Pelvic Inflammatory Disease (PID) and Chronic Pelvic Pain

Pelvic inflammatory disease is an infection of the female reproductive organs, including the uterus, fallopian tubes and/or ovaries. Pelvic inflammatory disease symptoms may include:

• abdominal or pelvic pain
• fever
• yellow or green vaginal discharge with foul odor
• pain during intercourse
• pain when urinating
• abnormal bleeding

Some women with pelvic inflammatory disease may have no symptoms at all, though most experience abdominal and pelvic pain to some degree. PID can lead to chronic pelvic pain if left untreated.

Pelvic inflammatory disease is caused by a bacterial infection that starts in the vagina and travels up to the reproductive organs. Though it can be caused by many different types of bacteria, it is commonly linked to the STDs gonorrhea and Chlamydia. PID is most common in sexually active women under the age of 35, and it is rare after menopause.

Most cases of pelvic inflammatory disease can be treated on an outpatient basis with a regimen of antibiotics. However, hospitilization may be necessary if:

• you are very ill, with fever, nausea and vomiting or dehydration
• a mass or tumor is suspected
• you are pregnant
• antibiotics have not been effective
• the need for emergency surgery cannot be ruled out (example: suspected appendicitis)

Pelvic inflammatory disease often causes pelvic pain, and some cases can lead to chronic pelvic pain if left untreated for too long. The infection of PID can cause scarring in and around the reproductive organs, which may require surgical intervention. Unfortunately, surgery to remove scarring caused by pelvic inflammatory disease does not always reverse chronic pelvic pain.

The best treatment for chronic pelvic pain caused by pelvic inflammatory disease is to take precautions against STDs and other bacterial infections. If you suspect you have PID, you should seek treatment as early as possible.

Hospitalizations and rates of PID have declined in the last decade, presumably due to more comprehensive screening and treatment of sexually active young women with these STDs. So, particularly if you are a young woman, you are encouraged to see your gynecologist and get tested for this often silent cause of infection that can go on to PID when left untreated.
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_Sources:

_{Centers for Disease Control and Prevention. Pelvic Inflammatory Disease - CDC Fact Sheet. Accessed 8/17/09. http://www.cdc.gov/std/PID/STDFact-PID.htm}

_{The Merck Manuals Online Medical Library. Pelvic Inflammatory Disease (PID). Accessed 8/17/09. http://www.merck.com/mmpe/sec18/ch246/ch246c.html}