Pelvic inflammatory disease caused by sexually transmitted infections: an integrative review

Abstract

Pelvic inflammatory disease (PID) is an upper genital tract infection that predominantly affects young, sexually active women. This condition results from contamination by endogenous cervicovaginal microorganisms and unprotected sexual intercourse, with Chlamydia trachomatis and Neisseria gonorrhoeae being the main etiological agents. This study aims to conduct an integrative literature review to synthesize and evaluate available data on PID caused by sexually transmitted infections (STIs) in women of reproductive age, as well as to present epidemiological data on this pathology in Brazil, relating it to sexual education and risk reduction of the disease. Searches were conducted in five databases (Science Direct, MEDLINE, PubMed, Web of Science, and SciELO) using health science descriptors: pelvic inflammatory disease, Chlamydia trachomatis, Neisseria gonorrhoeae, sexually transmitted infections, and sexual education, covering the period from 2015 to 2024 to ensure up-to-date data. Only articles that met the established inclusion and exclusion criteria were selected. The results indicated that PID primarily affects sexually active women aged between 20 and 39 years. Epidemiological data indicate that approximately 5% of untreated chlamydial infections progress to PID within the first few weeks, and about 60% of PID cases are asymptomatic, making early diagnosis and proper tracking challenging. The review highlighted that although treatment is effective when performed promptly, many cases remain underdiagnosed due to the absence of symptoms, especially among women who do not seek regular medical care. For effective advances in PID control, the integration between research, clinical practice, and public health policies is fundamental, with emphasis on prevention and early diagnosis. The development of new diagnostic and therapeutic strategies, combined with effective educational programs, will be crucial to reduce the impact of this disease on women's health.