Pelvic inflammatory disease

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Pelvic inflammatory disease (PID) is a general term for a condition that involves infection and inflammation of the upper female genital tract, including the womb (uterus), fallopian tubes, and ovaries. Any or all of these parts may be affected. It usually results from an infection (bacteria) in the vagina and the neck of the womb (cervix) passing to the internal reproductive organs. Some of the infections causing PID are caught through sexual contact.

Pelvic inflammatory disease can result from infection by the bacteria Chlamydia trachomatis, which can be passed through sexual contact. When chlamydial infection spreads from the cervix and along the Fallopian tubes, it causes inflammation (salpingitis). This causes the lining of the tubes to become red and swollen, and makes the already narrow canals even narrower. Fertilised eggs may not be able to move along normally, increasing the risk of ectopic pregnancy and infertility.

As the infection develops within the pelvis and becomes more widespread, PID may be diagnosed. If the infection remains untreated, the inflammation eventually spreads to involve the whole wall of the tubes, with pus coming from the open ends reaching the ovaries. The outer surfaces of the tubes may begin to stick to those of other organs such as the bladder and rectum.

Further infection with other bacteria is common. After a first episode of PID, 20 per cent of women have further episodes, mostly within two years.

It is estimated that 1.7 per cent of women have PID. This is almost certainly an underestimate, because many women are unaware of having contracted a sexually transmitted disease and are either free of symptoms or unaware of the cause of their symptoms.

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