger should be screened each year for [[chlamydia]] and [[gonorrhea]]. All women with new sexual partners or multiple partners should also be screened.

==Videos==
===Patient Education===
{{#ev:youtube|lGuXF8vpujQ}}

==Sources==
http://www.nlm.nih.gov/medlineplus/ency/article/000888.htm
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[[Category:Patient information]]
[[Category:Gynecology]]
[[Category:Abdominal pain]]
[[Category:Sexually transmitted diseases]]
[[Category:Disease]]
[[Category:Infectious disease]]