Pelvic Inflammatory Disease (PID): Symptoms & Causes

Discover the symptoms and causes of Pelvic Inflammatory Disease (PID) with GetWellGo. Stay aware, get informed, and take control of your health today!

Pelvic Inflammatory Disease (PID): Symptoms & Causes

  • Category

    Gynecology

  • Published By

    GetWellGo Team

  • Updated on

    25-Apr-2025

Pelvic Inflammatory Disease Symptoms

PID is the inflammation of the female organs, which are uterus, fallopian tubes, or ovaries that had been infected through the vagina by bacteria that are mostly transmittable through sexual contact. It has various manifestations commonly known as short, acute and chronic, but some people may not present any symptoms at all. Signs of pelvic inflammatory disease are:

  • Lower abdominal or pelvic pain
  • Abnormal vaginal discharge (possibly with an unpleasant odor)
  • Painful intercourse (especially during deep penetration)
  • Painful urination
  • It involves cases of abnormal menstruation including cases where a woman bleeds between her usual dates or experiences heavy flow.
  • Fever and chills
  • Fatigue or general malaise
  • Upper abdominal pain 

Less Common or Advanced Symptoms:

  • Nausea or vomiting
  • Difficulty walking due to pain
  • Sterility (due to injuries of the sexual organs in case they are not treated on time)
  • When there is scarring in the fallopian tubes due to PID, the chances of an ectopic pregnancy are likely to arise.

Pelvic Inflammatory Disease Causes

Pelvic Inflammatory Disease (PID) is an infection that often caused by a bacterial infection that has spread from the vagina or cervix to the reproductive system (endometrium, tubes, and ovaries). The main causes include:

Sexually Transmitted Infections (STIs):

  • Chlamydia trachomatis
  • Neisseria gonorrhoeae (gonorrhea)
  • These are the most common bacteria associated with PID

Other Bacterial Infections:

  • Even non-STI bacteria can cause PID. These bacteria may come from:
  • Normal vaginal flora (like Gardnerella vaginalis from bacterial vaginosis)
  • Postpartum or post-abortion infections
  • Pelvic procedures (e.g., intrauterine device [IUD] insertion, endometrial biopsy, dilation and curettage)

Factors That Predispose a Woman to Develop PID:

  • Multiple sexual partners
  • Unprotected sex
  • A history of STIs or PID
  • Douching (mows down the normal vaginal bacteria and shifts them up).
  • Young age (especially sexually active women under 25)
  • Recent gynaecological procedures

What is PID in women?

Pelvic Inflammatory Disease (PID) in women is defined as an infection of the female reproductive organs that include:

  • Uterus (womb)
  • Fallopian tubes
  • Ovaries
  • Cervix
  • Sometimes, even the lining of the abdominal cavity (peritoneum)

PID Symptoms in Females

PID in females has certain symptoms which range from mild to extremely severe or sometimes no symptoms at all during the early stage. Here's a breakdown:

Common Symptoms of PID in Females:

  • Lower abdominal or pelvic pain (the most frequent symptom)
  • Unusual vaginal discharge

– Sometimes, it may cause bad smell, yellowish or greenish in colour

  • Pain during intercourse (especially deep penetration)
  • Burning or pain during urination
  • Irregular menstrual bleeding

– Irregular periods which include having periods between the normal times or having more severe and painful periods

  • Fever and chills
  • Fatigue, nausea, or vomiting

Serious or Advanced Symptoms:

  • Severe abdominal pain (especially in the lower right or upper right)
  • Pain while walking or moving
  • Possible signs of shock which are extremely rare: Light headedness, fainting and palpitations.

Pelvic Pain and PID

Pelvic pain is also considered one of the first signs of PID, and the feeling and the moments when it takes place should be taken seriously.

What PID-Related Pelvic Pain Feels Like:

  • Dull, aching pain in the lower abdomen or pelvis
  • Can be constant or intermittent
  • This is because they become worse during intercourse, while urinating or bowel movements.
  • Can possibly be even worsened during your menstrual cycle
  • Sometimes, the severity of the pain is sharp or cramping.

Pelvic pain due to PID implies that the disease might have affected your uterus, tubes or ovaries. If not treated, this can cause the following:

  • Chronic pelvic pain
  • Infertility
  • Ectopic pregnancy
  • Scarring of reproductive organs

PID and Infertility

Pelvic Inflammatory Disease (PID) is one of the most cautionary causes of infertility among women. The connection between PID and infertility lies in how the infection affects the reproductive organs, particularly the fallopian tubes.

How PID Causes Infertility:

Fallopian Tube Damage:

  • Since PID may involve inflammation, scarring or blockage in the fallopian tubes, it may affect fertility.
  • This is where it stops the egg from coming into contact with the sperm, or where a fertilised egg cannot get to the uterus.

Tubo-Ovarian Abscess:

  • Severely affected PID can result in the formation of pus around ovaries and tubes and hence lead to permanent tissue damage.

Ectopic Pregnancy Risk:

  • This may be due to blockage or scarring of the tubes; in this case, the fertilized egg affixes itself in the tube instead of in the uterus. This is dangerous and does not particularly lead to pregnancy but it is life-threatening.

Chlamydia and Pelvic Inflammatory Disease

Chlamydia is one of the most common causes of Pelvic Inflammatory Disease (PID)—and often the most silent.

How Chlamydia Leads to PID:

  • This infective bacterium is sexually transmitted and affects the cervix among women.
  • When not treated it may extend to the uterus, fallopian tubes and ovaries.
  • This results to inflammation, infection, and sometimes complications that we refer to as PID.

PID Treatment Options

Being female, the occurrence of PID can be treated especially if it is diagnosed in the early stages. Treatment aims at eradicating the disease and its potential consequences for fertility.

Antibiotic Therapy (First-Line Treatment):

  • PID is usually given a combination of antibiotics even before the results are forthcoming to cover the most likely bacteria including chlamydia, gonorrhea and others.

Hospitalization May Be Needed If:

  • Mild symptoms include minor discomfort and pain and are contrasted with severe symptoms such as high fever, vomiting and severe abdominal pains.
  • No improvement after 48–72 hours of oral antibiotics
  • Tubo-ovarian abscess suspected
  • You're pregnant
  • Some pathological conditions cannot be excluded in emergency (e.g., ectopic pregnancy).

Surgical Intervention (Rare Cases):

  • In the case that antibiotics do not work, it is used for draining abscesses or removal of damaged tissue.
  • This is because laparoscopy may be required as a diagnostic or a therapeutic procedure.

PID Diagnosis Methods

Diagnosing of PID may be a little challenging sometimes because the symptoms are sometimes mild or they are similar to those of other illnesses. It is diagnosed averagely by the help of history, physical examination, laboratory, and imaging studies.

Medical History & Symptom Review

The doctor will ask about:

  • Pelvic or abdominal pain
  • Sexual history (e.g., unprotected sex, STIs, number of partners)
  • Vaginal discharge, bleeding, fever, etc.

Pelvic Examination

A physical exam includes:

  • Detecting pain or tenderness in the uterus, fallopian tubes and ovaries and other relevant structures.
  • Assuming that there is cervical motion tenderness (pain experienced when the cervix is moved).
  • While, inspecting the vaginal discharge as well as other signs’ of infection.

Lab Tests

To be sure of infection and eliminate other possibilities:

  • Cervical/vaginal swabs for chlamydia and gonorrhea
  • This test also covers the screening for Sexually Transmitted Infections or Urinary Tract Infections.
  • Lab analysis to assess if there are any inflammation marker (high WBC, CRP, ESR).

Imaging Tests (if needed)

Pelvic ultrasound to detect:

  • Swollen or damaged fallopian tubes
  • Abscesses or fluid buildup
  • Transvaginal ultrasound offer better ultrasonic visualization of internal genital organs
  • MRI or CT scan in more complex or unclear cases

Laparoscopy (Rare but Definitive)

  • A minimally invasive surgery used to view the pelvis of the patient through a camera.
  • It may be used when diagnosis is unclear or when there are signs that suggest complications such as abscesses.

PID and Ectopic Pregnancy

PID significantly increases the chances of ectopic pregnancy, which is a dangerous condition where a fertilized egg implants itself in a fallopian tube.

How PID Causes Ectopic Pregnancy:

  • PID causes inflammation and the scarring of fallopian tubes.
  • This pinches or closes the tube and hinders the passage of a fertilized egg to the uterus.
  • It may implant within the fallopian tubes thus resulting to an ectopic pregnancy.

Chronic Pelvic Pain Causes

Chronic pelvic pain or CPP is a pain that persists below the belt for more than six consecutive months. This also causes Lower abdominal pain in women and It may be due to various reasons, which are gynaecological and non-gynaecological factors.

Here is a list of various causes that are common among most patients:

Gynaecological Causes:

Pelvic Inflammatory Disease (PID)

  • If PID is left untreated or in the case of repeated occurrences, it can cause scaring leading to pelvic pain.

Endometriosis

  • This is a condition in which uterine tissue develops in other areas of the body causing soreness and particularly during the period.

Ovarian cysts or masses

  • May lead to pressure on the abdomen, swelling, and aching pain.

Uterine fibroids

  • Benign tumours on the walls of the uterus that may cause discomfort or pain that resembles those experienced when menstruating.

Adenomyosis

  • The endometrium extends itself into the muscular walls of the uterus making the monthly menstruation to be very painful.

Painful periods (Dysmenorrhea)

  • Especially if severe or linked to other conditions like endometriosis.

Pelvic adhesions

  • Bands of scar tissue that form after infections, surgery, or trauma.

Urological Causes:

  • Interstitial cystitis (painful bladder syndrome)
  • Urinary tract infections (UTIs)
  • Kidney stones

Gastrointestinal Causes:

  • Irritable bowel syndrome (IBS)
  • Constipation
  • Crohn’s disease or ulcerative colitis is the chronic inflammation of any part of the gastrointestinal tract.

Musculoskeletal Causes:

  • Pelvic floor dysfunction
  • Hernias
  • Chronic tension or posture issues

Neuropathic & Psychological Causes:

  • Nerve entrapment or injury (e.g., pudendal neuralgia)
  • Hence, it can be evident that depression, anxiety, or PTSD affects the perception of chronic pain.

PID and Sexually Transmitted Infections

The causes that are mainly associated with PID are sexually transmitted diseases such as chlamydia and gonorrhoea. They can subtly ascend from the vagina or cervical canal and affect the uterus, fallopian tubes as well as the ovaries.

STIs Most Commonly Linked to PID:

Chlamydia trachomatis

  • May present with mild or no symptoms frequently, thus, difficult to diagnose in its early stage
  • Responsible for the majority of PID cases

Neisseria gonorrhoeae (gonorrhea)

  • The ones that human beings are more likely to develop noticeable signs of such as discharge or pain.
  • May quickly extend up to the other organs applicable to the birth of babies.

Mycoplasma genitalium

  • There is another factor of PID that is not quite well-known, however, is steadily gaining attention.

Other vaginal infections (e.g., bacterial vaginosis)

  • It is not classified as STIs, but can cause PID if the normal formation present in the female reproductive system is suppressed.

How STIs Cause PID:

  • Bacteria enter the cervix
  • They rise up in the uterus, fallopian tubes and ovaries
  • This leads to inflammation of the tissues, tissue scarring, and even tissue formation that forms abscesses, amongst others.

PID Complications

There are various complications and some are severe and permanent, hence taking proper care and treatment as soon as PID is diagnosed cannot be overemphasized. Some of these impact a woman’s fertility, but other signs show that a woman has PID can include general pelvic and abdomen issues.

Major Complications of PID:

  • Infertility
  • Ectopic Pregnancy
  • Chronic Pelvic Pain
  • Tubo-Ovarian Abscess
  • Recurrent PID
  • Perihepatitis (Fitz-Hugh–Curtis Syndrome)

Top Hospitals in India

  • Artemis Hospital, Gurgaon
  • Medanta-The Medicity, Gurgaon
  • Fortis Memorial Research Institute, Gurgaon
  • Max Hospital, Saket
  • Apollo Hospital, Delhi

Best Doctors in India

  • Dr. Renu Raina Sehgal
  • Dr. Sabhyata Gupta
  • Dr. Preeti Rastogi
  • Dr. Anuradha Kapur
  • Dr. Geeta Chadha

Why Choose GetWellGo for Pelvic Inflammatory Disease Treatment?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

  • Complete transparency
  • Fair costs.
  • 24 hour availability.
  • Medical E-visas
  • Online consultation from recognized Indian experts.
  • Assistance in selecting India's top hospitals for PID treatment.
  • Expert gynaecologist with a strong track record of success
  • Assistance during and after the course of treatment.
  • Language Support
  • Travel and Accommodation Services
  • Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
  • Local SIM Cards
  • Currency Exchange
  • Arranging Patient’s local food
     

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