Pelvic inflammatory disease (PID) is an umbrella term that refers to infection of the upper tract of the female reproductive system, including the uterus, fallopian tubes and ovaries. This usually occurs as a result of an infection lower down in the system, such as chlamydia, that has spread upwards.

PID is common, but often does not cause any clear symptoms. Most women with the condition have mild, non-specific symptoms such as lower abdominal pain, pelvic discomfort during sex, pain upon urination, heavy or painful periods, unusual vaginal bleeding such as between periods and after sex, or unusual vaginal discharge. Occasionally more severe symptoms are experienced such as severe abdominal pain, a fever, nausea and vomiting.

The symptoms are often confused with other conditions – appendicitis, for example – and because there is no specific test for PID, it can be difficult to diagnose. This is an issue because, if left untreated, the upper reproductive organs can become damaged, which can cause problems with fertility and during pregnancy. One of the most dangerous problems is an ectopic pregnancy, when the fertilised egg implants in the fallopian tube instead of the uterus and the growing foetus causes the narrow tube to rupture.

PID can be treated using antibiotics – usually a mixture of medicines to try and tackle the most likely causative infections – during which time sexual intercourse should be avoided and partners tested and treated to reduce the risk of reinfection. Prevention is important, with condoms key in reducing the risk of contracting the infections in the first place that can lead to PID.

Other types of infection

As previously mentioned, there are some infections of the reproductive tract that are not necessarily sexually transmitted:

• Bacterial vaginosis (BV) is not sexually transmitted, but instead occurs as a result of an imbalance in the bacteria needed to keep the environment inside the vagina healthy. Contributing factors include vaginal douching (rinsing), using perfumed toiletries such as bubble baths or shower gels and having multiple sexual partners. Around 50 per cent of women don’t experience symptoms, although these can include a fishy smelling discharge from the vagina, which can be white or grey in colour and become thin and watery. Gels containing lactic acid or glycogen can be used to help restore the vaginal pH and ease symptoms. Antibiotics can also be used to treat BV. It’s important to note that the condition can recur
• Vaginal thrush occurs when the environment within the vagina alters – perhaps because of antibiotic use, pregnancy or lowered immunity – and a yeast that is usually present in low levels starts to multiply and get out of control. The most common symptoms are itching, redness and soreness of the vulva and vagina, and a thick white discharge. In men, the penis may become red, itchy and sore. Antifungal treatment is usually effective.