Too many infections or diseases affecting the female reproductive organs are thrown into the toilet infection box in Nigeria. But pelvic inflammatory diseases are not a "toilet infection".

 

This condition happens when sexually transmitted bacteria spread from the vagina to the uterus and other parts of a woman's reproductive organs. 

 

Sadly, this condition is on the rise among women in Nigeria. Dr. Paul Ogoegbulem, a medical practitioner in Abuja, says, "PID affects millions of women each year. And it is witnessing an uptick in Nigeria as well as other countries". 

 

The risk is even higher in women who are in a polygamous relationship. One study of female patients in Nigeria showed that 90% of women with PID-causing bacteria were polygamous married patients.

 

Causes of pelvic inflammatory disease 

 

Besides having unprotected sex, bacteria can be introduced into your reproductive tract when the cervix barrier is disturbed. This can happen during menstruation, miscarriage, abortion, childbirth, or IUD insertion.

 

Some bacteria that can cause PID when introduced to the cervix are:

 

• Gonorrhea 
• Chlamydia infections 
• Staphylococcus
• E coli
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Symptoms of pelvic inflammatory disease 

 

Often, the symptoms of pelvic inflammation can be mild. And many women do not realize they have PID till they develop chronic pelvic pain or have trouble getting pregnant. 

 

Other women will experience the following symptoms:

 

• Pain in the lower abdomen and pelvis (mild or severe).
• Heavy vaginal discharge with an unpleasant odour.
• Pain during sex. 
• Bleeding after sex.
• Fever.
• Painful urination. 

 

The risk of pelvic inflammatory disease is still higher in certain women than in others. The risk of having PID is higher in women who:

 

• Have a history of STI or PID.
• Douche regularly.
• Have sex without condoms.
• Have sex with someone who has more than one sexual partner.
• Have multiple sexual partners. 
• Are sexually active below the age of 25.
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Diagnosis and treatment options 

 

At the doctor's office, a pelvic examination is usually made. A gynaecologist would check for tenderness in your uterus or surrounding reproductive organs like the fallopian tubes and ovaries. 

 

Other forms of examination that might be made are:

 

• A lab test to check for PID-causing bacteria in your fluid sample.

• Blood test for infections. 

• Ultrasound to picture your internal organs.
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After the diagnosis is complete and it is confirmed that you have PID, your doctor may recommend oral antibiotics for you to take over a course of two weeks. If the symptoms are not subsiding, your doctor might recommend intravenous antibiotics. 

 

In the extreme case that neither works nor an abscess have formed, laparoscopic surgery is performed to drain it. 

 

Effects of Pelvic inflammatory disease 

 

When left untreated, pelvic inflammatory disease can cause scar tissue or abscess. This can result in the following. 

 

Ectopic pregnancy

 

Pelvic inflammatory disease is, in fact, one of the major causes of ectopic pregnancy. Having PID can cause scar tissue to form in the fallopian tube. This will prevent a fertilized egg from making its way to the uterus.

 

In a study of 30,450 patients, patients with PID were more likely to develop ectopic pregnancy and preterm labour than those who didn't have PID.

 

Infertility 

 

The more times you have had a pelvic inflammatory disease and delayed treatment, the greater your risk of infertility. PID can permanently damage not just the fallopian tubes but the entire reproductive system.

 

After three episodes of PID, the infertility rate can climb up to 50%.

 

Tubo ovarian abscess

This pus-filled pocket or sac forms when an infection occurs in the fallopian tube and ovary. When a pelvic inflammatory disease is left untreated, pus formed from the vaginal or cervical infection can travel up to the uterus and into the space that holds your internal organs, where it forms a mass. This can quickly become a life-threatening infection.

 

Chronic pelvic pain 

Pelvic inflammatory disease can lead to long-term pain around your pelvis and lower abdomen. This menstrual cramp-like pain might be even more intense during ovulation and intercourse.

 

Although the possibility is low, pelvic inflammatory disease can spread beyond the reproductive organs and cause death.

 

According to an Italian registry, from the year 1999 - 2019, 140 of the 2500 registered PID patients died. And researchers estimate about 150 women die from pelvic inflammatory disease in the US.

 

Can you get pregnant with PID? 

 

This is probably the top question in the mind of many women after learning about pelvic inflammatory diseases. There is no black-and-white answer to this. 

 

Women who have had a pelvic inflammatory disease in the past are more likely to have infertility problems when compared to women who didn't have it.

 

The risk of infertility is higher in women who have had:

 

• Several bouts of PID
• Chlamydia infection turn to PID
• Delayed treatment for PIDs
• PID that affected their fallopian tube.
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Do not make conclusions before you speak with your doctor, though. A medical practitioner can help you make a definite diagnosis of the cause of infertility. And find a solution for your unique case. 

 

Better prevented than cured!

 

The phrase prevention is better than cure for pelvic inflammatory disease. If you get it once, it is more likely that you will have more episodes in future whether you contract an STI again or not.

 

This is because often, not all bacteria may clear from treatment. 

 

So protect your vagina and cervix from any form of bacteria. Be certain about the hygiene of any external objects that would be introduced to it, even if it is just your hands or sanitary products like tampons. 

 

Also, protect yourself from getting STIs/STDs. Remember to go for general check-ups regularly. Prevention is better than cure.