Pelvic Adhesive Disease

What is pelvic adhesive disease?

Pelvic adhesive disease, also known as pelvic adhesions, is where scar tissue forms in the pelvic area. This scar tissue can develop between organs in the abdominal cavity, such as the uterus, ovaries and fallopian tubes, and in nearby organs and tissues.

Typically, the outsides of these organs are smooth and slippery, so as they shift, they glide past each other. With pelvic adhesive disease, the organs and tissues can become connected (adhered).

What causes pelvic adhesive disease?

Pelvic adhesions typically develop when your body tries to heal from inflammation, infection or pelvic surgery and forms bands of scar tissue. Pelvic adhesive disease can affect women of any age, but it’s most common during the reproductive years.

Common causes and risk factors include:

• Pelvic inflammatory disease (PID): PID is an infection of the female reproductive organs that’s typically caused by sexually transmitted infections (STIs) such as chlamydia or gonorrhea. Untreated, PID can cause inflammation and scarring of the pelvic organs.
• Endometriosis: With this condition, tissue lining the uterus (endometrium) grows outside the uterus, often on the pelvic organs. It can inflame and irritate tissue.
• Surgery: Procedures such as cesarean sections, hysterectomies or ovarian surgeries can trigger inflammation and scarring. Multiple surgeries, especially those that reposition or remove a lot of tissue, can increase your risk.
• Abdominal or pelvic trauma: Injuries to the abdomen or pelvis from accidents or falls can cause tissue damage and scarring.
• Inflammatory conditions: Conditions like inflammatory bowel disease or pelvic tuberculosis can make pelvic adhesive disease more likely.
• Infections: Intestinal infections like diverticulitis and appendicitis may cause pelvic adhesive disease.

Understanding these causes and risk factors can help you reduce your chances of scarring and minimize the impact of pelvic adhesive disease on your health and fertility. 

Symptoms of pelvic adhesive disease

You may not have symptoms of pelvic adhesive disease. If you do notice symptoms, they may be mild, moderate or severe and they could overlap with other pelvic conditions. They may significantly impact your quality of life.

Common symptoms include:     

• Infertility, since pelvic adhesive disease can cause structural problems in the reproductive organs or prevent the fallopian tubes and ovaries from working correctly. You could have trouble conceiving but not notice other symptoms of pelvic adhesive disease. 
• Persistent or recurring pelvic pain that may be dull, achy or sharp. It may be worse during menstruation, sexual intercourse or physical activity.
• Pain during sexual intercourse, known as dyspareunia. Adhesions can cause friction and discomfort during penetration, leading to pain and intimacy issues.
• Menstrual irregularities such as irregular periods, heavy bleeding (menorrhagia) or spotting between periods.
• Bloating, constipation, diarrhea, abdominal cramping and difficulty passing gas or having bowel movements.
• Frequent or urgent urination, pain during urination or urinary tract infections (UTIs).

Symptoms can make you physically uncomfortable, cause emotional distress and interfere with your activities. Pelvic adhesive disease can make it hard for you to work, engage in social activities, maintain your relationships and perform routine tasks.

If you have any symptoms of pelvic adhesive disease or suspect you might have the condition, talk to a health care provider. Diagnosing pelvic adhesive disease early can lower its impact on your health and fertility. Share your symptoms and concerns openly. Your provider can diagnose your condition so you can start treatment. 

Learn about diagnosis and treatment of pelvic adhesive disease. 

How pelvic adhesive disease can lead to infertility

Scar tissue from pelvic adhesions can affect the structure and function of your reproductive organs and interfere with ovulation, fertilization and implantation. Here’s how:

• Adhesions can block or twist the fallopian tubes, making it harder for eggs to move through them from the ovaries to the uterus. Pelvic adhesive disease increases the risk that a fertilized egg implants in the fallopian tube instead of the uterus (ectopic pregnancy).
• Adhesions in and around the ovaries may lead to irregular menstrual cycles, lack of ovulation (anovulation) or lower-quality eggs.
• Adhesions in the uterus may make it hard for a fertilized egg to attach to and develop into a pregnancy (implantation) or lead to miscarriage (pregnancy loss).

If you’ve been trying to get pregnant for 12 months and you are under age 35 (or for six months if you are over age 35), you may want to see a fertility specialist. These experts can assess your reproductive health and suggest diagnostic tests. They may recommend medication, assisted reproductive technologies such as in vitro fertilization (IVF) or surgery to treat pelvic adhesions and improve fertility.