Why you need to look after your pelvic floor
Pelvic inflammatory disease (PID), an infection of a woman's reproductive organs affecting the womb, Fallopian tubes and ovaries, is a devastating condition that can cause chronic pain and infertility. The common condition predominantly affects women who are sexually active between the ages of 15 and 24.
Laura, 30, from South London, was in her late teens when she started suffering from constant lower abdominal pain. "The level of pain would just get worse to the point where it crippled me and I would spend days in bed and then it would change again to a more manageable level," she says. "I completely forgot what it was like to be pain-free. These symptoms were also accompanied by very painful heavy irregular periods, as well as spotting."
Laura was referred to a gynaecologist and was tested for sexually transmitted infections (STIs), which came back negative. "The gynaecologist told me I was a typical teenager with heavy periods and diagnosed me with irritable bowel syndrome (IBS)," she says.
Because PID often doesn't have any obvious symptoms, it can go unrecognised by women and their doctors. When present, they can include lower abdominal or pelvic pain, discomfort during sex, pain whilst urinating, spotting between periods and abnormal vaginal discharge.
According to Professor Ying Cheong, a member the Wellbeing of Women Research Advisory Committee, women can often be diagnosed after they become very ill with severe lower abdominal pain, nausea/vomiting and a fever.
Laura was diagnosed with PID following an emergency hospital admission for suspected appendicitis. She says, "I had two days of tests, and a transvaginal scan to check my ovaries found my left Fallopian tube was filled with fluid, which was caused by PID."
Since Laura's diagnosis, she's had surgery to remove pelvic scar tissue, which she says has left her with very little pain.
The causes and complications of PID
There are a number of causes of PID; however, in most cases it's caused by a bacterial infection, from an STI such as chlamydia or gonorrhoea. It can also be caused by bacteria that already live in the vagina, which have spread from the vagina or the cervix to the reproductive organs, says Dr Hemlata Thackare, consultant gynaecologist and IVF specialist at the London Women's Clinic .
"PID can also occur if you've had an invasive procedure that involves opening the cervix, such as an abortion, inspection of the womb, or insertion of an intrauterine contraceptive device like the coil," she says.
Left untreated, the consequences of PID can be devastating. Dr Hemlata says it has the potential to leave some women infertile if they have recurrent bouts or if they receive delayed treatment.
"PID can cause the Fallopian tubes to become scarred and narrowed by the inflammation and infection, which can prevent eggs from passing through the ovaries efficiently into the womb. As a result, this can also increase your chances of having an ectopic pregnancy, when egg implantation takes place within the Fallopian tubes instead of the womb," she says.
"It's important to seek medical help if you think you may have the condition and take a diagnosis very seriously," advises Dr Hemlata.
"If diagnosed early, PID can be treated by your GP or sexual health clinic using antibiotics, which usually last around two weeks in duration. You will be provided with a mixture of antibiotics to cover the most likely infections," she says.
For Laura, PID has led to fertility complications due to both her Fallopian tubes being blocked, leaving IVF as her only option of conceiving.
Support for PID
"There is definitely not enough support out there," explains Laura. "I've had to do a lot of my own research as I was given little information. Doctors and work places don't understand how debilitating it can be."
She advises other women to get regularly checked for STIs. "If the doctors don't believe your symptoms and you're adamant something's not right with your body, don't ignore it. Push for a diagnosis, ask for second opinions - we know our own body and when something's not right listen to what it's telling you. Don't ever let yourself be in the position I am in now: battling chronic pain and struggling with fertility issues."
For more information and support for PID, visit Pelvic Pain Support Network.