What is PID (Pelvic Inflammatory Disease)?

Pelvic inflammatory disease, commonly called PID, is an infection of the female reproductive organs. PID is one of the most serious complications of a sexually transmitted disease in women: It can lead to irreversible damage to the uterus, ovaries, fallopian tubes, or other parts of the female reproductive system, and is the primary preventable cause of infertility in women.

Each year, more than 1 million women in the U.S. experience an episode of PID. As a result of PID, more than 100,000 women become infertile each year. In addition, a large proportion of the 100,000 ectopic (tubal) pregnancies that occur each year can be linked to PID. The rate of infection is highest among teenagers.
What causes PID?

PID occurs when bacteria move upward from a woman's vagina or cervix (opening to the uterus) into her reproductive organs. Many different organisms can cause PID, but many cases are associated with gonorrhea and chlamydia, two very common bacterial STDs. A prior episode of PID increases the risk of another episode because the reproductive organs may be damaged during the initial bout of infection.

Sexually active women in their childbearing years are most at risk, and those under age 25 are more likely to develop PID than those older than 25. This is partly because the cervix of teenage girls and young women is not fully matured, increasing their susceptibility to the STDs that are linked to PID.

The more sex partners a woman has, the greater her risk of developing PID. Also, a woman whose partner has more than one sex partner is at greater risk of developing PID, because of the potential for more exposure to infectious agents.

Women who douche may have a higher risk of developing PID compared with women who do not douche. Research has shown that douching changes the vaginal flora (organisms that live in the vagina) in harmful ways, and can force bacteria into the upper reproductive organs from the vagina.

Women who have an intrauterine device (IUD) inserted may have a slightly increased risk of PID near the time of insertion compared with women using other contraceptives or no contraceptive at all. However, this risk is greatly reduced if a woman is tested and, if necessary, treated for STDs before an IUD is inserted.

A number of factors may increase your risk of pelvic inflammatory disease, including:
- Being a sexually active woman younger than 25 years old
- Having multiple sexual partners
- Being in a sexual relationship with a person who has more than one sex partner
- Having unprotected sex
- Having had an IUD inserted recently
- Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and may mask symptoms that might otherwise cause you to seek early treatment
- Having a history of pelvic inflammatory disease or any sexually transmitted infection
What are PID symptoms?

Signs and symptoms of pelvic inflammatory disease may include:
- Pain in your lower abdomen and pelvis
- Heavy vaginal discharge with an unpleasant odor
- Irregular menstrual bleeding
- Pain during intercourse
- Low back pain
- Fever, fatigue, diarrhea or vomiting
- Painful or difficult urination

PID may cause only minor signs and symptoms or none at all. Asymptomatic PID is especially common when the infection is due to chlamydia.
How is PID diagnosed?

PID is difficult to diagnose because the symptoms are often subtle and mild. Many episodes of PID go undetected because the woman or her health care provider fails to recognize the implications of mild or nonspecific symptoms. Because there are no precise tests for PID, a diagnosis is usually based on clinical findings. If symptoms such as lower abdominal pain are present, a health care provider should perform a physical examination to determine the nature and location of the pain and check for fever, abnormal vaginal or cervical discharge, and for evidence of gonorrheal or chlamydial infection. If the findings suggest PID, treatment is necessary.

The health care provider may also order tests to identify the infection-causing organism (e.g., chlamydial or gonorrheal infection) or to distinguish between PID and other problems with similar symptoms. A pelvic ultrasound is a helpful procedure for diagnosing PID. An ultrasound can view the pelvic area to see whether the fallopian tubes are enlarged or whether an abscess is present. In some cases, a laparoscopy may be necessary to confirm the diagnosis. A laparoscopy is a surgical procedure in which a thin, rigid tube with a lighted end and camera (laparoscope) is inserted through a small incision in the abdomen. This procedure enables the doctor to view the internal pelvic organs and to take specimens for laboratory studies, if needed.
How is PID treated?

PID is commonly treated with several types of antibiotics. A health care provider will determine and prescribe the best therapy. However, antibiotic treatment does not reverse any damage that has already occurred to the reproductive organs. If a woman has pelvic pain and other symptoms of PID, it is critical that she seek care immediately. Prompt antibiotic treatment can prevent severe damage to reproductive organs. The longer a woman delays treatment for PID, the more likely she is to become infertile or to have a future ectopic pregnancy because of damage to the fallopian tubes.

Because of the difficulty in identifying organisms infecting the internal reproductive organs and because more than one organism may be responsible for an episode of PID, PID is usually treated with at least two antibiotics that are effective against a wide range of infectious agents. These antibiotics can be given by mouth or by injection.  The symptoms may go away before the infection is cured. Even if symptoms go away, the woman should finish taking all of the prescribed medicine. This will help prevent the infection from returning. Women being treated for PID should be re-evaluated by their health care provider three days after starting treatment to be sure the antibiotics are working to cure the infection. In addition, a woman’s sex partner(s) should be treated to decrease the risk of re-infection, even if the partner(s) has no symptoms. Although sex partners may have no symptoms, they may still be infected with the organisms that can cause PID.

Hospitalization to treat PID may be recommended if the woman (1) is severely ill (e.g., nausea, vomiting, and high fever); (2) is pregnant; (3) does not respond to or cannot take oral medication and needs intravenous antibiotics; (4) has an abscess in the fallopian tube or ovary (tubo-ovarian abscess); or (5) needs to be monitored to be sure that her symptoms are not due to another condition that would require emergency surgery (e.g., appendicitis). If symptoms continue or if an abscess does not go away, surgery may be needed. Complications of PID, such as chronic pelvic pain and scarring are difficult to treat, but sometimes they improve with surgery.

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Degea defeat in La Liga last minute transfer deadline to leave, in the end who is to blame? "Aspen" revealed that Real Madrid with Manchester United yesterday agreed on all transactions, but Navas is about to move to Manchester United last time seek to amend the contract, resulting in a timeout. Spanish Professional Football League confirmed that Real Madrid transfer files at learn more 0:28 on September 1 was sent to the Spanish Professional Football League, when the transfer fifa 16 münzen kaufen window had closed in 28 minutes before.

It is worth mentioning that the Premier League transfer fut coins kaufen deadline is at 1:00 on September 2, four major league although the transfer deadline can not be bought, but can still sell players, in theory, still possible to sign Manchester United Navas, and Real Madrid will miss Degea.

On Degea transfer, in fact, not all parties are satisfied, Manchester United do not want to lose thigh last season, but the "strong horse is not sweet," the country looking to join Real Madrid in Spain, which makes the tripartite began intense wrestling. But this is not simply a "love triangle" story, with Ramos transfer farce is turned on, Manchester United took the opportunity to seize the opportunity, on the surface, Manchester United hope to use Degea this "card" in exchange for Ramos to join, But Woodward Real Madrid will not give in long understood, twists and turns at Real Madrid before the transfer deadline and Manchester United to win the opportunity to negotiate the day.

"Aspen" broke the news today, local time at 23:30 on August 31, Real Madrid and Manchester United on the transfer agreement: Degea to join Real Madrid 30 million euros, while 15 million euros transfer Navas places will be Manchester United, this is a happy ending, but little Navas did not succumb to the mercy of fate, in the final stage of the transfer, the Costa Rican people have suddenly proposed changes to the contract, which allows contango, this is an unexpected outcome, but It may be planned long Manchester United, now, Real Madrid silly, Degea also silly, Manchester United and Navas but laugh together, this is a win-win situation, is not it?

Like a palace intrigue, intrigues, as at the end of last season Degea wanted to switch to Real Madrid, Manchester United began persuade, seeing their number one goalkeeper indifferent, it can be tough, said to go, take enough transfer fee. Real Madrid certainly will not pay for the one-year contract only Degea too much money, so the two sides deadlocked for a long time, Van Gaal sent the Degea bleachers to give in to force Real Madrid, Real Madrid will sign Spain country Casilla said he has There are alternatives. If the two sides to start negotiations as soon as possible, rather than the last time to come up with so much wrong, I am afraid it will not be referred to the this step.

Swansea 1-2 defeat to Manchester United, the season's first defeat in the league to fourth turn. Van Gaal's team is reversed, goalkeeper Romero record without conceding a goal in the league among the final knot in 331 minutes, the Argentine goalkeeper in the game among the unsatisfactory performance, he wants the team two conceded bear some responsibility, perhaps at this time the Manchester United fans began to miss Degea.

Romero before the new season's performance is quite perfect, he three Premier League games are not a clean sheet in two games in the Champions League play-offs which was only a grain lost fumble, but also Carrick own goal. Van Gaal, but it does not get 100% approval, Manchester United manager in an interview before the game is still in the spur Romero: "I do not think how perfect Romero played in the game before the opponent shot the number is very small, even less into our penalty area. I think he has not show their full, still needs to prove himself. His difficulty is that the run-run-in with the new teammates, as well as goalkeeper coach and the whole group, now is not the best of him. "

Van Gaal worst fears came. With the game in depth, Romero in some small details of the vulnerability is magnified closer in the game among the foot Romero technical performance was very rough, he was almost a mistake in the first half on He conceded. The first 26 minutes, Damien back to the Romero, Argentina goalkeeper then beside Swansea player is not tight, it should be said that he is fully capable of handling the ball learn more better, but very hasty Romero After the siege, the ball actually incredible drive directly to the frontier closed area Shelvey, Swansea midfield ball, do not stop direct volley, but unfortunately the ball just too positive, was Romero confiscated. If you hit the ball a little longer, then Diao, Romero did not even have time to react. BBC said: "Romero technologies to open Bigfoot is indeed most do not trust." In addition to this serious mistake, there are several treatment Romero this ball of the foot, the effect is not ideal, he appears to lack fut coins kaufen self-confidence.

Romero season without conceding a goal in the second half of the record was broken. The first 61 minutes, Rooney bad, Swansea form counterattack, Xigudesen in the right pass, Ayub a note in the middle of the top of the bouncing ball, Romero slower reaction, did not stop the ball into the net. Of course, this is also not conceded full responsibility for Romero, but he should also bear some responsibility. England legend Gary Lineker said:. "If it is Degea, then perhaps this ball will be rushed out," Argentine goalkeeper without conceding a goal record at the end of 331 minutes. Romero's first grain grain between the second clean sheet and only separated by 5 minutes, 66 minutes, Ayoubi sent a straight, after Gomis nearly shot the ball outside the instep, and the selected bit Romero They are fighting to do is not good, he had a chance to reject Gomis this one goal. Gary Lineker and immediately on his Twitter said: "I know that if Degea in the case, he would rush out Gomis that goal." Manchester Evening News reporter Dawson said: "For Romero This is a nightmare of the night. "

- Gary Neville said after the game: "As a Manchester United goalkeeper, you just need to have a world-class game 1-2 times saves, but Romero did not do it today." He also Naasenna before as a goalkeeper metaphor:. ". Ospina very good, but he is not wealthy club goalkeeper, they need a top goalkeeper they need is someone who can keep the team scores goalkeeper" Arsenal so the introduction of the cut Hz. Similarly, this theory can also be used at Manchester United who have been introduced Romero Van Gaal wanted him to replace Valdes, when the team of the 2nd goalkeeper, but after a falling out with the club Degea, Romero had 12 days immediately after joining the Red Devils became the starter, this is an opportunity for him, naturally, but for Manchester United is a considerable gamble. Although expensive for Argentina's main door, but the past two seasons, either efficacy or Monaco Sampdoria, are only goalkeeper Romero, so long season, his stability has been a risk, but today romero Luo's performance is clearly unconvincing.

"Goal network" after the game only gave Romero poor four points: "He treated every ball of the foot are very frightened, he should probably do better, facing two goals conceded, he actually has way to do fighting, but destined not belong to him tonight. "BBC said after the game Manchester United will miss very Degea, they need a top goalkeeper. Now the situation is somewhat complicated, Degea strained relationship with Van Gaal, and do not speak, can not yet play for Manchester United, but Van Gaal would like to introduce Xilai Sen originally did not come, Van Gaal bet a dead Romero words the future of Manchester United this season is hard to say, first the past two seasons at Sampdoria and Monaco can only substitute goalkeeper could kick a man to assume the burden of United's defense. Secondly, with Romero on behalf of the Argentine national team Cups different qualities lengthy league needs most is stability, Romero is more interested in the "nerve knife" goalkeeper, tend to have the flash in the pan, but a big club as fifa 16 münzen kaufen goalkeeper It was not enough.

Manchester United legend goalkeeper Peter Schmeichel said, perhaps it is to represent the voices of the current Red Devils fans. He said: "Yes, we can not deny the contribution made by De Gea to Manchester United, and now no good for both sides deadlocked Manchester United should make a decision as soon as possible, let him stay for a season, or sold to Real Madrid. If sold to Real Madrid, the need to buy as soon as possible instead of who take the team's performance to take the risk, there are some not worth it. "