STD: PELVIC INFLAMMATORY DISEASE

WHAT IS IT?

Pelvic inflammatory disease (PID) is a bacterial infection of the pelvic organs in women that can involve the uterus (in which case the infection is called endometritis), the Fallopian tubes [salpingitis), the ovaries [ovarian abscess), or the peritoneum (the lining of tissue around the pelvic organs,- pelvic peritonitis). One, several, or all of these organs can be affected. PID is usually caused by sexually transmitted bacteria such as gonorrhea and chlamydia, but it can be caused by other bacteria as well. It is the most serious infection of the genital area in women.

HOW COMMON IS IT?

It is estimated that about one million women develop PID each year, but this is likely to be an underestimate since in many parts of the country PID is not reportable to the local health department. Three-quarters of the women infected are younger than twenty-five, but women of any age can be infected.

About 85 percent of cases of PID are caused by sexually transmitted bacteria; a woman who has unprotected genital intercourse with a male partner infected with PID-causing bacteria is at high risk for becoming infected. The sexually transmitted bacteria break down the defenses in the cervix that normally prevent vaginal bacteria from moving up into the pelvic organs; thus they allow these bacteria to contribute to the infection.

The other 15 percent of cases of PID are caused by gynecological procedures that mechanically open the cervix and allow the vaginal bacteria to rise into the pelvic organs and cause infection. Women who have an invasive gynecological procedure—such as an abortion, the insertion of an intrauterine device IUD , or hysterosalpmgography (an X-ray study to examine the Fallopian tubes and uterus by means of the injection of dye into these structures)—are at increased risk for developing PID. In addition, women who use IUDs as a birth control method run a higher risk for developing PID if exposed to sexually transmitted infections. Women who douche are also in the high-risk category, possibly because douching pushes vaginal bacteria higher up into the genital tract. Women who have had PID in the past are at increased risk of having it again, because scarring from the infection makes them more vulnerable.

Men, obviously, do not get PID, but they can be infected with the bacteria that cause it.