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Pelvic Inflammatory Disease (PID)

July 11, 2018

What is Pelvic Inflammatory Disease?

Pelvic inflammatory disease, or PID, is an inflammation of a woman’s upper reproductive system. Affected areas can incorporate the structures of their uterus, ovaries, and fallopian tubes. Salpingitis, inflammation of the fallopian tubes, is the most frequent manifestation of the disease. PID is regarded as a long-term consequence of many sexually transmitted diseases as well as of bacterial vaginosis (BV), rectal surgery, along with other gynecologic procedures that cross the cervix.

It’s basically a preventable illness. It’s also a main cause of preventable infertility. 

Pelvic inflammatory disease isalso, essentially, brought on by the body overreacting to an infection. Since the immune system tries to fight off the invading bacteria, it causes local inflammation and discoloration. Although this can wall off the disease within the reproductive tract, it can be damage the organs. PID can lead to scarring in the uterus, fallopian tubes, and even in the pelvic cavity. This is one of the main causes it causes chronic pelvic pain.

The most common infections related to pelvic inflammatory disease are chlamydia and gonorrhea. Since the symptoms of PID are the result of the human body’s response to the underlying infection, treatment generally involves antibiotics to treat infection. In severe situations, or in an emergency, surgery might be required to drain an abscess that has that threatens to rupture.

What are the Symptoms of PID?

  • Pain in the lower abdomen and pelvis
  • Irregular intervals
  • Pain during sex
  • Pain during urination
  • Reduced back pain
  • Excess vaginal discharge with a foul odor
  • Fever, exhaustion, diarrhea, nausea, and other typical 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 infections (26 percent) than among women who had never reported an STD (10 percent). Fortunately, PID has become less common as screening for chlamydia and gonorrhea has become more prevalent. 

What are the Risk Factors for PID?

Risk factors for PID include:

  • Younger era: Sexually experienced teenagers are more likely to be diagnosed with PID compared to their 25- to 29-year-old counterparts. Researchers do not know, but why this is the situation. It could possibly be due to biological factors which make young women more susceptible to STDs. It might also reflect different sexual behaviours in these two age classes.
  • Hurry: African-American girls have the highest risk of PID of the cultural groups seen in the U.S.. This might be related to biological factors. It could also be related to their relatively large frequency of douching.
  • Contraceptive Option: Barrier procedures, such as condoms, and oral contraceptives reduce the risk of PID. Regardless of the issues with the Dalkon Shield from the 1970s, usage of modern intrauterine devices (IUD) isn’t considered to substantially increase the risk of PID, but maybe around the time of insertion.
  • Douching: Douching significantly increases a woman’s risk of PID.

Why Should I Be Concerned About PID?

Worldwide, PID is among the top causes of ectopic pregnancy and preventable infertility in women. Back in 2000, a study estimated that the cost of PID from the US was in the area of $2 billion.  A previous study that analyzed the prices of preventable infertility found that the prices were closer to $64 billion. This study included the cost of treating the  STDs and PID that caused the infertility, also controlling the infertility in couples who desired to become pregnant.

In contrast to the costs of treating PID infertility, the costs of preventing PID-related infertility are most likely much lower.

Those prices would primarily include those for education about safer sex, douching, and condom use as well as screening and treatment for chlamydia and other STDs. The expense of these preventative measures would probably be only a minuscule fraction of the cost spent on therapy.

The relationship between PID and infertility is relatively well accepted. PID causes infertility from the scarring process which happens during the recovery of sexually transmitted diseases. The extensive scarring can eventually occlude one or both fallopian tubes. Scarring tends to be worse among elderly women, smokers and women using IUDs. Based on the extent of scarring it may not be possible for sperm to get to the egg, or, if sperm can get through, the fertilized egg may be not able to get to the uterus. When a fertilized egg can not get to the uterus, it may grow to be an ectopic pregnancy. 

Unsurprisingly, the percentage of women who experience infertility due to PID is directly proportional to the number of episodes of PID they have experienced. Therefore, both treating and preventing PID are significant measures in the reduction of infertility in the USA.