Pelvic Inflammatory Disease Definition, Reason, Symptoms, Treatment & Prevention
Definition
Pelvic inflammation or pelvic inflammatory disease (PID) is an infection or inflammation that attacks the female reproductive organs.
This condition can occur in the uterus, fallopian tubes (the tube that connects the ovaries to the uterus), ovaries, or even all of them.
If not treated properly, pelvic inflammation can cause long-term complications in the female reproductive organs, including impaired fertility, chronic pelvic pain, or ectopic pregnancy (the fetus is outside the uterus).
Symptom
In the early stages, the symptoms of pelvic inflammation are often not noticed. Some women don’t even complain of any symptoms.
However, over time, pelvic inflammatory infection can cause signs and symptoms such as:
- Severe pain in the pelvic area and lower abdomen
- Abnormal vaginal discharge, such as smelling bad until it changes color
- Menstruation becomes longer and more volume
- Unbearable pain during menstruation
- Bleeding outside the menstrual cycle or after sexual intercourse
- Fever
- shivers
- Pain during intercourse
- Pain during BAK
- Feeling tired, weak
Reason
The most common cause of pelvic inflammation is infection with the bacteria Neisseria gonorrhoeae and Chlamydia trachomatis.
Apart from these bacteria, pelvic inflammation can also occur due to other pathogenic germs, such as Gardnerella vaginalis, Trichomonas vaginalis, Herpes simplex virus-2 (HSV-2), and Mycoplasma genitalium.
The bacterial infection in the vagina then spreads to the cervix, then to the internal reproductive organs such as the uterus, fallopian tubes and ovaries.
Risk Factors
Not all women are susceptible to pelvic inflammatory disease. Conditions that make a person more susceptible to the disease are:
- Sexually active and under 25 years of age
- Multiple sexual partners
- Having sex without a condom
- Douching
- There is a previous history of pelvic inflammation
- Have had a sexually transmitted infection
- Using an IUD ( intrauterine device ) or spiral contraception
Diagnosis
In determining the diagnosis of pelvic inflammation, an obstetrician and gynecologist will carry out a series of examinations as follows.
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Medical Interview
In a medical interview, the doctor will ask a series of questions.
For example, what symptoms have appeared, since when the complaint was felt, to risk factors that may be related, for example unsafe sexual intercourse or use of certain contraceptives.
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Physical examination
In addition to medical interviews, the doctor will carry out a physical examination, which can be in the form of checking the pelvis to assess cervical fluid, cervical tenderness, uterine (uterus) tenderness, adnexal tenderness, or whether there is a mass.
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Lab Examination
From the physical examination, the doctor will simultaneously do a swab or swab test of cervical fluid to be examined in the laboratory. This aims to detect what type of bacteria is causing the infection.
In addition, laboratory tests such as blood tests and urinalysis are also performed to detect the presence or absence of other infections, including sexually transmitted infections and urinary tract infections .
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Ultrasound examination
Ultrasound examination is one of the examinations in the diagnosis of pelvic inflammation to see whether there are abnormalities in the reproductive organs, including assessing whether there are complications such as abscesses in the reproductive organs.
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Advanced Examination
If the doctor does not get a clear picture with the examination carried out, further examinations such as laparoscopy and endometrial biopsy can be done.
Laparoscopic surgery is a procedure that uses small instruments that are placed through a small incision in the abdomen near the navel. Instruments that will later be used to see the condition of the internal reproductive organs more clearly.
An endometrial biopsy examination is performed to assess whether there is infection and inflammation. In this procedure, the doctor will use small instruments to be inserted into the uterus and remove a small amount of endometrial tissue for examination.
Treatment
Treatment of pelvic inflammation aims to reduce acute symptoms that appear, treat infections, and prevent complications.
Here’s how to treat pelvic inflammation that doctors generally give:
1. Drugs
To treat infections due to pelvic inflammation, the doctor will give antibiotics. According to the CDC, the treatment of pelvic inflammation in an outpatient setting is:
- Doxycycline
- Administration of metronidazole
If the pelvic inflammation is severe, the patient needs to be hospitalized because the drug is given by injection or infusion. The drug options given are:
- Cefoxitin plus doxycycline
- Cefotetan plus doxycycline
- Clindamycin plus gentamicin
Other drugs, such as paracetamol to treat fever and ibuprofen to treat pain due to pelvic inflammation, can be given.
2. Operation
Surgical procedures can be performed if complications arise in the form of abscesses in the reproductive organs. This action is useful for preventing rupture of an abscess or cleaning an abscess that has ruptured.
Until the doctor says the treatment has been completed, people with pelvic inflammation are advised not to have sex at all.
In order for pelvic inflammatory disease treatment to be more effective and prevent the recurrence of pelvic inflammatory disease, sexual partners must also be examined and treated.
Prevention
There are several ways you can do to prevent pelvic inflammation, namely:
- Have sex with only one person and do not change partners
- Use a condom when having sexual intercourse
- Examination with your partner to determine whether there is a sexually transmitted infection
- Do not douching, it is better to clean the female area from front to back
- Consult with your doctor regarding the selection of contraception
Complications
Pelvic inflammation that is not treated can cause several complications in the reproductive organs. This can result in permanent damage to the reproductive organs.
Some of the complications of pelvic inflammation include:
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Chronic Pelvic Pain
Chronic pelvic pain occurs in almost 1/3 of women who have pelvic inflammation. The pain experienced is related to inflammation, the presence of scar tissue, or even adhesions (adhesions) due to the infection that occurs.
It is strongly suspected that chronic pelvic pain is related to recurrent or incomplete pelvic inflammation in its treatment.
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Ectopic Pregnancy
One of the causes of ectopic pregnancy is pelvic inflammation. This occurs because of scar tissue in the fallopian tubes.
The presence of scar tissue eventually interferes with the fertilized egg’s journey to attach to the uterine wall.
Because it can’t attach to the uterus, the fertilized egg attaches where it shouldn’t, namely in the fallopian tube.
Heavy bleeding due to an ectopic pregnancy can cause a woman to go into shock and lose her life.
Therefore, an ectopic pregnancy is a condition that requires immediate treatment.
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Infertility Problems
Damage to the reproductive organs due to pelvic inflammation can cause infertility or infertility. To prevent this, the treatment of pelvic inflammatory disease needs to be done as soon as possible until it is complete.
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Abscess in the Fallopian Tubes (Ovary Tubes) and Ovary (Ovary)
The formation of pockets filled with pus or abscesses in the reproductive organs can also occur. Most often, abscesses occur in the fallopian tubes and ovaries but do not rule out the possibility of appearing in other reproductive organs such as the uterus.
Abscesses must be treated immediately, if left unchecked, the infection can spread throughout the body to become septic and life-threatening.
When to See a Doctor?
Immediately go to the doctor if the above symptoms and characteristics of pelvic inflammation appear, such as:
- Bleeding outside the menstrual cycle or after sexual intercourse
- High fever to chills
- Abnormal vaginal discharge
- Severe lower abdominal and pelvic pain