CONTENTS
HIGHLIGHTS
December 1995 |
Infection Overall, women using IUDs are about twice as likely to develop pelvic inflammatory disease (PID) as women using no contraception, according to most studies. These studies have involved women with both high and low risk of sexually transmitted diseases (STDs), which cause PID (41, 78, 81, 209, 265, 421). This increased risk of PID is largely concentrated in the first few weeks after insertion and is due to poor infection prevention during insertion. Thereafter, the risk is among women exposed to STDs. Thus, for women in mutually faithful sexual relationships, IUDs pose little ongoing risk of PID (208, 227, 507). Pelvic inflammatory disease is a broad term for any infection ascending from the cervix into the uterus, fallopian tubes, and ovaries (422). PID is fairly common in developed countries. About 1% to 2% of all women of reproductive age develop PID each year (30, 421, 532). In developing countries the incidence is unknown but may be higher in some areas (244, 302). In addition to STDs, postpartum and postabortion infections are major causes of PID (464). The complications of PID sometimes are severe. Even a single infection can permanently damage the lining of the fallopian tubes. This may partially or totally block one or both tubes, substantially increasing the chances of ectopic pregnancy andinfertility (136, 369, 421, 424). With each episode of PID the chances of tubal blockage and infertility increase (422). A woman who has had PID is more likely to have chronic pelvic pain than other women and is more susceptible to repeated infections (422). All these complications are most likely if PID is not treated promptly and appropriately (see Population Reports, Controlling Sexually Transmitted Diseases, L-9, June 1993). |