What is pelvic inflammatory disease?
Pelvic inflammatory disease (PID) is an infection of a woman's reproductive organs. It usually occurs when sexually transmitted bacteria spread from the vagina through the cervix, into the uterus, the fallopian tubes, and the ovaries.
The majority of cases of PID are a complication of sexually transmitted diseases (STDs), most commonly due to chlamydia (Chlamydia trachomatis) and gonorrhea (Neisseria gonorrhoeae) infections. Other bacteria normally found in the vagina, such as Gardnerella vaginalis, or the digestive tract, such as Escherichia coli, have also been associated with PID, though it is not well understood why this occurs.
Prompt and appropriate early treatment of STDs can prevent PID. Left untreated, PID can cause irreversible damage to one or more reproductive organs, leading to severe abdominal pain, infertility, ectopic pregnancy, and other problems, including abscess formation. Infertility, caused by scarring of the fallopian tubes, is one of the most common yet preventable consequences of PID.
Though cases of PID have been declining recently, it is still a significant disease with serious consequences. About 5% of women in the U.S. report being treated for PID at least once in their lives, according to the Centers for Disease Control and Prevention (CDC). About 1 in 8 women who have had PID experience some difficulty getting pregnant.
Because infections such as chlamydia may show no obvious signs or symptoms, or subtle, nonspecific symptoms, yet result in serious long-term problems, the CDC recommends annual screening for all sexually active women age 25 and younger and for other women who are at increased risk. (For more on this, see the articles on chlamydia and gonorrhea screening for Teens, Young Adults, Adults, and Adults 50 and Up.)
Although PID can affect any woman at any age, with or without sexual transmission, most cases occur in sexually active women of childbearing age. Examples of situations that put women at increased risk for PID include:
- Not getting treated for an STD
- Being sexually active and 25 years old or younger
- Having multiple sex partners
- Having a sex partner with multiple sex partners
- Having a past history of any STD
- Having a past history of PID
- Undergoing an insertion of an IUD within the last weeks
- Douching (which can flush bacteria into the uterus)