By Chioma Umeha
Pelvic
inflammatory disease, or PID, is an inflammation of a woman’s upper
reproductive tract, including the structures of the uterus, ovaries, and
fallopian tubes. Salpingitis, inflammation of the fallopian tubes, is the most
common manifestation of the disease. PID is known to be a long-term consequence
of many sexually transmitted diseases as well as of bacterial vaginosis (BV),
pelvic surgery, and other gynecologic procedures that cross the cervix.
It is
fundamentally a preventable condition.
Pelvic
inflammatory disease is, essentially, caused by the body overreacting to an
infection. As the immune system tries to fight off the invading bacteria, it
causes local inflammation and scarring. Although this may successfully wall off
the infection inside the reproductive tract, it can be damage the organs. PID
can cause scarring in the uterus, fallopian tubes, and even in the pelvic
cavity. This is one of the main reasons it causes chronic pelvic pain.
The
most common infections associated with pelvic inflammatory disease are
chlamydia and gonorrhea. Because the symptoms of PID are the result of the
body’s response to the underlying infection, treatment usually involves
antibiotics to treat that infection. In severe cases, or in an emergency,
surgery may be necessary to drain an abscess that has ruptured or that
threatens to rupture.
What
are the symptoms of PID?
These
include: Pain in the lower abdomen and
pelvis; irregular periods, pain during sex, pain during urination, lower back pain and excess vaginal
discharge with a foul odour.
Others
are: Fever, exhaustion, diarrhea, vomiting and other general signs of infection.
How
Common Is PID?
In
the early 1990s, the self-reported frequency of PID in women was approximately
one in nine. PID was more than twice as common in women with a history of
sexually transmitted diseases (26 percent) than among women who had never
reported an STD (10 per cent).
Risk
factors for PID include: Younger age: Sexually experienced teenagers are three
times more likely to be diagnosed with PID than their 25- to 29-year-old
counterparts. Scientists do not know, however, whether this is due to
biological factors that make young women more susceptible to STDs or different
sexual behaviours in these two age groups.
Women
have the highest risk of PID of the ethnic groups seen in the U.S. This may be
related to biological factors, or due to their comparatively high frequency of
douching.
Contraceptive
Choice: Barrier methods, such as condoms, and oral contraceptives reduce the
risk of PID. Despite the problems with the Dalkon Shield in the 1970s, use of
modern intrauterine devices (IUD) is not considered to significantly increase
the risk of PID, except possibly around the time of insertion.
Douching:
Douching greatly increases a woman’s risk of PID.
Why
Should I Be Concerned About PID?
Worldwide,
PID is one of the leading causes of ectopic pregnancy and preventable
infertility in women.
The
relationship between PID and infertility is relatively well accepted. PID
causes infertility by the scarring process that occurs during the healing of
sexually transmitted infections. The extensive scarring can eventually occlude
one or both fallopian tubes, and scarring tends to be worse among older women,
smokers and women using IUDs. Depending on the extent of scarring it may be
impossible for sperm to reach the egg, or, if sperm can get through, the
fertilized egg may be unable to get to the uterus.
Not
surprisingly, the percentage of women who experience infertility due to PID is
directly proportional to the number of episodes of PID that they have
experienced. Therefore, both treating and preventing PID are important steps in
the reduction of infertility in the United States.
