PID Can Be Prevented

PID Can Be Prevented
Pelvic inflammatory disease or PID will affect one is six women by the year 2000. In the United States, over one million women will get PID every year, and 300,000 women are hospitalized for the condition. In Canada, each year over 100,000 women will contract the disease. PID is the leading cause of preventable infertility and tubal pregnancy. Yet PID is perhaps the most ignored women's health problem.

Moreover, it can cause long-term health problems and complications. Scarring of the pelvic organs, chronic pain, tubal ovarian abscesses, and recurring infections are common after only one episode of PID.

The good news is that PID can be prevented. This is the urgent message of the Canadian PID Society, the only North American group which provides public education and prevention programs on PID.

"The most important measure that women can take to prevent PID is to use barrier methods of birth control." says Jill Weiss, co-ordinator of the PID Society. "Women can also protect themselves from PID by regular testing to ensure that they are free from cervical chlamydial infection or bacterial vaginosis which can cause PID."

Pelvic inflammatory disease is an infection or inflammation of a woman's reproductive organs (uterus, tubes, ovaries and surrounding tissues). It is caused by a number of different bacteria- the most common one being chlamydia. PID is usually acquired through sex. A common vaginal infection, bacterial vaginosis, is also associated with PID. Surgical procedures that open up the cervix like D-and-C's, abortions, and insertion of IUD's can predispose to PID.

Childbirth also opens the cervix and can result in PID. All pregnant women should be checked for cervical and vaginal infections and promptly treated. Women who have C-sections have a high risk of developing PID after surgery. Preventative antibiotics before a C-section or abortion drop the incidence of PID by 30 to 70 percent.

Symptoms of PID vary a great deal and do not give a good indication of the extent or even presence of infection. Most women with PID have normal temperatures, and most have only one or two mild symptoms. There is no specific lab test yet negative tests do not mean PID is not present. A high index of suspicion and willingness to investigate vague but suggestive symptoms is important.

At least fifteen studies have shown that clinical diagnosis is in error at least 40 percent of the time. In the United States, the Center for Disease Control estimates that at least 50 percent of women with PID are never diagnosed or treated. In addition, once diagnosed, women are often inadequately treated with a single antibiotic.

The Center for Disease Control recommends evaluation for PID if any of the following are present: fever, recent lower abdominal pain, increased pain or bleeding during periods, bleeding between periods, pain during sex, discharge that is not easily explained, tenderness of the tubes or pain when the cervix is moved during an internal exam or a positive test for chlamydia, or gonorrhea. Proper treatment requires multiple antibiotics taken for a full two weeks as well as treatment of partners.

An estimated 65 percent of Canadian teenagers use no protection during sex. Yet teenagers have the highest risk for PID. Each year, one in eight sexually active teenagers will develop the condition.

In spite of these appalling statistics, the prevention of PID is not only possible but highly effective. In Sweden, the rate of PID has decreased by 40 percent as the result of a widespread public education campaign which begins in elementary school. At the University of British Columbia in Vancouver, testing, education and increased condom use reduced chlamydial infection by 37 percent.

Women who regularly use condoms or diaphragms with spermicide have anywhere from 40 to 60 percent less risk of PID. The pill, on the other hand, causes changes in the cervix that make it more susceptible to infection.

To find out more about PID and its prevention, contact the Canadian PID Society 's free information line at 604-684-5704. An excellent book on PID is available through this group, the only one of its kind in North America.

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