Lynn figured it was food poisoning, likely from the salad she'd eaten at an iffy diner one Sunday. But what started out as fever, nausea and aches and pains just wouldn't go away. On the third day, she started to experience sharp, consistent abdominal pains. She immediately called her doctor.
During a gynecological exam, Lynn's doctor noted severe cervical pain. That was the first clue that she might be suffering from Pelvic Inflammatory Disease — an alarmingly common infection that is a leading cause of infertility, ectopic pregnancy, chronic pelvic pain and, in rare cases, death.
An annual Pelvic Inflammatory Disease (PID) screening is the easiest and best way to monitor gynecological infections that could lead to tubal scarring and potential infertility.
If you have symptoms at any time, such as painful urination, pelvic pain or unusual vaginal discharge, seek medical help immediately. Although PID is not easy to diagnose specifically, all doctors will take into account the combination of symptoms and will treat as if PID is present.
"Generally speaking, we do cultures, lab tests like a blood test or urinalysis; we make sure you're not pregnant, and then we'll treat you with antibiotics in or out of the hospital," explains Daniel Laury, M.D., of Medford.
All patients should be seen within 72 hours. "If you get better on the antibiotics, we assume it was PID," says Dr. Laury. "If not, we might do an ultrasound, laparoscopy or CAT scan."
Early treatment and proper follow-up generally lead to a good prognosis.
The doctor took a culture to isolate any infection and then immediately treated Lynn with a broad-spectrum antibiotic, known to kill most bacteria associated with PID. She assured Lynn that all would probably be all right, since this was her first infection, as long as she followed up within 72 hours and prevented re-infection by making sure her partner also got tested. Nonetheless, Lynn was shocked by the diagnosis — she'd never even heard of PID.
Considering the severity of Pelvic Inflammatory Disease, why don't more women know about it?
"It's actually got some negative connotations as an STD (sexually transmitted disease), and that might keep women from learning about it or getting treatment," says Daniel Laury, M.D., who specializes in women's health in Medford. "But really, it's a general term that relates to the infection of the uterus, tubes and ovaries."
Two-thirds of PID cases can be traced to the bacteria responsible for the sexually transmitted diseases chlamydia and gonorrhea; the other third is caused by sometimes unidentifiable infections. The bacterium makes its way past the cervix into the uterus, Fallopian tubes and/or ovaries, often resulting in tubal scarring. This can obstruct the natural flow of the eggs from the ovaries to the uterus, causing ectopic pregnancies and infertility.
"About a million women annually in the U.S. are treated for PID and it's estimated that another million cases go unreported," says Dr. Laury. "With about one in eight of the treated women coming in later with infertility issues, PID is considered a very serious medical problem."
Initial signs of PID are broad, including generalized pelvic and abdominal pain, fever and vaginal discharge.
"But a woman doesn't have to have all of these symptoms," says Dr. Laury. "Sometimes they just come in because of painful urination or painful sex and you find out they've got something going on."
Most at risk are sexually active women under the age of 25 and women who are in high risk groups for STDs, such as intravenous drug users and those with mental health issues that prevent them from making sensible sexual decisions, says Barbara Montgomery, nurse practitioner at Jackson County Health Department.
But all women are potential victims of the disease, which affects several dozen people a year in the Rogue Valley.
"There is no official number base, but what we see here is probably about four women a month on average," says Montgomery. She notes the number may be higher because other women suffering from PID likely go to an emergency room after hours or on the weekends.
Educating women about Pelvic Inflammatory Disease is the best way to stave off serious health repercussions and contagiousness, says Stacy Kostenbauer, clinic manager at Planned Parenthood in Medford and Ashland.
"It's completely preventable when a client does go into a clinic and gets the assessment and treatment they need," says Kostenbauer. "We encourage the public to have a screening for all STDs, especially women going through a partner change or women who are in a relationship where they agree not to be monogamous."
Asking your gynecologist to screen for PID during an annual exam is the best way to keep on top of the issue. With the right information and follow-up, most women should be able to prevent a first or recurrent episode.