Pelvic Inflammatory Disease

What Increases Your Risk

You have an increased risk for developing pelvic inflammatory disease (PID) if you:

• Are at risk for getting a sexually transmitted disease (STD). Sexually active teens and young women have the highest rate of STD infection. This is almost always from having sex without using a condom. The cells of the transformation zone in a younger woman's cervix are most likely to be infected with chlamydia and gonorrhea, two common STDs.
• Have had PID before. If you have had PID once, your reproductive tract may be less able to clear a new infection because of scar tissue from past PID.
• Have had chlamydia before, which can lead to a "hypersensitive response" when you are exposed to the bacteria again. A second infection can cause more irritation and pelvic organ damage that is worse than the first time.
• Douche. Doctors advise against douching because it increases your risk for vaginal and pelvic infections.
  • Douching may change the acidity of the vagina. This can help more "bad" bacteria grow, while killing off "good" bacteria, such as lactobacilli.
  • Douching done incorrectly may flush bacteria from the vagina into the uterus.

Use condoms to avoid exposure to sexually transmitted diseases.

Some gynecological procedures can increase your risk of PID by introducing bacteria into the reproductive tract. Such medical procedures include:

• Taking a tissue sample of the uterine lining (endometrial biopsy).
• Scraping the lining of the uterus (dilation and curettage, or D&C).
• Inserting an intrauterine device (IUD) when an infection is present at the cervix or in the vagina at the time of insertion.
• Examining the uterus or fallopian tubes with a lighted viewing tube (hysteroscopy or hysterosalpingogram).
• Inducing abortion.

PID is rare in women who are not sexually active, don't have menstrual periods, are pregnant, or have had their uterus or ovaries removed during a hysterectomy.

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Author:	Sandy Jocoy, RN	Last Updated: November 26, 2008
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
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