Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is the term used to describe an infection of any of a woman's pelvic organs, including the uterus, ovaries, or fallopian tubes. The disease has be-come increasingly common in the United States, affecting an estimated one million women each year. If not treated promptly, PID can lead to serious complications, including infertility and, in rare cases, death.

PID can be either acute or chronic. Acute PID comes on suddenly and is apt to be more severe. Chronic PID is a low-grade infection that may cause only recurrent mild pain and some-times backache. Some women with PID have no discernible symptoms and discover they have had the infection only when they later attempt to get pregnant and discover that they are infertile.

Causes

PID is caused by bacteria from contaminated se-men that ascend from the vagina into the normally sterile uterus. Most cases of PID used to be caused by gonococcus, the organism responsible for the sexually transmitted disease gonorrhea, or by chlamydia. Recently, researchers have linked other organisms to PID, including some commonly found in the vagina and else-where in the body. The risk of PID increases after childbirth, miscarriage, abortion, the insertion of an intrauterine device (IUD) for contraception, or certain operations, such as a dilation and curettage (D and C), all of which cause the cervix, or opening to the uterus, to widen temporarily. Douching also increases the risk of PID.

Diagnostic and Test Procedures

Your doctor will give you a pelvic examination. If there is evidence of an infection, he or she will use a cotton swab to obtain a sample of pus from in-side your vagina. The sample will be analyzed to determine which organism is causing the infection. Sometimes a laparoscopic examination - a surgical procedure in which a special viewing instrument is inserted into the abdominal cavity-is necessary for an accurate diagnosis. Your doctor may also use ultrasound to help with the diagnosis.

Treatment

Because PID can lead to serious complications, such as infertility, it must be treated with conventional antibiotics. Alternative therapies may be used, however, to complement the antibiotics and to help with recovery and prevention.

Conventional Medicine

Your doctor will prescribe one or more oral antibiotics, such as tetracycline, erythromycin, or doxycycline, to clear up the infection. You may be treated on an outpatient basis, but if you are pregnant or have severe symptoms or if your case presents other complicating factors, you may be hospitalized and given the antibiotics intravenously. If you have an IUD, your doctor will remove it. Until the PID is eradicated, you should avoid intercourse, which can cause the pelvic organs to move, spreading infected pus.

If your infection is chronic or recurrent and does not respond to oral antibiotics, your doctor may order intravenous antibiotics. When pelvic abscesses have developed, even intravenous antibiotics may not work; it may then be necessary to operate and drain the abscesses. If your pain is persistent and does not respond to other treatments, your doctor may recommend pelvic surgery to remove or repair infected tissue. Sometimes it is possible to spare one ovary, thus preventing premature menopause, and still get relief from the pain. Discuss this possibility with your doctor.

Alternative Choices

Use alternative methods during or after conventional antibiotic treatment to speed recovery and help prevent recurrences. To relieve the pain of a PID infection, for example, use castor-oil packs or get acupressure or acupuncture treatments from an experienced practitioner.

Herbal Therapies

To help fight PI D infection, herbalists recommend echinacea (Echinacea slap.) or calendula Calendula officinalis). Both these herbs are believed to have antimicrobial properties. Blue cohosh (Caulophyllum thalictroides) and false unicorn root (Chamaelirium luteum), which are prescribed general tonics for the female reproductive organs, are also recommended. You may take these herbs in either tea or tincture form.

Nutrition and Diet

To strengthen your immune system and help speed your recovery, eat plenty of whole (unprocessedi foods, especially fresh fruits and vegetables.

Vitamin supplements may also enhance your immune system. Take vitamin A (10,000 IU daily), vitamin C (500 to 2,000 mg daily), and vita-min B complex (50 mg three times a day).

Prevention

Use barrier contraception (condoms, diaphragm, or a cervical cap with spermicides).

Avoid putting anything in your vagina for two to three weeks after an abortion, a miscarriage, or a D and C and for six weeks after childbirth. This means no intercourse, no douching, and no tampons. You should also avoid bathing and swimming during this period; take showers or sponge baths instead.

Do not use an IUD. Women wearing an IUD are three to five times more likely to get PID than those not wearing one, especially if they have more than one partner.

If you have a history of pelvic infections or have several sexual partners, use barrier methods of contraception and avoid inter-course during your menstrual period. The cervix-the opening to the uterus-widens during menstruation to allow blood and uterine tissue to flow out.

Get prompt treatment for any sexually transmitted disease.

Submitted By

Muniruzzaman Md
The author is a gynacologist practicing in New York.

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