• feel pain when peeing?

• experience heavy periods?

Pelvic Inflammatory Disease (PID) is an infection of the reproductive organs, occurring when bacteria travels through cervix to the uterus and the fallopian tubes.

PID can cause infertility, ectopic pregnancy, chronic pelvic pain as well as tubal or ovarian abscesses. It can also cause adhesions/scar tissues, peritonitis 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 with 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 is 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. Many cases of PID are silent and involve no symptoms, and PID is often missed or undiagnosed

PID is caused by Sexually Transmitted Infections (STIs). Common causes include chlamydia and gonorrhoea.

Chlamydia is a common cause of silent PID, which means many women do not know they are infected. 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 after childbirth, miscarriage, abortion, endometrial biopsy, IUD insertion, HSG and hysteroscopy, and artificial insemination.

While pelvic infection can be caused by bacteria besides STIs, this is rarely called PID. The symptoms and treatment, however, may be similar.

Sexually active women of childbearing age are most at risk for PID. The more sex partners a woman has, the higher her risk of getting PID. Women who are 25 or younger are more likely to get PID than those older than 25.

Between 10% and 15% of women with acute PID become infertile.

If a woman has multiple episodes of acute PID, her risk of developing infertility rises. 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. When the blockage is near the ovaries, it’s more difficult to treat surgically.

PID may also cause hydrosalpinx. This occurs when a tube is blocked near the ovary and then dilates and fills with fluid. The presence of a hydrosalpinx can decrease the chances for successful IVF treatment.

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.

In rare cases, an especially acute infection may lead to an emergency hysterectomy. In the past, some doctors treated chronic PID with hysterectomy, but this is being used less and less. If your doctor suggests a hysterectomy as a cure for chronic PID, you may want to get a second opinion before making a decision that will seriously impact your future reproductive possibility. See more about this below, under “Treatments for PID”.

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 symptoms 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, diarrhoea 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 STI or you have other risk factors for PID, like a recent miscarriage, childbirth, abortion, or IUD insertion.

It’s not usual for chronic PID to go undiagnosed for months or years. If you’re experiencing regular pelvic pain or pain during intercourse, and your doctor has not been able to diagnose or treat the problem successfully, you may want to seek a second opinion. Keep pushing until you find appropriate treatment for your symptoms. Your future fertility and overall health depend on it.