Introduction
Sexually transmitted diseases (STDs) turn out to be an urgent topic for discussion for the citizen of the United States. If these diseases remain untreated, they can cause pelvic inflammatory disease (PID), which results in difficulties while getting pregnant and other health complications (The Centers for Disease Control and Prevention, 2019). Specific care plans and preventive interventions are developed to reduce the proportion of females aged between 15 and 44 years who need treatment for PID.
According to Das, Ronda, and Trent (2016), one of the methods to achieve positive results in dealing with PID is the improvement of awareness about STDs and PID, in particular. In this paper, the signs and symptoms of PID, its treatment, follow-up care, medications, and possible psychological issues will be discussed to clarify how to reduce the number of female patients and prevent STDs.
Signs and Symptoms
Pelvic inflammatory disease is a common infection that occurs in female reproductive organs. About 10% of untreated STDs lead to the progress of infections, including PID (The Centers for Disease Control and Prevention, 2019). This disease is explained as inflammation of the vagina and damage of fallopian tubes, uterus, and ovaries (Das et al., 2016). In some cases, patients who have PID are asymptomatic, and it is hard to identify the symptoms at the early stage of disease development. However, severer disease forms are characterized by abdominal pain, vaginal discharge, painful or bloody intercourse, and abnormal menstruations (Savaris, Fuhrich, Duarte, Franik, & Ross, 2017).
Regarding the information taken from the clinical practice guidelines, a physical examination of patients helps reveal cervical motion tenderness as the symptom of PID (The New Zealand Sexual Health Society, 2017). In some cases, fever or difficult urination is observed, and there is also a threat of pregnancies outside of the womb (Savaris et al., 2017). Patients who are older than 30 years and have multiple sexual contacts or past SDI history are at high risk of having PID.
Treatments per Current Clinical Guidelines
Patients are under threat of having PID-related complications like tubo-ovarian abscess or infertility. Therefore, it is recommended to start treatment as soon as some problems are identified. The nucleic acid amplification test (NAAT), endocervical culture swab, and high vaginal culture swab are required to check for chlamydia, gonorrhea, and candida (The New Zealand Sexual Health Society, 2017). Urine and blood tests are used to identify if there is inflammation in the organism. Ultrasound shows the images of female reproductive organs and reveals abnormalities if any.
Patients with PID as their diagnosis should follow a clear treatment plan. Regimes usually depend on the level of PID, and mild PID females take ceftriaxone 500 mg (im stat), doxycycline 100 mg, and metronidazole 400 mg twice per day for two weeks (The New Zealand Sexual Health Society, 2017). If the patient is pregnant, azithromycin 1 g PO stat and one week later should be offered as a part of therapy, but the same drug is not recommended if PID is of a gonococcal type (The New Zealand Sexual Health Society, 2017).
In their study, Savaris et al. (2017) discover the superiority of azithromycin over doxycycline, but no clear evidence of differences between such drugs as quinolone and cephalosporin, nitroimidazole and nitroimidazole, or clindamycin. In total, the use of antibiotics and temporal abstinence are the two critical elements of pharmacological and non-pharmacological therapy for PID patients.
Follow-Up
Today, patients have access to appropriate care and diagnostic services to control their STDs and improve their well-being. However, in many cases, females aged between 15 and 44 years neglect follow-up recommendations and face similar problems within the next several years or even months. Therefore, the New Zealand Sexual Health Society (2017) and the Centers for Disease Control and Prevention (2019) pay attention to the required follow-ups.
They include repeated bimanual examination, reviews in the next 48-72 hours and two weeks, and sexual health checks three months after treatment (The New Zealand Sexual Health Society, 2017). In addition, the management of sexual contacts cannot be ignored because PID is an inflammation, meaning that some partners could have bacteria or other irritants for the already damaged organism.
Psychological Issues
As well as an STD or other health problem, PID could cause certain psychological changes in women. Female mental health cannot be ignored when treating them from infections or inflammations. Shen et al. (2016) underline the possibility of psychiatric comorbidities like depression, anxiety, sleep disorders, schizophrenia, and bipolar disorders in PID patients. Psychological issues are based on the fact that 15-44-year-old females are at their reproductive age, and the presence of PID reduces their chances of having a baby. Another critical factor of PID is its asymptomatic nature and the inability to predict complications. Long-term physiological changes like infertility or chronic pelvic pain determine the quality of human life, which results in depressive and anxious symptoms being developed.
Side Effects
The reduction of women who require treatment for PID is possible if the evaluation of side effects of the disease and medication is properly organized. Even though pharmacological treatment is used to control PID and prevent complications, sometimes, patients face certain side effects of particular drugs. Nausea and vomiting are the most common problems that can be the result of taking drugs or the disease in general (Savaris et al., 2017). Diarrhea and stomach pain are the gastric effects that are frequently observed in many patients with infections and inflammations (The New Zealand Sexual Health Society, 2017). Finally, rash or itching may bother patients due to drug incompatibility.
Statistics
Many modern organizations aim at analyzing the current situation in countries. For example, the Centers for Disease Control and Prevention (2019) informs that the number of females aged 15-44 years has dramatically increased during 2006-2013 and decreased between 2013 and 2015. Today, PID complaints decline nationally but remain one of the major causes of female morbidity (The Centers for Disease Control and Prevention, 2019).
The numbers differ in American states, and New Jersey does not introduce clear statistics about PID but focuses on such STDs as syphilis, chlamydia, and gonorrhea. In 2015, syphilis was observed in 4.2 per 100,000 people, and chlamydia and gonorrhea (PID causes) were diagnosed among 350.6 per 100,000 citizens of New Jersey (The Centers for Disease Control and Prevention, n.d.). The racial disparity is insignificant for PID diagnosis, but this factor is still investigated.
Conclusion
In general, the current statistics and the discussion of symptoms and risk factors show that PID remains a burning health problem among US citizens. Females with gonorrhea or chlamydia history are challenged by the possibility of having PID and infertility as its severe outcome. Therefore, clinical practice guidelines and official reports focus on the development of recommendations to prevent PID or treat it effectively, avoiding side effects, and choosing appropriate therapies.
References
The Centers for Disease Control and Prevention. (2019). Sexually transmitted disease surveillance 2018. Web.
The Centers for Disease Control and Prevention. (n.d.). New Jersey – State health profile. Web.
Das, B. B., Ronda, J., & Trent, M. (2016). Pelvic inflammatory disease: improving awareness, prevention, and treatment. Infection and Drug Resistance, 9, 191-197. Web.
The New Zealand Sexual Health Society. (2017). Pelvic inflammatory disease (PID): Management summary. Web.
Savaris, R. F., Fuhrich, D. G., Duarte, R. V., Franik, S., & Ross, J. (2017). Antibiotic therapy for pelvic inflammatory disease. The Cochrane Database of Systematic Reviews, 2017(4). Web.
Shen, C. C., Yang, A. C., Hung, J. H., Hu, L. Y., Chiang, Y. Y., & Tsai, S. J. (2016). Risk of psychiatric disorders following pelvic inflammatory disease: A nationwide population-based retrospective cohort study. Journal of Psychosomatic Obstetrics & Gynecology, 37(1), 6–11. Web.