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Pelvic inflammatory disease and infertility

Did you know that pelvic inflammatory disease (PID) is the most common preventable cause of infertility? Around 1 in 8 women with PID struggle to get pregnant and around 1 million women in the US are diagnosed with it.

What is PID?

It is an infection of the female reproductive organs, and it most often occurs when sexually transmitted bacteria are spread from the vagina to the uterus, fallopian tubes or ovaries. In most cases you might not experience any symptoms and you don’t realize that you have the disease until it’s time to conceive or you start to experience chronic pelvic pain. 

Causes of PID

The usual suspects that cause PID are bacteria, with the most common to be gonorrhea or chlamydia infections, that are caused during unprotected sex. Less commonly, bacteria can enter the reproductive tract anytime the normal barrier created by the cervix is disturbed. This can happen during menstruation and after childbirth, miscarriage or abortion.

Situations that increase the possibility of PID:

  • Being sexually active and younger than 25 years old
  • Having multiple sexual partners
  • Being in a sexual relationship with someone who has more than one sex partner
  • Having unprotected sex
  • Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and might mask symptoms
  • Having a history of pelvic inflammatory disease or a sexually transmitted infection

Symptoms

  • Pain -mild to severe- to lower abdomen and pelvis
  • Unusual or heavy vaginal discharge that may have an unpleasant odor
  • Unusual bleeding from the vagina, especially during or after sex, or between periods
  • Pain during sex
  • Fever, sometimes with chills
  • Painful, frequent or difficult urination

Fortunately, PID is treatable, and the sooner it’s addressed, the better. Although some scar tissue may be able to be removed surgically, the scarring process itself can cause permanent damage. So if you’re diagnosed with PID, your doctor will start by treating the infection with antibiotics. The antibiotics can be in pill form or given via injection or intravenously depending on the severity of your infection. But you might need to be hospitalized if the infection is serious, if you’re pregnant or if you have an abscess in one of your fallopian tubes or ovaries.  

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Men and PID

Men can carry the bacteria that causes the disease without having any symptoms, so they can pass the infection on to their sexual partners without knowing it. But getting tested for STIs can help. If a man has an STI that’s known to cause PID (like gonorrhea or chlamydia), he can take steps to avoid infecting his partner by using condoms, getting treated with antibiotics and not having sex until the STI is cleared.

PID and infertility

The disease can make it difficult for a woman to conceive, and it results in 1 in 10 women to be completely infertile. It also raises the risk of ectopic pregnancies. If PID infects the fallopian tubes, it can scar the lining of the tubes, making it more difficult for eggs to pass through. If a fertilized egg gets stuck and begins to grow inside the tube, it can cause the tube to burst, which can sometimes lead to severe and life-threatening internal bleeding. If you’re diagnosed with an ectopic pregnancy, you may be given medication to stop the egg growing or have surgery to remove it.

As well as an increased risk of ectopic pregnancy, scarring or abscesses in the fallopian tubes can make it difficult for women to get pregnant if eggs can’t pass easily into the womb. You could become infertile as a result of the condition, and there’s a higher risk of infertility if you delay treatment or have repeated episodes of PID. But a long-term study in the US showed that people who’d been successfully treated for PID had the same pregnancy rates as the rest of the population. Blocked or damaged fallopian tubes can sometimes be treated with surgery. If that doesn’t work there is always the possibility of a fertility treatment, like IVF. According to URA, about 100,000 women start infertility treatments because of their PID, and with the same pregnancy rates as women not suffering from the disease. 

Prevention of PID

There are a few ways to reduce the risk of pelvic inflammatory disease on your own but if the problem persists you should definitely consult a healthcare specialist. 

Practice safe sex and get you and your partner tested for PID and STIs. Many forms of contraception do not protect against the development of PID, so using barrier methods, such as a condom, helps to reduce the risk. Even if you take birth control pills, using a condom every time you have sex with a new partner will protect you against STIs.

In general, women who are sexually active should get tested regularly for STDs and schedule annual well-woman exams. 

If you decide on proceeding with a specific treatment, such as IVF, reach out to us for more information. Greece is considered one of the best countries for fertility treatments, with top-notch fertility clinics, good legislation and affordable prices. 

PID in most cases is treatable and women can conceive after all, so don’t be discouraged and seek professional help! 

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