Alternative causes of pelvic inflammatory disease.

Seminal fluid from asymptomatic men reveals a wide variety of aerobic and anaerobic bacteria. The number of bacteria tends to correlate with the sexual experience of the individual. Experimental evidence has shown that these bacteria can attach themselves to moving spermatozoa and travel through ovulatory-phase cervical mucus. Exogenously added bacteria also exhibit the same potential. These experimental results suggest a rational explanation for the development of pelvic inflammatory disease in promiscuous women with multiple sexual partners. In addition, the findings help to explain the marked difference observed in the rate of pelvic inflammatory disease among patients using barrier-type birth control and oral contraceptives as compared with the rate among women who use intrauterine devices, with which the ovulatory-phase cervical mucus is unprotected.