Pelvic Inflammatory Disease

It is estimated that annually there are more than 750,000 women who have ever suffered from acute PID. From 10 to 15% of these women could become infertile as a result of a PID. A large proportion of the ectopic pregnancies that occur each year are the result of a PID.

PID occurs when bacteria pass from the vagina or cervix (the opening to the uterus) of the woman to her other reproductive organs. Different types of organisms can cause PID, but many cases are associated with gonorrhea and chlamydia, two very common bacterial sexually transmitted diseases. Having ever suffered from PID increases the risk of it happening again because the reproductive organs may have suffered damage the first time the infection occurred.

Sexually active women who are of childbearing age are those who are exposed to an increased risk, and women who are less than 25 years of age are more likely to get PID than women older than this age. This is because the cervix of adolescent girls and young women is not fully formed, which increases their susceptibility to contracting sexually transmitted diseases related to PID.

The more sexual partners a woman has, the greater the risk she has of getting EIP. Likewise, a woman whose sexual partner has more than one sexual partner faces an increased risk of contracting this disease because she is potentially exposed to more infectious agents.

Women who use douching have a higher risk of getting EIP than women who do not use douching. Research has indicated that showers alter in a harmful way the composition of the vaginal flora (microorganisms that live in the vagina) and can push the bacteria from the vagina to the upper internal genital organs.

Women who use intrauterine devices (IUDs) may have a slightly higher risk of developing PID during the time close to insertion of the device than women who use other contraceptive methods or women who do not use any. However, the risk is significantly reduced if a woman is tested for sexually transmitted diseases, and if necessary, she is given the indicated treatment before inserting the IUD.

PID can present with mild symptoms or severe symptoms. When PID is caused by a chlamydial infection, a woman is more likely to experience mild symptoms or not have symptoms at all even when her genitals are being affected. Because the symptoms are so unspecific, PID is often not detected by women or doctors. Women who have symptoms of PID generally suffer from pain in the lower part of the belly. Other signs and symptoms include fever, unusual vaginal discharge that may have a bad odor, painful sexual intercourse, painful urination, irregular menstruation and pain in the upper right part of the abdomen (rare).

Early and adequate treatment can help prevent complications caused by PID, such as permanent damage to the female genital organs. The bacteria that cause the infection can invade the fallopian tubes without presenting symptoms and transform normal tissue into scar tissue. This fibrous tissue blocks or interrupts the normal movement of the ovules to the uterus. If the fallopian tubes are totally blocked by the scar tissue, the sperm can not fertilize the egg and the woman becomes infertile. Infertility can also occur when the fallopian tubes are partially blocked or slightly damaged. 10 to 15% of women with PID may become infertile and, if the woman has multiple PID cases, the chances of infertility increase.

Also, a partially blocked or slightly damaged fallopian tube can cause a fertilized egg to remain in the fallopian tube.

If the fertilized egg begins to grow in the tube as if it were in the uterus, an ectopic pregnancy occurs. As it progresses, the ectopic pregnancy can rupture the fallopian tube and cause great pain, internal bleeding and even death.

The appearance of scar tissue in the fallopian tubes and other pelvic structures can also cause chronic pelvic pain (a pain that lasts for months and even years). Women who have repeatedly suffered from PID are more likely to suffer infertility, ectopic pregnancy or chronic pelvic pain.