Do You Have Pelvic Inflammatory Disease Symptoms?

What You Need to Know About PID Signs and Symptoms

Pelvic inflammatory disease (PID) occurs when an untreated infection (typically but not always a sexually transmitted infection) travels from the vagina to the uterus, from the uterus to the fallopian tubes, and then up into the pelvis.

PID causes infection and subsequent scar tissue in the reproductive organs which may lead to infertility. The signs and symptoms of PID can be mild to severe. 

PID symptoms can be acute, chronic, or silent. Sometimes, a person does not have any symptoms or the only symptom they have is infertility. Other times, they become seriously ill and need emergency medical care.

With acute PID, the symptoms are usually more severe (often sending someone to the emergency room and can require hospitalization).

If someone has chronic PID, the symptoms might be barely noticeable or vague, which can make diagnosing the condition difficult or prolonged.

With silent PID, a person might not experience any signs or symptoms. In this case, a person often only learns they have PID after trying unsuccessfully to conceive.

The symptoms of PID can be confused with those of other diseases, including endometriosis or appendicitis.

Having mild or no symptoms does not rule out PID. If you are having symptoms that concern you, it's best to talk to your doctor about them. However, if you are experiencing severe symptoms, do not delay seeking medical care. If you have severe PID that goes untreated, it can be fatal.

If you have the following symptoms, you need to go to the emergency room for treatment.

  • Fever over 101 F
  • Severe pain in your lower abdomen
  • Signs of shock (like feeling faint)
  • Vomiting

Pain in the Lower Abdomen

woman with abdominal pain, from pelvic inflammatory disease symptoms

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Pain in the lower abdomen is the most common symptom of pelvic inflammatory disease. The pain can feel like dull pressure or a more intense cramping-type pain.

In chronic PID, the pain might be mild but is present all the time. The cramping during your menstrual cycle might also be more intense, even so much that it interferes with your day-to-day life.

The pain of acute PID can be so intense that you cannot even stand up. If you have severe pain in your abdomen or pelvis, you need to go to the emergency room.

Pelvic Pain During Intercourse

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Pain during intercourse is not normal. Some women feel embarrassed to mention sexual pain to their doctor. They often worry that they will be told the cause of their pain is psychological and not physical.

Pelvic pain during sex is a common symptom of PID. That said, painful sex can also be caused by other conditions and diseases.

You should tell your doctor if you have pain during intercourse. They can help figure out what is causing the pain and find the right treatment for you.

Lower Back Pain

Woman holding her back, having lower back pain from PID

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Mild pain in your lower back around the time of your period can be normal. If you experience the pain throughout your cycle, or the pain is especially intense during menstruation, this is something you should tell your doctor about.

You should always tell your doctor if you experience back pain around your kidneys and liver, as there are many conditions that can cause pain in these locations.

Irregular Menstrual Bleeding

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Bleeding that is heavier than normal or having spotting between cycles can be a symptom of PID. If you are bleeding heavily enough to need to change your menstrual pad every hour for more than two or three hours, call your doctor right away.

Unusual Vaginal Discharge

Close up of sanitary napkins, needed for discharge during PID

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Vaginal discharge that is especially heavy, has an unpleasant or fishy odor (which might be worse when you are having sex), or is an unusual color can indicate an infection somewhere in your reproductive system, including PID.

An untreated vaginal infection can lead to PID. Tell your doctor if you have symptoms of an infection and complete the treatment they prescribe.

Unusual Urinary Discharge or Problems With Urination

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PID can cause unusual discharge from the urethra (where you pee). Frequent urination, burning during urination, and difficulty urinating can be symptoms of PID.

If you experience repeated urinary tract infections, it could be caused by PID or bacteria associated with PID.

Flu-Like Symptoms

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Pelvic inflammatory disease can sometimes lead to flu-like symptoms, including:

  • Chills
  • Fatigue
  • Low-grade or high fever
  • Malaise (a general feeling of being unwell)
  • Swollen lymph nodes
  • Weakness

Stomach Upset, Including Diarrhea and Vomiting

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PID sometimes causes gastrointestinal symptoms. You might have a lack of appetite (not feeling hungry) or have vomiting and diarrhea.

If vomiting is especially severe or persistent, seek immediate medical care. You are at risk for complications like dehydration and an imbalance of electrolytes, which can be dangerous.

Infertility

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Around 10% of women with PID become infertile. Even if you've already been treated for PID, or you've received treatment for STDs, it's still possible to experience infertility.

Some women only discover that they have PID after having infertility testing.

Antibiotic treatment only targets the infection, it cannot undo the damage to your fallopian tubes caused by PID.

What If You Have No Symptoms?

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It is not uncommon for PID to be silent, meaning there are no outward signs or symptoms. You might be diagnosed with PID when your doctor is trying to find a cause for your infertility. PID is a common cause of blocked fallopian tubes.

Chlamydia is one sexually transmitted disease that can lead to PID. While about 1 million women are diagnosed each year, half of those women report that they never experienced any symptoms.

If you think you have contracted or been exposed to a sexually transmitted disease, or your partner has been diagnosed with one, tell your doctor—even if you do not have any symptoms.

When to See Your Doctor

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The longer PID goes untreated, the more likely it is to cause damage to the reproductive organs. If you have been trying to conceive for more than a year (even if you have no other infertility risk factors or symptoms) talk to your doctor. If PID is the cause, it is important that you get treatment as soon as possible.

If you experience symptoms of acute PID, like a high fever, vomiting, fainting, or severe pain, go to the nearest emergency room.

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Article Sources
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  1. Centers for Disease Control and Prevention. Pelvic Inflammatory Disease (PID) - CDC Fact Sheet. Updated January 2017.

  2. Johns Hopkins Medicine. Pelvic inflammatory disease.

  3. Harvard Medical School. Pelvic Inflammatory Disease (PID). January 2019.

  4. American Academy of Family Physicians. Dysmenorrhea. Updated January 2019.

  5. Cleveland Clinic. Pelvic inflammatory disease (PID). Updated September 2015.

  6. Wake Forest Baptist Health. Pelvic inflammatory disease.Updated January 2014.

  7. American College of Obstetrics and Gynecologists. Pelvic inflammatory disease (PID). August 2019.

  8. Centers for Disease Control and Prevention.  Pelvic Inflammatory Disease (PID) - CDC Fact Sheet. Updated December 2015.

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