Pelvic Inflammatory Disease (cont.)
What Is the Follow-up for Pelvic Inflammatory Disease?
Take all medications the health care practitioner prescribes. Symptoms may resolve before the infection is cured and the person may feel much better, but they should still finish taking all the antibiotics prescribed. Patients should follow-up with the doctor or in a clinic within 3 days to monitor improvement. Whether on oral or IV therapy, most individuals usually improve within 72 hours.
- If symptoms worsen, even with treatment, prior to the 72-hour follow-up appointment, the individual should return to the doctor's office or hospital. Additional testing, treatments, and surgery may be required to effectively reduce symptoms and eliminate PID.
- Patients should not have sexual activity until the infection is cured. Any sexual partners the patients have had within 2 months of becoming infected with PID should also be treated.
How Can I Prevent Pelvic Inflammatory Disease?
The following steps may be taken to avoid pelvic inflammatory disease or to keep PID from becoming worse:
- Practice safe sex: if people choose to have sexual intercourse, they should use barrier devices such as a latex condom. Use only water-based lubricants with condoms. For oral sex, use a device called a dental dam. It's a rubbery device a person places over the opening of the vagina before having oral sex. As an alternative, a person can cut an unlubricated male condom open and place it over the opening to the vagina. However, no barrier devices are 100% effective (in either birth control or preventing PID); for some people, the choice is not to have sexual relations.
- Birth control pills and intrauterine devices do not prevent PID. Recently inserted intrauterine devices (IUDs), in fact, may increase the risk of getting PID.
- STD treatment: Sexual partners need to be treated if the person is diagnosed with a bacterial infection such as a sexually transmitted disease. The individual may become reinfected if this is not done; in addition, the sexual partner may become ill also.
- Individuals should limit the number of sexual partners and avoid high-risk partners (for example, those that do not use condoms) to reduce the chance of infections.
- If people are at risk for PID (for example, individuals that have multiple partners and earn money from sexual encounters), they should have regular tests for sexually transmitted diseases done.
- Frequent vaginal douching is a potential risk factor for PID. Douching may push bacteria into the upper genital tract. Douching also may ease discharge caused by an infection, so women may not think they have symptoms and may delay seeking medical care. Douches are not recommended; the vagina cleans itself naturally. Regular showers and baths are enough to keep the body clean.
- Wipe from front to back after a bowel movement. This keeps bacteria from entering the vagina.
- If a person has vaginal itching, do not scratch. Wash with water only, use no potentially irritating soaps and discuss the symptoms with a health care practitioner.
As in other sexually transmitted diseases, education about prevention techniques is a way to reduce the chance of getting PID.
What Is the Prognosis for Pelvic Inflammatory Disease?
If diagnosed and treated early, the patient outcome is good. The outcome may not be as good if individuals wait too long before treatment and/or continue to engage in unsafe sexual practices. Complications that can occur include:
- Tubal damage and scarring can result in infertility. PID is the most common cause of infertility in women. Following a single episode of PID, 8% of women were infertile; after two episodes, 19.5% of women were infertile; and after three or more episodes, 40% of women were infertile.
- Ectopic pregnancy rates are 12%-15% higher in women who have had an episode of pelvic inflammatory disease.
- Ovarian abscesses can occur after an episode of PID. Untreated PID also puts you at risk for a tubo-ovarian abscess (TOA). Rupture of a TOA can result in widespread peritoneal infection with shock and can be fatal.
- Females diagnosed with PID are at increased risk of getting PID again. As many as one-third of women who have had PID will have the disease at least one more time. With each case, the risk of becoming infertile is increased.
- Chronic pelvic pain is defined as pain in the reproductive organs or pelvis of at least six months duration that is severe enough to impact a woman's functioning. The pain may occur both during and/or apart from the menstrual period. As many as one-third of women with PID develop chronic pelvic pain, although the exact reasons for this are unclear. Chronic pelvic pain may be related to the scarring and inflammation associated with PID and occurs in up to 18% of women with PID.
- Enlargement of a Fallopian tube is known as hydrosalpinx. After an episode of PID, the damaged Fallopian tube can become blocked, fluid-filled and enlarged.
Medically reviewed by Wayne Blocker, MD; Board Certified Obstetrics and Gynecology
Centers for Disease Control. Pelvic Inflammatory Disease: The Facts.
eMedicine.com. Pelvic inflammatory disease.
emedicine.com. Pelvic Inflammatory Disease/Tubo-ovarian Abscess.
Medically Reviewed by a Doctor on 11/28/2016
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