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Pelvic inflammatory disease

Pelvicinflammatorydisease(PID)occurswhenaninfectionspreadsfromthevaginatothecervix, endometrium(liningoftheuterus)andfallopiantubes.Theinfectionisusuallysexually transmitted.Itcanalsooccurafteraruptured(burst)appendixorabowelinfection. Somesurgicalprocedures,suchasabortionorinsertionofanintrauterinedevice(IUD),canleadto PID.Theinfectionusuallyoccursinthreestages-thecervixisinfectedfirst,followedbythe endometriumandthenthefallopiantubes. The silent epidemic PIDisoftencalledthesilentepidemicbecauseitiscommonamongsexuallyactivewomenbut doesnotalwayscausesymptoms.About10,000womeninAustraliaaretreatedforPIDinhospital eachyear.About10to30timesthatnumberaretreatedasoutpatients.Womenaged20to29 havethehighestreportedincidenceofPID. Signs and symptoms that can occur SignsandsymptomsofPIDthatmayoccurinclude: Lowerabdominalpainortenderness Menstrualdisturbances Burningpainwhenurinating(dysuria) Achangeinsmell,colouroramountofvaginaldischarge Deeppainduringsexualintercourse Fever.

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Female infertility can be a devastating consequence ScarringandblockageofthefallopiantubesisthemostfrequentlongtermcomplicationofPID. Infertilityoccursbecausethefertilisedeggcannotpassthroughthetubetotheuterus: OneepisodeofPIDdoublestheriskoftubalinfertility. Theriskoffallopiantubeblockagerisesto75percentafterthreeormoreepisodesofPID. Theriskofectopicpregnancy(wherethefoetusdevelopsoutsidetheuterus)afterone episodeofPIDisincreasedsevenfold.

Chlamydia and gonorrhoea are the most common causes of PID Chlamydiaisresponsiblefor50percentofPIDcaseswhilegonorrhoeaisthecausein25percent ofcases.TheriskoffallopiantubeblockageisslightlyhigherforPIDcausedbygonorrhoea.Both arebacterialinfectionsandaresexuallytransmitteddiseases(STDs).Non-specificurethritis,the mostcommonSTDamongmen,ismostoftencausedbychlamydia. Diagnosing PID Yourdoctorwilltestforpossiblecauseslikechlamydiaandgonorrhoea.Insomecases, laparoscopyisrequiredtocorrectlydiagnosePID.Laparoscopyinvolvesinsertinganendoscope (whichislikeasurgicalvideocamera)intotheabdomentoviewthereproductiveorgans. Without treatment, chronic pain may develop Chronicpainand,sometimes,severedisabilitycanoccurifPIDisnottreated.Thisisusuallydueto extensivescarring.Treatmentinvolves: Antibioticsthatareactiveagainstabroadrangeoforganisms-amoxycillin(atypeof penicillin)anddoxycyclineareusuallyprescribed. Testingmalepartnersandtreatingthem,ifnecessary-symptomsmaybemildornonexistentinmen.

Pelvicinflammatorydisease

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Avoidinggenitalsexualcontactuntilthetreatmentiscompleteandanegativetestresultis obtained. Surgerytoremovescartissue.

WomenwithsevereepisodesofPIDmustbehospitalisedfortreatment. Protecting yourself from PID TohelppreventthetransmissionofthebacteriathatcancausePID: Usecondomsduringvaginaloranalintercourse. Usecondomsifyouhaveanintrauterinedevice(IUD)inserted.

ThestringattachedtotheIUDcanactasawickforaninfectionfromthevaginaintothecervix andbeyond.WomenwhouseIUDsare1.5timesmorelikelytodevelopPID.Thismaynotapplyto thenewprogesteroneIUD(Mirena). Use of the oral contraceptive pill may help Sexuallyactivewomenwhoareonthepillappeartohaveonlyone-thirdtheriskofPIDcompared towomennotonthepill.However,thisdatawascollectedinthe1970sanditisnotknownifthe lower-dosepillsmorecommonlyusednowhavethesameprotectiveeffect,althoughitislikely thattheydo. Where to get help MelbourneSexualHealthCentreTel.(03)93416200or1800032017orTTY(forthe hearingimpaired)(03)93478619 Yourdoctor NurseonCallTel.1300606024forexperthealthinformationandadvice(24hours,7 days)

Things to remember

PIDisknownasthesilentepidemicbecauseitiscommonandoftendoesnotcause symptoms. Thesexuallytransmitteddiseaseschlamydiaandgonorrhoeaarethemostcommoncause ofPID. PIDcanleadtoscarringofthefallopiantubesandinfertility.

This page has been produced in consultation with, and approved by:

RoyalWomen'sHospital

Copyight 1999/2009StateofVictoria.ReproducedfromtheBetterHealthChannel(www.betterhealth.vic.gov.au)at nocostwithpermissionoftheVictorianMinisterforHealth.Unauthorisedreproductionandotherusescomprisedinthe copyrightareprohibitedwithoutpermission. ThisBetterHealthChannelfactsheethaspassedthrougharigorousapprovalprocess.Forthelatestupdatesandmore informationvisitwww.betterhealth.vic.gov.au.

Pelvicinflammatorydisease

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