Pelvic inflammatory disease - Complications of pelvic inflammatory disease

Pelvic inflammatory disease (PID) can sometimes lead to serious and long-term problems, particularly if the condition is not treated promptly with antibiotics.

However, most women with PID who complete their course of antibiotics have no long-term problems.

Recurrent pelvic inflammatory disease

Some women will experience repeated episodes of PID. This is known as recurrent pelvic inflammatory disease.

The condition can return if the initial infection is not entirely cleared, often because the course of antibiotics was not completed, or because a sexual partner has not been tested and treated.

If an episode of PID damages the womb or fallopian tubes, it can become easier for bacteria to infect these areas in the future, making you more susceptible to developing the condition again.

Repeated episodes of PID are associated with an increased risk of infertility (see below).

Abscesses

PID can sometimes cause collections of infected fluid called abscesses to develop, most commonly in the fallopian tubes and ovaries.

Abscesses may be treated with antibiotics, but sometimes laparoscopic surgery (keyhole surgery) may be needed to drain the fluid away. The fluid can also sometimes be drained using a needle that's guided into place using an ultrasound scan.

Long-term pelvic pain

Some women with PID develop long-term (chronic) pain around their pelvis and lower abdomen, which can be difficult to live with and can lead to further problems such as depression and difficulty sleeping (insomnia).

If you develop chronic pelvic pain, you may be given painkillers to help control your symptoms and tests to determine the cause may be carried out. If painkillers do not help control your pain, you may be referred to a pain management team or a specialist pelvic pain clinic.

Ectopic pregnancy

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes.

If PID infects the fallopian tubes, it can scar the lining of the tubes, making it more difficult for eggs to pass through. If a fertilised egg gets stuck and begins to grow inside the tube, it can cause the tube to burst, which can sometimes lead to severe and life-threatening internal bleeding.

Therefore, medication to stop the egg growing or surgery to remove it may be recommended if you are diagnosed with an ectopic pregnancy.

Infertility

As well as increasing your risk of having an ectopic pregnancy, scarring or abscesses in the fallopian tubes can make it difficult for you to get pregnant if eggs cannot pass easily into the womb.

It's estimated that about one in every 10 women with PID becomes infertile as a result of the condition, with the highest risk in women who had delayed treatment or repeated episodes of PID. However, a long term study in the US showed that women who had been successfully treated for PID had the same pregnancy rates as the rest of the population.

Blocked or damaged fallopian tubes can sometimes be treated with surgery, but if this is not possible and you want to have children, you may want to consider an assisted conception technique such as in-vitro fertilisation (IVF).

IVF involves surgically removing eggs from a woman's ovaries and fertilising them with sperm in a laboratory, before planting the fertilised eggs are into the woman's womb. This technique can help you get pregnant if you cannot have children naturally, but it's important to be aware that it does not have a high success rate.