But PID is much more than an annoyance. If the infection moves up the reproductive tract to the fallopian tubes, it can cause permanent damage to these critical reproductive organs, resulting in infertility. Gonorrhea causes an inflammation that can permanently scar the delicate fallopian tubes, decreasing their width, and making them unfit to transport eggs to the uterus. While chlamydia produces a milder form of infection than does gonorrhea, it can linger in the tubes for months prompting a violent immune response that can damage the tubes just as thoroughly as a sudden bacterial onslaught. In addition to destroying reproductive capacity, just one episode of PID can greatly increase your chances of having an ectopic pregnancy in which an egg begins to grow in the fallopian tube rather than in the uterus where it belongs.
Ectopic pregnancies can be a life-threatening emergency requiring hospitalization and surgery.
Experts estimate that the risk of death due to ectopic pregnancy is 10 times greater than it is in childbirth and 50 times greater than it is in properly performed surgery. If you develop this problem, surgical exploration is necessary to determine the cause and extent of the disease. If your doctor suspects that you may have PID, he or she must be able to distinguish between the disease and emergency conditions such as an ectopic pregnancy and appendicitis. For every 100 women suspected of having PID, about three or four will actually have an ectopic pregnancy and another three or four will turn out to have appendicitis. Most women who develop PID have abdominal pain, pelvic tenderness, and some symptoms of a lower genital tract infection such as cervicitis.