PID and Endometriosis

September 24, 2008

It All Began Way Back When

When a woman contracts an STD (sexually transmitted disease), often the consequences are very long term, causing problems and pain for many years to come. Many STDs find their culmination in a condition known as pelvic inflammatory disease (PID). Other causes of PID are bacterial vaginosis, pelvic surgery and some other types of gynecologic procedures. It is fundamentally a preventable condition.

What Is PID?

In PID, a woman's upper reproductive tract is inflamed. All of the organs of the reproductive system, including the uterus, ovaries and fallopian tubes are affected, with the most common inflammation, salpingitis, occurring in the fallopian tubes.

The immune system, in reaction to an infection, fights invading bacteria which causes local inflammation and scarring. Although the infection may be stopped within the reproductive tract, organs may be damaged in the process. PID can cause scarring in the reproductive organs - the uterus, fallopian tubes and can even scar the pelvic cavity causing chronic pelvic pain. Because the underlying infection causes the symptoms of PID, it is most frequently treated with antibiotics.

The Damage Caused by PID

Pelvic inflammatory disease is the major cause of female infertility worldwide and is one of the leading causes of ectopic pregnancy. There is a well accepted relationship between PID and infertility. PID, like other STDs creates heavy scarring during the healing process. This extensive scarring can eventually plug one or both of the fallopian tubes. Scarring tends to be much worse among older women, smokers and IUD users. The scarring, depending upon its severity, may prevent the sperm from reaching the egg, or, if the sperm is able to get through, the fertilized egg may not be able to get to the uterus.

Endometriosis Causes Infertility

Similarly, endometriosis creates blockages in the reproductive organs and may account for up to 30 percent of infertility cases. There is evidence suggesting that between 30-50 percent of women who suffer with endometriosis are infertile - although endometriosis alone rarely causes an absolute inability to conceive. However, it can be a contributor directly or indirectly.

What Is Endometriosis?

Endometriosis is a condition where the tissue that would normally be within the uterus, called the endometrium, grows outside of the uterus on other organs causing pain and irregular bleeding. Research is being conducted which focuses on the defects in the immune system which may be responsible for endometriosis and which may also cause the associated infertility. Additional research has shown unusually low levels of the substances which allow the fertilized egg to adhere to the uterine lining as well as more genetic abnormalities in the eggs of women with endometriosis.

The condition causes infertility when implants or lesions of growth happen in the fallopian tubes where the egg's passage may be blocked. Implants occurring in the ovaries prevent the release of the egg and in severe cases of endometriosis, rigid webs of scar tissue called adhesions form between the uterus, ovaries and fallopian tubes prohibiting the transfer of the egg to the fallopian tube.

Surgery - The Only Way To Know For Sure

The only way to properly diagnose endometriosis is through surgery and until such time, pain is generally managed with the use of non-steroid anti-inflammatory drugs (NSAIDs).

 

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