Overview of Pelvic Inflammatory Disease (PID) – Understanding Symptoms, Causes, and Treatments
Pelvic inflammatory disease (PID) is an infection of the reproductive organs, occurring when bacteria travels through cervix to the uterus and fallopian tubes. PID can cause infertility, ectopic pregnancy, chronic pelvic pain, tubal or ovarian abscesses, adhesions, peritonitis (infection of a silk-like lining that covers the abdominal organs) and perihepatitis (inflammation of the coating of the liver). In rare, severe cases, untreated PID can lead to death.
Pelvic inflammatory disease can be acute (meaning sudden, severe symptoms), chronic (long-term with less intense symptoms) or silent (no symptoms.)
With PID, the presence or lack of symptoms do not indicate how much damage the reproductive organs sustain. It’s possible to have no symptoms and have serious blockages and adhesions, leading to infertility. Some women will only discover they have PID after trying to conceive unsuccessfully or after experiencing an ectopic pregnancy.
According to the U.S. Centers for Disease Control and Prevention, more than 750,000 women experience an episode of acute PID each year. Up to 300,000 of these women are hospitalized for acute PID. Because many cases of PID are silent and involve no symptoms, and PID is often missed or undiagnosed, the actual number of cases of PID is likely higher.
You might not notice any symptoms of PID early on. But as the infection gets worse, you can have:
- Pain in your lower belly and pelvis
- Heavy discharge from your vagina with an unpleasant odor
- Bleeding between periods
- Pain during sex
- Fever and chills
- Pain when you pee or a hard time going
Call your doctor right away if you have any of these.
PID can cause serious problems if it’s not treated. For example, you might have trouble getting pregnant or have pain in your pelvic area that doesn’t go away.
In some cases, PID can bring on more intense symptoms, and you’ll need to go to the emergency room. Get medical help right away if you have:
- Severe pain in your lower belly
- Signs of shock, like fainting
- Fever higher than 101 F
Some of these also can be signs of other serious medical conditions, like appendicitis or an ectopic pregnancy (a pregnancy that happens in a fallopian tube outside the womb). You would need medical help right away for these as well.
Signs of an STI
Treating an STI right away can help keep you from getting PID. Symptoms of STI are a lot like those of PID. They include heavy discharge from your vagina with an unpleasant odor, pain when you pee, and bleeding between periods.
Call your doctor as soon as you notice any of these to lower your chances of PID.
PID is caused by sexually transmitted diseases (STDs). Common causes include chlamydia and gonorrhea. Chlamydia is a common cause of silent PID, which means many women do not know they are infected.
If you have an undiagnosed STD, your risk of PID is higher any time the cervix is open and infection can potentially enter the uterus. You have a higher risk of PID after childbirth, miscarriage, abortion, endometrial biopsy, IUD insertion, HSG and hysteroscopy, and artificial insemination.
While pelvic infection can be caused by bacteria besides STDs, this is rarely called PID. The symptoms and treatment, however, may be similar.
How Does It Cause Infertility?
Between 10% and 15% of women with acute PID become infertile. If a woman has multiple episodes of acute PID, her risk of developing infertility rises.
The most common cause of PID-related infertility is blocked fallopian tubes. The tubes typically become blocked from the adhesions caused by the inflammation, and the blockage is usually found closer to the ovaries than the uterus. When the blockage is near the ovaries, it’s more difficult to treat surgically.
PID may also cause hydrosalpinx. This occurs when a tube is blocked near the ovary and then dilates and fills with fluid. The presence of a hydrosalpinx can decrease the chances for successful IVF treatment.
Ectopic pregnancies can also be caused by PID-related damage. If you undergo surgery to repair tubal damage caused by PID, your risk of ectopic pregnancy will also be higher.
In rare cases, an especially acute infection may lead to an emergency hysterectomy.
In the past, some doctors treated chronic PID with hysterectomy, but this is being used less and less. If your doctor suggests a hysterectomy as a cure for chronic PID, you may want to get a second opinion before making a decision that will seriously impact your future reproductive possibility. See more about this below, under Treatments for PID.
Symptoms of pelvic inflammatory disease differ from person to person, depending on whether or not they are experiencing acute, chronic or silent PID.
The most common symptoms of PID is pelvic pain. Other symptoms include pelvic pain during intercourse, lower back pain, irregular menstrual bleeding, unusual vaginal discharge, problems with urination, flu-like symptoms, like fatigue, fever, chills, weakness or swollen lymph nodes; lack of appetite, diarrhea, and vomiting, and infertility.
Many of the symptoms can be mistaken for other diseases, including appendicitis, endometriosis or a urinary tract infection. It is important to be upfront with your doctor if you suspect you may have contracted an STD or you have other risk factors for PID, like a recent miscarriage, childbirth, abortion, or IUD insertion.
It’s not usual for chronic PID to go undiagnosed for months or years. If you’re experiencing regular pelvic pain or pain during intercourse, and your doctor has not been able to diagnose or treat the problem successfully, you may want to seek a second opinion.
Keep pushing until you find appropriate treatment for your symptoms. Your future fertility and overall health depend on it.
What are the complications of PID?
If PID isn’t treated, it can lead to serious health problems that are sometimes life-threatening. The infection may spread to other parts of your body. PID can increase your risk for ectopic pregnancy, which can be life-threatening. People with PID can experience chronic pain in their lower belly, and infertility.
The longer you have PID, the more likely it is that you’ll have dangerous long-term health problems and infertility. That’s why it’s really important to have any symptoms checked out by a doctor, and get tested regularly for STDs — the sooner, the better.
PID can be treated. But treatment might not be able to undo damage (like scarring) caused by long-term PID infections.
How can I prevent PID?
Getting tested for STDs is one of the best ways to prevent PID, because PID is usually caused by chlamydia or gonorrhea. Most people with chlamydia or gonorrhea don’t have any symptoms, so testing is the only way to know for sure if you have one of these infections.
Chlamydia and gonorrhea can be easily treated and cured with antibiotics — and the sooner you (and any sexual partners) get tested and treated, the lower your risk is for developing PID. You can also help prevent these and other STDs by having safer sex and using condoms every time you have sex.
And hormonal birth control does NOT prevent sexually transmitted infections, so even if you’re using birth control you’re at risk for STDs. So it’s a good idea to use a condom with your birth control to prevent STDs that can turn into PID.
Douching is generally not healthy for your vagina, and can cause irritation and infections. Douching may also lead to PID, because it pushes bacteria deeper into your body. So don’t douche!
PID is really common, and it’s easy to develop PID without knowing it. That’s why it’s so important to get tested for STDs and see a doctor if you notice any symptoms of PID.
How can I find out if I have PID?
The only way to know for sure if you have PID is to see a doctor. They’ll give you tests and talk to you about your symptoms and medical and sexual history. It’s important to be honest — PID can be mistaken for other infections, so doctors need all the facts to give you the right treatment before the infection gets worse. Don’t worry: they’re there to help, not judge.
Doctors can usually find out if you have PID by doing a pelvic exam. You may also be tested for chlamydia, gonorrhea, and other infections, because they often cause PID. Your nurse or doctor may take samples of urine, blood, and/or fluids from your vagina and cervix.
In some cases, your doctor might need to do other tests or procedures. These can include an ultrasound; endometrial biopsy (taking a small sample of tissue from the lining of your uterus); and laparoscopy (inserting a tiny camera through a small cut in your belly button to look at your reproductive organs).
Is there treatment for PID?
In most cases, antibiotics are used for pelvic inflammatory disease treatment. If you’re being treated for PID, make sure you:
- Take your medicine exactly the way the doctor tells you to. Finish ALL of your medicine, even if you feel better before it’s done.
- Take care of yourself!
- Rest in bed. You might need to stay in bed for several days if you have a serious infection.
- Drink lots of water, and eat healthy foods.
- Don’t douche or use tampons.
- If you’re in pain, you can take aspirin, ibuprofen (Advil), acetaminophen (Tylenol), or naproxen (Aleve). A heating pad may also help.
- Don’t have sex until you finish all of your medicine and your doctor says your infection is totally gone. When you do have sex, using condoms every time will help prevent infections that could cause you to get PID again.
- Tell your sexual partner(s) that you have pelvic inflammatory disease. Anybody that you’ve had sex with recently should get tested and treated if needed, even if they feel fine. If your partner doesn’t get treated, you can get PID again.
- Keep your follow-up appointments to make sure the treatment worked — even if your symptoms are gone.
If you’ve had PID for a long time or your infection is severe, it’s possible to develop health problems that require more treatment. You may need to have surgery to fix or remove parts of your reproductive organs.
Even though PID is curable, treatment might not be able to undo damage (like scarring or infertility) caused by chronic pelvic inflammatory disease. That’s why it’s so important to get treated as soon as possible.
Since PID is caused by a sexually transmitted disease, it is preventable. Unprotected sex with multiple partners increases your risk of getting PID. If you are not in a committed relationship with a partner who has already been tested for STDs, practicing safe sex by using male latex condoms and getting regular STD testing is essential.
IUD insertion can also lead to PID if you already have an STD. Testing and treatment for STDs prior to IUD insertion can greatly reduce your risk of infection.
Also, douching has been found to increase your risk of PID. Douching alters the natural flora and pH of the vagina, increasing your risk of vaginal infection. Douching also negatively impacts cervical mucus, which is important when trying to conceive.
Invasive fertility testing, like HSG and hysteroscopy, and fertility treatments that involve the cervix and uterus like insemination or IVF, can lead to PID if you have an undiagnosed STD. This is one reason why most fertility clinics conduct STD testing and vaginal cultures before conducting fertility testing and treatment.
If you’ve had unprotected sex that may have exposed you to an STD, and you are in the middle of fertility testing or treatment, be sure to tell your doctor so you can be retested.
Natural Therapies Help Clear PID Toxins and Strengthen Immune Defenses
If you have PID, you need to eliminate the infection. To do this, start with medical treatment from your doctor. You may not have expected to read that, but you will likely need a course of one or more antibiotics. For complete treatment, use your medications exactly as prescribed. After the infection is eliminated, it is then that a follow-up natural fertility program using natural therapies to cleanse toxins, improve immune defenses, and promote better circulation to the reproductive organs will be most effective.
Home remedies for Pelvic Inflammatory Disease
A natural treatment plan for PID can consist of various home remedies alongside the conventional treatment plan prescribed by doctors.
Do, however, be sure to consult your doctor’s PID treatment guidelines when designing your supplementary treatment plan. Here are the various ways in which you can help your body fight against PID and recover fully from the infection:
Diet rich in calcium and antioxidants
Consuming a healthy and nutritious diet is the first step in helping your body recover from bacterial infections responsible for PID.
You will want to consume foods that are rich in calcium, such as dark green leafy vegetables like spinach and kale, broccoli, beans, and almonds. Dairy products and milk are usually the best sources of calcium, but you may have to rely on plant sources if you happen to have an allergy to them.
You can access a wide range of antioxidants such as vitamins C and E, selenium, and carotenoids (e.g. beta-carotene, lycopene, lutein, and zeaxanthin) by consuming a wide variety of fruits and vegetables.
A Daily Multivitamin
Since high-doses of antioxidant supplements have been linked to health risks and may interact with certain medicines, it would be best to obtain antioxidants from natural substances.
If you are unable to obtain sufficient nutrients through your diet, however, you should rely on a daily multivitamin that contains vitamins A, B-complex, C, E, and minute quantities of minerals such as magnesium, calcium, zinc, and selenium.
Omega-3 Fatty Acids
Likewise, omega-3 fatty acids can also help to reduce inflammation. You can rely on fish oil capsules (1 to 2 capsules per day), or obtain omega-3 fatty acids from food sources such as flax seeds, chia seeds, salmon, beef, walnuts, tofu and sardine.
Omega-3 Fatty Acids Counters Inflammation
When you are injured in some way, may you have an infected wound or a splinter, you will notice the skin around your injury puff up and become warm and red. This is inflammation at work. Inflammation is your immune system working to correct a problem within your body.
Chemicals originating in white blood cells are released and make their way to the wounded or infected area in the body. The problem is that sometimes too much of this chemical is produced. When that happens, inflammation starts to affect healthy tissue.
Inflammation can sometimes even dangerously affect your organs. This usually happen as result of an autoimmune disease. The organs most likely to be affected are the kidneys, lungs and heart. Some signs to look out for are;
- Shortness of breath
- Kidney failure
- Fluid retention
Omega-3 is good for countering excess inflammation, especially when coupled with certain anti inflammatory medications.
Diet can be very beneficial when it comes to avoiding excess inflammation. Some foods to avoid are Omega-6 rich foods, highly processed carbohydrates and high-sugar foods.
A lack of sleep, regular exercise and high levels of stress can also negatively contribute to excess inflammation
Bee Propolis is a resinous mixture of tree sap, tree buds, tree leaves, and other botanical sources that the bees make to seal small openings in their hives. Larger openings are sealed with beeswax. Once again the chemical constituents of bee propolis vary by region because different plants live in different climates.
Studies on “typical” northern temperate propolis showed it to contain 50% vegetable balsams, 30% waxes, 10% essential oils, and 5% pollen. This northern region propolis is mainly derived from conifers and poplars.
A study published in Fertility and Sterility (2003;80:S32) showed that 60% of women with endometriosis-related infertility who took 500mg of bee propolis twice a day for 9 months became pregnant as opposed to 20% in the placebo group. Endometriosis pain, scar tissue, and adhesion formation are thought to be triggered by an inflammatory response. Bee propolis has been shown to be extremely anti-inflammatory which may reduce endometriosis.
It appears more research on the benefits of bee propolis are in order. Because preliminary studies suggest its highly anti-inflammatory properties, it may be greatly beneficial for fertility issues that may trigger inflammation responses such as uterine fibroids, endometriosis, ovarian cysts, blocked fallopian tubes, Pelvic Inflammatory Disease (PID), and reproductive trauma or surgeries.
Bee propolis may also contain immunomodulating properties. This may be beneficial for autoimmune related fertility issues, such as recurrent miscarriage due to an immunological response (mothers body attacks and rejects the fetus), autoimmune-related Premature Ovarian Failure and antisperm antibodies. Antisperm antibodies can be present in women as an allergic reaction to sperm, thus triggering an immune response to attack the sperm. These antisperm antibodies can also be present in men as well, where their bodies attack their own sperm. This is commonly seen in up to 70% of men who get a vasectomy.
Probiotic supplement (which contains Lactobacillus acidophilus)
Probiotic supplements promote the growth of beneficial bacteria to help overcome digestive disorders. Forever Living comprehensive Probiotics formula offers a balanced spectrum of healthy bacteria to line every inch of your digestive tract for optimum intestinal health.
Replenish Beneficial Bacteria For Digestive Health:
- Most complete beneficial bacteria formula to maintain digestive health and maximize nutrient absorption
- Produces immune factors and protects from harmful bacteria in foods, such as E. Coli
- Consumes old fecal matter and enhances regularity
- May delay the development of allergies
- Restore the balance of microflora, which may help prevent vaginal and urinary infections
- Now stabilized to maintain full potency for 18 months at room temperature–even longer when refrigerated
Probiotics have some proven benefits for women’s health and many more that need to be studied further. They help restore a healthy microbial balance in your reproductive system and may be able to help you prevent and treat infections, such as bacterial vaginosis, urinary tract infections, sexually transmitted infections, and pelvic inflammatory disease.
Bromelain (Ananus comosus)
Taking a 40 mg standardized extract thrice per day can help your body cope with the pain and inflammation. Bromelain can be also be consumed by eating pineapple. However, do consult your doctor if you are also taking blood-thinning medication such as aspirin.
Reishi mushroom (Ganoderma lucidum)
Reishi mushroom will also be helpful in boosting immunity and fighting inflammation. Take a 150 to 300 mg extract 2-3 times each day. But as with bromelain, do consult your doctor if you are also taking blood-thinning medication such as aspirin.
Garlic has long been known for its anti-bacterial properties and is an effective home remedy to treat bacterial caused vaginal discharge and vaginitis. It is also an effective home remedy for pelvic inflammatory disease.
For treatment of PID, you can either consume one or two raw garlic cloves along with a glass of water the first thing in the morning on an empty stomach. Or you can add as much garlic as you can stomach to your cooking.
For a topical application, crush several cloves into a fine paste and gently fry in vegetable oil until golden. Strain the garlic oil and allow to cool.
When cool, soak cotton balls in the oil and place in the vagina. Remove the balls, leaving the oil behind and allow to rest for a few hours before rinsing with water. Repeat every day until the infection passes.
Ginger is another herbal remedy that has strong antimicrobial properties. It can be used for a variety of health issues including the problems of unwanted discharge from the vaginal area. Its anti-bacterial properties will also help fight the PID infection
Get two teaspoons of dry ginger powder, add it to 250 ml of water, and boil it till the water is reduced to half. Drink the solution on a daily basis until the infection has cleared.
Since turmeric has antiseptic and anti-inflammatory properties, its powder is can also be used to treat bacterial infections of the vagina, excess vaginal discharge and in particular, PID.
Take one tablespoon of turmeric powder and gently simmer the powder in some milk. Drink at least one glass a day.
Traditionally turmeric paste is applied to wounds due to its wound healing activity and also due to its ability to clear sepsis. Turmeric acts as a strong anti-microbial agent :
- Antibacterial agent: Staph infection, E.coli, Psuedomonas species, H.pylori
- Antiviral agent: HPV, HIV, Influenza virus, Herpes simplex virus
- Antifungal agent: Candida species, Trichophyton species
What we understand from this is that turmeric and curcumin have a broad spectrum inhibitory action against microbes which suggests that it could be useful in treating most genital infections.