Pelvic Inflammatory Disease (PID)

What it is

Pelvic inflammatory disease (PID) is an infection that ascends from the vagina and cervix to the uterus, fallopian tubes and ovaries. It is most often caused by untreated STIs, such as chlamydia and gonorrhea, but can also occur after gynecological procedures or due to bacteria from the vaginal flora itself. Symptoms include lower abdominal pain, foul-smelling discharge, fever, pain during intercourse and bleeding outside the menstrual period — although some cases have few signs. Diagnosis is clinical, supported by laboratory tests and ultrasound. Antibiotic treatment should begin as soon as possible, to reduce the risk of complications such as abscesses, chronic pelvic pain, ectopic pregnancy and infertility. More severe cases may require hospitalization. The sexual partner also needs to be assessed and treated.

Most common symptoms

• Pain in the lower abdomen, on one or both sides
• Discharge with altered odor or color
• Fever and malaise
• Pain during intercourse
• Bleeding outside your period or after intercourse
• Pain or burning when urinating
• Mild or absent symptoms in some cases

Causes and risk factors

• Untreated chlamydia and gonorrhea
• Bacteria from the vaginal flora itself, as in vaginosis
• Intercourse without a condom and multiple partners
• A previous episode of PID
• Recent gynecological procedures, in specific situations
• Vaginal douching

How it is diagnosed

The diagnosis of PID is essentially clinical and should not be delayed. At the consultation, your gynecologist assesses the pain, fever, discharge and sexual history, and performs a gynecological exam, in which pain on movement of the cervix and tenderness of the uterus and adnexa are important signs. Blood tests, testing for chlamydia and gonorrhea, a urine test and a pregnancy test complement the assessment. Transvaginal ultrasound is ordered to identify abscesses or fluid collections in the fallopian tubes and ovaries.

How we treat it at Femi Saúde

Antibiotic treatment should begin as soon as PID is suspected, without waiting for all test results, to reduce the risk of complications such as abscesses, chronic pelvic pain, ectopic pregnancy and infertility. Femi Saúde's gynecology team prescribes regimens that cover the most common agents, with reassessment within a few days to confirm improvement. The sexual partner is evaluated and treated, and abstinence is recommended until treatment is complete. Cases with high fever, vomiting, an abscess or pregnancy may require hospitalization and intravenous antibiotics; abscesses that do not respond may need drainage or laparoscopy. Follow-up continues until complete resolution.

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