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Pelvic Inflammatory Disease in Adolescents

Pelvic inflammatory disease (PID) is a general term referring to infection and inflammation of the upper genital tract, primarily involving the fallopian tubes and uterus. Other terms for PID in common use include endometritis (infection of the uterus) and salpingitis (tubal infection with inferred endometrial involvement). This article reviews the epidemiology, diagnosis, and management of PID in adolescents.

Epidemiology of Pelvic Inflammatory Disease

Of the estimated 1.25 million women in the United States who acquire PID each year, 16% to 20% are adolescents. Of women who have had PID, one out of three experienced her first episode before she was 19 years of age. Two factors confer a particularly high risk of acquiring PID on adolescents: multiple sexual partners and a high prevalence of sexually transmitted infections.

Adolescent girls in the United States begin sexual activity at a mean age of 16.2 years. In 1988, 26% of 15-y-old women, 51% of 17-y-old women, and 75% of 19-y-old women reported having had premarital sexual intercourse. Three fourths of these sexually active adolescents had had two or more sexual partners, and 45% had had four or more sexual partners. It is not surprising that young women with more than one sexual partner during a 3- to 6-mo interval are more than four times as likely to develop PID than are those who have only one partner.

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