For many women, the words “pelvic inflammatory disease” don’t ring a bell. But they should—an alarm bell. PID, as it’s known, affects more than 1 million American women each year, with consequences that can include infertility and even death. It’s important for women to learn about PID because in many cases it’s preventable.
PID is the name given to a group of infections that occur in the reproductive system. These infections usually start in the vagina and can work their way up to the cervix, uterus, fallopian tubes and ovaries. Infection can also spread to the abdominal lining.
The most common culprits are infections caused by chlamydia and gonorrhea. Because both chlamydia and gonorrhea are sexually transmitted diseases, they can be prevented. Preventing them, in turn, can prevent PID.
Being monogamous with a mate who is also monogamous is the best way to minimize the risk of PID. Certain methods of birth control either reduce or increase the risk of PID. Condoms, the diaphragm, the cervical cap and spermicides act as barriers to the spread of bacteria. Oral contraceptives lower a woman’s risk of contracting PID by causing the mucus in the cervix to thicken, making it tougher for germs to travel up the reproductive tract.
Women who use an intrauterine device, or IUD, are at increased risk of developing PID. That fact led many people to believe that the device itself can cause PID. However, although IUD insertion may occasionally trigger an infection, researchers now believe that IUD users are at increased risk because, unlike other forms of contraception, the device offers no protection from PID.
Preventing PID is important because of the long-term effects these infections can have. Women who have had PID are at increased risk for ectopic pregnancy. In an ectopic pregnancy, the fertilized egg implants and begins to grow somewhere other than the uterus—almost always in a fallopian tube. If a tubal pregnancy goes undetected and the tube ruptures, the massive internal bleeding that ensues can quickly lead to death.
A PID infection also can cause infertility. Risk of infertility increases with the number of episodes of PID a woman has had.
Chronic pelvic pain is another long-term effect of PID. Such pain can be caused by scar tissue (adhesions) formed as a result of the infection. If the pain is severe, the patient may need surgery.
The serious health implications of PID make it important to recognize and seek treatment promptly for the symptoms of chlamydia, gonorrhea or PID. Symptoms for chlamydia and gonorrhea include yellowish vaginal discharge, pain when urinating, lower abdominal or rectal pain, mucus-covered stools, intermittent vaginal bleeding and pain or bleeding during intercourse. However, up to 75 percent of women infected with chlamydia and 50 percent of women infected with gonorrhea experience no symptoms.
PID, too, is frequently “silent.” Symptoms may include fever, vaginal discharge, pain during intercourse and abdominal pain, which often begins during or soon after a menstrual period. Nausea and vomiting may occur if the infection has spread to the lining of the abdomen, a condition called peritonitis.
PID is treated with antibiotics. Because in most cases PID is caused by sexually transmitted disease, a woman’s partner must be treated as well to avoid reinfection.
If you’re at risk for PID, take steps to protect yourself. If you have female friends or relatives at risk, sound the alarm to alert them to the dangers of this sometimes silent, often devastating disease.