Pelvic inflammatory disease, a "female killer" that cannot be ignored

Author: Lou Wenjia Peking Union Medical College Hospital

Reviewer: Zhu Lan, Chief Physician, Professor, Doctoral Supervisor, Peking Union Medical College Hospital

Pelvic inflammatory disease is a common gynecological disease in women. Common symptoms include fever, lower abdominal pain, increased vaginal discharge with odor, etc.

The incidence of pelvic inflammatory disease is high. Some patients may develop rapidly within a few days, with obvious symptoms such as abdominal pain and fever; some patients may develop slowly and may last for several weeks or even months, and the symptoms are not obvious and are easily ignored. If not treated in time, it can lead to infertility, tubal pregnancy, chronic pelvic pain and repeated inflammation, affecting women's reproductive health.

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1. Why do women suffer from pelvic inflammatory disease?

Pelvic inflammatory disease refers to inflammation of the female upper reproductive tract organs and their surrounding tissues, such as the uterus, fallopian tubes, ovaries, parauterine tissues and pelvic peritonitis. The adjacent tissues that may be affected mainly include endometritis, salpingitis, tubo-ovarian abscess, pelvic peritonitis, etc.

Why do women get pelvic inflammatory disease?

1. The pathogen spreads along the vaginal mucosa all the way up to the cervix, uterine mucosa, fallopian tubes, ovaries, and abdominal cavity; a common situation is after frequent sexual intercourse.

2. Pathogens invade along the lymphatic vessels in the wounds of the vulva, vagina, cervix and uterus. For example, there are often wounds on the cervix and uterus after childbirth or miscarriage.

3. Other infection foci in the body can infect the pelvic cavity and internal reproductive organs through the blood circulation, such as pulmonary tuberculosis.

4. Direct spread of infection from other adjacent organs, such as appendicitis leading to right salpingitis.

Which female friends are at higher risk of pelvic inflammatory disease?

1. All sexually active women are at risk of pelvic inflammatory disease, and those with multiple sexual partners are at higher risk.

2. Aged less than 25.

3. The sexual partner has a sexually transmitted disease.

4. Have had a sexually transmitted disease or pelvic inflammatory disease in the past.

5. Need to undergo cervical manipulation, such as artificial abortion.

6. Poor personal hygiene habits, including having sex during menstruation, using dirty menstrual pads, etc.

In addition, many female friends are concerned about whether the placement of an IUD will increase the risk of pelvic inflammatory disease. The risk of pelvic inflammatory disease with an IUD mainly occurs in the first 3 weeks after insertion, and there is generally no increased risk of pelvic inflammatory disease after that. For female friends with an IUD, if pelvic inflammatory disease occurs, empirical antibiotic treatment is generally performed first. If the symptoms do not improve after treatment, then consider removing the IUD.

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2. Impact of pelvic inflammatory disease on women's health

Pelvic inflammatory disease can cause a lot of trouble to women's health, such as chronic pelvic pain, dyspareunia, and repeated inflammation. Inflammation can also cause pelvic adhesions, fallopian tube blockage, and hydrosalpinx, leading to infertility, ectopic pregnancy, etc. In addition, pelvic inflammatory disease has the following effects on women's bodies.

1. Lower abdominal pain, distension and discomfort. This is due to inflammation leading to abdominal adhesion and pelvic congestion. If it is chronic pelvic inflammatory disease, the early symptoms are not obvious, but there will be a feeling of distension in the abdomen and dull pain for a long time. If it is acute pelvic inflammatory disease, the pain may be severe, especially before and after menstruation.

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2. If an abscess is formed, a mass may also form in the pelvic cavity. If the mass is in front of the uterus, it will irritate the bladder, which may lead to difficulty urinating or frequent urination. If the mass is behind the uterus, it will irritate the rectum, which may lead to diarrhea, or inability to defecate.

3. Increased vaginal discharge. If there is an infection in the cervical canal mucosa or uterine cavity, the amount of mucus secreted by the cervix will change, resulting in increased vaginal discharge, pus-like, brown or green, and accompanied by a foul odor.

4. The patient is in general poor condition, physically fatigued, and has a persistent low-grade fever.

3. Diagnosis and treatment of pelvic inflammatory disease

The diagnosis of pelvic inflammatory disease requires a comprehensive assessment of multiple factors.

After conducting routine urine and blood tests (routine blood test, C-reactive protein), the following tests are generally required for diagnosis.

1. Gynecological examination. Check for tenderness in the uterus and adnexal area, as well as uterine rocking pain.

2. Bacterial culture of vaginal swabs. This can help determine whether there are pathogenic bacteria in the vagina.

3. B-ultrasound or MRI. It can show whether the fallopian tube is thickened, whether there is fluid accumulation, whether there is pus accumulation or mass in the pelvic cavity.

4. If necessary, invasive examinations and treatments such as laparoscopy and endometrial biopsy can also be used.

The incidence of pelvic inflammatory disease is relatively high, so it is even more important to take preventive measures in advance. Women should pay attention to the following three points in their daily lives.

1. Pay attention to personal hygiene : Paying attention to personal hygiene can effectively reduce the risk of bacteria invading the pelvic cavity and keep your private environment clean and dry. You must change your underwear frequently and use clean sanitary napkins and hygiene products.

2. Take good contraceptive measures : If you are not planning to get pregnant, take good contraceptive measures to reduce and prevent the risk of pelvic inflammatory disease caused by an unexpected pregnancy or artificial abortion. In addition, using condoms can effectively reduce the risk of pelvic inflammatory disease.

3. Pay attention to sex during special periods : After abortion or IUD insertion or removal, or during sensitive periods such as menstruation, women's body resistance will decrease, and pathogenic bacteria can easily enter, causing infection and pelvic inflammatory disease. Therefore, during these special periods, do not have sex, bathe in a tub, or swim.

Conclusion

If pelvic inflammatory disease is diagnosed, you must strictly follow the doctor's instructions for treatment. Even if the symptoms are alleviated during medication, you still need to complete the course of treatment and cannot stop taking the medicine on your own, otherwise you will give up halfway. For special pathogens, the pathogens should be rechecked after treatment.