Symptoms:

The most common symptoms of PID include:

• Fever (not always present; may come and go)
• Pain or tenderness in the pelvis, lower abdomen, or sometimes the lower back
• Vaginal discharge with abnormal color, texture, or smell

Other symptoms that may occur with PID:

• Bleeding after intercourse
• Chills
• Fatigue
• Frequent or painful urination
• Increased menstrual cramping
• Irregular menstrual bleeding or spotting
• Lack of appetite
• Nausea, with or without vomiting
• No menstruation
• Painful sexual intercourse

Note: There may be no symptoms. People who experience an ectopic pregnancy or infertility often have had silent PID, which is usually caused by chlamydia infection.

Signs and tests:

You may have a fever and abdominal tenderness. A pelvic examination may show:

• A cervix that bleeds easily
• Cervical discharge
• Pain with movement of the cervix
• Tenderness in the uterus or ovaries

Lab tests that look for signs of infection are:

• C-reactive protein (CRP)
• Erythrocyte sedimentation rate (ESR)
• WBC count

Other tests include:

• Culture of your vagina or cervix to look for gonorrhea, chlamydia, or other causes of PID
• Pelvic ultrasound or CT scan to look for other causes of your symptoms, such as appendicitis or pregnancy, and to look for abscesses or pockets of infection around the tubes and ovaries
• Serum HCG (pregnancy test)