HOW DOES PELVIC INFLAMMATORY DISEASE (PID) CAUSES INFERTILITY?

Pelvic inflammatory disease (PID) is an infection of the reproductive organs, occurring when bacteria travels through cervix to the uterus and fallopian tubes. PID can cause infertility, ectopic pregnancy, chronic pelvic pain, tubal or ovarian abscesses, adhesions, peritonitis (infection of a silk-like lining that covers the abdominal organs) and perihepatitis (inflammation of the coating of the liver). In rare, severe cases, untreated PID can lead to death.

Pelvic inflammatory disease can be acute (meaning sudden, severe symptoms), chronic (long-term with less intense symptoms) or silent (no symptoms.)

With PID, the presence or lack of symptoms do not indicate how much damage the reproductive organs sustain. It’s possible to have no symptoms and have serious blockages and adhesions, leading to infertility. Some women will only discover they have PID after trying to conceive unsuccessfully or after experiencing an ectopic pregnancy.

Women have been diagnosed with PID at some point in their lives because many cases of PID are silent and involve no symptoms, and PID is often missed or undiagnosed, the actual number of cases of PID is likely higher.

CAUSES

PID is usually caused by sexually transmitted diseases (STDs). Common causes include chlamydia and gonorrhea. Chlamydia is a common cause of silent PID, which means many women do not know they are infected. However, some bacteria that are normally found in the vagina can lead to PID if they’re overgrown enough to cause bacterial vaginosis.

If you have an undiagnosed STD, your risk of PID is higher any time the cervix is open and infection can potentially enter the uterus. You have a higher risk of PID if you douche or if you’ve recently had an IUD inserted or had a miscarriage or abortion.

HOW DOES IT CAUSE INFERTILITY?

Women with a history of PID will have trouble getting pregnant.

The most common cause of PID-related infertility is blocked fallopian tubes. The tubes typically become blocked from the adhesions caused by the inflammation, and the blockage is usually found closer to the ovaries than the uterus.

PID may also cause hydrosalpinx. This occurs when a tube is blocked near the ovary and then dilates and fills with fluid.

Ectopic pregnancies can also be caused by PID-related damage. If you undergo surgery to repair tubal damage caused by PID, your risk of ectopic pregnancy will also be higher.

SYMPTOMS

Symptoms of pelvic inflammatory disease differ from person to person, depending on whether or not they are experiencing acute, chronic or silent PID.

The most common symptom of PID is pelvic pain. Other symptoms include pelvic pain during intercourse, lower back pain, irregular menstrual bleeding, unusual vaginal discharge, problems with urination, flu-like symptoms, like fatigue, fever, chills, weakness or swollen lymph nodes; lack of appetite, diarrhea, and vomiting, and infertility.

Many of the symptoms can be mistaken for other diseases, including appendicitis, endometriosis or a urinary tract infection. It is important to be upfront with your doctor if you suspect you may have contracted an STD or you have other risk factors for PID, like a recent miscarriage, childbirth, abortion, or IUD insertion.

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