Pelvic inflammatory disease (PID) is a serious infection of the
female reproductive system that can develop when certain
sexually transmitted diseases (STDs)
go untreated. In most cases, it occurs when bacteria from the STD
in the vagina or cervix move into the uterus and upper genital
tract. The most common organisms that lead to PID are
, highly contagious STDs.
Untreated PID can damage the fallopian tubes, ovaries, and uterus,
leading to chronic pelvic pain and serious damage to the
. PID is the most common, preventable cause of infertility, and can
also lead to
The good news is that when PID causes symptoms, it is easy to
diagnose and can be treated with antibiotics. The essential part is
to detect it before it leads to serious health problems. About 2
out of 3 cases of PID are unrecognized and, therefore, may be
untreated if people aren't screened for STDs. So teenage girls
who are sexually active should take precautions to keep from
contracting STDs, and eventually PID, and be screened for STDs
Signs and symptoms of PID often appear during or after
menstruation but may appear days, weeks, or longer after exposure
to an STD, or not at all.
The most frequent symptoms of PID include:
- vaginal discharge with an odor
- pain during urination
- aching pain in the lower abdomen
- fever and chills
- nausea and vomiting
- irregular menstrual bleeding
- pain during sex
If your daughter complains of any symptoms associated with PID,
she should see her doctor as soon as possible. You should be
especially alert to these symptoms if she has had PID before
because they may signal a repeat infection.
The STDs that can lead to PID are highly contagious. All sexual
partners of someone who is diagnosed with chlamydia or gonorrhea
should be notified and treated with antibiotics, even if they have
no signs or symptoms.
Because STDs can lead to PID, the best way to prevent it is to
abstain from having sex. Sexual contact with more than one partner
or with someone who has more than one partner increases the risk of
contracting any STD.
When properly and consistently used,
decrease the risk of STDs. Latex condoms provide greater protection
than natural-membrane condoms. The female condom, made of
polyurethane, is also considered effective against STDs.
birth control pills
offer no protection against STDs, they may provide some protection
against PID by causing the body to create thicker cervical mucus,
making it more difficult for bacteria to reach the upper genital
Using douche can actually increase a female's risk of
contracting STDs because it can change the natural flora of the
vagina and may flush bacteria higher into the genital tract.
A teen who is being treated for PID also should be tested for
other STDs, and should have time alone with the doctor to openly
discuss issues like sexual activity. Not all teens will be
comfortable talking with parents about these issues. But it's
important to encourage them to talk to a trusted adult who can
provide the facts.
PID can be treated with antibiotics, which kill the bacteria
that cause the disease. If damage has already occurred in the
reproductive organs, antibiotics will not be able to reverse it but
will stop further spread of the infection. In some cases, girls
with PID do have to be hospitalized, particularly if they develop a
high fever, severe nausea, and vomiting; if they need intravenous
antibiotics; or if the diagnosis is uncertain.
In trying to diagnose PID, the doctor will likely ask questions
about your daughter's medical history, method of birth control,
and her sexual activity and that of her partner. The doctor may
then perform a
to find out if her reproductive organs are tender or swollen and to
identify the location of the infection.
Diagnosing PID is not always a simple procedure because the site
of the infection cannot be examined easily and PID symptoms are
similar to other conditions such as appendicitis. During the pelvic
exam, the doctor may take samples to look for the germs that cause
gonorrhea and chlamydia infections. Blood tests also may be done.
Other procedures may be required to determine whether the fallopian
tubes are swollen or if an abscess (collection of pus) is
Prompt treatment of PID and follow-up care can cure the
infection and prevent complications. Rest can help your daughter
recover. Hot baths and heating pads applied to the lower back and
abdomen can help relieve discomfort.
Your daughter should finish all medicines as prescribed because
the PID infection may continue even after the symptoms disappear.
To prevent re-infection, her partner also should be examined and
treated. It's important to abstain from sex until treatment of
both partners is completed and the doctor determines that the
infection is gone.
If your teen is thinking of becoming sexually active or already
has started having sex, it's important to talk with him or her
about it. Make sure your teen knows how STDs can be spread (during
anal, oral, or vaginal sex) and that these infections often
don't have symptoms, so a partner might have an STD without
It can be difficult to talk about STDs, but just as with any
other medical issue, teens need this information to stay safe and
healthy. Provide the facts, and let your child know where you
It's also important that all teens have regular full
physical exams - which can include screening for STDs. Your teen
may want to see a gynecologist or a specialist in adolescent
medicine to talk about sexual health issues. Community health
organizations and sexual counseling centers in your local area also
may be able to offer some guidance.
Larissa Hirsch, MD
Date reviewed: August 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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