Pelvic inflammatory disease Introduction   Pelvic inflammatory disease (PID) is a categorical name for numerous medical conditions of the female reproductive system.  Upper genital infections, such as in the lining of the uterus (endometritis), the oviducts (salpingitis), the ovary (oophoritis), the uterine wall (myometritis) and the pelvic cavity, are all categorized under the general name, Pelvic inflammatory disease.  Most long-term, PID problems result from the destruction of the fallopian tubes (the tubes that connect the uterus to the ovary) by infection. [1]  Infections that cause Pelvic inflammatory disease are usually sexually transmitted, but can also be from the insertion of a foreign object such as an IUD for contraception.   Pelvic inflammatory disease is now estimated to affect over 1 million women a year in the U.S. alone.  PID is the most common gynecological condition that results in the  hospitalization of women of child-bearing age.  Over one-fourth of these women will suffer serious long-term consequences and are at risk for reoccurrences. [2]  It is now considered a leading cause of infertility and may be responsible for the increased risk of ectopic pregnancy (implantation and growth outside of the uterus). [3]   Acute pelvic inflammatory disease results from an ascending infection from the vagina to cervix.  Bacteria colonize and infect the endometrium and fallopian tubes, and may travel towards the ovaries and other nearby soft tissues. It is often a disease of sexually active young women, and occurs spontaneously in roughly 85% of all cases.  Other instances of PID are, largely, due to a disruption in the vaginal flora.  The may result after surgery or insertion of an IUD.  Infections will usually travel upwards into the more susceptible tissues, causing significant long-term damage.  Risk factors may include an earlier start to sexual activity and having multiple sex partners.     Pelvic inflammatory disease Symptoms    It is extremely important to recognize the signs and symptoms of Pelvic inflammatory disease because of the potential for complications and damage. The classic presentation is lower abdominal pain and tenderness during a routine examination, or motion of the cervix during a vaginal examination.   Some women will have discomfort during urination or intercourse, or both.   A vaginal discharge of pus or an excessive amount of normal discharge may be present, as well as irregular vaginal bleeding or swelling in the ovary region. [4]   Chills, present with a moderately high fever, nausea and vomiting, and a white blood cell count of over 20,000/ul is also common. Pelvic inflammatory disease symptoms will often begin during or within one week of menstruation because the opening of the cervix is larger during this time of the month, making it easier for infections to ascend.  A differential diagnosis of Pelvic inflammatory disease would include appendicitis, gallstones, kidney infections, ovarian cysts, and ectopic pregnancy.       Ideally, a laparoscopic examination would improve the diagnostic accuracy and allow the physician an opportunity to take laboratory samples.  However, this procedure is expensive and not practical to use regularly. Pelvic inflammatory disease is usually due to an infection with either Chlamydia or N. gonorrhea; other organisms such as Mycoplasma, Streptococcus and Ureaplasma urealyticum can also be present.   It is estimated that between 5-14% of screened women between the ages of 16-20 years old, and 3-12% of women 20-24 years old are infected with Chlamydia. [5]   Current research suggests that over 1/3 - 1/2 of cases of Pelvic inflammatory disease are due to either Chlamydia or N. gonorrhea. [6]    Education and prevention of sexually transmitted disease is imperative to help decrease the risk of acquiring Pelvic inflammatory disease later in life.   Pelvic inflammatory disease Statistics Over one million women a year in the U.S. develop pelvic inflammatory disease 1/4 of these women will require hospitalization Chlamydia causes 50% of cases of pelvic inflammatory disease in Europe,  and 20-30% of cases in the U.S.   Learn More About Pelvic inflammatory disease Pelvic inflammatory disease Introduction Pelvic inflammatory disease Treatment Products helpful for Pelvic inflammatory disease   Learn More

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