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Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is a bacterial infection of the female upper genital tract, including the womb, fallopian tubes and ovaries. It is a common disease and around 1 in 50 sexually active women in the UK are diagnosed with PID every year. An estimated one woman in five who have PID becomes infertile as a result. However, most women are able to get pregnant without problems after a single episode of PID.

Bacteria and other micro-organisms can find their way through the vagina and the cervix to the internal reproductive organs. A bacterial infection can cause inflammation in these organs and their surroundings. This most commonly occurs in the Fallopian tubes.

When the infection spreads upwards from the cervix (entrance to the womb), it causes one or more of the following:

•inflammation and infection of the endometrium (womb lining), known as endometritis

•inflammation and infection of the fallopian tubes, known as salpingitis

•inflammation and infection of the tissue around the womb, known as parametritis

•inflammation and infection of the ovaries, known as oophoritis

•a pocket of infected fluid in the ovary and fallopian tube, known as an abscess

Although PID is often difficult to diagnose, the common symptoms to look for are;

• Pain around the pelvis or lower abdomen

• Discomfort or pain during sex that is felt deep inside the pelvis

• Bleeding between periods and after sex

• Unusual vaginal discharge, especially if it is yellow or green

• Fever and vomiting

Many more women with PID experience few or no symptoms. PID mostly affects sexually active women between the ages of 15 and 24.

There are no specific causes to PID, for some women it may be as a result of terminating a pregnancy or following childbirth. Occasionally it can be caused from having sex with a new partner; the most common cause of PID is from contracting chlamydia or gonorrhoea. In the UK, the bacteria that cause chlamydia (Chlamydia trachomatis) are responsible for 50-65% of cases of PID. The bacteria that cause gonorrhoea (Neisseria gonorrhoeae) are responsible for about 14% of cases. About 8% of women with PID are infected with both chlamydia and gonorrhoea.

This means that the most effective way of preventing PID is to protect yourself against STIs by using a barrier method of contraception such as a male or female condom, and to get regular sexual health check-ups.

It’s important to see your GP if you experience any of the above symptoms. Delaying treatment for PID or having repeated episodes of PID can increase your risk of infertility. If PID is diagnosied early than your GP can prescribe a course of antibiotics, it is important to note that those women who have had a case of PID are more likely to contract it again. As many as one woman in five has more episodes, mostly within two years.

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