Pelvic inflammatory disease (PID) is the most serious complication of sexually transmitted infections (STIs, also known by the older name of sexually transmitted diseases or STDs) such as chlamydia and gonorrhea.
PID affects the upper female genital tract including the cervix, uterus, ovaries, and fallopian tubes. Each year, there are approximately 100, 000 cases of symptomatic PID in Canada, and up to two-thirds of cases go unrecognized. It’s the leading cause of tubal infertility in young assigned female at birth, but it can usually be prevented if STIs are detected and treated early. One of the long-term consequences of PID is chronic pelvic pain
PID is caused by a bacterial infection in parts of the upper reproductive tract. The most commonly affected organs include the fallopian tubes, ovaries, and uterus. The bacteria most commonly associated with PID are Neisseria gonorrheae and Chlamydia trachomatis, but bacteria normally present in the vagina and cervix may also be involved. The cervix produces mucus that normally prevents bacteria from spreading to the upper reproductive tract.
Researchers believe that the bacteria migrate upwards when this normal body defense is not working at its strongest (i.e., during ovulation and menses). It rarely develops before onset of first menses, after menopause, or during pregnancy.
Risk factors for PID include:
PID can be cured with antibiotics, but it’s important to start treatment as early as possible. Most people are treated at home, but some will be treated in the hospital. Hospitalization may be needed for those who:
Treatment usually consists of at least 2 antibiotics, which commonly include ceftriaxone, doxycycline, metronidazole, or levofloxacin. More than one antibiotic is used because it can be difficult to identify the bacteria causing PID. To avoid reinfection, sexual partners should also be tested for gonorrhea and chlamydia even if they don’t have symptoms.
PID can be prevented by:
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