You might have heard of pelvic inflammatory disease (PID). But did you know that it’s diagnosed in more than 1 million U.S. women each year — or that it’s the most common preventable cause of infertility? 

PID can make it harder to conceive, as well as put pregnancies at risk for serious complications. Here’s what every woman should know about this condition, including where it comes from, how to spot it and the best way to treat it.

What is pelvic inflammatory disease?

Pelvic inflammatory disease is an infection that can affect the uterus, fallopian tubes and/or ovaries. It occurs when bacteria travels from a woman’s vagina or cervix into her other reproductive organs.

The infection and inflammation from PID can cause scarring, which can increase the chance for infertility and ectopic pregnancy. PID can also cause chronic pelvic pain, abscesses (pockets of pus-filled, infected tissue) and other serious health problems. 

How does pelvic inflammatory disease affect fertility?

PID can make getting pregnant harder, and 1 in 10 women with the condition become infertile. Bacteria that makes its way into the fallopian tubes can lead to inflammation, which causes scar tissue to form. And that scar tissue can create blockages in the tubes that make it harder for the sperm and egg to meet. 

Even just a little bit of scar tissue can make it harder to get pregnant. But many women with PID can still get pregnant with the help of fertility treatments

Pelvic inflammatory disease symptoms

PID doesn’t always show symptoms early on, or they can be so mild that a woman doesn’t notice them. But as it gets more serious, PID can cause:

  • Lower abdominal pain
  • Fever or chills
  • Bad-smelling vaginal discharge
  • Longer, heavier or more painful periods
  • Pain during sex
  • Painful urination

PID symptoms often develop slowly, but they can also come on fast, seemingly out of nowhere. Either way, you should see your doctor ASAP once you notice them. The sooner PID is diagnosed and treated, the less likely it is to cause infertility or other serious problems.  

Pelvic inflammatory disease causes

PID can occur when bacteria from the vagina or cervix moves into the reproductive organs. Most often the bacteria comes from sexually transmitted infections like gonorrhea or chlamydia. But STIs aren’t the only cause. Douching can make it easier for PID-causing bacteria to grow, and it can push bacteria from the vagina up into the reproductive tract, causing an overgrowth of harmful bacteria (which is one of the big reasons experts say you shouldn’t douche). 

Intrauterine devices (IUDs) can also increase the chance for PID. But the odds of getting PID from an IUD are small, and the risk mostly applies to the first three weeks after the IUD is first inserted. If you’re thinking about using an IUD for birth control but are concerned about the risk of PID, your doctor can help you weigh the pros and cons. 

Pelvic inflammatory disease treatments

PID is treatable — and the sooner it’s addressed, the better. The longer you have PID, the more likely it is to cause serious problems. And although some scar tissue may be able to be removed surgically, the scarring process itself can cause permanent damage.

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.  

How does pelvic inflammatory disease affect pregnancy?

PID can make it harder to get pregnant in the first place. It can also increase the risk of ectopic pregnancy — where a fertilized egg implants outside of the uterus — by as much as sixfold. 

PID-related scarring can make it harder for a fertilized egg to successfully travel down the fallopian tubes, so it might end up growing in the tube instead. Ectopic pregnancies are never viable and can put women at risk for life-threatening bleeding. They almost always require surgery or treatment with a medication called methotrexate. 

Men and pelvic inflammatory disease

Men can carry the bacteria that causes PID without having any symptoms (like discharge or painful urination), so they can pass the infection on to their 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 clears.

When to call the doctor about PID

Untreated PID can affect your fertility and your overall health, so it should be taken care of as quickly as possible. You should call your gynecologist right away if you notice any symptoms that seem like they might be related to PID. Getting treated sooner will help keep the infection in check and reduce the chances of scarring that could impact your fertility.

Pelvic inflammatory disease is a serious condition that can make it harder to conceive and increase the risk for some pregnancy complications. Knowing the possible causes as well as the symptoms can help you stay protected. But if you suspect that you might have PID, you should let your doctor know right away. Infections that are treated sooner are less likely to cause fertility problems.