Untreated Pelvic Inflammatory Disease Can Lead to Major Complications

An uncomfortable condition usually caused by sexually transmitted infections (STIs), pelvic inflammatory disease can be seriously uncomfortable and may lead to further complications if left untreated.

Pelvic inflammatory disease (PID) is an infection in the uterus, fallopian tubes and/or ovaries. It occurs when bacteria move from the vagina to the cervix and, potentially, other parts of the body.

PID can lead to chronic pain or other serious health problems, such as infertility, due to the irreversible damage to reproductive organs caused by the infection, warned June Gupta, N.P., the Maryland-based senior director of medical services at Planned Parenthood Federation of America.

"PID is usually caused by bacterial sexually transmitted infections like chlamydia or gonorrhea," Gupta said. "These STDs can be cured easily with antibiotics, but many people don't know they have them because they usually don't have symptoms—that's why regularly getting tested for STIs is so important."

The symptoms of pelvic inflammatory disease

If you're experiencing any unusual symptoms and have recently had unprotected sex, it's important to see a doctor right away.

"PID can increase your risk for ectopic pregnancy, which can be life-threatening. Also, people with PID can experience chronic pain in their lower belly and infertility," Gupta said. "The longer you have PID, the more likely it is that you'll have dangerous, long-term health problems and infertility. That's why it's really important to have any symptoms checked out by a doctor and get tested regularly for STDs—the sooner, the better."

Common symptoms of PID include:

• Pain (can be mild to severe) in the lower abdomen and pelvis
• Abnormal vaginal discharge that may have an unpleasant odor
• Abnormal uterine bleeding
• Pain during intercourse
• Fever, sometimes with chills
• Painful, frequent or difficult urination

Is there a connection between UTIs and PID?

Some people may wonder if there is a correlation between urinary tract infections (UTIs) and PID. Although a UTI can come from sex, it is not a sexually transmitted infection, said Asia Sullivan, a physician assistant in Los Angeles. In rare cases, an untreated UTI can spread from the urinary tract to the reproductive organs, causing PID, Sullivan said.

"A urinary tract infection is an infection in the urinary tract. The infection can occur in the bladder, kidneys, ureters, [the] tubes that lead from the kidney to the bladder, and urethra, the tube you pee out of. PID happens in the uterus, fallopian tubes and/or ovaries, which is separate from the urinary tract," Gupta explained.

The risks of untreated PID

One risk of untreated PID is sepsis, which is the body's extreme response to an infection. Sepsis can spread through the body via the bloodstream.

"It is very dangerous and can lead to death," Sullivan said. Other risks include infertility, pelvic abscess (a collection of infected fluid) and chronic pelvic pain.

If PID is left untreated, potentially life-threatening complications may follow, Gupta confirmed.

"Some problems might include a more complicated infection that requires hospitalization for treatment, or increased risk for infertility and ectopic pregnancy," Gupta said. "Even though PID is curable, treatment might not be able to undo damage, like scarring or infertility, caused by chronic pelvic inflammatory disease."

Hysterectomy is not needed if the infection is treated, Sullivan said, however, the uterus may be permanently damaged and unable to carry a fetus.

"In some cases, such as abscess formation, the uterus may need removal, but that would be very drastic," Sullivan said.

Treating PID

PID is typically treated with antibiotics. Sullivan said mild cases can be treated with an injection of antibiotics followed by oral antibiotics for two weeks.

"Some cases will require hospitalization for IV antibiotics and close monitoring/surgery," she added.

Gupta recommended people follow their doctor's instructions as directed.

"If you're being treated for PID, make sure you take your medicine exactly the way the doctor tells you to and get rest," she said. "It's also important not to have sex until you finish all of your medicine and your doctor says your infection is totally gone. When you do have sex, you should use a condom every time to prevent infections that could cause you to get PID again."

Moreover, it is important to notify your sexual partner(s) that you have pelvic inflammatory disease. As PID typically stems from STIs, both partners should get tested and treated if needed, even if they feel fine.

"If your partner doesn't get treated, you can get PID again," Gupta emphasized. "Conversations about STIs don't have to be uncomfortable and awkward. You can start by saying, 'I'm a little nervous to bring this up, but I think it's important, and I'll have more fun if I know we're being safe.' You may be surprised by how well your partner reacts; many people are relieved when the other person brings it up."

If you notice any symptoms of PID, it is best to go to your doctor, nurse or local health clinic. Having open and honest conversations about safer sex, STI testing and STI status can help end the stigma and promote a healthier and more enjoyable sex life.