Pelvic inflammatory disease is an illness that every woman should be aware of. However, health experts say that at times, it might not show signs and symptoms, but it is dangerous and can lead to infertility or worse. Dr Raoul Kabadi Gizenga at Hôpital La Croix du Sud (HCS), Remera says, pelvic inflammatory disease (PID) is simply an infection of a woman’s reproductive organs including the uterus, cervix, ovaries and the fallopian tubes. PID is caused by bacteria from sexual transmitted infections. Dr Iba Mayele, an obstetrician gynaecologist at Clinic Galien, Kimironko, explains that pelvic inflammatory disease occurs when sexually transmitted bacteria spreads from the vagina to the womb. He says, many types of bacteria can cause PID but gonorrhoea or chlamydia infection are the most common; these microbes can enter the reproductive tract anytime the barrier created by the cervix is disturbed. This can happen after childbirth, miscarriage or abortion. Mayele stresses that several different types of bacteria can cause PID, including the same bacteria that causes the sexually transmitted infections (STIs), gonorrhoea and chlamydia. RISK FACTORS Gizenga explains that someone who has had an STI before, girls who have sex before 25 years of age, intercourse with more than one partner, a partner who has other sexual partners, or unprotected sex, are at higher risk of PID. SIGNS AND SYMPTOMS “Many women may not know they have PID due to lack of signs or symptoms, but whenever someone experiences a heavy vaginal discharge with a bad smell, painful sex, pain in the lower abdomen or painful urination, it is evident that the person could be having PID,” he says. Mayele notes that abnormal uterine bleeding, especially during or after intercourse, or between menstrual cycles, pain or bleeding during intercourse sometimes fever with chills, could be an indicator of PID. WHEN TO SEE THE DOCTOR If a person is having severe pain in the lower abdomen, nausea and vomiting, fever, with a temperature higher than 101 F (38.3 C), a foul vaginal discharge, painful urination or bleeding between menstrual cycles—which can be associated with a sexually transmitted infection, Mayele says, it is advisable to see the doctor. COMPLICATIONS Gizenga notes that PID might damage the reproductive organs and cause infertility, can lead to an ectopic pregnancy, where the scar tissue from PID prevents the fertilised egg from making its way through the fallopian tube to implant in the uterus. Ectopic pregnancies can cause enormous, severe bleeding and require emergency medical attention. He adds that PID might cause a sore (a collection of pus can form in the uterine tube and ovaries), which can result into an infection if one delays to get treatment. PREVENTION “Practice safe sex, have only one sexual partner, if you have pelvic inflammatory disease or an STI, advise your partner to be tested to prevent the spread of STI. If anyone is at risk of an STI, such as chlamydia, make an appointment with your doctor for testing because early treatment of an STI gives you the best chance of avoiding PID. Talk to your doctor about the proper contraception safe to use,” Mayele states. TREATMENT To prevent reinfection with an STI, your sexual partner or partners should be examined and treated. Infected partners might not have any noticeable symptoms, avoid sexual intercourse until treatment is completed and tests indicate that the infection has cleared in your partner, Mayele notes He adds that surgery is not common, however, one might need it if they don’t respond to antibiotic treatment or if one or more of the signs or symptoms of PID are absent. Gizenga says, diagnosis can be through blood and urine tests, ultrasound, (this test uses sound waves to create images of your reproductive organs), or laparoscopy (the doctor inserts a thin, lighted instrument through a small incision in the abdomen to view pelvic organs). editorial@newtimesrwanda.com
