Can pelvic inflammatory disease cause ectopic pregnancy

Pelvic inflammatory disease overview

• Pelvic inflammatory disease (PID) is an infection of the female reproductive system caused by bacteria.
• Untreated, PID can cause damage to the ovaries and fallopian tubes, which may contribute to infertility.
• Pelvic inflammatory disease is commonly caused by complications from a sexually transmitted disease (STD).
• Oral antibiotics are the most common treatment for PID, but more serious cases may require intravenous antibiotics or surgery.

What is pelvic inflammatory disease?

Pelvic inflammatory disease (PID) is an infection of the female reproductive system, causing scarring of the uterus, ovaries, fallopian tubes, cervix and vagina. Left untreated, PID can cause irreversible damage to the reproductive system and result in a woman’s infertility.

Pelvic inflammatory disease is the most common treatable cause of fertility problems. Early treatment is key to avoiding infertility.

PID can also cause ectopic pregnancy, in which the fertilized egg cannot pass through the fallopian tube to the uterus and implants outside the uterus instead, generally in the fallopian tube. This can be a life-threatening condition.

Chronic pelvic pain is also caused by PID, due to scarring of the pelvic organs. This pain can last for years and usually occurs during ovulation and intercourse.

What causes pelvic inflammatory disease?

Bacteria causes PID. Complication from a sexually transmitted disease, usually gonorrhea or chlamydia, accounts for approximately 90 percent of all cases of pelvic inflammatory disease. Bacteria that enters the vagina during unprotected sex spreads to the ovaries, uterus or fallopian tubes.

Bacteria can also cause PID by entering the reproductive tract when the cervix’s normal barrier is broken. This can occur during an abortion, childbirth, insertion of an intrauterine device (IUD) and pelvic procedures.

Who is at risk for pelvic inflammatory disease?

• Women with an untreated STD
• Women who have had a prior case of PID or STD
• Women who use an IUD for birth control
• Women with many sexual partners, or whose sexual partner is active with others
• Women who douche
• Sexually active women who are 25 or younger

What are the symptoms of pelvic inflammatory disease?

Symptoms of PID can be mild or even non-existent. Physical symptoms of PID include:

• Painful urination
• Abnormal yellow or green vaginal discharge accompanied by an unusual odor
• Vaginal bleeding between periods
• Pain during sexual intercourse
• Chills or high fever
• Nausea or vomiting
• Pain or tenderness in the lower abdomen or lower back
• Fainting or other signs of shock

If a woman experiences any of the symptoms above, she should see her doctor immediately.

Tests & treatment for pelvic inflammatory disease

Doctors generally diagnose pelvic inflammatory disease by reviewing symptoms, conducting a pelvic exam, and doing cultures and urine tests. Biopsy of endometrial tissue, ultrasound and even laparoscopic surgery to view pelvic organs may also be used in the diagnosis.

Pelvic inflammatory disease treated early can reduce damage to the reproductive system, but treatment will not undo any of the damage that has already happened.

Most cases of PID are treated with oral antibiotics. Although physical symptoms may subside after a few days of antibiotics, a woman with PID will need to take the antibiotics as prescribed by her doctor until the prescription is empty. If she stops taking the antibiotics too soon, the infection may return and cause more damage.

More advanced cases of pelvic inflammatory disease may require a woman to be admitted to the hospital for intravenous antibiotics or surgery to remove any abscesses caused by the infection.

In all cases of PID, the woman should abstain from sexual intercourse until she is clear of the disease. Her sexual partner(s) should also be treated with antibiotics in order to prevent the infection from returning.

If a woman has PID and struggles with infertility, there are several assisted reproductive treatments that can help her conceive.

Learn More About Fertility Treatment Options

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Untreated sexually transmitted diseases (STDs) can cause pelvic inflammatory disease (PID), a serious condition, in women. 1 in 8 women with a history of PID experience difficulties getting pregnant. You can prevent PID if you know how to protect yourself. This fact sheet answers basic questions about PID.

What is PID?

Pelvic inflammatory disease is an infection of a woman’s reproductive organs. It is a complication often caused by some STDs, like chlamydia and gonorrhea. Other infections that are not sexually transmitted can also cause PID.

How do I get PID?

You are more likely to get PID if you

• Have an STD and do not get treated;
• Have more than one sex partner;
• Have a sex partner who has sex partners other than you;
• Have had PID before;
• Are sexually active and are age 25 or younger;
• Douche;
• Use an intrauterine device (IUD) for birth control. However, the small increased risk is mostly limited to the first three weeks after the IUD is placed inside the uterus by a doctor.

How can I reduce my risk of getting PID?

The only way to avoid STDs is to not have vaginal, anal, or oral sex.

If you are sexually active, you can do the following things to lower your chances of getting PID:

• Being in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results;
• Using latex condoms the right way every time you have sex.

How do I know if I have PID?

There are no tests for PID. A diagnosis is usually based on a combination of your medical history, physical exam, and other test results. You may not realize you have PID because your symptoms may be mild, or you may not experience any symptoms. However, if you do have symptoms, you may notice

• Pain in your lower abdomen;
• Fever;
• An unusual discharge with a bad odor from your vagina;
• Pain and/or bleeding when you have sex;
• Burning sensation when you urinate; or
• Bleeding between periods.

You should

• Be examined by your doctor if you notice any of these symptoms;
• Promptly see a doctor if you think you or your sex partner(s) have or were exposed to an STD;
• Promptly see a doctor if you have any genital symptoms such as an unusual sore, a smelly discharge, burning when peeing, or bleeding between periods;
• Get a test for chlamydia and gonorrhea every year if you are sexually active and younger than 25 years of age.
• Have an honest and open talk with your health care provider if you are sexually active and ask whether you should be tested for other STDs.

Can PID be cured?

Yes, if PID is diagnosed early, it can be treated. However, treatment won’t undo any damage that has already happened to your reproductive system. The longer you wait to get treated, the more likely it is that you will have complications from PID. While taking antibiotics, your symptoms may go away before the infection is cured. Even if symptoms go away, you should finish taking all of your medicine. Be sure to tell your recent sex partner(s), so they can get tested and treated for STDs, too. It is also very important that you and your partner both finish your treatment before having any kind of sex so that you don’t re-infect each other.

You can get PID again if you get infected with an STD again. Also, if you have had PID before, you have a higher chance of getting it again.

What happens if I don’t get treated?

If diagnosed and treated early, the complications of PID can be prevented. Some of the complications of PID are

• Formation of scar tissue both outside and inside the fallopian tubes that can lead to tubal blockage;
• Ectopic pregnancy (pregnancy outside the womb);
• Infertility (inability to get pregnant);
• Long-term pelvic/abdominal pain.

Sources

American College of Obstetricians and Gynecologists (ACOG). Pelvic Inflammatory Disease. ACOG Patient Education Pamphlet, 1999.

Westrom L and Eschenbach D. In: K. Holmes, P. Sparling, P. Mardh et al (eds). Sexually Transmitted Diseases, 3rd Edition. New York: McGraw-Hill, 1999, 783-809.

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