Pelvic Inflammatory Disease: Symptoms and Treatment

Pelvic inflammatory disease is an infection and inflammation affecting the upper female reproductive organs, often after an untreated sexually transmitted infection. It can involve the uterus, fallopian tubes and ovaries. Early symptoms may be mild, so assessment matters even when discomfort is limited.

Pelvic inflammatory disease commonly presents with pelvic pain, pain during sex, painful periods or unusual vaginal discharge. You may also notice bleeding between periods or after sex, fever, nausea, pain when urinating or feeling unwell. Some people have no symptoms. Severe pain, fever, vomiting, faintness or possible pregnancy requires urgent assessment.

The infection can spread upward from the vagina or cervix. Chlamydia and gonorrhoea are recognised causes, although other vaginal or cervical bacteria can also be involved. A negative test for one infection does not rule out pelvic inflammatory disease.

Without treatment, inflammation may damage the fallopian tubes or form scar tissue. Treatment clears infection but cannot always reverse damage that has already occurred. New or worsening pain during treatment, fever or vomiting should prompt a review. Sudden one-sided pain with a missed period needs urgent assessment because ectopic pregnancy is a serious possibility.

Risk can be higher with a current or recent sexually transmitted infection, a new sexual partner, more than one partner, or a partner with an untreated infection. Previous pelvic inflammatory disease also raises the chance of another episode. These factors are not proof that someone has the condition.

Diagnosis uses symptoms, pelvic examination and tests rather than one single result. A clinician may take vaginal or cervical swabs, arrange STI screening, test urine or blood, and use an ultrasound when an abscess or another cause of pain is suspected. Tell the clinician about a possible pregnancy, medication allergies and recent antibiotic use.

Antibiotics are started when pelvic inflammatory disease is suspected; waiting for every test result can delay care. Take the prescribed course as directed and return if symptoms do not improve. Sexual partners may need assessment and treatment, and sex should be avoided until treatment advice is complete. Hospital care may be needed for severe illness, pregnancy, an abscess or inability to take medicines by mouth.

Rest, drink fluids and use only pain relief that is suitable for you. Complete treatment even if pain settles quickly. Arrange follow-up if pain, discharge or fever continues, and discuss fertility concerns after recovery.

Possible consequences include scarred or blocked fallopian tubes, persistent pelvic pain, an abscess, difficulty conceiving and a higher risk of ectopic pregnancy. Prompt assessment and treatment can reduce the chance of lasting harm.

Condoms and regular STI screening can help identify infections before they spread. Seek testing after a new sexual partner or if a partner has an STI. Do not share leftover antibiotics, and attend partner follow-up when advised.

A gynaecologist or sexual-health clinician can assess pelvic pain, arrange testing and start treatment. Seek urgent care for severe pain, faintness, heavy bleeding, high fever or symptoms during pregnancy.