what is Pelvic Inflammatory Disease

More than 50% of cases of infertility comes from PID alone. It’s a nightmare for a woman to know, but it’s true. The name “Pelvic Inflammatory Disease” refers to pelvis and inflammation, but it can hardly indicate the range of destruction it can cause to the reproductive system of a woman. Once the tissue is affected, the condition is more or less permanent unless corrected by surgery, but the chances are low for a full recovery. No woman wants to lose her capacity to motherhood, so it’s better to know how to prevent this condition.

What is PID?

PID is the inflammation of the female reproductive system, especially uterus, fallopian tubes, and the ovaries. The common seat of inflammation is either the ovaries or the fallopian tubes. A common condition called Salpingitis is a result of this inflammation when fallopian tubes are affected. Either tube is narrowed or totally blocked. Pelvic inflammatory disease can come from any STD or from bacterial vaginitis. BV results in the ascension of microorganisms from the cervix and vagina to the upper genital tract. Chlamydia and Gonorrhea are the two probable STDs to cause this state.

It’s easier to prevent than to get a cure. This condition primarily comes from bacterial infections and causes induration or a fibroid condition of ovaries too. The primary inflammation causes scarring if the condition is not treated in time. This is a permanent damage to the reproductive system is irreversible. It can only be treated successfully by surgery in some cases.

The uterus is also not free from this scarring. There are other organs and tissues which get affected by this scarring. The inexplicable pelvic pain that women experience, comes from the process of scarring during a PID onslaught. During the primary inflammation state, it’s treatable with antibiotics and treatments same as used to treat other bacterial infections. Acute ruptures in the fallopian tube due to ectopic pregnancy can only be with surgery.

Causes of PID

PID can come from a wide array of microorganisms, so it’s considered a polymicrobial infection. Gonorrhea and Chlamydia are very similar in their manifestation and very similar in nature. Both are caused by bacteria and both are capable of causing PID.

Neisseria gonorrhea and Chlamydia trachomatis have been identified to be present in women with PID infections almost half of the times. Other anaerobic organisms which cause bacterial vaginosis in women have also been found in women with PID. Latest developments in medicine indicate that Mycoplasm genitalium may also be responsible for milder cases of PID. All in all, this is a complication mainly caused by bacteria responsible for infection of the vaginal tract.

Frequent vaginal douching can disturb the vaginal flora because it disturbs the normal chemical and microbial balance of the vagina. It also increases the chances of PID.

Women use douching to clean their vagina from time to time. The techniques used are different in different women. A wide variety of techniques are used with different cleaning agents and liquids. Use of plain cold water is common. Some use lukewarm water for better comfort and better cleaning. Some women may use diluted vinegar or various antiseptics. It may involve a non-pressurized rinsing to a high-pressure jet. It is always risky, but women do it anyway when they want to get rid of the foul odor. If the odor is due to a BV, they increase the chances of PID.

What are the Symptoms of PID?

  • Pain in the lower abdomen and pelvis
  • Irregular menstrual cycles
  • Bleeding between menstrual periods
  • Excess and foul-smelling vaginal discharge
  • Painful urination
  • Painful sex
  • Lower back pain
  • Fever and other general signs of infection with exhaustion

Risk factors for PID

Sexually active teenagers are more prone to this than women ranging between 25- to 29 years of age. The probable cause for this seems that the reproductive tracts of young teens are fully developed to deal with pathogens and bacteria.

African-American women seem to be in the high-risk category of PID. This may be due to their ethnicity or biological factors. They use regular douching which may be a possible cause for Pelvic Inflammatory Disease.

The relationship between PID and infertility is established beyond doubt, but there may be “Nay-Sayers,” as there are always a few, but it’s ultimately your life. Women generally want a baby at mature age except for the ones with the “teen-mom” desire. What if they discover their infertility at too old an age? Pelvic Inflammatory Disease takes hold of the female reproductive system at a younger age when they least expect it. The last word, prevent it! That’s the easiest way to do it. If you have the slightest reason to believe that you might have contacted Chlamydia or Gonorrhea, get an STD Testing.

Note: Even if everything seems normal an extra STD test doesn’t hurt. Considering the risk factors and the future expenses the amount you spend on testing is nothing.


Gonorrhea is very similar to Chlamydia in its pathogenesis and symptoms. Both these STDs are caused by bacteria, so they are similar to other sexually transmitted diseases caused by bacterial infections.

Main characteristics of Chlamydia symptoms is the absence of any bothering or painful complaints during initial infection. Gonorrhea shares very similar characteristics with Chlamydia, it causes no bothering symptoms during Prodome, especially in women.

The incubation period for Neisseria gonorrhoeae,  the bacteria responsible for this STI, is not very standard. It has different time durations for different people even different in men and women. So, you would always find conflicting and confusing data on the incubation period of a gonorrhea incubation period.

There’s another reason which adds to this confusion- the absence of painful symptoms of this bacteria.

Symptoms are perceived changes in health which are mostly considered an aberration, never an advantage. The key is the perceived aspect, so it’s very subjective. Subjective things are changeable even in the same individual. That’s the reason why the incubation period of micro-organisms is always baffling.

OK, back to the incubation period of Neisseria gonorrhoeae. Some project it as 2 to 5 days, some as 7 to 21 days. There are cases where the first symptoms don’t appear even before 30 days. After all who is sure of the exact date of the infection? 🙂

In some extreme cases, symptoms only show up after the disease develops tertiary stage, i.e. after it spreads to other parts of the body. In other words, it’s called the constitutional stage of Gonorrhea.

Gonorrhea Symptoms in Women

The primary symptoms are very general, so they can be confused with normal fungal or yeast infection. A normal bladder or vaginal infection can manifest similar symptoms, a Gonorrheal infection is not conclusive. Only a NAAT Test or Urine Gonorrhea test can confirm it. Following are the symptoms which immediately follow after the incubation period:

  • Frequent urination with burning and smarting pains in lower abdomen particularly in the region of bladder and ovary.
  • Fever or a rise in body temperature a couple of degrees above normal body temperature
  • Lassitude and general tiredness.
  • Genital itching.
  • Itching and burning in anus
  • Bleeding or discharge from anus
  • Transparent, white, and creamy vaginal discharge which is very offensive odor
  • Vaginal bleeding during or after sex, and, between periods.
  • Irregular menstrual cycles
  • Swollen and painful Bartholin glands (at the opening of the vagina).
  • Dryness in vagina in some cases
  • Pain during sexual intercourse.
  • A sore throat and hoarseness.
  • Redness of eye just as acute conjunctivitis.

Gonorrhea Symptoms in Men

In men Gonorrhea symptoms are more marked than in women, at least they are more obvious to seek a Gonorrhea test. There are rare cases too where men don’t develop clear-cut symptoms. This asymptomatic state is very contagious and most men pass the Gonorrhea infection to their sexual partners and spouses.

The following symptoms are seen in males who are infected:

  • Discharge of a milky white pus-like fluid from the penis at first. Then slowly it turns yellow. Sometimes it may be creamy or blood-tinged.
  • Frequent desire to urinate with scanty urination. Burning, smarting and painful urination, urethritis, and itching in the urethra.
  • Itching in the anus. There’s  bleeding or a transparent discharge in some cases.
  • Soreness and hoarseness in the throat.
  • Feverish with weakness and a desire to lie down.
  • Pain in the testes can be found in some rare cases.
  • Redness of eye just as acute conjunctivitis.


Complications of  Gonorrhea

If the subject isn’t able to understand that there is an infection, the symptoms grow mild after a few weeks. There may be occasional discharges- blood from the vagina in case of women and creamy white pus from the urethra in case of the male. In some cases, the symptoms are suppressed and the disease becomes constitutional. It’s called “Disseminated gonococcal infection” or DGI.


Constitutional Gonorrhea  symptoms

  • Stiff and painful joints even in young people which resembles arthritis.
  • Skin rash like scabies with gradual thickening of the skin.
  • Gradual weakening of heart with palpitation, sometimes missing beats.
  • Blood affection is a normal process where the RBC and WBC counts drop.
  • The tendons are inflamed and they become painful and non-functional.

Constitutional Gonorrhea or disseminated gonococcal infection opens the doors for other STIs especially AIDS.


What is Gonorrhea?

Gonorrhea is the second most common STD in the human race only next to Chlamydia.  It’s the result of the infection by bacteria Neisseria gonorrhoeae.

The spread of this sexually transmitted disease is enormous. In US alone there are 700,000 fresh cases every year as per the official report. The actual cases are most likely to be quite more than that as many STD cases go unreported. The estimation of the cases of Gonorrhea as per Centers for Disease Control and Prevention (CDC) confirms this trend.

Gonorrhea is caused by a direct or intimate sexual contact with an infected person. That’s why it’s also called a venereal disease or VD. The word “venereal” comes from the Latin word “Veneris” which refers to the Greek God of love. Since 1990, the general term “VD” is replaced with more meaningful terms such as STD or STI to describe infections caused as a direct result of sexual contact.

The name of this disease comes from one of its most visible symptoms; a semi-transparent white discharge from the urethra, mostly painless. The specific term “Gonorrhea” is a refinement of Latin word “Gonorrhoea” where “Gonos” means seed or semen, and “Rhoe” means flow or discharge.

Infections by bacteria generally cause localized infections and the bacteria reside locally in the body fluids. Bacteria are organisms with one cell. They are microscopic and hardly a few microns in size. A single bacterium consists of DNA, cytoplasm, cell membrane, cell wall, and capsule. It has the structures needed for independent metabolism and reproduction (they are asexual).


How can you catch Gonorrhea?

When somebody is infected with Gonorrhea, the Neisseria gonorrhoeae bacteria is available in the mucous of the sex organs. He/she transmits the bacteria to the sex partner during intimate sexual contact when the mucous or mucous membranes come in contact with one another. So, the bacteria can potentially infect during vaginal, oral, and anal sex. Unprotected sex is an invitation to such killer infections.

In cases of oral sex, the bacteria in the genital/saliva of the infected person can transmit to that of the non-infected person. In such cases, the bacteria infect the oral cavity and causes “oral Gonorrhea” or “Gonorrhea of mouth.” It affects the mouth, soft palate, tongue, and throat. Every year there are many such cases of gonorrhea oral infections reported.

Any sexually active person can get infected. Infections are very high among teenagers and young adults between the ages of 15 and 30. They are impulsive and indulge in frequent sex but without sufficient protection. People who had been treated for gonorrhea in the past have very little immunity against the bacteria.

Gonorrhea can infect an infant during vaginal birth if the mother is infected. It infects the eyes, mouth and the general health of a child. At times, if not treated properly this infection can be fatal. Many cases of infant mortalities can be attributed to this infection alone. If this STI is allowed to remain without treatment, it can cause bone and organ deformation, blindness, meningitis, encephalitis, and even death.

Gonorrhea symptoms can indicate the presence of the bacteria but can’t confirm it. A NAAT test is the only way to confirm a possible infection. It’s curable as any other bacterial infection, but the treatment has to be timely. In adults, gonorrhea is treated with antibiotics.  It could be oral pills or through an injection. To decide the course of your treatment first gets a gonorrhea urine test done. After confirmation of an infection consult an authorized medical practitioner to get a prescription.


Prevention of Gonorrhea

Abstinence can be the only absolute method of preventing gonorrhea but it’s not possible. 🙂   A monogamous relationship is more prudent to reduce your risk of an infection.  Use condoms when you have sex with a partner of unknown sexual history. You and your partner should make it a habit to get tested for the STDs if you are at increased risk.