The bacteria that cause PID are usually transmitted through unprotected sexual contact with an infected person. Two common causes are gonorrhea and chlamydia. Other bacteria that can cause PID either are sexually transmitted (e.g., Mycoplasma hominis) or are vaginal bacteria that are not sexually transmitted (e.g., Gardnerella vaginalis).
Women with multiple sexual partners are at increased risk for PID. A woman who has unprotected sex with an infected partner while she is menstruating is also at higher risk, since at this time of the month the natural defenses of the cervix are less effective. Younger women may be more vulnerable because they are more likely to practice unsafe sex and may have more frequent exposure to partners who are infected with sexually transmitted bacteria.
For women who are sexually active with male partners, condoms and spermicide (nonoxynol-9) can help prevent transmission of PID-causing bacteria if they are used correctly and consistently and if the condom does not break or leak. Cervical caps and diaphragms, used with spermicide, may also help decrease the risk of infection, but they are not as effective as condoms. Whatever their sexual orientation, women who have had unprotected sexual contacts in the past and who have never been examined for sexually transmitted diseases should be tested for PID and other STDs, even if they are symptom free.
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