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  |  Women's Health  |  Reproductive Health  |  Pelvic inflammatory disease: the facts
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Some surprising facts from the Colonel

Pelvic inflammatory disease: the facts

by Dr Lesley Hickin
Unless PID is treated quickly, it could have drastic consequences for fertility, says Dr Lesley Hickin

Known as PID, pelvic inflammatory disease is caused by bacterial infection of the pelvic organs and surrounding tissues, including the uterus, Fallopian tubes and ovaries. Bacteria pass from the vagina through the cervix into the cavity of the uterus. From there they can ascend through the tubes to the ovaries and into the peritoneal cavity in which the pelvic organs are suspended by slings of tissue.

The bacteria most commonly responsible are chlamydia and gonorrhoea, two very common STIs (sexually transmitted infections), although it is thought that some bacteria which normally exist harmlessly in the vagina and bowel may be involved on occasion. The mechanism of this is not well known but it is thought that the normally protective mucus plug in the cervix becomes less effective during a period and at ovulation, enabling bacteria to pass through into the upper genital tract.

PID can occur after having a baby, a miscarriage or termination, and after an IUD (coil) has been fitted. Most commonly it happens after having unprotected vaginal sex with an infected partner.

Who is at risk?

  • Women with STIs, particularly chlamydia and gonorrhoea infection, are at greater risk of developing PID.
  • A previous episode of PID makes a woman more likely to develop a further episode because the tissues in the pelvis are already damaged.
  • Sexually active teenagers, who have easily damaged tissues, are more at risk than older women, as they also are of developing abnormal cells in the cervix.
  • The more sexual partners a woman has the more likely she is to be infected.

    What are the symptoms?
    PID can range in severity from a mild condition with few symptoms to a life-threatening illness. Not everyone will have symptoms from PID, particularly when it is caused by chlamydia, when there may be only minor symptoms or none at all, even though it can seriously damage the reproductive organs.

    The major symptoms otherwise are lower abdominal pain and abnormal vaginal discharge. Accompanying symptoms, such as painful sexual intercourse, pain in the upper abdomen, fever, and heavy or irregular vaginal bleeding, can also occur.

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