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Stomachache
I have lower abdominal pain
Have a fever
Stomachache gets worse when pressed
Stomach tenses when pressed lightly
Abdominal pain
Pain in the lower abdomen
Not seeing your symptoms? No worries!
What is Pelvic Inflammatory Disease?
Pelvic Inflammatory Disease (PID) is a serious condition where there is infection and inflammation of the female pelvic organs such as the uterus, fallopian tubes and ovaries. It can present with abdominal pain, fever and foul vaginal discharge, and requires medical treatment. Some cases but not all are related to sexual activity and sexually transmitted diseases (STD). It is possible to get PID without an STD. Delayed treatment can lead to infertility due to damage to the fallopian tube.
Typical Symptoms of Pelvic Inflammatory Disease
- Stomach or abdominal pain with the abdomen becoming hard when gently pressed
- Increased vaginal discharge that is smelly
- Abnormal color, amount or odor of vaginal discharge
- Increase in vaginal discharge
- Stomach or abdominal pain occurs or worsens after sexual intercourse
- Fever
- History of infection of the pelvis
- Stomach pain that worsens when pressing and releasing stomach
Diagnostic Questions for Pelvic Inflammatory Disease
Your doctor may ask these questions to check for this disease:
- Do you have stomach or abdominal pain with your abdomen becoming hard when gently pressed?
- Has the vaginal discharge odor worsened recently?
- Have you noticed any changes in the color, amount, or odor of your vaginal discharge?
- Have you had more vaginal discharge lately?
- Does your stomach or abdominal pain occur or worsens after sexual intercourse?
Treatment of Pelvic Inflammatory Disease
Treatment for PID requires antibiotics for several weeks. Depending on the severity it can be treated in the clinic or emergency room, but occasionally may also require admission to the hospital. In some cases, surgery or a procedure may be needed to drain pus from an abscess (infected collection).
Reviewed By:
Ravi P. Chokshi, MD (Obstetrics and Gynecology (OBGYN), Critical Care)
Current Maternal Fetal Medicine Fellow with Dual board certification in Obstetrics & Gynecology and Critical Care Medicine. | 5+ years experience managing a general Ob/Gyn practice and working in the Intensive Care Unit. | Previously Physician Lead of a large single specialty practice with 8 Physicians and 10+ Advanced practitioners. | Member of the Society of Maternal Fetal Medicine Patient education committee. | Frequent Medscape Consult contributor.
Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))
Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.
Content updated on Dec 5, 2025
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Smelly vaginal discharge
- Vaginal discharge changed
- Lots of vaginal discharge
- Vaginal discharge odor
- Smelly vaginal discharge
- There is a large amount of vaginal discharge with bad smell
- Increase in vaginal discharge
- Excessive amount of vaginal discharge
- White vaginal discharge
- Increased vaginal discharge
- Yellow vaginal discharge
- Greyish vaginal discharge
- Excessive vaginal discharge
- Slight increase in vaginal discharge
- There is an increase in vaginal discharge
See full list
Symptoms Related to Pelvic Inflammatory Disease
Diseases Related to Pelvic Inflammatory Disease
FAQs
Q.
Pelvic Pain? Why Your Pelvis is Aching & Medically Approved Next Steps
A.
Pelvic pain can stem from many causes, from normal cramps or ovulation to conditions like endometriosis, ovarian cysts, pelvic inflammatory disease, UTIs, fibroids, IBS, or muscle and nerve issues, and red flags like sudden severe pain, heavy bleeding, fever, fainting, or pain in early pregnancy need urgent care. Medically approved next steps include tracking symptoms, trying short-term relief if mild, and scheduling prompt evaluation with a gynecologist if pain persists, worsens with periods or sex, or comes with unusual discharge or heavy bleeding. There are several factors to consider that can affect fertility and your care plan, so see the complete guidance below.
References:
* Soler-Pastor C, Valls I, Pardo M, et al. Chronic Pelvic Pain in Women: An Update. Curr Pain Headache Rep. 2020 Oct 14;24(12):70. doi: 10.1007/s11916-020-00912-3. PMID: 33052445.
* Howard FM. Diagnostic Approach to Chronic Pelvic Pain. Clin Obstet Gynecol. 2022 Mar 1;65(1):16-30. doi: 10.1097/GRF.0000000000000676. PMID: 35140134.
* De Cicco Nardone C, Di Domenico D, Brunori M, et al. Management of chronic pelvic pain: a comprehensive review. Clin Exp Obstet Gynecol. 2023 Mar-Apr;50(2):29. doi: 10.31083/j.ceog5002029. PMID: 37052950.
* Aredo JV, Bhargava A. Etiology, Pathophysiology, and Clinical Characteristics of Chronic Pelvic Pain. J Minim Invasive Gynecol. 2021 Jan;28(1):2-5. doi: 10.1016/j.jmig.2020.06.013. Epub 2020 Jul 2. PMID: 32622943.
* Vercellini P, Viganò P, Barbara G, et al. A Multidisciplinary Approach to Chronic Pelvic Pain. Obstet Gynecol Clin North Am. 2020 Sep;47(3):377-386. doi: 10.1016/j.ogc.2020.05.004. PMID: 32773030.
Q.
Pelvic Pain? Pelvic Inflammatory Disease & Medically Approved Next Steps
A.
Pelvic inflammatory disease is a common, serious, and treatable cause of pelvic pain, often linked to chlamydia or gonorrhea; warning signs include new pelvic or lower abdominal pain with unusual discharge, bleeding between periods or after sex, fever, or pain during sex, and early antibiotics can prevent complications like infertility and ectopic pregnancy. There are several factors and medically approved next steps to consider, including when to seek urgent care, who to see, what tests and treatments to expect, and how to protect partners and prevent recurrence; see the complete guidance below.
References:
* Workowski KA, et al. Update to CDC's Sexually Transmitted Infections Treatment Guidelines, 2021: Recommendations for Pelvic Inflammatory Disease. MMWR Morb Mortal Wkly Rep. 2021 Nov 12;70(45):1567-1570.
* Ramrakha CA, Wiesenfeld HC. Clinical challenges in the diagnosis and management of pelvic inflammatory disease. Infect Dis Clin North Am. 2023 Sep;37(3):477-495.
* Wølner-Hanssen P. Pelvic inflammatory disease: current concepts in pathogenesis, diagnosis, and treatment. Curr Opin Infect Dis. 2021 Feb;34(1):50-55.
* Ross JDC, et al. Pelvic Inflammatory Disease: Diagnosis, Treatment, and Prevention. Sex Transm Infect. 2020 Aug;96(5):329-335.
* Grodstein SA, Wiesenfeld HC. Sequelae of Pelvic Inflammatory Disease. Best Pract Res Clin Obstet Gynaecol. 2021 Oct;76:30-41.
Q.
Constant IUD Pain? Why Your Body Reacts & Medically Approved Next Steps
A.
Mild cramping after insertion can be normal, but constant or worsening IUD pain is not and may point to displacement or expulsion, infection including PID, ovarian cysts, or rarely perforation. Seek urgent care if you have fever, heavy bleeding, fainting or dizziness, or a positive pregnancy test with pain. Next steps include tracking symptoms, arranging a pelvic exam and ultrasound with infection and pregnancy testing, using pain relief if placement is correct, and discussing removal if pain persists; there are several factors to consider, and the complete details below could affect your next steps.
References:
* Zheng Y, Li H, Du G, Wang F, Jiang X, Yuan W. Persistent Pelvic Pain Following Intrauterine Device Insertion: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol. 2023 Mar;30(3):195-207. doi: 10.1016/j.jmig.2022.10.009. Epub 2022 Oct 25. PMID: 36306915.
* O'Connell K, Diedrich J. Role of Inflammation in Intrauterine Device-Associated Pain and Bleeding. J Clin Med. 2023 Mar 25;12(7):2540. doi: 10.3390/jcm12072540. PMID: 37049444; PMCID: PMC10094770.
* Lara LAS, Silva RC, Valadares NCG, Vieira CS, Rezende JG, Simoes JA, Godoi B, Costa-Filho R, Vieira VAF, Faria FL, Costa LMC, Resende JAD, Martins CBM, de Paula LB. Intrauterine device expulsion, perforation, and pain: a systematic review and meta-analysis. Contraception. 2022 Jan;106:110-120. doi: 10.1016/j.contraception.2021.11.002. Epub 2021 Nov 13. PMID: 34789066.
* Mansour D, Mansour A, Fraser IS. Management of common side effects of intrauterine devices. Womens Health (Lond). 2023 Jan-Dec;19:14748472221150059. doi: 10.1177/1745506522650059. PMID: 35072045.
* Diedrich J. Pain and bleeding with intrauterine contraception. Contraception. 2017 Jul;96(1):15-18. doi: 10.1016/j.contraception.2017.03.003. Epub 2017 Mar 9. PMID: 28286084.
Q.
Pelvic Pain? Why Your Pelvis is Hurting and Medically Approved Next Steps
A.
Pelvic pain has many causes, from menstrual cramps, ovulation, UTIs, PID, endometriosis, ovarian cysts, digestive conditions, and pelvic floor problems to emergencies like ectopic pregnancy or appendicitis, and details like timing, location, and related symptoms help point to the cause. There are several factors to consider; medically approved next steps include tracking symptoms, trying safe home relief if mild, getting STI or other testing when appropriate, and seeking urgent care for red flags such as sudden severe pain, fever, heavy bleeding, dizziness or fainting, or pain in pregnancy; see below for complete guidance to choose the right next step.
References:
* Hwang A, Jeon N. Chronic Pelvic Pain in Women: Pathophysiology and Update of Care. Int J Mol Sci. 2023 Mar 29;24(7):6436. doi: 10.3390/ijms24076436. PMID: 37021175; PMCID: PMC10094770.
* Howard FM. Chronic Pelvic Pain in Women. Clin Obstet Gynecol. 2018 Dec;61(4):677-686. doi: 10.1097/GRF.0000000000000398. PMID: 30379893.
* Pontari M. Chronic Pelvic Pain Syndrome in Men. Clin Obstet Gynecol. 2021 Dec 1;64(4):713-718. doi: 10.1097/GRF.0000000000000657. PMID: 35091726.
* Ripa G, Del Savio MC, Litta P, Saccardi C. Multidisciplinary Approach to Chronic Pelvic Pain Management. J Clin Med. 2023 Apr 10;12(8):2775. doi: 10.3390/jcm12082775. PMID: 37060132; PMCID: PMC10140733.
* Cianci S, Cucinella G, De Franciscis P, Cignini P, Vianello F, Marchetti A, Ferrero S, Zanghi M, Pavone D, Palomba S. Chronic Pelvic Pain in Women: An Update. Diagnostics (Basel). 2022 Feb 16;12(2):507. doi: 10.3390/diagnostics12020507. PMID: 35205566; PMCID: PMC8871329.
Q.
Tired of Pelvic Pain? Why Your Pelvis is Inflamed and Medically Approved Next Steps
A.
Persistent pelvic pain is not normal and often reflects inflammation from conditions like endometriosis, pelvic inflammatory disease, adenomyosis, ovarian cysts, painful bladder syndrome, or pelvic floor dysfunction; seek urgent care for sudden severe pain, fever, fainting, vomiting, or sharp pain with signs of pregnancy. Medically approved next steps include tracking symptom patterns, scheduling a gynecologic evaluation with exam, STI testing and ultrasound, and pursuing individualized treatments such as hormones, antibiotics, pelvic floor physical therapy, pain management, or laparoscopic surgery. There are several factors to consider. For important details that can influence your next steps, see below.
References:
* Ahangari, A., Ghanbari, Z., & Tabatabaei, S. M. R. (2020). Chronic Pelvic Pain: An Update on Pathogenesis, Diagnosis, and Treatment. Journal of clinical and diagnostic research: JCDR, 14(6), OE01–OE05.
* Lowenstein, L., & As-Sanie, S. (2021). Understanding Chronic Pelvic Pain: A Review of Pathophysiology and Therapeutic Approaches. Pain, 162 Suppl 1, S17–S28.
* Buffington, P., Al-Khatib, T., & Vasan, V. (2022). The Role of Inflammation in Chronic Pelvic Pain. Pain and Therapy, 11(3), 665–680.
* Morfín-Urías, C., Lino-Silva, L. S., García-Montalvo, I. A., & Moreno-Rodríguez, I. S. (2022). Pharmacological Treatment of Chronic Pelvic Pain: A Systematic Review and Meta-analysis. Pain Physician, 25(6), E789-E803.
* Tu, F. F., & Chen, J. X. (2020). Non-pharmacological Approaches for Chronic Pelvic Pain: A Review. Pain and Therapy, 9(2), 241–252.
Q.
What conditions should be considered if heavy menstrual bleeding persists?
A.
Heavy menstrual bleeding, also known as menorrhagia, can be a significant concern for many women. If this condition persists, it is essential to consider various underlying causes to ensure appropriate diagnosis and management.
References:
Brenner PF. Differential diagnosis of abnormal uterine bleeding. Am J Obstet Gynecol. 1996 Sep;175(3 Pt 2):766-9. doi: 10.1016/s0002-9378(96)80082-2. PMID: 8828559.
Borzutzky C, Jaffray J. Diagnosis and Management of Heavy Menstrual Bleeding and Bleeding Disorders in Adolescents. JAMA Pediatr. 2020 Feb 1;174(2):186-194. doi: 10.1001/jamapediatrics.2019.5040. PMID: 31886837.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Curry A, Williams T, Penny ML. Pelvic Inflammatory Disease: Diagnosis, Management, and Prevention. Am Fam Physician. 2019 Sep 15;100(6):357-364. PMID: 31524362.
https://www.aafp.org/pubs/afp/issues/2019/0915/p357.htmlRavel J, Moreno I, Simón C. Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease. Am J Obstet Gynecol. 2021 Mar;224(3):251-257. doi: 10.1016/j.ajog.2020.10.019. Epub 2020 Oct 19. PMID: 33091407.
https://www.ajog.org/article/S0002-9378(20)31193-5/fulltextBrunham RC, Gottlieb SL, Paavonen J. Pelvic inflammatory disease. N Engl J Med. 2015 May 21;372(21):2039-48. doi: 10.1056/NEJMra1411426. PMID: 25992748.
https://www.nejm.org/doi/10.1056/NEJMra1411426Gradison M. Pelvic inflammatory disease. Am Fam Physician. 2012 Apr 15;85(8):791-6. PMID: 22534388.
https://www.aafp.org/pubs/afp/issues/2012/0415/p791.htmlFord GW, Decker CF. Pelvic inflammatory disease. Dis Mon. 2016 Aug;62(8):301-5. doi: 10.1016/j.disamonth.2016.03.015. Epub 2016 Apr 20. PMID: 27107781.
https://www.sciencedirect.com/science/article/abs/pii/S0011502916000894?via%3DihubCDC - PID
https://www.cdc.gov/std/treatment-guidelines/pid.htm