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Love Hurts

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I suppose it’s part of growing up, realizing something that feels so good can hurt you —like piling your party plate with ice cream, chocolate rolls, and prawn crackers, and inhaling it all in mixed mush mouthfuls before you can say pass the parcel. It’s a developmental lesson, the barfing afterwards.

As we get older, exclusively adult excesses can lead to feeling ill too. In the past decade, the incidence of sexually transmitted infections (STIs) has skyrocketed, and that’s particularly bad news for us women. Our biology, and the way our internal sexual organs connect, means STIs can be more serious for us than for men.

The rapid rise in STIs is largely due to a prolific increase in chlamydia, the most widespread of them all. This insidious, sometimes symptom-less, sexual nasty can linger.

And that’s the danger, because left undetected and untreated, chlamydia can lead to pelvic inflammatory disease (PID), which we absolutely don’t want. An infection that severely damages our pelvic organs, PID will leave two out of ten women infertile, three out of ten with persistent pain despite treatment. One in a one hundred can expect a potentially fatal ectopic pregnancy.

Estimates suggest one million American women have PID, although it’s probably far more, as plenty don’t seek medical help. Perhaps they ignore symptoms, such as thick vaginal discharge, bleeding between periods, pain in the lower back and abdomen, sex that hurts, and possibly a slight fever. Or maybe their symptoms are so mild they don’t bother. But one thing is certain—the longer PID is left undetected, the greater harm it can do.

PID is almost always the result of an untreated STI. Between 50 to 60 percent of cases are thought to be due to chlamydia bacteria. Most of the rest are due to gonorrhoea. Although certainly not exclusively a consequence of a sexual infection (the contraceptive coil, a pregnancy termination, and childbirth are all possible—although highly unlikely—causes), PID is most often found in women under the age of twenty-five. That’s because until then, the cervix, which acts as a barrier to infection, is softer, not fully matured. Young women with multiple sexual partners are more at risk.

Tracey’s circumstances are indicative of a typical PID scenario. Now she says her waking thoughts revolve around “if only I hadn’t done that.”

Tracey went to her doctor six months ago, when she had bleeding between periods and pain in her pelvis.

“At the time I was more focused on my broken heart,” she says. “The year before, I’d split with my long-term boyfriend and since then, I’d had a few casual partners. I was on the Pill and didn’t bother with condoms… which of course I really, really regret now.”

Tracey’s doctor diagnosed chlamydia. “I hadn’t even heard of it before,” she says, “although apparently cystitis can be a symptom, and I certainly had that. The bleeding and pain were [symptoms] too.”

The doctor prescribed antibiotics, which usually effectively wipe out chlamydia.

“I thought that’d be the end of the problem,” Tracey explains. “How wrong…”

“The pain in my abdomen just became worse. In the end, the doctor did an internal examination, which really hurt. Apparently that level of tenderness showed my cervix was probably infected. Then I had an ultrasound scan, which revealed my fallopian tubes were so damaged by infection they’d turned to pulp. I was diagnosed with PID.”

Of course, the implications were enormous. Tracey was given a two-week-long prescription of two types of antibiotics to try and kill the infection. They worked. But the damage to her internal organs could not be reversed.

“My tubes were removed two months ago,” she says, “along with any hope of ever being able to conceive a baby naturally. The day of the op was the most devastating of my life. When I do find Mr. Right and want to start a family, it’ll have to be with IVF.”

Of course, you don’t need to have lots of boyfriends to succumb to a sexual infection. Sometimes all you need is a husband, as Melanie discovered.

“I caught chlamydia about fifteen years ago,” she explains. “The day it was diagnosed, I realized my husband must have been unfaithful and our marriage was over.”

Like Tracey, Melanie’s infection had been left so long, she’d already developed PID. She had backache, a fever, and a nasty greenish discharge and she was given antibiotics to try and clear the infection. They didn’t work completely.

“Three years later, I was divorced and in a new relationship,” she says. “I was still getting pelvic pain. Sex was sometimes agony, but we really wanted a baby.”  

In fact, Melanie did become pregnant—with a life-threatening ectopic pregnancy. “Doctors said the PID had caused lots of scarring inside my fallopian tubes which had caused blockages. The fertilized egg couldn’t get through to my womb, so it implanted in a tube instead. The pain was worse than you can imagine. The embryo had to be surgically removed immediately because there was real danger of my insides rupturing.”

“I’m still finding it tough to accept I’ll never be a mother. I trusted my ex-husband, and yet he did this to me.”

It’s hard to learn lessons from Melanie. Infidelity, especially within a marriage, can’t easily be predicted.

But it shows that when it comes to your sexual health, it’s always better to insist on a condom and be in control.

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