Pelvic inflammatory disease (PID), an infection of the upper genital tract, affects more than 1 million women every year in the United States. PID can affect the uterus, ovaries, fallopian tubes, and other reproductive areas; untreated, it may lead to infertility, tubal pregnancy, chronic pelvic pain, and other serious problems.
PID can be either acute or chronic. Acute PID comes on suddenly and is usually more severe than chronic PID. Chronic PID is a low-grade infection that causes only mild pain and a backache. Often, women with PID have no symptoms of the infection and only discover it when they try to become pregnant and find out they are infertile.
PID is caused by bacteria from contaminated semen that spreads from the vagina to the uterus. Many different organisms can cause PID, although most cases are associated with gonorrhea and chlamydia. It can also be caused by bacteria normally present in small amounts in the vagina and cervix.
The risk of PID increases after childbirth, miscarriage, abortion, insertion of an intrauterine device (IUD) for contraception, or operations like dilation and curettage (D and C). Douching also increases risk.
As many as one-third of women who have had PID will have the disease at least one more time. With each episode of reinfection, the risk of infertility increases.