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Pelvic inflammatory disease in adolescents

Gray-Swain, M Rosanna; Peipert, Jeffrey F

Current Opinion in Obstetrics and Gynecology: October 2006 - Volume 18 - Issue 5 - p 503–510
doi: 10.1097/01.gco.0000242952.87125.69
Adolescent and pediatric gynecology
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Purpose of review We discuss the epidemiology, risk factors, microbiology, diagnosis, treatment and prevention of pelvic inflammatory disease in adolescents.

Recent findings Young age is one of the most important risk factors for sexually transmitted diseases and pelvic inflammatory disease. Sexually active adolescents have the highest incidence of Chlamydia trachomatis, Neisseria gonorrhoeae, and pelvic inflammatory disease of any sexually active age group. Long-term sequelae of pelvic inflammatory disease include ectopic pregnancy, tubal factor infertility, tubo-ovarian abscesses and chronic pelvic pain. Subclinical pelvic inflammatory disease is responsible for a significant portion of these long-term sequelae. New (2006) Centers for Disease Control and Prevention treatment guidelines for pelvic inflammatory disease are available. One of the best methods of prevention of pelvic inflammatory disease is to screen and treat sexually active adolescents for chlamydial infection. Implementation of nucleic acid amplification assays allows screening of adolescents via self-collected urine or vaginal swab samples.

Summary Pelvic inflammatory disease is a highly preventable source of reproductive morbidity for adolescents. It is prudent that clinicians provide counseling regarding healthy sexual behaviors, STD prevention, and contraception whenever an adolescent presents in need of STD screening or evaluation for pelvic inflammatory disease.

Washington University in St. Louis, School of Medicine, Barnes-Jewish Hospital, Missouri, USA

Correspondence to Jeffrey F. Peipert, MD, MPH, Vice Chair of Clinical Research, Department of Obstetrics and Gynecology, Washington University School of Medicine, Campus Box 8219, 4533 Clayton Avenue St. Louis, MO 63110-1094, USA Tel: +1 314 747 4016; fax: +1 314 747 4019; e-mail: peipertj@wustl.edu

© 2006 Lippincott Williams & Wilkins, Inc.