Sexually-transmitted infections can wreak havoc on future child-bearing plans — and your child’s life — if you’re not careful. The biggest fertility-killing culprit is a serious complication that can arise if a bacterial STI (like gonorrhea or chlamydia) is left untreated. It’s called pelvic inflammatory disease (PID), and both men and women can get it.
Women, though, are believed to be most at risk.“Essentially the infection ravages the pelvis,” said Toronto fertility doctor Marjorie Dixon. “I see it all the time, sadly.” It develops in 10 to 15 per cent of women with untreated chlamydia, according to University of Toronto epidemiologist Dionne Gesink. What’s perhaps most concerning, though, is that you may not even realize you have it.
It develops in 10 to 15 percent of women with untreated chlamydia, according to University of Toronto epidemiologist Dionne Gesink. What’s perhaps most concerning, though, is that you may not even realize you have it.
Up to 70 per cent of women and 50 percent of men have no symptoms of chlamydia after infection. Most women infected with gonorrhea are also asymptomatic. So the consequences of PID may not be felt until it’s too late.“‘Silent’ PID may cause the most damage, including permanent damage, to the fallopian tubes and uterus, which can lead to infertility.”
One in eight (12 per cent of) women who have a history of PID will have trouble getting pregnant, Gesink says. They’re also at greater risk of an ectopic pregnancy, which is when the fetus develops outside the uterus. Five per cent of the total population of women have PID, Gesink adds.
However, it’s hard to say what percentage of them have it from a previous bout of chlamydia or gonorrhea because of the various symptoms causing by PID. Various ailments include non-STI bacterial infections like bacterial vaginosis, endometriosis, and intrauterine devices (IUDs).Gesink says IUD problems “are usually limited to the first three weeks after insertion.”
How does PID cause damage?
Gesink explains PID causes the pelvis to swell and pushes organs together. As they touch, a sticky web is formed that will prevent sperm from reaching the egg because it won’t be able to make its way up through the now-blocked Fallopian tubes.
“You can think of it like a little kid playing with gum in your hands. The gum sticks to both sides of your hands and when you pull your hands apart and get this web.”
Even after the PID is treated and the swelling goes down, the “gumming” remains.While women won’t necessarily feel the web forming, those who do have symptoms may feel pain (which in some cases can become chronic) and experience fever as well as an unusual discharge. Some will feel pain or bleed during sex. They may also see spotting between periods and feel a burning sensation while peeing.
Getting treatment for it won’t reverse the damage to one’s pelvic anatomy, according to Gesink. Surgery to improve the blocked tubes might help. However, Gesink says it can also sometimes create scarring that leaves its blockage.
Pelvic inflammatory disease (PID). PID occurs when pathogenic organisms migrate upward from the urethra and cervix into the upper genital tract. PID can lead to infertility, ectopic pregnancy, and chronic pain. Doctors often prescribe at least two broad- spectrum antibiotics for PID because it is hard to identify the organisms responsibly.
In men, Gesink says, chlamydia or gonorrhea can cause chronic inflammation of the urethra which is “like PID but for men.”
It can reportedly cause the urethra to narrow and limit sperm flow. In some cases it can also creep its way up the urethra into the epididymis (a tube behind the testes that stores and carries sperm) leading to inflammation of the epididymis called epididymitis which is “also like PID for men.”
So how can you prevent it?
The length of time it takes for gonorrhea or chlamydia to turn into PID depends on the person, Gesink says.“Some women can develop PID within a matter of days.”
“This is why it’s important to get tested. If you don’t have symptoms, it doesn’t mean you’re infection-free.”
The sooner an STI is treated, the less chance there is for PID to develop and for extensive damage to occur.
“There’s one other easy way to avoid this whole ordeal.“ Tell the men to wear rubber booties,” Dixon said. “Always, always, always.”
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