Skip Navigation Links
Centers for Disease Control and Prevention
 CDC Home Search Health Topics A-Z
National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention
  Division of Sexually Transmitted Diseases
    Program and Training Branch
STD Prevention STD Training Home Links Contact Us Glossary 
STD Prevention
Self-Study Modules
Pelvic Inflammatory Disease (PID)
Course Objective
Line separator
Target audience
Line separator
Continuing education
Lessons
Line separator
Epidemiology
Line separator
Pathogenesis and microbiology
Line separator
Clinical manifestations and sequelae
Line separator
Diagnostic methods
Line separator
Patient management / treatment
Line separator
Patient counseling and education
Line separator
Partner management / Public health
Line separator
Case study
Line separator
Resources
Line separator
 

Self-Study STD Module - PID

Epidemiology (continued)

Risk Factors

The following are risk factors for PID:

  • Adolescence
  • History of PID
  • Gonorrhea or chlamydia or history of gonorrhea or chlamydia
  • Male partners with gonorrhea or chlamydia
  • Multiple partners
  • Current douching
  • Insertion of IUD
  • Bacterial vaginosis
  • Demographics (socioeconomic status)
  • Oral contraceptive use (in some cases)

Adolescence is a major risk factor because of the high age-related chlamydia and gonorrhea rates in adolescents. In addition, cervical cellularity (ectopy), which is often present in adolescents, allows for greater adherence of infectious organisms in the cervix. The risk of acquiring acute salpingitis for a sexually active 15-year-old is 1:8 compared to 1:80 for women 24 and older.

(Click on image for larger view)
Normal Cervix with Ectopy

History of having had PID increases the risk for developing PID. The damage that occurs to fallopian tube mucosa during an episode of PID makes women more susceptible to recurrent infection.

Having a history of a gonorrheal or chlamydial infection increases the likelihood of recurrent disease, which, in turn, increases the risk for PID. A woman’s risk also increases if her male partner has gonorrhea or chlamydia, or if she has multiple sex partners.

Douching increases the risk for PID because it contributes to vaginal flora changes, epithelial damage, and disruption of the cervical mucous barrier, all of which can increase the likelihood of developing PID.

The insertion of an intrauterine device (IUD) is a risk factor within the first 21 days of placement, but after 21 days, the risk returns to baseline.

Bacterial vaginosis (BV) has been associated with the development of PID.

Oral contraceptive (OC) use may increase the risk of cervical chlamydial infection due to cervical ectopy associated with OC use. OC use also causes thickening of the cervical mucous, which may be protective against lower genital tract organisms ascending into the upper genital tract. Socioeconomic status is also seen as a risk marker that may be related to access of care.

Click here for a Study Question

Page 2 of 13 BackStatusStatusNext



Page last modified: June 3, 2009
Page last reviewed: June 3, 2009

Content Source: Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention


STD Home
| STD Index

CDC Home | Search | Health Topics A-Z

Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention
     Division of Sexually Transmitted Diseases Prevention