Many women with pelvic inflammatory disease (PID) experience no symptoms. Among those women who experience symptoms, the most common include:

• Lower abdominal pain or tenderness during examination
• Tender cervix during pelvic examination
• Unusual or odorous vaginal discharge
• Pain during sexual intercourse (dyspareunia)
• Bleeding between menstrual periods (irregular bleeding)
• Fever
• Nausea and vomiting

Tenderness in the abdomen or cervix particularly during examination are the most common signs of PID. A young, sexually active woman who experiences them will be treated for PID, regardless of the eventual diagnosis. The most common symptoms usually last less than a week and nausea or vomiting typically occurs when the disease is more advanced.

PID symptoms frequently appear shortly after menstruation. The cervix dilates during menstruation, which may allow bacteria to travel to the upper reproductive tract. This is common with PID caused by gonorrhea. PID caused by chlamydia is more likely to have no symptoms or milder symptoms, yet can cause severe inflammation. PID that occurs after insertion of an intrauterine device may be more advanced at the time of diagnosis. In those cases, the early signs and symptoms are frequently mistaken as related to the insertion itself.

It is important to note that all the symptoms listed may be caused by conditions other than PID, including appendicitis, ovarian cysts, adhesions or ectopic pregnancy. Any patient experiencing these symptoms should notify her physician immediately, preferably a gynecologist.

Even without symptoms, PID can permanently damage the reproductive organs. Women have been diagnosed with infertility problems caused by PID (such as tubal scarring) and cannot recall any symptoms that would have indicated an infection.