Pelvic Inflammatory Disease (PID) Treatment in Nigeria : Medications

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What is Pelvic Inflammatory Disease (PID)?

It is an infection of the female reproductive organs and it usually occurs mostly when sexually transmitted bacteria is contracted and spread from the vagina to the uterus, fallopian tube, or ovaries. On the onset, in most cases, symptoms of PID may not be apparent. More than 100,000 cases are reported in Nigeria per year.

Causes

Pelvic inflammatory disease (PID) is a bacteria-infected disease that is sexually transmitted. This sexually transmitted infection (STIs) spreads via the vagina or cervix to your womb, fallopian tubes, or ovaries.

Common bacteria involved most times in PID are either gonorrhea or chlamydia or previously contacted STI. However, one can develop PIS without ever having STI. 

Other risk factors that may lead to PIS include:

• Multiple sexual partners
• Unprotected sex
• Having sex under 25
• Inserting an intrauterine device (IUD)
• Having a history of PID
• Vaginal touching; which is the vagina with water or a mixture of fluids to eliminate odors and clean the vagina. Douching has some complications. Washing affects the pH balance of the vagina and flushes out the vaginal flora that helps stop the infection and prevent irritation in the vagina.

Symptoms & Signs

Signs and symptoms of PID may be mild and sometimes difficult to detect, while in some women no signs are seen. When signs and symptoms are present, they may include:

• Pain in the lower abdomen and pelvis–mild or severe.
• Pain during sexual intercourse.
• Painful, frequent, and difficult urination.
• Fever
• Abnormal vaginal discharge 
• Abnormal uterine bleeding between the menstrual cycle and during or after intercourse.

Diagnosis

PID cannot be accurately be diagnosed with a test, instead, your doctor will tell on a combination of finding derived from:

• Medical History

Findings from your sexual habits, history of STI’s and method of birth control. 

• Physical Examination

Signs and symptoms you are experiencing and a check of your pelvic region.

• Lab Tests

Among which includes:

• Swab test of the vaginal fluid
• Urine test
• Blood test

To test for pregnancy, HIV and STIs, measure WBC counts, or any trace of infection or inflammation.

1. Ultrasound; to view your reproductive organs.
2. Laparoscopy; to view your pelvic organs.
3. Endometrial Biopsy; to test for infection and inflammation in the uterus.

Treatment 

Treatment may include medications, extra steps to manage the PID, and in extreme situations, surgery.

Medications

Placement on antibiotics after your lab test results is received by your doctor.

Antibiotics for PID include:

• Cefoxitin
• Probenecid
• Doxycycline
• Cephalosporin
• Metronidazole
• Gentamicin
• Ampicillin
• Clindamycin
• Azithromycin,
• Cefotetan, etc.
• Treatment of your partner to prevent infection with STI, even if your partner is not showing noticeable signs.
• Temporary abstinence from intercourse with your partner to check reinfection until your treatment is complete.

Surgery

PID can be treated successfully with medication with antibiotics. However, if an access ruptures or threatens to rupture, your doctor will have to drain it. You might need to do surgery if you do not respond to antibiotic treatment or have a questionable diagnosis.

Complications

Untreated PID might cause abscesses to develop and therefore cause permanent damage to the reproductive organs. This may lead to the following complications:

• Ectopic Pregnancy

The scar tissue caused by PID prevents the fertilized egg movement to the uterus through the fallopian tube.

• Infertility

Damage to your reproductive organs may cause infertility.

• Tubo-Ovarian Abscess

PID might cause an abscess to form in your reproductive tract. This pus collection affects the fallopian tube and ovaries. It can also develop in the uterus and other pelvic organs. Abscess, if left untreated is life-threatening.

• Chronic Pelvic Pain

PID can cause pelvic pain that might last for years. May also cause pain during intercourse and ovulation.

PID Treatment in Nigeria

A lot of work has been done in the medical sector as regards pelvic inflammatory disease (PID) in Nigeria. The pharmaceutical departments have risen to the challenge considering the wave of rising juvenile delinquencies and sexual abuses in Nigeria. 

More than 100,000 people in Nigeria are infected with PID per year and in a country where proper and accurate statistics are difficult to come by, this figure may very well be on the increase as days go by. PID drugs in Nigeria ranges from between $6 to $16 (2,000 to 15,000 Naira), especially in Lagos and Abuja.