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Understanding Pelvic Inflammatory Disease

Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs (cervix, uterus, fallopian tubes, and ovaries). There are two types of PID in women: acute and chronic.

Acute PID usually occurs suddenly and the symptoms are severe, including significant lower abdominal pain, increased vaginal discharge that may be yellow and purulent, and elevated body temperature. Treatment with antibiotics is usually rapid and effective.

Chronic PID is often caused by incomplete treatment of acute PID or prolonged illness. Some women may develop chronic PID directly without experiencing acute PID. Common causes of PID include:


  • Infection after delivery or miscarriage: Patients who are weak after delivery or miscarriage may have the cervix dilated and not closed properly. At this time, bacteria in the vagina or cervix may infect the pelvic cavity. If there is placenta or fetal membrane residue in the uterus, the chance of infection is even higher.

  • Infection after gynecological surgery: After undergoing procedures such as artificial abortion, IUD insertion or removal, tubal flushing, hysterosalpingography, endometrial polypectomy, or submucosal uterine fibroid resection, the infection may occur if the disinfection is not strict or if there is pre-existing chronic inflammation in the reproductive system. Some patients may also develop an infection after surgery due to poor personal hygiene or failure to follow postoperative instructions, and sexual activity may also cause bacteria to travel upwards and cause PID.

  • Lack of attention to hygiene during menstruation: During menstruation, the endometrium is shed, and the blood sinuses in the uterine cavity open, providing a favorable condition for bacterial growth. If hygiene is not observed during menstruation, such as using unqualified sanitary pads or toilet paper or engaging in sexual activity, it may provide bacteria with the opportunity for retrograde infection and cause PID.

  • Spread of inflammation from adjacent organs: The most common situation is when appendicitis or peritonitis occurs, as they are adjacent to the female reproductive organs, and inflammation can directly spread and cause PID. When suffering from chronic cervicitis, inflammation can also spread through the lymphatic system and cause connective tissue inflammation in the pelvic cavity.

Patients with chronic PID often have mild or non-specific symptoms, which usually occur at the end of menstruation or a few days after menstruation. The initial symptom for most patients is mild to moderate lower abdominal pain, usually more severe on one side. Other symptoms include irregular vaginal bleeding and abnormal vaginal discharge, sometimes accompanied by an odor.

Chronic PID can cause significant harm. Chronic PID can cause adhesion of the inner layer of the fallopian tube due to inflammation, which can narrow or block the lumen of the tube. This can obstruct the passage of eggs, sperm, or fertilized eggs, leading to infertility. Severe PID can spread to the pelvic peritoneum, uterus, and other tissues, eventually leading to extensive adhesions of these organs and tissues.

Therefore, women should carefully prevent pelvic inflammatory disease in the following ways:

  • Keep the perineal area clean: Wash the external genitalia with water every night, use a separate basin, never use your hand to clean the inside of the vagina, and do not use hot water, soap, etc. to clean the external genitalia; change underwear frequently, and do not wear tight-fitting or synthetic underwear.

  • Avoid improper sexual activity: During menstruation, after gynecological surgeries such as abortion and IUD removal, there may be bleeding in the vagina. At this time, sexual activity, swimming, and soaking in a bath should be avoided to prevent pathogenic bacteria from entering and causing infection.

  • Minimize gynecological surgeries: During procedures such as abortion and cesarean section, pathogenic bacteria may invade and cause pelvic inflammatory disease. Therefore, contraception should be used to reduce the trauma of induced abortions.

Pelvic inflammatory disease (PID) is the most common preventable cause of infertility. If a person is diagnosed with PID or experiences pelvic discomfort symptoms, they should seek prompt treatment to avoid serious consequences such as infertility.

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