|What Causes PID?
Pelvic inflammatory disease (PID) is a generic term to describe inflammation of the uterus, fallopian tubes, and/or ovaries which can cause severe abdominal pain. If untreated, damaged tissues and nearby organs develop scar tissues and adhesions (they literally stick together). PID is most often caused by bacterial infections (40 different types of bacteria can cause it), although it can also be caused by viral, parasitic or fungal infections. PID can only occur if bacteria enter the vagina, travel through the cervix and into the uterus and fallopian tubes. Although a sexually transmitted disease is most often the source of infection, bacteria can enter in other ways. These are discussed below.
Sexually Transmitted Diseases
In the United States and western world most cases of PID are the result of catching an STD. Women who are infected with gonorrhea or chlamydia account for 50 percent of all PID cases. Both conditions can be asymptomatic, which means an infected woman may be unaware of her status and not seek treatment. Meanwhile the bacteria quietly and insidiously attack her reproductive organs. One study noted that between 10 to 40 percent of women with untreated gonorrhea and 20 to 40 percent of women with untreated chlamydia develop PID. One piece of good news is that recent trends show a reduction in the amount of women being hospitalized for severe cases of PID. This decrease coincides with the decrease in chlamydia and gonorrhea cases reported. It seems to indicate that STD prevention campaigns are working.
Exposure To Bacteria
Bacteria or other organisms that lead to PID can also enter through the vagina via an endometrial biopsy, pelvic surgery, an abortion procedure, miscarriage or childbirth. While the risk is low, it is possible. In other instances normal bacteria found in the vagina and on the cervix can sometimes cause the condition, doctors are not sure why this happens.
Intrauterine devices (IUDs - birth control method also called the coil) do carry some risk of infection - but not due to the IUD itself, rather due to non-sterile insertion techniques by healthcare workers or because the woman already has an existing STD. If symptoms of pelvic inflammatory disease do occur, they are likely to do so within the first 21 days of the IUD being inserted. If the insertion is properly performed and you are screened for STDs beforehand, the risk is minimal. Women who show symptoms of PID or test positive for an STD before an IUD is inserted, should be treated first and only when the infection is cleared can the IUD be inserted.
Although still controversial, there is some evidence linking untreated bouts of bacterial vaginosis to PID. While bacterial vaginosis may be linked to STDs, it can occur in virgins and women with IUDs. You might increase your risk of PID from a vaginitis infection by douching. Douching can push bacteria further into the reproductive tract.
8 Risk Factors For PID
1. Young women under the age of 25. This may be because they have a higher exposure risk to chlamydia and gonorrhea, or because their cervix is less mature and able to fight infection.
2. Prior history of PID: damaged ovaries and fallopian tubes may be more susceptible to recurrent infection.
3. Prior history of chlamydia or gonorrhea - increases your likelihood of recurrent infection.
4. You have had multiple sexual partners.
5. Douching it may contribute to vaginal flora changes, damage delicate vaginal tissue, disrupt the cervical mucus barrier or push bacteria through the cervix.
6. You had an IUD inserted within the last 21 days. After this your risk returns to normal.
7. Bacterial vaginosis: although the role in this condition in developing PID is controversial.
8. Oral contraceptive pill use: while the Pill may increase the risk of chlamydia infection, it can decrease the risk of symptomatic PID (for unknown reasons).
1. Symptoms of PID are so vague that 85 percent of women with the condition delay seeking medical care. A late diagnosis of pelvic inflammatory disease increases your risk of infertility and ectopic pregnancy.
2. One study showed that if a national screening program for chlamydia were implemented, the number of PID incidences would drop 60 percent. In the meantime, see recommended health screenings for women.
3. The incidence rate of PID is 2 to 3 times higher in American black women than white women. This is probably because the rate of STDs is higher in American blacks.