Prevention of Pelvic Inflammatory Disease
Prevention of Pelvic Inflammatory Disease: Early and complete treatment can help prevent complications of PID. Without treatment, PID can cause permanent damage to the female internal reproductive organs. Infection-causing bacteria can silently invade the fallopian tubes, causing normal tissue to turn into scar tissue. Scar tissue blocks or interrupts the normal movement of eggs into the uterus. If the fallopian tubes are totally blocked by scar tissue, an egg will not be fertilized by sperm or move to the uterus to develop into a baby. Totally blocked fallopian tubes cause a woman to be infertile. Infertility can also occur if the fallopian tubes are partially blocked or even slightly damaged. About one in five women with PID becomes infertile. If a woman has multiple episodes of PID, her chances of becoming infertile are increased.
In addition, a partially blocked or slightly damaged fallopian tube may cause a fertilized egg to get stuck in the tube. This fertilized egg may begin to grow in the tube as if it were in the womb. This is an ectopic pregnancy, which is a pregnancy in the fallopian tube or elsewhere outside the uterus. As it grows, an ectopic pregnancy can rupture the fallopian tube and cause severe pain, internal bleeding, and even death. Scarring in the fallopian tubes and other pelvic structures can also cause chronic pelvic pain (pain that lasts for months or even years). Women with repeated episodes of PID are more likely than women with a single episode to suffer infertility, ectopic pregnancy, or chronic pelvic pain.1
The main cause of PID is an untreated STD. Women can protect themselves from PID by taking action to prevent STDs or by getting early treatment if they do get an STD:
Limit the number of sex partners, and do not go back and forth between partners.
Practice sexual abstinence, or limit sexual contact to one uninfected partner. Do not have sex with anyone who has genital sores.
Use condoms correctly every time with every sex act.
Persons who choose to engage in sexual behaviors that can place them at risk for STDs should use latex condoms every time they have sex. A condom put on the penis before starting sex and worn until the penis is withdrawn can help protect both the male and the female partner from STDs. When a male condom cannot be used appropriately, sex partners should consider using a female condom.
Such common methods of birth control as the oral contraceptive pill or the contraceptive shot or implant do not give women protection from STDs. Women who use these methods should also use condoms every time they have sex to prevent STDs.
Get a screening test for STDs.
Persons who are young, sexually active, and who do not use condoms correctly every time they have sex should be screened for chlamydia. Screening and treatment of women with chlamydia or gonorrhea infection of the cervix reduces the likelihood of PID.
If you think you have an STD, avoid sexual contact, and see a health care provider immediately.
Any genital symptoms such as an unusual sore, rash, discharge with odor, burning during urination, or bleeding between cycles could mean infection. If you have any of these symptoms, stop having sex, and consult a health care provider immediately. Treating STDs early can prevent PID.
If you are told you have an STD, notify all your sex partners immediately.
If you are told you have an STD and receive treatment, you should notify all of your recent sex partners so they can see a health care provider and be evaluated for STDs. Sexual activity should not resume until all sex partners have been examined and, if necessary treated.
Women can play an active role in protecting themselves from PID by taking the following steps:
- Signs of discharge with odor or bleeding between cycles could mean infection. Early treatment may prevent the development of PID.
- If used correctly and consistently, male latex condoms will prevent transmission of gonorrhea and partially protect against chlamydial infection.
Although much has been learned about the biology of the microbes that cause PID and the ways in which they damage the body, there is still much to learn. Scientists supported by the National Institute of Allergy and Infectious Diseases (NIAID) are studying the effects of antibiotics, hormones, and substances that boost the immune system. These studies may lead to insights about how to prevent infertility or other complications of PID. Topical microbicides and vaccines to prevent gonorrhea and chlamydial infection also are being developed. Clinical trials are in progress to test a suppository containing lactobacilli – the normal bacteria found in the vaginas of healthy women. These bacteria colonize the vagina and may be associated with reduced risk of gonorrhea and bacterial vaginosis, both of which can cause PID.
Rapid, inexpensive, easy-to-use diagnostic tests are being developed to detect chlamydial infection and gonorrhea. A recent study conducted by NIAID-funded researchers demonstrated that screening and treating women who unknowingly had chlamydial infection reduced cases of PID by more than 60 percent. Meanwhile, researchers continue to search for better ways to detect PID itself, particularly in women with "silent" or asymptomatic PID.
1. excerpt from PID: DSTD
2. excerpt from Pelvic Inflammatory Disease, NIAID Fact Sheet: NIAID
Last revision: June 10, 2003
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