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Pelvic Inflamatory disease

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I'm wondering , as I think I heard something about this possible side effect, and can't find it on Google.

I don't want to go running to the doc, but the pain in my lower right abdomen is alarming (only the 2nd day, maybe I'm being a hypochondriac). But I did read that it could be PID. I am post-menopausal.

I know there are several causes for this pain. but I wanted to check out the possibility of this relationship before seeing my GP, who knows next to nothing about Psychiatric drugs. Actually, I don't want to see the GP at all, and my appt. with my pdoc is almost 2 wks from now.

Has anyone heard of this?

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Being the resident OB/GYN nurse--I gotta say this is totally new to me. PID is usually (repeat: USUALLY) caused by a sexually transmitted disease you don't know you have.

I can't figure out what the connectiion with any psych disease could be, unless something lowers your resistance to infection. And even then, you gotta get the infection.

Actually there are multiple possibilities that might be causing lower right abdominal pain, and many of them have NO connection to your reproductive organs. You need to see a doc--and if it continues thru the weekend, and/or you get a fever, nausea, etc--go to an ER. If you have any kind of pelvic infection, it is not something to screw around with (no pun intended) And at the risk of scaring you shitless, ovarian cancer also can produce the same kind of pain, out of the blue.

I'm gonna check on the drug-PID thing, but please call your doc--yourmedical doc, or your GYN.

Love, china

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I don't find anything in the PDR about PID for valproic acid/depakote. Note that they are actually two different compounds but even the manufacturer uses the names interchangeably even in the safety data.

PID is an inflammatory reaction to bacterial infection from any of a dozen or more agents. The immediate cause would still be bacteria and require antibiotics. A thorough discussion can be found at eMedicine: http://www.emedicine.com/med/topic1774.htm

From a diagnosis perspective, PID involves the genitourinary tract so I would expect the pain to be diffuse across the entire abdomen. One differential diagnosis for pain on the right abdomen is Appendicitis. Additional symptoms might be a fever and especially nausea and no desire for food.

If the pain continues or gets acute before you can see your GP on Monday, don't hesitate to go to the ER. Acute belly pain is one of the most common causes for ER visits and because it can be caused by many dangerous conditions, it is a great challenge for ER docs.

Hope you feel better soon. a.m.

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There are several rather large warnings with Depakote about liver disease as well as pancreititis. Neither are minor--but both organs are a bit higher on your right side.

Nevertheless, you need to have labs done to rule out these complications, NOW-- If you go to the ER, be SURE to tell them you are taking Depakote (if thats what you are taking--) and be sure they run liver panels, etc. in your blood tests.

I learned something new--always a good day when that happens, altho I sure hope none of the above applies to you!

Please let us know whats going on with you----and AM is right, ER's are a good place for belly pain that doesn't resolve, gets worse, or other stuff starts. They are used to ruling stuff out, so they can cut right to the chase--but being your own advocate is best, and be SURE they know about the Depakote--and the liver/pancreas thing--


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OK, our local clinic is open tomorrow morn. so if this is still happening I'll go there if I can get in. Tell 'em it's an emergency I guess.

It hurts like hell when I pee, then gets better after a bit. Not like a bladder infection, tho- at all. I keep hoping it's just being plugged up, or gas, so I took a herbal laxative tonight,,lol

but yeah, I'll get it checked out. I HATE going to doctors!

btw- this difference between Valproic Acid, Valproate, Depakote and Epival is very confusing to me. Here it's called Epival and is labeled on the bottle : Apo-divalproex, then Divalproex Sodium. (I think it dissolves in the intestine rather than stomach.) But my GP was completely flummoxed and the pharmacist unintelligable. My pdoc says it's basically the same stuff, or words to that effect. I had a liver test recently, so that's good.

Thanks so much for doing the research, you guys! I read that website, a.m., and it's a little frightening but helpful to be informed. And it looks like PID is out of the picture. I don't know where I heard that- I feel a little silly now. STD indeed!

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I just found a website-


. The site is Medscape something. This page is about the side effects in the treatment of BP.

Anyway, in the section about mood stabilizers, it says that the assn of PCOS and Divalproex is not clear and that indications show a comordity with BP and PCOS before taking Divalproex. hmmm

another site I looked at said that newer studies show no assn. ( btn pcos & divalproex)

There seems to be no correlation between that and PID. I thiink I was way off base with the PID thing. Thanks Dee.

But I'm still in the bloody uncomfortable (and scary) position of having to see a GP today. Maybe it'll help the anxiety, maybe it'll ramp it up. Shit.

[edited to fix link. a.m.]

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I'm not sure why your second assumption that belly pain would be PCOS. PCOS is a systemic disorder with multiple and promininent symptoms that would NOT suddenly appear from nowhere. Since you report being post menopausal, by definition, the ovaries would no longer active, and the ravages of the disease would have largely run their course over the previous 40 years. There are concerns with depakote in relation to diabetes and blood sugar control. Something that your pdoc should be monitoring with annual bloodwork. a.m.

From Wikipedia:

Common symptoms of PCOS include

Oligomenorrhea, amenorrhea - irregular, few, or absent menstrual periods; cycles that do occur may comprise heavy bleeding (check with a gynecologist because heavy bleeding is also an early warning sign of endometrial cancer, for which women with PCOS are at higher risk)

Infertility, generally resulting from chronic anovulation (lack of ovulation)

Elevated serum (blood) levels of androgens (male hormones), specifically testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS), causing hirsutism and occasionally masculinization

Central obesity - "apple-shaped" obesity centered around the lower half of the torso

Androgenic alopecia (male-pattern baldness)

Acne, oily skin, seborrhea

Acanthosis nigricans (dark patches of skin, tan to dark brown or black)

Acrochordons (skin tags) - tiny flaps of skin

Prolonged periods of PMS-like symptoms (bloating, mood swings, pelvic pain, backaches)

Sleep apnea

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I have PCOS and the doctors would not give me valproic acid/depakote because it could make my PCOS wrose.

AirMarshall is right when he says "PCOS is a systemic disorder with multiple and promininent symptoms that would NOT suddenly appear from nowhere"

I think what I said give you no help but I'll try to look something up for you.

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I don't know anything- I'm in the wilderness here. the GP said I need an ultrasound and D&C!!! I don't wanna.

I don't mind the ultrasound but i do want to find an alternative to surgery. Well, I admitted for the first time to anyone that I'd had post-menopausal spotting a couple of times and I NEVER go to doctors.

She started talking about hysterectemy and I went into a fog. they're so quick to get you under the knife, and I'm really really afraid of being pressured by doctors, and end up being hurt by them. (past experience)

She noted that I'm Bipolar by the meds I take, but couldn't understand my anxiety. (maybe there is no relation? Anxiety paralizes me.)

She said I am SO in Denial! It is unbelievable to her that I would ignore my body like this.

I've been doing quite well, moodwise, lately. Depression, anxiety (just one attack), irritability, not acute. Pdoc has reduced the meds.

Now now it's slipsliding away and I want to cancel everything, including social stuff and all doc. appts, Tdoc, Pdoc- all of them. I want to hide in a hole, but I'm afraid of the pain, too! I'm afraid of how my sweet schyzoaffective son will cope if I'm gone. I'm the only one he can talk to while in an episode.

It's hard to talk about this. My mind is nattering away but I'm outwardly in a clench. I never did let my husband know anything about this physical stuff until now. I try to keep the emotions hidden from him. No fucking reason- he is very supportive about all of it- the moods, the broken ankle which is still healing, this shit.

and maybe this should be moved to another forum. The topic name is sure not about what's happening.

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You've been to the doc, so good. Now, take things one at a time.

The thing about meds is that they can be adjusted as needed. When you were doing well, your pdoc lowered them. Now that you are having problems, you need to call your Pdoc Monday and either get an near appointment or directions for med changes.

They probably don't do an ultrasound AND a D&C at the same time, so get the ultrasound scheduled first, and once that's done you will have a complete picture of your situation and what other treatment you need so you can make an informed decision. No doubt some of the ladies here can answer questions you have. You may want to start another thread for that.

The best way to take care of your son and your husband is to take care of yourself. You can't ignore your body!

best, a.m.

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i think that they like to trot out the worst case scenarios right from the get-go, so people don't later say 'you never warned me about this'.

AM's right, the ultrasound comes first. can you find out WHY the doc said D&C and hysterectomy? the hyst is usually for something like fibroids or cysts...which do cause pain, but usually they try drug treatment first.

go get some more info. also, i recommend taking someone to doc with you, to take notes. a lot of people go into a fog, so docs are actually used to and relieved when patients bring in someone to be 'extra memory'.

keep us posted, 'k?

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TWO WORDS--- "Second Opinion" Get the Ultrasound, and get the results in your hot little hands, then ask your doc, sweetly, who you might see for a second opinion. If you live near a big medical center, or medical school, call there and tell them what you need.

PCOS and PID are NOT related, and PCOS doesn't come one suddently, and isn't what you have simce you are meopausal. Why are you convinced it isn't a UTI? Or a kidney infection???

You still need a liver screen to check your liver fuction and look for any pancreatic problems.

Sometimes a hysterectomy isn't a bad thing--they have a bad rep, but can often be a god-send. My daughter also had something called a Uterine Ablation--they basically killed off the inside of her uterus with heat, so she no longer has periods, but her ovaries work, etc. This is fairly new, but she was having major period problems--every 2 weeks, very long, ovarian cycts, etc. (She is 36 and does not want to have any kids--) This is a good alternative to a hysterectomy--ask your doc if he does those (or has ever heard of them!! LOL)

PM me if I can help further with questions, etc.--always here! And ask Loon--NOTHING grosses me out.

love, china rn

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