A Silent Threat to Reproductive Health
- Students vs. Pandemics
- 7 days ago
- 4 min read
By Kiki Huang
Each year, in the United States, over 1 million women are diagnosed with pelvic inflammatory disease, PID (ACOG). Of those 1 million, the majority of women with new PID diagnoses are under the age of 25 (Hasiya). PID occurs when someone experiences an infection of one or more of the reproductive organs; uterus, ovaries, and or fallopian tubes. PID is primarily caused by bacteria from untreated sexually transmitted infections (STI) which spread to the reproductive organs. If PID is left untreated, the disease can lead to infertility, ectopic pregnancies, and severe chronic pain in the abdomen.
PID is mainly caused by STIs, highly contagious STIs, such as gonorrhoea and chlamydia are responsible for the majority of PID cases. It is recorded that around 90% of these PID cases are caused by both of these highly contagious STIs (Cleveland Clinic). Both of these are caused by bacterias through physical sex, such as vaginal, oral, and anus. The progression of these infections in the female reproductive system increases the likelihood of developing PID over time. Consequently, someone can be diagnosed with PID if they have an infection due to gonorrhea or chlamydia. Even if these STIs are treated, there are still chances that someone can get PID. A study has shown that the risk of PID to occur during the 1-year period following treatment for gonorrhea or chlamydia is about 9% (Rothman, et al.) In addition, when someone has diagnosed STI infections multiple times, there is a higher chance of getting PID. Without early treatment and healthy sex practices, the serious risk of getting STI and PID increases and cycles.
Diagnosing PID can be challenging because its symptoms are often mild or overlap with other conditions such as endometriosis, ectopic pregnancy or appendicitis. Due to this limitation, there are many asymptomatic, undiagnosed cases of PID. It is estimated that over 200,000 cases of PID go undiagnosed each year in the United States (U.S Centers for Disease Control). Women with PID may experience unusual vaginal discharge, irregular vaginal bleeding pain during sex, and most commonly, pelvic pain.
If PID is not treated within an appropriate time frame, the disease can lead to serious and long-term health consequences. Due to PID often causing severe scarring in the fallopian tubes and abscesses, the complications from PID may include ectopic pregnancies, infertility, and chronic pelvic pain. Scarred fallopian tubes and abscesses impact the ability of eggs to travel from the ovary to the uterus, making it more likely that eggs will either not be fertilized, leading to fertility complications, or that they will implant outside of the uterus (ectopic). One study suggested that of womenbetween 20-24 years of age that developed PID, about 18% developed chronic pain, 8.5% developed ectopic pregnancies, and 16.8%struggled with infertility (Lindsey & Diann). Once PID has advanced to the point that people are experiencing chronic pain and infertility, there may be limited options for treatment. Untreated PID is also associated with an increased risk of ovarian cancer and stroke (Ovarian Cancer Association Consortium). Therefore, prompt diagnosis and treatment of PID are crucial in reducing these risks and preserving reproductive health.
To reduce the risk of pelvic inflammatory disease, sexually active individuals should get regular STI screening. It is recommended that sexually active women under the age of 25, as well as women aged 25 and older who have risk factors, undergo annual testing for gonorrhea and chlamydia in the US (CDC). In addition, it is suggested that antibiotics such as doxy-PEP are taken after 24-74 hours after condomless sex practices to cover the primary pathogens, including Neisseria gonorrhoeae and Chlamydia trachomatis(Lindsey & Diann). Antibiotics, such as metronidazole, target SITE-specific pathogens and reduce the inflammation and swelling of the reproductive system. In fact, recent studies have reported that the proportion of PID cases attributable to N. gonorrhoeae or C. trachomatis is decreasing due to the availability of appropriate antibiotic treatment. (Sexually Transmitted Infections Treatment Guidelines, 2021) Moreover, it is suggested that any sexually active woman at risk for STIs with unexplained lower abdominal or pelvic pain and at least one of the minimum clinical criteria are present on the pelvic examination; cervical motion tenderness, uterine tenderness, or adnexal tenderness should get screened by doctors (CDC 2015 Sexually Transmitted Diseases Treatment Guidelines). By prioritizing regular screenings, timely antibiotic treatment, and educating women on early symptoms, the risk of PID can be significantly reduced.
PID is a serious health issue that is often overlooked until individuals experience long-term problems like infertility, chronic pain, and ectopic pregnancy. Since PID is primarily caused by untreated STIs, the best way to prevent developing PID is through regularly attending STI screenings, practicing safe sex, and receiving appropriate antibiotic treatments for STIs.
References
https://www.health.ny.gov/publications/3804/#:~:text=Pelvic%20Inflammatory%20Disease%2C%20 or%20PID,%2C%20especially%20teens%2C%20get%20PID.
https://www.inquirer.com/health/pelvic-inflammatory-disease-teen-girls-20190215.html#:~:text=PID%20is%20very%20 common%2C%20 yet,cases%20are%20 missed%20 each%20 year.
This post is not a substitute for professional advice. If you believe that you may be experiencing a medical emergency, please contact your primary care physician, or go to the nearest Emergency Room. Results from ongoing research is constantly evolving. This post contains information that was last updated on May 16, 2025.
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