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Olivia Ware - September 3, 2020

Pelvic Inflammatory Disease & The Reproductive Cost of Untreated STIs

Nearly everyone is familiar with common STDs symptoms whether a tingling on the toilet or an itch that can’t be scratched. However, STDs can occur without any indication of discomfort in asymptomatic carriers. Where’s the harm in that? If there is no sign of something wrong down there, why get tested? 

Aside from gaining peace of mind and being a responsible partner, taking control of your sexual health can greatly minimize painful and costly effects on your reproductive health down the road. If left untreated, otherwise harmless STDs such as chlamydia and gonorrhea or vaginal infections, like Bacterial Vaginosis (BV), can lead to Pelvic Inflammatory Disease, causing more serious problems for the reproductive system. PID occurs when untreated bacterial infections target the reproductive system. PID can cause irreversible damage to the female reproductive system, including infertility. This is why getting regular STD screenings is essential, even without exhibiting STD symptoms.

What is Pelvic Inflammatory Disease?

Pelvic Inflammatory Disease refers to complications in the female reproductive tract characterized by inflammation resulting from an untreated bacterial infection. Bacteria traveling from the vagina or cervix into the upper reproductive tract may infect the uterus and the fallopian tubes. Untreated gonorrhea and chlamydia are responsible for the development of up to half of all pelvic infections according to the CDC. This means that many PID cases are entirely preventable—gonorrhea and chlamydia are easily curable if treated. It is also possible to develop PID without an STD. As mentioned, otherwise benign bacterial infections such as untreated Bacterial Vaginosis can lead to PID. The use of tampons, IUDs, douching, and surgical intervention may also introduce bacteria into the upper reproductive tract causing Pelvic Inflammatory Disease. 

PID and Infertility

If left untreated, the long-term effects of PID can do serious damage to the reproductive system. Pelvic Inflammatory Disease can cause chronic pelvic pain, tissue scarring, and reproductive complications including ectopic pregnancies and infertility. 

Can You Have PID for Years and Not Know It?

Pelvic Inflammatory Disease often goes unrecognized and undiagnosed. In the early stages of PID, symptoms are often mild and easily dismissed. PID presents differently with varying, nonspecific, and inconsistent symptoms that make it difficult for patients and medical professionals to target. The longer an infection goes untreated, the greater the risk to long-term health as a result of inflammation and irreversible scarring.

It is also worth noting that PID can show up differently depending on the location impacted. For example, Endometriosis is an infection within the lining of the uterus whereas Salpingitis is an infection in one or both of the fallopian tubes. 

Which Pelvic Inflammatory Disease Symptoms Should You Look Out For?

PID symptoms vary among those who suffer, ranging from subtle to nonspecific. PID symptoms may also come in waves which makes them easier to ignore. 

Common Symptoms of PID

  • Pelvic pain or tenderness

  • Fatigue

  • Fever

  • Pain during intercourse 

Many  symptoms of Pelvic Inflammatory Disease can be ignored as minor discomfort or another common vaginal infection, like UTI. PID symptoms may come and go for months, even years without notice. Something as subtle as feeling intermittently “flu-ish” could be a sign of PID. 

Asymptomatic PID can lay dormant and is therefore difficult to diagnose. The infection may progress into acute PID before medical treatment is sought. Acute PID symptoms such as abnormal bleeding (including longer, heavier, and more painful periods), odorous vaginal discharge characterized by a thick and yellowish color, painful intercourse, and abdominal pain may increase in length and severity while the infection is active. Nausea, vomiting, and fever can accompany severe pelvic pain with acute PID. 

Since untreated chlamydia and gonorrhea are common causes of PID, getting regular STD screenings is a good way to prevent Pelvic Inflammatory Disease.

How Long Does It Take for PID to Develop?

PID develops when bacteria passes from the vagina or cervix into the upper reproductive tract causing infection. The amount of time it takes for an untreated bacterial infection to travel into the upper reproductive tract is unknown. Since PID may develop without noticeable symptoms, it is difficult to gauge how long the infection has been present in the body. Many sufferers do not seek treatment until the symptoms of PID have progressed, causing further harm to the reproductive system. Oftentimes, women are unaware they have PID until attempting to become pregnant since untreated PID can cause infertility. What may feel like a minor annoyance in your 20’s may  have a major impact on your reproductive health later on when you attempt to conceive.

How to Test Yourself for PID

Since PID symptoms vary, there is no single laboratory test for PID. It is important to pay attention to any discomfort or irregularity in your body. If something feels off, it is better to seek medical advice than to ignore the issue. Pelvic pain that cannot be attributed to other reproductive, urinary, and gastrointestinal tract diseases may be an indication of PID. 

Beyond pelvic pain, common criteria for a PID diagnosis include:

  • Cervical tenderness

  • Uterine tenderness

  • Elevated presence of white blood cells in a sample analysis of vaginal fluid 

There are several methods of diagnosing PID, but no single catchall. Blood tests, pap tests, and ultrasounds are helpful methods of diagnosis depending on how PID is presenting in the body. In an ultrasound, PID typically shows up as an abscess or excess fluid in the fallopian tube. However, PID occurring in other parts of the pelvic region may be more difficult to detect. Having a culture done of the infection is an important next step to determine whether it can be treated with antibiotics. 

PID Treatment

The use of antibiotics for PID treatment is common and effective. Taking the right course of antibiotics can eliminate the infection and prevent long-term health complications. However, if the antibiotic is taken only partially, the infection may persist indefinitely. 

How Long Does PID Last After Treatment?

Pelvic Inflammatory Disease can be cured with antibiotic treatment. Antibiotics will not reverse scarring that has already taken place. Scarring can permanently damage the reproductive system, which is why it is important to seek PID treatment early. It is also recommended that all sex partners be treated to prevent PID reinfection. Though PID in men is often asymptomatic, it is easily transmittable. The best way to protect your reproductive health is to get tested early and often. Staying informed and paying close attention to your body’s messaging can prevent years of pain, questioning, and fertility struggles resulting from Pelvic Inflammatory Disease.