Pelvic Inflammatory Disease: Symptoms and Treatment Options

Is it possible to have pelvic inflammatory disease?

Hello, I have been experiencing some symptoms recently:
1.
My menstrual cycle is normal, but for four consecutive months, the menstrual flow has been significantly less than usual.
In the fifth month, the flow returned to normal, but I have not had my period for the past two months (though I feel like it might come soon).

2.
I have recurrent vaginal inflammation.
The suppositories prescribed by my doctor improve the condition, but it recurs shortly after.
The symptoms include yellow, solid discharge with a fishy odor, and sometimes it feels gritty.

3.
Whenever a fan blows directly on my back, I experience soreness in my lower back, which improves once the fan is turned off.
However, I usually do not feel discomfort.

4.
At night, when I have the urge to urinate, I sometimes feel a bit of pain in my abdomen (not every day, but it occurs occasionally).
The pain is located around the lower abdomen, near the sides of the navel, but it goes away after I get up and urinate.
I generally do not feel discomfort, but it doesn't feel like gastrointestinal pain, so I wonder if it could be a urinary issue.

5.
I usually have constipation issues that cause bloating, but for the past three days, I have been having bowel movements about 2-3 hours after waking up.

I apologize for having multiple questions.
I researched my symptoms online and found that they could indicate pelvic inflammatory disease, but I usually do not experience pain, so I am hesitant to confirm this.
I do not have a partner, so I have not engaged in sexual activity.
If I need to see a doctor, which specialty should I consult? What tests should I undergo? If it is a gynecological issue, should I go to a hospital or a general gynecology clinic? If it is indeed pelvic inflammatory disease, can it be treated with medication? Will it affect my fertility? I am worried about the possibility of needing laparoscopic surgery...
Also, what are the symptoms of chronic pelvic inflammatory disease? Thank you.

Jiajia, 20~29 year old female. Ask Date: 2015/08/13

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
Pelvic inflammatory disease (PID) often presents with lower abdominal pain, which may worsen upon palpation.
It can sometimes be accompanied by lower back pain.
This condition is more commonly seen in individuals who have recently engaged in sexual activity.
There may be an increase in vaginal discharge, which could have a foul odor.
The more of these symptoms you experience, the higher the likelihood of PID.
Based on your description, the likelihood does not seem very high.
2.
Vaginal inflammation can recur, and symptoms may improve after using the prescribed suppositories, but they often return shortly thereafter.
The discharge is described as yellow, solid, and foul-smelling, sometimes with a gritty texture.
Based on your description, this is more indicative of candidiasis (yeast infection).
Possible reasons for recurrent infections include inadequate ventilation of the vulva (wear breathable clothing), excessive washing leading to vaginal moisture (avoid washing inside the vagina), the presence of drug-resistant Candida (consider changing the treatment), insufficient treatment duration (ask your doctor for a longer course of medication), and possible coexisting bacterial infections (consult your doctor for confirmation), among others.
3.
If you still have concerns, it is advisable to visit a hospital for further examination.
Sincerely, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2015/08/13

More Info

Pelvic Inflammatory Disease (PID) is a significant health concern that can affect women of reproductive age. It is an infection of the female reproductive organs, including the uterus, fallopian tubes, and ovaries, often caused by sexually transmitted infections (STIs) such as chlamydia and gonorrhea. However, it can also result from other infections, including those that are not sexually transmitted. Understanding the symptoms and treatment options for PID is crucial for effective management and prevention of complications.

Symptoms of Pelvic Inflammatory Disease
The symptoms of PID can vary widely among individuals, and some may not experience any symptoms at all. Common symptoms include:
1. Pelvic Pain: This is often the most prominent symptom. It may be constant or intermittent and can vary in intensity. Some women may experience pain during intercourse or during menstruation.

2. Abnormal Vaginal Discharge: Women with PID may notice an increase in vaginal discharge, which can be yellow or green and may have a foul odor.

3. Irregular Menstrual Cycles: Changes in menstrual patterns, such as heavier or lighter periods, or missed periods, can occur.

4. Fever and Chills: Some women may experience systemic symptoms like fever, chills, or malaise, indicating a more severe infection.

5. Painful Urination: Some women report discomfort or pain when urinating, which can be mistaken for a urinary tract infection.

6. Back Pain: As you mentioned, back pain can also be a symptom, particularly in the lower back.

Treatment Options for Pelvic Inflammatory Disease
The treatment for PID typically involves antibiotics to eliminate the infection. The choice of antibiotics may depend on the severity of the infection and the specific bacteria involved. Commonly prescribed antibiotics include:
- Ceftriaxone: Often used for gonorrhea.

- Doxycycline: Effective against chlamydia and other bacteria.

- Metronidazole: Used to treat anaerobic bacteria and certain protozoa.

In cases where the infection is severe or does not respond to oral antibiotics, hospitalization may be necessary, and intravenous antibiotics may be administered.

Management and Follow-Up
1. Regular Check-Ups: It's essential to follow up with your healthcare provider to monitor your condition and ensure the infection is resolving. If symptoms persist or worsen, further evaluation may be needed.

2. Avoiding Irritants: As you noted, avoiding direct airflow from fans or other irritants may help alleviate discomfort, especially if you notice that it exacerbates your symptoms.

3. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain associated with PID.

4. Lifestyle Modifications: Maintaining a healthy lifestyle, including a balanced diet and regular exercise, can support your overall health and immune function.

Concerns About Fertility and Chronic PID
One of the significant concerns with PID is its potential impact on fertility. If left untreated, PID can lead to scarring of the reproductive organs, which may cause infertility or increase the risk of ectopic pregnancy. Chronic PID can present with ongoing pelvic pain and recurrent infections, which can be challenging to manage.

When to Seek Medical Attention
Given your symptoms, it would be advisable to consult a healthcare provider, preferably a gynecologist, who specializes in women's health. They can perform a thorough evaluation, including a pelvic exam, ultrasound, and possibly laboratory tests to determine the underlying cause of your symptoms.
In conclusion, while PID can be a serious condition, early diagnosis and appropriate treatment can lead to a good prognosis. If you suspect you have PID or are experiencing concerning symptoms, do not hesitate to seek medical attention. Early intervention is key to preventing complications and preserving reproductive health.

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