Pelvic inflammatory disease (PID) is a potentially life-threatening condition that can lead to infertility and other serious complications including ectopic pregnancy, pelvic abscess, and pelvic peritonitis. Many cases of PID result from untreated sexually transmitted infections (STIs), most commonly Chlamydia trachomatis (chlamydia) and Neisseria gonorrhea (gonorrhea). Chlamydia is the most common sexually transmitted infection in North America, followed by gonorrhea. Up to 40% of untreated chlamydia cases result in PID.
Pelvic inflammatory disease occurs when micro-organisms gain entry from the lower genital tract (vagina and cervix) to the upper genital tract (uterus, fallopian tubes and pelvic peritoneum).
Pelvic inflammatory disease affects at least 1 million women each year in the U.S., leaving approximately 100,000 infertile due to scarring of the fallopian tubes resulting from infection.
Who is at risk?
- Sexually active women in childbearing years, with women under 25 more at risk than those over 25 due to incomplete maturation of the cervix;
- Women with multiple sex partners;
- Women whose sexual partner has multiple sexual partners, both of which increase the risk of exposure to STD;
- Women who douche (douching may change the population of organisms residing in the vagina, and organisms can be forced from the lower genital tract to the upper genital tract);
- Women who have Intrauterine devices (IUDs), especially during the time shortly after insertion;
- Women who have STD (especially gonorrhea and chlamydia).
Symptoms range from none to severe despite damage to the reproductive organs. Because symptoms may be absent or mild, PID can go unrecognized in up to two thirds of cases.
In cases of symptomatic PID, lower abdominal pain is the most common complaint, but symptoms may also include:
- fever,
- unusual vaginal discharge (with or without a foul odor),
- pain during intercourse and/or urination,
- irregular menstrual bleeding,
- and rarely, pain in the right upper abdomen.
Prevention of PID
The major preventable cause of pelvic inflammatory disease is sexually transmitted infection; therefore, prevention strategies involve reducing the risk of acquiring sexually transmitted infections (STI), as well as early recognition and treatment of STI:
- Abstaining from sexual intercourse;
- Monogamous relationship with a partner tested and known to be uninfected;
- Consistent, correct usage of latex condoms during sexual intercourse;
- Prompt recognition and treatment of STD when it occurs;
- Annual chlamydia testing of sexually active women under age 25;
- Annual chlamydia testing of women older than age 25 with a new sex partner or multiple sex partners.
Further reading on pelvic inflammatory disease:
Pelvic inflammatory disease: What is it?
Sexually transmitted infection
Sources:
Sequelae of STD: Pelvic inflammatory disease and ectopic pregnancy.
