What is PID?
PID or Pelvic inflammatory disease, is an infection that happens to women. PID affects the upper part of the female reproductive system namely the uterus, ovaries, and the fallopian tubes and inside of the pelvis.Often there may be no symptoms of this illness.
PID is caused by bacteria that spread from the vagina and the cervix. Infections by diseases like Chlamydia trachomatis and gonorrhea are mostly present in 75-90 % of cases of PID. Often there several different bacterium are involved in development of this disease. The risk factors involved with PID are similar to those of STD (sexually transmitted disease) and include history of drug use and high number of sex partners. Vaginal douching also increase the risk of getting infected with this disease.
Experts Advice and Cure :
Experts are of the opinion that this disease be considered in all women who are of childbearing age and are suffering from lower abdominal pain.Ultrasound scanning of the reproductive organs is often useful for diagnosis of this disease.Efforts that can prevent PID are not having sex or limiting the number of sex partners and also using condoms. Antibiotics are generally prescribed for the treatment of this disease.PID is more recurrent on women who has a prior history of this disease. Recent onset of menses, use of IUD (intrauterine device) or if the partner has a STD are also some of the other reasons for getting infected with this disease.
It has been observed that even when PID infection is cured, the effects of this disease may be permanent in many women. Hence an early detection is an essential factor for curing this disease. Since late diagnosis of this malady often can lead to the damage to the patient’s reproductive system. Formation of scar tissues due to recurrent episodes of PID can increase the risk of the inability to get pregnant as the multiple recurrence of this illness often results in tubal blockage of the fallopian tubes. Which can also later on be a cause for development of an ectopic pregnancy.
There are also instances when the PID infection when left untreated has spread to inside the peritoneum causing formation of scar tissues on the external surface of the liver leading to (Fitz-Hugh-Curtis) syndrome.
Blood tests are also conducted at times to determine the severity of this illness. In such a case the erythrocyte sedimentation rate (ESR) and erythrocyte sedimentation rate (ESR) are done on the patients suspected of this disease.
Endometriosis is an often painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.
With endometriosis, displaced endometrial tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle. Because this displaced tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.
The primary symptom of endometriosis is pelvic pain, often associated with your menstrual period. Although many women experience cramping during their menstrual period, women with endometriosis typically describe menstrual cramp that's far worse than usual. They also tend to report that the pain increases over time.
Common Signs and Symptoms of Endometriosis may include:
Pain with intercourse. Pain during or after sex is common with endometriosis.
Pain with bowel movements or urination. You're most likely to experience these symptoms during your period.
Infertility. Endometriosis is first diagnosed in some women who are seeking treatment for infertility.
The severity of your pain isn't necessarily a reliable indicator of the extent of the condition. Some women with mild endometriosis have intense pain, while others with advanced endometriosis may have little pain or even no pain at all.
Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as Pelvic Inflammatory Disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis.
When to see a doctor
See the doctor if you have signs and symptoms that may indicate endometriosis.
Endometriosis can be a challenging condition to manage. An early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis may result in better management of your symptoms.
Although the exact cause of endometriosis is not certain, possible explanations include:
Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial cells.
Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial cell implants during puberty.
Endometrial cells transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
Immune system disorder. It's possible that a problem with the immune system may make the body unable to recognize and destroy endometrial tissue that's growing outside the uterus.
Several factors place you at greater risk of developing endometriosis, such as:
Never giving birth
Starting your period at an early age
Going through menopause at an older age
Short menstrual cycles — for instance, less than 27 days
Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
Low body mass index
One or more relatives (mother, aunt or sister) with endometriosis
Any medical condition that prevents the normal passage of menstrual flow out of the body
Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis end temporarily with pregnancy and end permanently with menopause, unless you're taking estrogen.
The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg. Inspite of this, many women with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise women with endometriosis not to delay having children because the condition may worsen with time.
Ovarian cancer does occur at higher than expected rates in women with endometriosis. Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in women who have had endometriosis.
Diagnosis: To diagnose endometriosis and other conditions that can cause pelvic pain, the doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.
Tests to check for physical clues of endometriosis include:
Pelvic exam. During a pelvic exam, the doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it's not possible to feel small areas of endometriosis, unless they've caused a cyst to form.
Ultrasound. A transducer, a device that uses high-frequency sound waves to create images of the inside of your body, is either pressed against your abdomen or inserted into your vagina (transvaginal ultrasound). Both types of ultrasound may be done to get the best view of your reproductive organs. Ultrasound imaging won't definitively tell the doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas).
Laparoscopy. Medical management is usually tried first. But to be certain you have endometriosis, the doctor may advise a surgical procedure called laparoscopy to look inside your abdomen for signs of endometriosis.
While you're under general anesthesia, the doctor makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for endometrial tissue outside the uterus. He or she may take samples of tissue (biopsy). Laparoscopy can provide information about the location, extent and size of the endometrial implants to help determine the best treatment options.
Treatment for endometriosis is usually with medications or surgery. The approach you and the doctor choose will depend on the severity of your signs and symptoms and whether you hope to become pregnant.
Generally, doctors recommend trying conservative treatment approaches first, opting for surgery as a last resort.
The doctor may recommend that you take an over-the-counter pain reliever, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others), to help ease painful menstrual cramps.
If you find that taking the maximum dose of these medications doesn't provide full relief, you may need to try another approach to manage your signs and symptoms.
Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. The rise and fall of hormones during the menstrual cycle causes endometrial implants to thicken, break down and bleed. Hormone medication may slow endometrial tissue growth and prevent new implants of endometrial tissue.
Hormone therapy isn't a permanent fix for endometriosis. You could experience a return of your symptoms after stopping treatment.
Therapies used to treat endometriosis include:
Hormonal contraceptives. Birth control pills, patches and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month. Most women have lighter and shorter menstrual flow when they're using a hormonal contraceptive. Using hormonal contraceptives — especially continuous cycle regimens — may reduce or eliminate the pain of mild to moderate endometriosis.
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists. These drugs block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. This causes endometrial tissue to shrink. Because these drugs create an artificial menopause, taking a low dose of estrogen or progestin along with Gn-RH agonists and antagonists may decrease menopausal side effects, such as hot flashes, vaginal dryness and bone loss. Your periods and the ability to get pregnant return when you stop taking the medication.
Progestin therapy. A progestin-only contraceptive, such as an intrauterine device (Mirena), contraceptive implant or contraceptive injection (Depo-Provera), can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms.
Danazol. This drug suppresses the growth of the endometrium by blocking the production of ovarian-stimulating hormones, preventing menstruation and the symptoms of endometriosis. However, danazol may not be the first choice because it can cause serious side effects and can be harmful to the baby if you become pregnant while taking this medication.
If you have endometriosis and are trying to become pregnant, surgery to remove as much endometriosis as possible while preserving your uterus and ovaries (conservative surgery) may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery — however, endometriosis and pain may return.
The doctor may do this procedure laparoscopically or through traditional abdominal surgery in more extensive cases.
Assisted reproductive technologies
Assisted reproductive technologies, such as in vitro fertilization (IVF) to help you become pregnant are sometimes preferable to conservative surgery. Doctors often suggest one of these approaches if conservative surgery doesn't work. If you wish to discuss about any specific problem, you can consult a gynaecologist.
While genital infections are an uneasy topic to discuss and seek treatment for, ignoring them leads to severe complications like infertility and even death. Most of these can be treated with a regular course of antibiotics and some topical treatment when identified early. Genital infections can be broadly classified into sexually transmitted and non-sexually transmitted. Read on to know some more common infections in both the categories.
Sexually transmitted diseases:
Non-sexually transmitted diseases: There two major genital infections not transmitted by sex are bacterial vaginosis and candidiasis.
Early diagnosis and intervention of these infections can prevent severe symptoms in most cases. If you wish to discuss about any specific problem, you can consult a gynaecologist.
Mirena is a contraception that can be inserted into the uterus for long term use. This insertion is done with a proper clinical procedure. The Mirena is a device that may be classified as a hormonal Intrauterine device (IUD). This device releases a kind of progestin, which prevents the sperm from travelling to the egg to fertilise it. This hormone basically makes the cervical mucus thick and makes the uterine lining thin, so that ovulation gets suppressed.
Let us get to know more about the procedure and the results of Mirena Insertion.
Reasons: There are a variety of reasons why women use this kind of long term contraception. After insertion, one does not need to have any interruptions in the act of sex in order to look for and use contraception. It also reduces the risk of developing pelvic inflammatory disease. This kind of disease is usually caused by sexually transmitted diseases. This kind of device can also help in bringing down the pain experienced during menstrual cycles. It also reduces the risk of falling prey to endometrial cancer as well as cervical cancer.
Eligibility: You are not an eligible candidate for this kind of procedure if you have suffered from breast cancer, cervical cancer or liver disease. Also, if you suffer from diabetes or other cardiovascular diseases, then it is not safe to go through this procedure.
Procedure: The procedure will be carried out at the doctor’s clinic. The gynaecologist will insert a speculum into your vagina. Then, the doctor will continue to clean the area including the cervix with the help of an antiseptic solution. Thereafter, a special instrument will be used in order to align the uterine cavity with the cervical canal. During this process, the doctor will also measure the depth of the patient’s uterine cavity. The device will then be folded and placed within an applicator tube, which will be inserted into the cervical canal. Then, the applicator tube will be removed. After this, the device will remain in place.
Result: Once the device has been inserted, it will be effective for a period of at least five years. Every month, you will need to get the strings of the device checked so that they are not protruding from the cervix. You may experience side effects like pain during sex as well as others like headaches and persistent migraines. These must be reported to the doctor so that the doctor may deal with any complications.
Removal: If there are any kinds of complications and risks that may develop after the procedure, the doctor can remove this device. This can be done with the help of forceps. The device can also be removed and replaced after five years. If you wish to discuss any specific problem, you can consult a gynaecologist.
Diagnostic laparoscopy is a surgical process for examining different kinds of organs present in the abdomen. It is a low-risk and minimally invasive process in which just a small incision is made. This allows the doctor to evaluate the conditions of your abdominal organs without opting for an open surgery. It’s mostly performed when the patient complains of pain in the pelvic region and when other assessing methods have failed to detect the reason behind the pain and discomfort.
How is laparoscopy done?
The laparoscope is a slim and well-lit telescope that allows your doctor to evaluate the conditions of various organs in your body. It can help in determining whether there is any instance of fibroid or endometriosis. It can help in performing a variety of surgeries like removal of ovarian cysts, hysterectomy and tubal ligation. This surgery involves much lesser healing time compared to other elaborate surgeries.
Why should you go for laparoscopy?
Your gynaecologist may recommend you to get a laparoscopy for a treatment or for diagnosis. It is mostly performed due to unexplained pelvic ache, infertility and a history of pelvic infection. Laparoscopy is also performed for the diagnosis of conditions such as uterine fibroids, ovarian cysts, endometriosis, pelvic pus or abscess, ectopic pregnancy, painful scar, inflammatory disease in the pelvic region and reproductive cancers.
How to prepare for gynaecological laparoscopy?
Your gynaecologist would ask you to prepare for the laparoscopy test on the basis of the type of surgery. Your doctor would ask you about the medication you take, which would include health supplements and over-the-counter medications and in certain cases you may have to stop certain medications. This process is performed under anaesthesia and you would be able to go home on the same day. The following process depends on the type of process. The diagnosis process is completed faster than the surgical process in which an incision is required to be made. The instrument would be inserted through the incision and then the surgery is executed by inserting the laparoscope tool. Once the process is completed, all the tools are removed from the body and the incision would be closed with stitches and the affected area would be bandaged.
In recent times, the laparoscopic process has advanced to a great extent and robotic surgery is often used for performing the surgical process. This is because it has been proven that robotic hands are steadier than human hands and can perform fine manipulations effortlessly. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.
Unexpected or abnormal vaginal bleeding usually refers to the kind of bleeding that occurs any time outside of the normal time of menstruation. Also termed as spotting, inter-menstrual bleeding or metrorrhagia, bleeding between periods always calls for extra measures to be taken against it, and is a matter of serious concern. The primary causes for unexpected vaginal bleeding generally are:
While in most cases, this type of bleeding is naturally corrected, some women might need to undergo treatments when the case is severe. Overlooking an otherwise minor issue might thrust you in the face of life-threatening circumstances, if it develops into a case of cancer, infection, or any other type of disorder.
‘Prevention’ of vaginal bleeding, as such, is indeed a narrow possibility and the measures will almost always vary since the factors that cause intermenstrual bleeding aren’t the same in all cases. However, what your doctor will always advise you in this regard will be to ensure that your diet is balanced, your weight under control and your lifestyle is essentially healthy. If you happen to be on birth control medications, be so while adhering to medical instructions. Resorting to taking aspirin doses often might also influence the incidence of such abnormal conditions. If your pain still persists after you experience unexpected bleeding, you must consult a doctor without any further delay.
What is PID?
Experts Advice and Cure :