Pelvic inflammatory disease linked to pelvic pain
Researchers have identified a range of factors that increase the risk of developing chronic pelvic pain from pelvic inflammatory disease (PID), which results from vaginal infection, often sexually transmitted, that ascends into the pelvis.
“Recurrent PID repeatedly damages the uterus, fallopian tubes, and ovaries, increasing the likelihood of chronic pelvic pain and infertility,” warned the team leader Dr. Catherine L. Haggerty.
In the longitudinal PID Evaluation and Clinical Health (PEACH) study of 780 mostly black urban women with clinically suspected PID, more than one third (36 percent) experienced chronic pelvic pain during the 2 to 5 years they were followed.
“All women in the PEACH study with clinically suspected PID were treated with cefoxitin and doxycycline, a CDC-recommended treatment regimen for PID,” Haggerty, from the University of Pittsburgh, noted in comments to Reuters Health.
Having two or more prior PID episodes, and smoking, increased the likelihood that a woman would experience chronic pelvic pain, the investigators report in the journal Sexually Transmitted Diseases.
Older women were also at greater risk than younger women for chronic pelvic pain after PID, which is not surprising given that advancing age is an established risk factor for chronic pain.
Women who douched more than once per month were about 30 percent more likely to experience chronic pain following PID, although this pattern could have occurred by chance “Douching disrupts the natural flora of the vagina and may facilitate upward movement of sexually transmitted bacteria from the vagina to the upper genital tract,” Haggerty noted.
“The most important take home message for women,” she said, “is to seek immediate medical care for symptoms of sexually transmitted infection and pelvic inflammatory disease. If untreated, STDs may lead to PID, which may in turn lead to chronic pelvic pain and infertility if not treated promptly.”
Haggerty added, “Chronic pelvic pain can be rather severe, difficult to treat, and can significantly affect quality of life.”
STD symptoms to watch for include “painful urination, increased or unusual vaginal discharge, genital itching and irritation, and bleeding between periods. In addition to these symptoms, women with PID will experience lower abdominal or pelvic pain,” Haggerty advised.
“Those who waited three or more days before seeking treatment were about 25 percent more likely to experience chronic pelvic pain,” she warned, “although the association was not statistically significant.”
Haggerty urged women “to protect themselves from sexually transmitted disease and PID through abstinence, monogamy, or consistent condom use,” and to avoid douching.
SOURCE: Sexually Transmitted Diseases, May 2005.
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