Today’s Ugandan woman is faced with many health risks, from lifestyle to genetic diseases. Throughout the month of March, in commemoration of International Women’s Day, Health and Science explores the top killer diseases threatening Uganda’s woman. This week, Rebecca Nalunga examines Pelvic Inflammatory Disease (PID)
This seemingly mild disease is a cause for concern among Ugandan women. Dr. Ibrahim Ntale, a physician at The Practice Medical Center, Najjera, describes Pelvic Inflammatory Disease (PID) as an infection of the uterus, fallopian tubes, tissues in, around and near the uterus and ovaries.
PID arises from complications from some sexually transmitted diseases, especially chlamydia and gonorrhoea. Ntale says the bacteria that cause these two diseases migrate upward from the woman’s vagina or cervix into her womb and other reproductive organs.
“Even though it can be caused by many different organisms, the bacteria responsible for PIDs are associated with chlamydia and gonorrhea,” he says.
The disease scars the tissue in the fallopian tubes, or the womb and can cause ectopic pregnancies and infertility.
A study in the Teso and Ankole regions was done to determine the causes of low and high fertility rates.
In Teso, where women experienced low fertility, (37/1,000) of 340 women, 25% tested positive for pelvic-related infections as compared to 8.9% of 250 women in the highly fertile Ankole region. In Teso, 18.3% of the women tested positive for cervical-related illnesses and gonorrhea.
This was a huge margin as compared to 2.4% of women in Ankole region.
Who is at risk?
Women who are sexually active and of child bearing age, especially under the age of 25, are at high risk.
“This is partly because the cervix of teenage girls and young women is not fully matured, making them prone to the disease,” Ntale explains.
Other categories of women at risk are:
Women with multiple sexual partners
Women with promiscuous partners
Women who douche regularly, something that, Ntale says, tampers with the good vaginal bacteria. As a result, douching forces bacteria from the vagina into the upper organs.
Women who have intra-uterine devices may have slightly higher chances prior to insertion. It is, therefore, advisable to have a test done.
Symptoms, treatment
The signs and symptoms can be elusive, according to Ntale and one may pass them off as a mild infection. Because of this, the disease often goes undetected by women and their healthcare providers. In addition, the signs and symptoms vary from mild to severe.
“If Pelvic Inflammatory Disease results from chlamydial infection, a woman is more likely to experience only mild symptoms even when extensive damage has been done to her reproductive organs,” Ntale says.
The most common symptoms are:
Lower abdominal pain
Fever
Painful urination
Irregular menstrual bleeding
Unusual vaginal discharge with a foul odour and pus
Painful intercourse
Pain in the right upper and lower abdomen
Treatment
Treating PID calls for strict adherence to medication. It is cured by several antibiotics although, unfortunately, they do not reverse any damage that may have already occurred to the reproductive organs.
Ntale points out that two antibiotics are used in the treatment because it is difficult to identify the disease-causing organisms. “Once the patient commences the medication, she should go back to the health centre for re-evaluation,” he adds.
Her sexual partner should also undergo treatment even if he does not display any signs and symptoms to eliminate chances of re-infection.
This treatment, Ntale says, does not need hospitalisation unless the patient is severely ill, with nausea, vomiting, diarrhoea or if she is pregnant. She can also be hospitalised if she does not respond to the treatment or if she has an abscess in the fallopian tube.
Protect yourself
One does not have to suffer from PID if one practises preventive measures like abstaining from sex as well as taking measures to prevent Sexually Transmitted Diseases like gonorrhea and chlamydia by using condoms correctly. Overall, proper treatment of all STDs will keep one safe from PID.
Research has also shown that birth control methods, particularly the birth control pill, patch (a small patch that sticks to the skin to prevent pregnancy) and the vaginal ring, thicken the cervical mucus and help prevent infection of the uterus, fallopian tubes and ovaries. However, these do not offer protection against STDs.
Complications
If untreated, PID results in serious, life-threatening complications. These include:
The infection easily spreading to the blood or other parts of the body
A ruptured fallopian tube
Increased risk of ectopic pregnancies where the fertilised ovary implants in the fallopian tube instead of the uterus. This can lead to death, so if you experience irregular vaginal bleeding, abdominal pain, sudden weakness or fainting, consult a doctor.
