epidemiology
Last edited 10/2020 and last reviewed 07/2021
- among women aged 15 to 49 years, the estimated global prevalence of chlamydia was 3.4%, gonorrhoea was 2%, and trichomoniasis was 4.0% (1)
- PID is almost always caused by a sexually transmitted infection (STI) (2)
- Chlamydia trachomatis accounts for 14–35% of cases
- other causative organisms include Neisseria gonorrhoeae (2–3% of cases)
- however, based on the pattern of organisms isolated from the upper genital tract, the infection may often be polymicrobial (caused by more than one type of bacteria) (1)
- this suggests that initial damage produced by C trachomatis or N gonorrhoeae may permit the opportunistic entry of other bacteria, including anaerobes
- however, in many cases, no infection is found in the
lower genital tract
- risk factors for developing PID include:
- sexual behaviour related factors, for example (2):
- women younger than aged 25 years
- early age of first coitus
- recent new partner (within the previous 3 months)
- multiple sexual partners.
- past history of STI in the woman or her partner
- Iatrogenic - for example:
- termination of pregnancy.
- insertion of an intrauterine device - suggested that may be not immediate and within the past 4–6 weeks, especially in women with pre-existing gonorrhoea or C. trachomatis infection (2)
- hysterosalpingography.
- in vitro fertilization and intrauterine insemination
- sexual behaviour related factors, for example (2):
- in the UK, the prevalence of PID is about 2% among women between 16 and 46 years old
- 10% to 20% may become infertile, 40% will develop chronic pelvic pain, and 10% of those who conceive will have an ectopic pregnancy
Reference:
- Savaris RF et al. Antibiotic therapy for pelvic inflammatory disease. Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No.: CD010285. DOI:0.1002/14651858.CD010285.pub3.
- NHS CKS (Accessed 10/10/2020). Pelvic inflammatory disease (PID).