PID and Pregnancy: What's the Connection?

Medically reviewed on December 10, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What Is PID?
• Understanding PID And Pregnancy
• How To Prevent PID
• Beat PID To The Punch With Everlywell

Pelvic inflammatory disease (PID) occurs when sexually transmitted bacteria infect the female reproductive system. Among other symptoms, PID can cause scarring that can impact fertility. In fact, 1 in 10 women with PID becomes infertile.[1]

In less severe cases, pelvic inflammatory disease can lead to an ectopic pregnancy, which can be life-threatening.[2] Let’s take a closer look at the relationship between PID and pregnancy.

What Is PID?

After having unprotected sex, the likelihood of having a sexually transmitted disease (STD) increases. In the case of PID, there is an increased risk of developing two STDs: chlamydia and gonorrhea. The bacteria enter the body through the vagina and, if left untreated, can travel up the reproductive tract to infect the uterus, fallopian tubes, and/or ovaries.[3]

Pelvic inflammatory disease is fairly common: more than one million women a year are diagnosed, and it most commonly affects women ages 15 to 25.[3]

Initially, your PID symptoms may mirror those commonly associated with chlamydia and gonorrhea, which are two STDs:

• Chlamydia – Chlamydia is typically an asymptomatic sexually transmitted infection, which is why it’s very common for it to go untreated. Women who do have symptoms can experience painful urination, painful sex, lower belly pain, and yellow vaginal discharge.[4]
• Gonorrhea – Women with gonorrhea may have unusual sores or rashes as well as abnormal discharge, painful urination, lower belly pain, and spotting.[5]

Accordingly, pelvic inflammatory disease can be asymptomatic when the infection first enters the body. However, as the infection spreads, PID symptoms can arise suddenly. These include [3]:

• Pain and tenderness in the lower abdomen
• Yellow, green, and/or odorous discharge
• Chills or fever
• Nausea and vomiting
• Pain during sex
• Pain during urination
• Irregular periods, spotting, or cramping

Understanding PID And Pregnancy

It’s rare to become pregnant while having pelvic inflammatory disease; however, it can happen. A review of 49 PID-concurrent pregnancies found that 60.5% of the pregnancies ended in viable births, while 39.5% resulted in nonviable births.[6]

In the case of pelvic inflammatory disease, the most common cause of a nonviable birth is ectopic pregnancy, in which the egg implants into the fallopian tube, rather than the uterus.[2,6]

This occurs when untreated pelvic inflammatory disease creates scar tissue in the fallopian tubes. This impedes the mature, fertilized egg from traveling through the fallopian tube and implanting itself in the uterine lining, where it can receive the nutrients and protection it needs to grow. As the fetus matures, it can rupture the tube and cause severe internal bleeding.[2],[6]

Conversely, untreated PID may prevent a pregnancy altogether. Severe bacterial damage to the reproductive organs can cause infertility, and the risk of infertility only rises the more times you’ve had pelvic inflammatory disease.[2]

While pelvic inflammatory disease most commonly occurs from a sexually transmitted infection (STI), harmful bacteria can also enter the reproductive system following childbirth or a miscarriage.[3]

How To Prevent PID

To reduce your risk of pelvic inflammatory disease, it’s critical to protect yourself against harmful bacteria. A few strategies include [2]:

• Practicing safe sex – Chlamydia and gonorrhea are the two leading causes of pelvic inflammatory disease, and risky or unsafe sex can significantly increase your risk of contracting a sexually transmitted infection. To reduce your risk, always have sex with a condom or dental dam, and speak to your sexual partners about their sexual health and history. It’s also beneficial to request STI testing before you engage in any type of sexual activity.
• Getting tested regularly – Since chlamydia, gonorrhea, and PID can be asymptomatic, it’s possible to go months with the infection without knowing you have it. Unfortunately, the longer the infection remains in the body, the more it can damage your reproductive organs and the chance of conception. Fortunately, getting tested regularly and/or between partners can help identify the infection early so you can undergo PID treatment.
• Avoiding bacterial infection – STIs aren’t the only cause of pelvic inflammatory disease. Everyday bacteria can also enter your reproductive system and cause the infection. To mitigate the danger, avoid douching or getting an intrauterine device (IUD), which can put you at risk of bacterial infection for up to three weeks after its insertion.
• Talking to your healthcare provider – Speak to your healthcare provider to learn more about PID prevention methods. They can help walk you through best practices and help you identify possible warning signs to assist in early detection and PID treatment.

Beat PID To The Punch With Everlywell

Pelvic inflammatory disease can damage the female reproductive system, which may cause complications in conception, pregnancy, and fertility. That’s why it’s so important to get tested regularly to ensure that your reproductive organs are healthy and bacteria-free.

At Everlywell, we provide an at-home Chlamydia & Gonorrhea Test to conveniently check for sexually transmitted infections. Simply collect a urine sample and ship it to one of our partnered labs. You’ll receive confidential, physician-reviewed digital results and a consultation with a healthcare provider if you test positive. Or, for more information about your overall health, meet with a clinician via our women’s online health services. This way, you can meet with a provider to discuss your symptoms and get peace of mind.

Put your reproductive health first with Everlywell.

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References

1. Pelvic Inflammatory Disease (PID). ACOG. URL. Accessed Nov 18, 2023.
2. Pelvic inflammatory disease (PID) - Symptoms & causes - Mayo Clinic. Mayo Clinic. Published April 30, 2022. URL. Accessed Nov 18, 2023.
3. Professional CCM. Pelvic inflammatory disease. Cleveland Clinic. URL. Accessed Nov 18, 2023.
4. What are the symptoms & signs of chlamydia? Planned Parenthood. URL. Accessed Nov 18, 2023.
5. Detailed STD facts - Gonorrhea. URL. Accessed Nov 18, 2023.
6. Marcinkowski KA, Mehta V, Mercier R, Berghella V. Pelvic inflammatory disease in pregnancy: a systematic review focusing on perinatal outcomes. American Journal of Obstetrics & Gynecology MFM. 2022;4(4):100643. doi:10.1016/j.ajogmf.2022.100643URL. Accessed Nov 18, 2023.

Jordan Stachel, M.S., RDN, CPT works with a wide variety of individuals, ranging in age from children to the elderly, with an assortment of concerns and clinical conditions. She helps individuals optimize overall health and/or manage disease states using personalized medical nutrition therapy techniques.