How Pelvic Inflammatory Disease (PID) Can Impact Fertility?

Pelvic Inflammatory Disease (PID) is a common yet often misunderstood condition affecting the female reproductive organs. It can cause significant discomfort and, if left untreated, may lead to complications such as infertility. In the UK, PID is a leading cause of preventable fertility issues among women of reproductive age.*

At JIVA Fertility, we understand how important it is to access clear, compassionate, and trustworthy information. This guide explains what PID is, what symptoms to look out for, how it is treated, and what to know if you are trying to conceive after a PID diagnosis.

What Is Pelvic Inflammatory Disease (PID)?

Pelvic Inflammatory Disease (PID) is an infection of the female upper genital tract, including the uterus (womb), fallopian tubes, ovaries, and the peritoneum (inner lining of the abdomen and pelvis). It usually develops when micro-organism from the vagina or cervix spread upwards, often after a sexually transmitted infection (STI) such as chlamydia or gonorrhoea.

Not all cases are linked to STIs; PID can also result from non-sexually transmitted bacteria, especially after childbirth, miscarriage, termination of pregnancy or procedures such as following insertion of a copper or a hormone coil, though the increased risk is small and mostly limited to the first three weeks after insertion.

What Are the Symptoms of PID?

Early and Mild Symptoms

PID symptoms can vary. Some people may have no symptoms at all, which is why it can go undiagnosed until complications occur.

Common symptoms include:

• Lower abdominal or pelvic pain
• Unusual vaginal discharge (often with an unpleasant smell)
• Pain during intercourse
• Pain when urinating
• Irregular menstrual bleeding
• Fever or feeling unwell

When to Seek Medical Advice

If you notice any of these symptoms, especially if they are new or worsening, it’s important to speak with a GP or sexual health clinic. Early diagnosis and treatment reduce the risk of long-term complications.

What Causes Pelvic Inflammatory Disease?

PID usually starts with a vaginal or cervical infection that travels upwards into the uterus, fallopian tubes, ovaries and the inner lining of the pelvis and abdomen (peritoneum).

Common Causes Include:

• Sexually transmitted infections: Chlamydia is the most commonly identified cause in up to 35% of PID cases, Mycoplasma genitalium in 10-25% and gonorrhoea in 2-3% of the cases.
• Other micro-organisms that are part of the normal vaginal microbiome have also been associated with the development of PID
• Some respiratory or enteric (bowel) pathogens may be transmitted from the oropharynx or rectum to the vagina during sex and then colonize the lower genital tract, which may then ascend into the upper genital tract causing infection.
• Long-term use of hormone or copper coil can cause Pelvic actinomycosis, a very rare, chronic bacterial pelvic infection
• Rarely, infection can reach the upper genital tract through blood or lymphatic system
• It is sometimes possible that no pathogen is found

Young women under 25 are more likely to be affected due to biological and behavioural factors.

Risk Factors Include:

• Age younger than 25 years.
• Not using a barrier method of contraception.
• Younger age at onset of sexual activity (less than 15 years).
• Multiple sexual partners.
• Recent new sexual partner (within the previous 3 months).
• Previous history of PID.
• History of sexually transmitted infection (STI) in the woman or her sexual partner
• Recent procedures such as termination of pregnancy (TOP), Hysterosalpingography or hysteroscopy, or In vitro fertilization (IVF) or other assisted reproductive techniques.
• Insertion of a hormone or copper coil within the past 3 weeks, especially in women with pre-existing gonorrhoea or chlamydia infection.

How Is PID Diagnosed in the UK?

There is no single test for PID. Diagnosis is based on symptoms, medical history, examination findings and test results.

Your healthcare provider will:

• obtain a detailed medical history
• perform an abdominal and pelvic examinations
• take vaginal and cervical swabs to test for infections
• request blood tests or an ultrasound scan (if complications are suspected)

In many cases, treatment is started before test results return, to prevent worsening infection.

Treatment Options for PID

First-Line Treatment: Antibiotics

PID is usually treated with a combination of antibiotics, started immediately. It is vital to complete the full course, even if symptoms improve quickly.

Your sexual partner(s) will need assessment and treatment. Avoid sexual activity until treatment is completed and follow-up confirms the infection has cleared.

Hospital Treatment

Management of severe condition will require hospital admission, especially if:

• There is no improvement after 3 days of antibiotics
• You are very unwell or pregnant
• An abscess is suspected

Can PID Affect Fertility?

Yes. PID can cause scarring and blockage of the fallopian tubes, increasing the risk of:

• Infertility (difficulty conceiving)
• Ectopic pregnancy (pregnancy outside the womb)
• Chronic pelvic pain

Up to 1 in 10 women with PID may become infertile, with risk increasing after repeated infections.*

If you have had PID and are planning to conceive, it is important to discuss this with a fertility specialist. At JIVA Fertility, we offer thorough assessments and compassionate care for individuals concerned about fertility after PID.

Book a fertility consultation

Preventing PID: What You Can Do

• Use condoms during sex to reduce STI risk
• Regular STI screenings, especially if under 25 or have new/multiple partners
• Seek prompt treatment for any vaginal or urinary symptoms
• Attend follow-ups after gynaecological procedures

Maintaining sexual health and hygiene can significantly reduce your risk of PID.

UK Data & Clinical Guidance on PID

• In 2023, 26,454 PID diagnoses were recorded in hospital settings in England (rate: 238 per 100,000 women aged 15–44)
• The condition remains most common among sexually active women under 30
• NICE and BASHH guidelines recommend starting treatment based on clinical suspicion—don’t wait for test results if symptoms suggest PID

FAQs About Pelvic Inflammatory Disease

Q: What are the first signs of PID?

A: Mild pelvic pain, unusual discharge, or discomfort during sex may be early signs. Some people may have no symptoms at all.

Q: Can PID be cured?

A: Yes. With early antibiotic treatment, most cases clear up fully. Prompt care helps reduce long-term effects.

Q: Can I get pregnant after PID?

A: Many people conceive naturally after PID. However, if you have had recurrent infections, it’s worth speaking to a fertility clinic.

Q: Is PID contagious?

A: PID itself is not contagious, but the infections that cause PID (like chlamydia and gonorrhoea) are sexually transmitted.

Q: How do I know if PID has affected my fertility?

A: If you have been trying to conceive for over 12 months without success and have a history of PID, book a consultation with a fertility specialist.

Compassionate Fertility Support After PID

If you have experienced PID and are concerned about your fertility, please arrange an initial consultation with one of our experts at JIVA Fertility. We specialise in helping individuals and couples navigate their fertility journey with expert care and kindness.

Book an appointment with our team

Disclaimer: This article is intended for educational purposes and does not replace individual medical advice. Please consult a healthcare provider for assessment and treatment decisions.

*References:

1. NHS: https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/
2. UKHSA (2023 PID Report): https://www.gov.uk/government/publications/pelvic-inflammatory-disease-in-england/
3. NICE Clinical Knowledge Summaries: https://cks.nice.org.uk/topics/pelvic-inflammatory-disease/
4. BASHH Guidelines: https://www.bashh.org/guidelines
5. Leeds NHS Trust: https://flipbooks.leedsth.nhs.uk/LN004415.pdf

Disclaimer: This article is intended for educational purposes and does not replace individual medical advice. Please consult a healthcare provider for assessment and treatment decisions.