Health and Me

Tanya Dutt

How A Simple Mistake In The Bedroom Could Risk Your Fertility?

Unprotected sex with an infected partner—can silently jeopardize your fertility. Sexually transmitted diseases (STIs) such as chlamydia and gonorrhea are usually symptomless but can cause <span>Pelvic Inflammatory Disease</span> (PID), which can result in permanent damage to reproductive organs. Without protection, dangerous bacteria can travel, leading to scarring of the fallopian tubes, ectopic pregnancy, and even infertility.

A woman's fertility and sexuality are closely connected, being the root of her general health. Although <span>reproductive health</span> discussions have increased, diseases such as Pelvic Inflammatory Disease (PID) remain hidden in the background, undiagnosed until it is too late and severe damage has already occurred. PID is not only an infection; it is a stealthy disruptor that can compromise a woman's fertility, induce chronic pain, and affect her quality of life. Knowing its causes, symptoms, and treatments is important in protecting reproductive health.

Pelvic Inflammatory Disease (PID) refers to a bacterial infection of the upper reproductive organs, i.e., the ovaries, fallopian tubes, and uterus. It usually results from untreated sexually transmitted diseases (STIs) like chlamydia and gonorrhea, which penetrate the reproductive organs upon unprotected sex. PID can lead to permanent scarring, reproductive complications, as well as long-term pelvic pain if left untreated.

As per Dr. Manasa G V, Associate Consultant - Obstetrics and Gynecology, "Pelvic Inflammatory Disease (PID) is an infection of a woman's reproductive organs and is most commonly caused by bacterial infections transmitted through sexual intercourse, like chlamydia and gonorrhea. PID, if not treated, can cause infertility, chronic pelvic pain, and complications of ectopic pregnancy. Early diagnosis and treatment are essential to avoid long-term complications."

PID occurs when bacteria travel from the vagina or cervix to the uterus, fallopian tubes, or ovaries, leading to infection and inflammation. The most common culprits are the bacteria responsible for chlamydia and gonorrhea, but other infections can also be to blame.

Dr Shibani Devi, Consultant Obstetrics and Gynaecology explains, "Pelvic inflammatory disease (PID) is an infection of one or more of the upper reproductive organs, including the uterus, fallopian tubes and ovaries. Untreated <span>sexually transmitted infections</span> can ascend up and involve upper genital organs causing damage to uterus lining, fallopian tube epithelium which can result in significant morbidity and mortality like tube ovarian abscess, chronic pelvic pain, infertility, ectopic pregnancy, Fitz Hugh cutis syndrome."

<ul><li>Unprotected sex with an infected partner</li><li>Multiple sexual partners, increasing exposure to STIs</li><li>Poor hygiene, allowing bacteria to thrive</li><li>Recent gynecological procedures (such as IUD insertion, endometrial biopsy, childbirth, miscarriage, or abortion)</li><li>Douching, which disrupts the vagina's natural balance of bacteria</li></ul>

By practicing safe sex and regularly being screened for STIs, women can decrease their risk of developing PID quite substantially.

<h2>Symptoms of Pelvic Inflammatory Disease</h2>

One of the reasons PID is the most worrisome is because its symptoms will be mild or even absent and therefore difficult to diagnose early on. Some women do not even know they have PID until they have trouble becoming pregnant or present with chronic pain in the lower abdomen.

<ul><li>Abdominal pain in the lower part of the abdomen (severe with motion)</li><li>Abnormal vaginal discharge (thick and yellowish, or malodorous)</li><li>Sexual pain</li><li>Irregular menstruation (heavy bleeding, heavy spotting, painful ovulation)</li><li>Fever</li><li>Chills</li><li>Nausea</li><li>Vomiting</li></ul>

Disregarding these warning signs may result in serious complications. Women with persistent pelvic pain or abnormal discharge must immediately consult a doctor.

<h2>How Pelvic Inflammatory Disease Impacts Fertility?</h2>

If left untreated, PID can have disastrous consequences on a woman's fertility. The infection leads to scarring and blockage of the fallopian tubes, which may hinder sperm from reaching an egg or block a fertilized egg from being implanted in the uterus.

<ul><li>Doubles the risk of tubal infertility after a single episode</li><li>Increases the risk of ectopic pregnancy (a life-threatening condition in which the embryo implants outside the uterus)</li><li>Permanently damages reproductive organs, making it hard to conceive</li><li>Women who have had multiple episodes of PID are at 75% greater risk of having their fallopian tubes blocked, significantly lowering their chances of natural conception. Early treatment and preventive care are essential to maintaining fertility.</li></ul>

<h2>Treatment of Pelvic Inflammatory Disease</h2>

Dr Shibani adds, "It is well accepted that acute PID is a polymicrobic infection by Neisseria gonorrhoeae and Chlamydia trachomatis, Mycoplasma genitalium, anaerobic and facultative bacteria, similar to those associated with bacterial vaginosis. Treatment includes 7-14 days of oral or intravenous antibiotcs like ceftriaxone, azithromycin, doxycycline and metronidazole depending on symptom severity. It is equally important to treat the partner simultaneously for effective recovery and advise to refrain from sexual activity during treatment."

In order to decrease the risk of PID in lifetimes, safe sexual practice, limiting number of sexual partners, routine pap smear testing are considered as right measures for decreasing incidence. PID can be very successfully treated if caught early. The usual regimen consists of a regimen of antibiotics, for a period of at least two weeks, to eliminate infection.

<strong>Antibiotic treatment</strong> – Issued by a physician to clear infection

<strong>Avoiding sexual activity </strong>– Until fully cleared of the infection

<strong>Testing and treating of the partner</strong> – To avoid reinfection

<strong>Optional IUD removal</strong> – If an intrauterine device is the cause

Hospitalization may be necessary in more severe cases for intravenous antibiotics or surgically draining abscesses. Failure to treat can result in long-term problems, so treatment early on is important.

<h2>Prevention Steps for PID in Women</h2>

<strong>Practice safe sex </strong>– Use condoms and reduce the number of sexual partners

<strong>Regular STI testing</strong> – Particularly if sexually active

<strong>Treat infections right away</strong> – Even if the symptoms are minor

<strong>Don't douche</strong> – To keep the vagina's flora balanced

<strong>Stay aware</strong> – Knowledge is the best protection against reproductive health problems

Women must immediately consult a doctor if they have:

<ul><li>Severe lower belly pain</li><li>Extreme fever (over 101°F/38.3°C)</li><li>Persistent vomiting and nausea</li><li>Pus-like smelling vaginal discharge</li><li>Even if the symptoms are slight, routine check-ups and STI tests can identify PID at an early stage, avoiding permanent reproductive damage.</li></ul>

<strong>Dr. Manasa G V is an Associate Consultant - Obstetrics and Gynaecology at Manipal Hospital, Goa in India.</strong>

Dr Shibani Devi is a Consultant <strong><em>Obstetrics</em></strong> and Gynaecology at Manipal Hospital, Bhubaneshwar <strong><em>in India.</em></strong>

Health Conditions A-Z

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Unprotected sex with an infected partner—can silently jeopardize your fertility. Sexually transmitted diseases (STIs) such as chlamydia and gonorrhea are usually symptomless but can cause Pelvic Inflammatory Disease (PID), which can result in permanent damage to reproductive organs. Without protection, dangerous bacteria can travel, leading to scarring of the fallopian tubes, ectopic pregnancy, and even infertility.A woman's fertility and sexuality are closely connected, being the root of her general health. Although reproductive health discussions have increased, diseases such as Pelvic Inflammatory Disease (PID) remain hidden in the background, undiagnosed until it is too late and severe damage has already occurred. PID is not only an infection; it is a stealthy disruptor that can compromise a woman's fertility, induce chronic pain, and affect her quality of life. Knowing its causes, symptoms, and treatments is important in protecting reproductive health.Pelvic Inflammatory Disease (PID) refers to a bacterial infection of the upper reproductive organs, i.e., the ovaries, fallopian tubes, and uterus. It usually results from untreated sexually transmitted diseases (STIs) like chlamydia and gonorrhea, which penetrate the reproductive organs upon unprotected sex. PID can lead to permanent scarring, reproductive complications, as well as long-term pelvic pain if left untreated.As per Dr. Manasa G V, Associate Consultant - Obstetrics and Gynecology, "Pelvic Inflammatory Disease (PID) is an infection of a woman's reproductive organs and is most commonly caused by bacterial infections transmitted through sexual intercourse, like chlamydia and gonorrhea. PID, if not treated, can cause infertility, chronic pelvic pain, and complications of ectopic pregnancy. Early diagnosis and treatment are essential to avoid long-term complications."How PID Develops?PID occurs when bacteria travel from the vagina or cervix to the uterus, fallopian tubes, or ovaries, leading to infection and inflammation. The most common culprits are the bacteria responsible for chlamydia and gonorrhea, but other infections can also be to blame.Dr Shibani Devi, Consultant Obstetrics and Gynaecology explains, "Pelvic inflammatory disease (PID) is an infection of one or more of the upper reproductive organs, including the uterus, fallopian tubes and ovaries. Untreated sexually transmitted infections can ascend up and involve upper genital organs causing damage to uterus lining, fallopian tube epithelium which can result in significant morbidity and mortality like tube ovarian abscess, chronic pelvic pain, infertility, ectopic pregnancy, Fitz Hugh cutis syndrome."Common Causes of PIDUnprotected sex with an infected partnerMultiple sexual partners, increasing exposure to STIsPoor hygiene, allowing bacteria to thriveRecent gynecological procedures (such as IUD insertion, endometrial biopsy, childbirth, miscarriage, or abortion)Douching, which disrupts the vagina's natural balance of bacteriaBy practicing safe sex and regularly being screened for STIs, women can decrease their risk of developing PID quite substantially.Symptoms of Pelvic Inflammatory DiseaseOne of the reasons PID is the most worrisome is because its symptoms will be mild or even absent and therefore difficult to diagnose early on. Some women do not even know they have PID until they have trouble becoming pregnant or present with chronic pain in the lower abdomen.Abdominal pain in the lower part of the abdomen (severe with motion)Abnormal vaginal discharge (thick and yellowish, or malodorous)Sexual painIrregular menstruation (heavy bleeding, heavy spotting, painful ovulation)FeverChillsNauseaVomitingDisregarding these warning signs may result in serious complications. Women with persistent pelvic pain or abnormal discharge must immediately consult a doctor.How Pelvic Inflammatory Disease Impacts Fertility?If left untreated, PID can have disastrous consequences on a woman's fertility. The infection leads to scarring and blockage of the fallopian tubes, which may hinder sperm from reaching an egg or block a fertilized egg from being implanted in the uterus.Doubles the risk of tubal infertility after a single episodeIncreases the risk of ectopic pregnancy (a life-threatening condition in which the embryo implants outside the uterus)Permanently damages reproductive organs, making it hard to conceiveWomen who have had multiple episodes of PID are at 75% greater risk of having their fallopian tubes blocked, significantly lowering their chances of natural conception. Early treatment and preventive care are essential to maintaining fertility.Treatment of Pelvic Inflammatory DiseaseDr Shibani adds, "It is well accepted that acute PID is a polymicrobic infection by Neisseria gonorrhoeae and Chlamydia trachomatis, Mycoplasma genitalium, anaerobic and facultative bacteria, similar to those associated with bacterial vaginosis. Treatment includes 7-14 days of oral or intravenous antibiotcs like ceftriaxone, azithromycin, doxycycline and metronidazole depending on symptom severity. It is equally important to treat the partner simultaneously for effective recovery and advise to refrain from sexual activity during treatment."In order to decrease the risk of PID in lifetimes, safe sexual practice, limiting number of sexual partners, routine pap smear testing are considered as right measures for decreasing incidence. PID can be very successfully treated if caught early. The usual regimen consists of a regimen of antibiotics, for a period of at least two weeks, to eliminate infection.Process of Managing PID:Antibiotic treatment – Issued by a physician to clear infectionAvoiding sexual activity – Until fully cleared of the infectionTesting and treating of the partner – To avoid reinfectionOptional IUD removal – If an intrauterine device is the causeHospitalization may be necessary in more severe cases for intravenous antibiotics or surgically draining abscesses. Failure to treat can result in long-term problems, so treatment early on is important.Prevention Steps for PID in WomenPractice safe sex – Use condoms and reduce the number of sexual partnersRegular STI testing – Particularly if sexually activeTreat infections right away – Even if the symptoms are minorDon't douche – To keep the vagina's flora balancedStay aware – Knowledge is the best protection against reproductive health problemsWhen to Visit a Doctor?Women must immediately consult a doctor if they have:Severe lower belly painExtreme fever (over 101°F/38.3°C)Persistent vomiting and nauseaPus-like smelling vaginal dischargeEven if the symptoms are slight, routine check-ups and STI tests can identify PID at an early stage, avoiding permanent reproductive damage.Dr. Manasa G V is an Associate Consultant - Obstetrics and Gynaecology at Manipal Hospital, Goa in India.Dr Shibani Devi is a Consultant Obstetrics and Gynaecology at Manipal Hospital, Bhubaneshwar in India.