PELVIC INFLAMMAT...

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Definition

Pelvic inflammatory disease is a general term for infection of the uterus lining, fallopian tubes, or ovaries.

See also: Endometritis

Alternative Names

PID; Oophoritis; Salpingitis; Salpingo-oophoritis; Salpingo-peritonitis

Causes, incidence, and risk factors

Most cases of pelvic inflammatory disease are caused by the same bacteria that lead to sexually transmitted diseases (such as chlamydia, gonorrhea, mycoplasma, staph, and strep).

The most common cause of PID is through sexual contact. However, bacteria may also enter the body after gynecological procedures such as:

• Childbirth
• Endometrial biopsy
• Insertion of an intrauterine device (IUD)
• Miscarriage
• Therapeutic or elective abortion

In the United States, nearly 1 million women develop PID each year. About 1 in 8 sexually active adolescent girls will develop PID before age 20. Since PID is often undiagnosed, statistics are probably greatly underestimated.

Risk factors include:

• Insertion of an IUD
• Multiple sexual partners
• Past history of any sexually transmitted disease
• Past history of PID
• Sexual activity during adolescence

Birth control pills are thought in some cases to lead to cervical ectropion, a condition that allows easier access to tissue where bacteria may grow. However, birth control pills may protect against PID by stimulating the body to produce a thicker cervical mucus. This makes it harder for semen to carry bacteria to the uterus.

Symptoms

The most common symptoms of PID include:

• Fever (not always present; may come and go)
• Pain in the abdomen or pelvis
• Vaginal discharge with abnormal color, texture, or smell

Other symptoms that may occur with PID:

• Bleeding after intercourse
• Chills
• Fatigue
• Frequent urination
• Increased menstrual cramping
• Increased pain during ovulation
• Irregular menstrual bleeding or spotting
• Lack of appetite
• Low back pain
• Nausea, with or without vomiting
• No menstruation
• Painful sexual intercourse
• Pain with urination
• Tenderness

Note: There may be no symptoms. People who experience an ectopic pregnancy or infertility often have silent PID, which is usually caused by chlamydia infection.

Reviewer Info: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 09/07/2008