Pelvic inflammatory disease in adolescents.

Over one million women experience an episode of pelvic inflammatory disease (PID) each year. It is the most common serious complication of STDs; long-term sequelae include ectopic pregnancy, chronic pelvic pain, and tubal infertility. One in five cases of PID occurs among younger women < 19 years of age. Although only about half of female adolescents are sexually active, they have the highest age-specific rates of PID among sexually experienced women. The risk of developing PID for a 15-year-old sexually active girl is estimated to be 10 times that of a 24-year-old woman. The higher relative risk of PID for younger women has been attributed to their greater biologic vulnerability and their behavioral and cognitive risk factors. In addition, HIV-infected women with PID may be at increased risk for more severe pelvic disease, a growing concern as rates of HIV infection among adolescent girls continue to rise. This article reviews the epidemiology, risk factors, pathogenesis, clinical assessment, and management of PID in adolescent females, including age-specific information when available.