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 gonorrhea and chlamydia, highly contagious STDs.
Untreated PID can damage the fallopian tubes, ovaries, and uterus, leading to chronic pelvic pain and serious damage to the reproductive system. PID is the most common, preventable cause of infertility, and can also lead to ectopic pregnancies.
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 regularly.
Symptoms
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
- fatigue
- diarrhea
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.
Prevention
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, condoms 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.
Although 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 tract.
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.
Treatment
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 pelvic exam 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 present.
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.
Getting Help
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 knowing it.
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 stand.
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.
Reviewed by: Larissa Hirsch, MD
Date reviewed: August 2007
