Despite the availability of advanced medical facilities, more than one million women are affected by Pelvic Inflammatory Diseases (PID) involving infection in the reproductive system like ovaries, fallopian tubes, uterus and cervix.
The common cause of pelvic inflammation is gonococcal infection and chlamydia, which ranges from 10 per cent to 40 per cent. If not treated properly and preventive steps for re-occurrence are not taken on time, it can lead to infertility, ectopic pregnancy and chronic pelvic pain.
Dr Roya Rozati, senior infertility specialist, explains how PID is a growing concern in reproductive women and why it is important to address it on time.
What are pelvic inflammatory diseases? What is the incidence of these diseases in India?
Pelvic Inflammatory Disease (PID) is a spectrum of infection and inflammation of the upper genital tract organs typically involving the uterus, endometrium, fallopian tubes, ovaries, pelvic peritoneum and surrounding structures. The incidence of pelvic infection is on the rise in India due to the rise in sexually transmitted diseases. The incidence varies from 1 to 2 per cent, per year among sexually active women. About 85 per cent are spontaneous infection in sexually active females of reproductive age. The remaining 15 per cent infections are due to ‘organisms ascend up’, which could be due to the spread of the micro-organisms from the cervical canal to the continuous pelvic structures.
Do improper miscarriages, self-prescribing anti-abortion pills and missing regular check-ups lead to these infections?
An improper abortion or miscarriage is found to retain conception parts in the body. This can lead to the growth of bacteria and women who are moderately or severely anaemic will have further blood loss. All these factors increase the chance of infection and the risk of affecting the complete reproductive system. PID is one of the most serious infections seen in infertility centres, family planning units, post-natal cares and sterilisation facilities in India. More and more young women in the reproductive age group are coming with this problem.
What are the tell-tale signs once the infection sets in?
Severe pain in the right part of the abdomen, pain during urination, burning sensation and foul-smelling discharge are some of the signs that women must look out for.
What are the treatment options?
It is treated with medication such as antibiotics. It is important to maintain proper vaginal hygiene and ensure that the course of medicines is completed. We often find that women do not take the complete set of medicines and there are cases of relapse within a few months due to sexual activity. Surgery might be needed in severe cases.
Though there is a very good understanding of the disease in the medical fraternity along with the availability of diagnostic tools like ultrasound scans and wide range of medicines, this condition continues to be a health hazard.
Are ectopic surgeries caused due to PID?
Yes. The infection affects the reproductive organs due to which there is pregnancy outside the uterus. PID is one of the causes for this complication of pregnancy where the embryo attaches outside rather than inside the uterus.
How can women prevent PID?
Women must use condoms, limit sexual partners, get tested for sexually transmitted diseases which will help them prevent PID.
Symptoms of PID
Patients with acute PID present with a wide range of non-specific clinical symptoms. These symptoms usually appear at the time and immediately after menstruation:
- Pain in the lower abdomen and in the pelvic region. In case of gonococcal infection there will be acute pain for three days. In case of chlamydial infection there will be pain for five to seven days.
- Fever and headache
- Irregular and excessive vaginal bleeding
- Abnormal vaginal discharge which can also smell foul
- Nausea and vomiting
