What is pelvic inflammatory disease?
Pelvic inflammatory disease (PID) refers to infection of female 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 or gastrointestinal tract, such as Gardnerella vaginalis or 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 complications of 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 bacterial scarring of the fallopian tubes, is the most common yet preventable consequence of PID. Each year in the US, more than one million women have an episode of PID and 10-15% become infertile. About 1 in 8 sexually active adolescent girls will develop PID before age 20. Because infections such as chlamydia may show no obvious symptoms, or subtle, non-specific ones, yet result in serious long-term problems, the Centers for Disease Control and Prevention (CDC) recommends annual screening for all sexually active women age 25 and under 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. Situations that put women at increased risk for PID include:
- Sexual activity during adolescence
- A male sex partner with gonorrhea or chlamydia
- Multiple sex partners
- Past history of any STD
- Past history of PID
- Recent insertion of IUD
- Douching (which can flush bacteria into the uterus)
- Child birth
- Miscarriage or abortion
Since the uterus is sealed off during gestation, an occurrence of PID during pregnancy is rare.