Pelvic inflammatory disease (PID) refers to the infection that occurs in the female reproductive organs. It happens when sexually transmitted bacteria infect the uterus, ovaries or fallopian tubes on spreading from the vagina. Generally, the cervix plays the role of preventing the bacteria from entering the vagina and infecting the reproductive organs. But when the cervix becomes exposed to an STD, it loses its power to put a stop to the spread of these microorganisms to the reproductive organs.

What causes this condition?
STDs like gonorrhea and chlamydia have been found to be responsible for about 90% of PID cases.

Some of the other causes include
- Abortion
- Childbirth
- Pelvic procedures

The condition is only detected later in life when you face difficulty in getting pregnant or have chronic pelvic pain complaints. If you experience symptoms like vomiting, high fever, pain in the lower abdomen and instances of fainting, you should immediately seek a doctor.

What puts you at risk for PID?
Certain factors may put you at a higher risk for PID and these are:

- Instances of sexually transmitted diseases like Chlamydia (an STD that can occur from anal, oral or vaginal sex) and gonorrhea (a condition that causes discharge from the vagina or urethra) can make you prone to developing PID.

- Douching on a regular basis can increase your risk of PID as it disrupts the equilibrium of good and bad bacteria in your vagina, and may hide the symptoms of the condition as well.

- Even a previous history of PID can increase your chances of having another episode of PID.

- Compared to older women, teenagers who are sexually active are more prone to developing PID.

- Having multiple sexual partners can also put you at a greater risk for PID and STDs.

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Could you be at a risk of pelvic inflammatory disease (PID)?

During pregnancy a woman s body undergoes constant changes. The entire body tries to accommodate place for the growing uterus as hormones levels drastically fluctuate and ligaments stretched. Pelvic pain and the ensuing discomfort around this time is a common phenomenon experienced by most women. 

Though the pain may be harmless, at times it may also lead to serious repercussions. Therefore the identification of the causes that lead to pelvic pain during pregnancy is crucial. Some of them are: 

1. Accommodation pain: In the initial stages of pregnancy, women may experience cramps which are akin to the pain that precedes menstruation. However, in the case of pregnant women, the pain leads to no bleeding, but in all probability, is caused due to the expansion of the uterus.
2. Round ligament pain: Amidst the host of changes that the body goes through, the ligament that goes from the uterus to the groin also undergoes a change; it expands. This is responsible for the pain in the sides especially when women are walking or getting up from a chair.
3. Baby s weight: As the weight of the fetus begins to increase it exerts a pressure on the nerves that move from the vagina to the legs. This causes a dull pain in the pelvic region which increases considerably with walking and riding a car. This is most commonly felt by women who are in their third trimester.
4. Urinary Tract Infection: According to reports, most women suffer from urinary tract infection or UTI during pregnancy. This results in uncontrolled, often times, bloody urination and a pain in the abdomen. This is a major cause of concern as, if untreated, it infects the kidneys which in turn increases the risk of an early labour.
5. Miscarriage: In the first trimester, a pain in the abdomen may be an indication of a miscarriage. In such a situation, the pain is followed by bleeding and cramps.
6. Early labour: During pregnancy, an intermittent pain in the pelvic area and a back ache can also be suggestive of an early labour. If the contractions continue for over two hours after taking the necessary precautions like urinating and taking rest, it may be a sign of an early labor.

Pelvic Pain During Pregnancy

Pelvic pain is generally referred to as the pain in the lower abdominal region. Pelvic pain might be acute, sudden, or chronic, recurrent, cyclical in nature. It may present as central or lateralized pain and might spread to the thighs and buttocks. Pelvic pain might be an indication that something is wrong with the internal reproductive organs located in the pelvic region such as ovaries, fallopian tube, uterus and vagina in which case occurrence of pain may be related to particular time in menstrual cycle.

Pelvic pain can be indicative of a pelvic infection or related to the pelvic bones/spine problems.

Also it may indicate that there is something wrong with the digestive system or urinary system.

Causes-

The causes are as follows:

Pelvic pain occurs commonly in disorders of the internal reproductive organs such as ovarian cysts or pelvic inflammatory disease (where in sexually transmitted bacteria spread through the reproductive organs and cause infection) or pain during ovulation.

Pelvic pain might also occur due to endometriosis (a form of disorder where the endometrial tissues that are located inside the uterus tend to grow outside the uterus resulting in severe pain), adenomyosis (a disorder wherein the endometrial tissues which line the wall of the uterus tend to grow within the uterus), , pelvic adhesions or ectopic pregnancy (when the fertilized egg gets inserted somewhere else other than the main uterine cavity),

Pelvic pain can occur due to bladder disorders, kidney stones, infection in the urinary tract, constipation, flatulence,inflammatory bowel disease, irritable bowel syndrome and chronic hernia.

It can also be a symptom in some cancers such as ovarian cancer, colonic cancer, advanced ovarian , endometrial and cervical cancer.

The following symptoms might occur along with pelvic pain:

Sustained pain in the hips and the groin

Sudden fever

Severe pain while urinating , passing stools or during sexual intercourse (dysparuenia)

Vaginal bleeding or vaginal discharge .

Blood in stool

Severe menstrual pain ( dysmenorrhoea)

Repeated instances of constipation or diarrhoea

Increase In pain with stress and physical movements

Investigations-

The Gynaecologist will do physical examination including bimanual internal examination. Also, complete blood count, urine for microscopy, vaginal swabs if discharge, stool examination. Ultrasound examination of the pelvis is an important investigation.

Treatment-

If the pain is gynaecological and depending on the cause doctors might suggest different therapies. In cases where pain is due to an ovarian cyst or endometriosis, doctors may prescribe birth-control pills. In cases of suspected pelvic infection, antibiotics are prescribed. Also, laparoscopic surgery might be advised in cases of acute pain due to cyst, endometriosis, or pelvic adhesions: for confirmation of diagnosis and excision or removal of cysts and endometriotic implants and division of adhesions respectively. In some cases of chronic pain, the gynaecologist may manage the case with inputs from gastroenterologist and pain consultant.

Causes and Symptoms of Pelvic Pain

Pelvic or abdominal pain is a pain that occurs below a woman's belly button. The pain can usually occur due to their periods or menstruation. Pelvic pain can be acute or chronic and varies from woman to woman. Acute means that you are having this pain for the first time. Chronic means that pain has been a problem for a long time may be more than six months. Pelvic pain is more common in women than in men.

Causes of Chronic Female Pelvic Pain:
The commonly known causes of pelvic pain are a urinary disorder, such as bladder or kidney problems, a bowel problem or a problem with the reproductive system which includes the uterus, Fallopian tubes and ovaries. Scar tissue in the pelvic area after an infection or surgery can also lead to such pain. At times physical or sexual abuse is also attributed to such a pain.

How to diagnose chronic female pelvic pain:
You should always see a doctor if you are not sure of what is causing the pain. The doctor will ask questions regarding your periods, urine and bowel movements and about general symptoms such as fever, nausea and vomiting.

Next, the doctor will examine your abdomen and may examine you internally if necessary. The doctor may ask you to have a urine test done which can be tested for infection. If you have symptoms of vaginal discharge or other related symptoms the doctor may take some vaginal swabs. A pregnancy test may be advised. The doctor may ask you to undergo a routine ultrasound scan to diagnose problems such as ovarian cysts.
If the first tests don't find a cause, you may have other tests that show pictures of the organs in your belly. These may include Transvaginal ultrasound, MRI, CT scan of the pelvis.
You may also have to undergo a minor surgery called laparoscopy which is basically a surgical diagnostic procedure which is used to examine the organs inside the abdomen.

Treatment:
You will be treated for the particular problem that causes pelvic pain. Some common treatments include:

Prescribing birth control pills or hormone treatment for problems related to your periods
You might have to undergo a surgery to remove a growth, cyst, or tumor
Medicine to treat the problem, such as an antibiotic for infection or medicine for irritable bowel syndrome
You can try some home remedies as well-
Try nonprescription medicine, such as ibuprofen
Apply heat on the lower abdomen or the area where you feel the pain
Lie down and elevate your legs by placing a pillow under your knees to reduce the back pain
You can go in for some relaxation techniques, such as meditation, yoga and some breathing exercises as well.

How To Cure Pain In Pelvic & Abdominal Area?

Endometriosis is a painful disorder in which tissue that normally lines the inside of your uterus, the endometrium grows outside (endometrial implant). It commonly involves ovaries, bowel or tissues lining your pelvis. The main symptoms are pelvic pain and infertility. While chronic pain exists throughout, it tends to aggravate during menstruation and / or sex. Though the cause is not entirely clear, women with a family history of the condition need to be extra cautious. Endometriosis is normally detected by its symptoms combined with a medical imaging. Though the growth is not generally cancerous, a biopsy is recommended to eliminate doubts. 

The condition of endometriosis is attached with social and psychological effects as it affects a woman's child bearing ability. Most minds race anxiously as to what the surgeon might find and will your body heal after the procedure. Here are some tips to prepare for your endometriosis laparoscopy

 Before the surgery: read up as much as possible about your condition and note down questions you want to ask your doctor. Get details about the entire procedure and how the doctor is treating your specific case. Having knowledge will help you stay calm and focused. Next, gear your home for the process. Stock your fridge with quick heat home made meals. It's best for you and the family to have healthy food than the store bought preservative laden food. Clean your home, change your sheets and purchase some loose fit clothing for later use. Last but not the least, stock up on some reading material that will come handy during your rest period. 
 On day of surgery: do not eat or drink anything from 12 midnight until the time of your surgery. You may also need the unpleasant enema procedure during your prep. Remove your nail polish and leave your jewellery, watch and valuables at home. Shower and get to the hospital early to get on with the forms you'll need to fill. The procedure requires anesthesia so do discuss your allergies or any concerns you may have with this aspect of the procedure. Once you are set with you iv and anesthesia, the doctor takes over to do what they do best cure you.
 The procedure: a small incision is made near the belly button and the abdomen is filled with co2 gas which lifts it away from other organs. During the laparoscopy, the doctor examines the pelvic organs, looking for obvious and atypical endometriosis lesions as well as endometriomas (endometriosis'filled cysts, adhesions, and scarring. He may then remove the lesions to send to a lab for biopsy
 After surgery: you'll most likely wake up groggy in the recovery room after your surgery. You may feel some pain as you come around but if it's a day procedure, you'll be able to leave as soon as you feel ready. 

Although pregnancy may temporarily suppress the symptoms of endometriosis, it does not eradicate the disease. The symptoms will almost always return after the baby is born. If you are suffering from this painful condition and want to seek help, you can consult here.

How To Prepare For Your Endometriosis Laparoscopy

Pelvic Inflammatory Disease, also known as PID, is characterized by an infection that occurs in a lady's reproductive organs. Usually this occurs as a result of a complications arising from a STD. The disease causes severe damage to the ovaries, fallopian tubes and the uterus. It is one of the bigger causes of infertility in women. 

Causes-

The cervix which is the entry to the uterus has the function of stopping bacteria that are present in the vagina from spreading to the other organs. Once infected by a STD, the cervix can no longer perform its function of preventing the bacteria from spreading to other organs. PID develops when the infection spreads from the cervix to the upper areas of the genital tract. 

There are certain factors which increase the chances of being affected by PID: 

Being sexually active 
Already affected by STDs such as gonorrhea 
Past history of PID 
Having multiple sexual partners 
Symptoms-

Women may experience pain while urinating and engaging in sexual intercourse, coupled with sore feeling in the stomach along with nausea. Abnormal vaginal discharge and a rise in body temperature are common symptoms as well. 

Treatment-
Once the disease has been diagnosed by a doctor, a treatment plan is devised. The treatment options that you can avail of are: 

Medications: If the symptoms are mild, then the doctor will prescribe antibiotic medications. Usually the antibiotics are administered by mouth unless the symptoms are severe, when the drugs are administered intravenously. Your partner would also require medications if you happen to be diagnosed with PID, so that he/she does not catch it. 
Surgery: Surgery is recommended by the doctor in case of tissue inflammation and the presence of pus (abscess). The aim of surgery is to get rid of the abscess to prevent any further infection. 
In addition to the treatment methods, there are certain precautionary measures that you can adopt to be safe: 

Have protected sex.
Try and stick to one sexual partner.
Visit your gynecologist for regular checkups.

Pelvic Inflammatory Disease - Can STDs be the Reason Behind it?

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