Uterine Conditions: Pelvic Inflammatory Disease

Uterine Conditions: Pelvic Inflammatory Disease²⁵
One of the most common and serious complications of STDs among women is pelvic inflammatory disease (PID). PID is an infection of the upper genital tract that can lead to infertility, tubal pregnancy, chronic pelvic pain and other serious consequences affecting the uterus, ovaries, fallopian tubes or pelvic organs. More than one million American women and teens experience an episode of acute PID each year, and the condition is responsible for the majority of ectopic (tubal) pregnancies that occur annually in this country. PID is the most common, preventable cause of infertility in the United States.

Causes. PID is caused by bacteria that migrate from the vagina or cervix into the fallopian tubes, ovaries and uterus. Although numerous types of bacteria can cause PID, the two most common are the bacteria that cause gonorrhea and chlamydia. The more sexual partners you have, the greater your risk of PID.

In some cases, bacteria that normally live in the vagina can also cause PID. These bacteria are thought to gain access to the upper genital tract during ovulation and menstruation, particularly if menstrual blood flows backward from the uterus into the fallopian tubes. Some experts believe douching may also contribute to the disease by flushing bacteria into the uterus, ovaries and fallopian tubes. An intrauterine device (IUD) may slightly increase your PID risk. PID can develop days, weeks or months after the initial infection.

Symptoms. You may have PID but no symptoms, particularly if the original cause was chlamydia. The most common symptoms of PID are lower abdominal pain and abnormal vaginal discharge. Other symptoms include: fever, painful intercourse, irregular menstrual bleeding and pain during a pelvic exam.

Sometimes, PID can produce scar tissue in other areas of your abdomen, causing chronic pelvic pain that can last for months or even years. The more bouts with PID you have, the more likely you are to become infertile, suffer an ectopic pregnancy, and develop chronic pelvic pain.

Diagnosis. PID is often hard to diagnose if the symptoms are mild or nonexistent.
Because there is no specific laboratory test for PID, the disease is usually diagnosed using a pelvic exam and tests for gonorrhea and chlamydia. Many physicians recommend laparoscopy to diagnosis recurrent PID.

Treatment. PID can be cured with antibiotics, but the damage it can cause is irreversible. Your sexual partner(s) should also be treated to prevent reinfection.

Prevention. Abstinence or limiting your sexual partners, correctly using male or female latex condoms, and seeking medical attention for any vaginal discharge with odor or bleeding between periods (a sign of possible infection) are the main preventive measures you can take. Avoiding douching and getting tested regularly for STDs can also help. Oral contraceptives may provide some protection by creating thicker cervical mucus, making it more difficult for bacteria to reach the upper genital tract.