Can Pelvic Inflammatory Disease Cause Infertility?
Pelvic inflammatory disease (PID) is an inflammation of a woman’s upper reproductive tract, including the structures of the uterus, ovaries, and fallopian tubes. Salpingitis, inflammation of the fallopian tubes, is the most common manifestation of the disease. PID is known to be a long-term consequence of many sexually transmitted diseases as well as of bacterial vaginosis (BV), pelvic surgery, and other gynecologic procedures that cross the cervix.
It is fundamentally a preventable condition.
Pelvic inflammatory disease is, essentially, caused by the body overreacting to an infection. As the immune system tries to fight off the invading bacteria, it causes local inflammation and scarring. Although this may successfully wall off the infection inside the reproductive tract, it can be damage the organs. PID can cause scarring in the uterus, fallopian tubes, and even in the pelvic cavity. This is one of the main reasons it causes chronic pelvic pain.
The most common infections associated with pelvic inflammatory disease are chlamydia and gonorrhea. Because the symptoms of PID are the result of the body’s response to the underlying infection, treatment usually involves antibiotics to treat that infection. In severe cases, or in an emergency, surgery may be necessary to drain an abscess that has ruptured or that threatens to rupture.
Symptoms
lPain in the lower abdomen and pelvis
lIrregular periods
lPain during sex
lPain during urination
lLower back pain
lExcess vaginal discharge with a foul odour
lFever, exhaustion, diarrhea, vomiting, and other general signs of infection.
In the early 1990s, the self-reported frequency of PID in women was approximately one in nine. PID was more than twice as common in women with a history of sexually transmitted diseases (26 per cent) than among women who had never reported an STD (10 per cent).
Risk factors
Younger age: Sexually experienced teenagers are three times more likely to be diagnosed with PID than their 25- to 29-year-old counterparts. Scientists do not know, however, whether this is due to biological factors that make young women more susceptible to STDs or different sexual behaviors in these two age groups.
Women have the highest risk of PID of the ethnic groups seen in the U.S. This may be related to biological factors, or due to their comparatively high frequency of douching.
Contraceptive Choice: Barrier methods, such as condoms, and oral contraceptives reduce the risk of PID. Despite the problems with the Dalkon Shield in the 1970s, use of modern intrauterine devices (IUD) is not considered to significantly increase the risk of PID, except possibly around the time of insertion.
Douching: Douching greatly increases a woman’s risk of PID.
Concerns about PID
Worldwide, PID is one of the leading causes of ectopic pregnancy and preventable infertility in women.
In 1988, a study estimated that the cost of preventable infertility in the US was in the vicinity of $64 billion, and it is probably substantially higher today. This includes the costs of both treating the STDs and PID that cause