Can you please tell me about PID?

Q: Can you please tell me about salpingitis (PID)? What causes this? Can douching (even gently) cause PID, especially if there is another infection present, such as bacterial vaginosis?

A: Salpingitis is an inflammation of the fallopian tubes. The term is often used interchangeably with PID (pelvic inflammatory disease), although technically, PID may involve infection of other reproductive organs.

Each month in women of reproductive age, an unfertilized egg travels through one of the fallopian tubes from the ovaries to the uterus, where it awaits fertilization.

By far the most common cause of PID is a vaginal infection which spreads upwards to the tubes, ovaries or uterus. Bacterial infections that can lead to PID include sexually transmitted diseases, such as chlamydia and gonorrhea, and other types of vaginal infections, such as bacterial vaginosis.

PID is a serious problem. In the United States, more than one million women have episodes of PID every year and more than 100,000 become infertile as a result of the disease. PID can also cause ectopic pregnancy, a dangerous condition in which an egg is implanted and fertilized outside the uterus.

Some! research indicates that frequent douching (more than twice a month) may increase the risk of developing PID. The douching may push the bacteria upwards. It is likely that douching when you have a bacterial infection will compound that risk.

By the way, despite what you see in advertisements, douching is not advised for women, unless recommended by your doctor. Natural secretions and discharge cleanse the vagina under normal circumstances. If you have an infection, you should see a doctor to get appropriate treatment.

Nancy Snyderman, M.D., F.A.C.S

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