What is it about ?
Pelvic inflammatory disease (PID) is inflammation located in the small pelvis (pelvis) of women, particularly in the uterus, fallopian tubes and / or ovaries. The cause is almost always a bacterial infection. In the majority of cases, the culprit is a sexually transmitted infection (STI), such as chlamydia infection or gonorrhea. But many other bacteria can also be involved. Several bacteria are often present at the same time. The infection rises from the vagina and enters the uterus through the cervix.
Left untreated, PID can lead to infertility. It also increases the risk of ectopic pregnancy (or ectopic pregnancy).
What is its frequency?
The disease mainly affects young women of childbearing age. STIs have been gaining ground in recent years: Chlamydia is the most frequently diagnosed STI in Belgium: 6,788 cases in 2016 compared to 988 cases in 2002. Chlamydia infection is mainly contracted between the ages of 15 and 34 years old and is almost twice as common in women as in men. The gonorrhea, on the other hand, affects men more (three times more often), mainly between the ages of 20 and 50 years. Women are more often diagnosed at a younger age. Both infections are more common in young gay men.
How to recognize it?
PID typically begins after menstruation or after a procedure (e.g. placing a IUD). The intensity of symptoms can vary widely, ranging from almost imperceptible to severe. Most often, it is manifested by pain in the lower abdomen, white discharge and fever. Sometimes it is irregular bleeding between periods. The person may feel a burning sensation when they urinate.
As the infection spreads to the uterus, fallopian tubes, and ovaries, symptoms increase over time. Stomach aches are aggravated by vibrations and shocks, in the car for example.
There may also be general signs of infection such as fever, chills, lack of appetite, and feeling unwell.
How is the diagnosis made?
The doctor will always start by asking you how the complaints started and how they evolved:
- Do you have fever ?
- Where exactly did you hurt?
- Do you have any bleeding between periods?
- Have you recently had an IUD inserted?
- Have you recently given birth?
He will also be particularly interested in the possibility of an STI:
- Have you had unprotected sex with one or more partners?
- Have you had unprotected sex with a new partner?
- Have you had unprotected sex with someone who had an STI?
- Does your partner have other sexual partners?
Then the doctor will perform a standard pelvic examination and, if necessary, a smear. If he sees a purulent discharge from the cervix, he will take a sample for analysis. He will also do a pregnancy test and take a sample of blood and urine, which he will send to the laboratory. If in doubt, he will refer you to the gynecologist for further examinations (eg ultrasound).
What can you do ?
Until you are in a stable relationship, it is best to always use a condom. If you have any signs of infection, let your partner (s) know and ask them if this is also their case. It may be helpful to take a pregnancy test. Take your temperature every day. Avoid strenuous efforts until the severe stomach pains disappear.
What can your doctor do?
Treatment involves giving different (usually 3) types of antibiotics simultaneously for 14 days. A follow-up visit is scheduled after 2 days to assess the effect of the treatment. The IUD can optionally be removed. The doctor will also invite your sexual partner (s) for an examination, even if they have no symptoms. If they have an STI, they will also be put on treatment. If the result of the treatment is insufficient, you will be referred to your gynecologist.
Want to know more?
- What are STIs? (video) – LoveAttitude
- Modes of transmission of STIs – Depistage.be
- Protecting yourself against STIs – PPS – AIDS prevention platform
Are you looking for more specialized help?
- Approved family planning centers in Wallonia and Brussels – LoveAttitude
- Testing centers – PPS – AIDS prevention platform