|Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is an infection of any of a woman's pelvic
organs, including the uterus, ovaries, or fallopian tubes, or the peritoneum,
the membrane covering the abdominal cavity. One million women are diagnosed with
PID annually in the United States. Acute PID comes on suddenly and tends to be
more severe, whereas chronic PID is a low-grade infection that may cause only
mild pain and sometimes backache. If not treated promptly, PID can result in
infertility and, in rare cases, death.
|Signs and Symptoms|
Acute PID is accompanied by the following signs and symptoms.
- Severe pain and tenderness in lower abdomen
- Vaginal discharge
Chronic PID is accompanied by the following signs and
- Mild, recurrent pain in lower abdomen
- Irregular menstrual periods
- Pain during intercourse
- Heavy, unpleasant-smelling vaginal
|What Causes It?|
PID occurs when bacteria from the vagina or cervix infiltrate the normally
sterile pelvic organs.
|Who's Most At Risk?|
People with the following conditions or characteristics are at risk for
- Frequent sexual encounters, many partners
- History of sexually transmitted diseases or previous history of
- Young age (14 to 25 years old), particularly early age at first
|What to Expect at Your Provider's Office|
If you are experiencing symptoms associated with PID, you should see your
health care provider. A combination of a physical exam, lab tests, imaging, and
other procedures are used to make a diagnosis.
Barrier methods of birth control (condoms, diaphragms, vaginal spermicides)
reduce the risk of PID. Rapid diagnosis and effective treatment of lower urinary
tract infections can help prevent PID from developing. Experts recommend routine
screening for infections in high-risk individuals.
Your health care provider may recommend hospitalization or outpatient
treatment with follow-up. Outpatient therapy consists of rest and
Your provider may prescribe the following antibiotics or combination of
|Surgical and Other Procedures|
Some conditions, such as an abscess in the ovary or fallopian tube, may make
|Complementary and Alternative Therapies|
A comprehensive treatment plan for PID may include a range of complementary
and alternative therapies.
- Eat whole foods such as fresh vegetables, whole grains, and essential
fatty acids (nuts, seeds, and cold-water fish)
- Avoid sugar, refined foods, and saturated fats (animal products,
Potentially beneficial nutrient supplements include the
- Vitamin C (1,000 mg three to four times per day), zinc (30 mg per
day), selenium (200 mcg per day), vitamin E (400 IU per day), B-complex (50 to
100 mg, especially folic acid 800 mcg per day), and vitamin A (25,000 IU one to
two times per day) or beta carotene (50,000 IU one to two times per day)
- Bromelain (500 mg three times per day between meals)
- Anti-inflammatory oils (for example, flax, borage, evening primrose)
1,500 mg two to three times per day
- Acidophilus (one capsule with
Herbal remedies may offer relief from symptoms. Herbs are generally available
as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol
extraction, unless otherwise noted). Dose for teas is 1 heaping tsp. per cup of
water steeped for 10 minutes (roots need 20 minutes).
- For acute infection, combine half parts of yarrow (Achillea
millefolium), pasque flower (Pulsatilla pratensis), marigold
(Calendula officinalis), and poke root (Phytolacca americana) with
one part each of coneflower (Echinacea purpurea) and goldenseal root
(Hydrastis canadensis). Take 30 to 60 drops tincture every two to four
hours. Use caution with poke root.
- For chronic infection, combine equal parts of coneflower, goldenseal,
licorice root (Glycyrrhiza glabra), myrrh gum (Commiphora molmol),
wild indigo (Baptisia tinctoria), and red root (Ceonothus
americanus). Take 30 drops tincture two to three times per day.
- Turmeric (Curcuma longa, 500 mg three times per day). Use with
bromelain to enhance anti-inflammatory
Place a castor oil pack on the abdomen to reduce inflammation. Saturate a
cloth with castor oil and apply directly to the skin, placing a heat source,
such as a hot water bottle, on top. Leave in place for 30 minutes or more. Use
for three to four consecutive days per week. Packs may be used
Acupuncture may help enhance immune function and reduce pain and
inflammation, especially with chronic
In 85 percent of cases, the initial treatment succeeds, and in 75 percent of
cases, patients do not experience a recurrence of the infection. However, when
there is a recurrence, the likelihood of infertility increases with each episode
of PID. Potential complications from PID include a tubo-ovarian abscess;
fallopian tube obstruction, which can result in ectopic pregnancy or
infertility; chronic pelvic pain; and sexual dysfunction.
Your health care provider will schedule a follow-up visit 48 to 72 hours
after treatment is started. If you are diagnosed with PID, you should inform any
sexual partners so that they can be examined and treated if the infection has
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|Review Date: March 2000|
|Reviewed By: Participants in the review process include: Anne McClenon, ND, Compass Family
Health Center, Plymouth, MA; Scott Shannon, MD, Integrative Psychiatry, Medical
Director, McKee Hospital Center for Holistic Medicine, Fort Collins, CO; Leonard
Wisneski, MD, FACP, George Washington University, Rockville,
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