What Are the Symptoms of PID?

Q: I am 30 years old with two young children. I had the Mirena IUD for 3 years after I had my daughter. I had a period monthly with the IUD, just spotting for 3-4 days.
At the 3 years mark I had my period as normal. I had sex shortly after that. About 2 weeks after my period, I had spotting and cramping on the left pelvic area. Spotting lasted about a week. Pain persisted after that and has gradually moved around my lower back, down my buttocks and thigh, up my side to under my breast. This pain is on left side. I had the IUD removed at a low-cost clinic because I was uninsured, hoping pain would go away. But pain has not subsided. I also had breast tenderness like with pregnancy, but had negative pregnancy test. I then started having diarrhea. Then I had bloating, feeling full, gas and excessive belching. I can barely button my pants and scale shows a gain of 4 lbs in a week. Diarrhea has gone but now there are soft stools. I also feel frequent need to urinate but there is no pain or blood with urine.

I went to the ER, since pain is gradually getting worse. I was told that I have BV and kidney infection. My blood test was normal while urine showed high white blood cell counts.
I have just started medication for both but I am not convinced with the diagnosis. I do have an appointment with a Gynae in 2 weeks. But I am wondering if I should find some way to get a US done sooner to look for cyst. Symptoms are freaking me out because they are consistent with ovarian cancer based on my online research.
I should add that my gallbladder was removed 4 years ago.


Your symptoms point towards some infective process. It’s unlikely to be a malignancy, though it’s always better to rule it out.

It is common to get pelvic infections after IUD removal.

A broad term for such infections is PID or pelvic inflammatory diseases. This includes infection in any of the organs in the pelvis like vagina, cervix, uterus, tubes etc.

Common Symptoms of PID

Signs and Symptoms of pelvic inflammatory disease include:

  • Pain in lower abdomen
  • Pain in lower back
  • Painful urination
  • Fever
  • Nausea or vomiting
  • Stomach upsets like diarrhea
  • Pain during sex
  • Foul smelling vaginal discharge
  • Pain in rectum (buttocks)
  • Bleeding between periods or irregular periods

UTIs may accompany. Infections of urinary tracts give symptoms like :

  • Increased frequency of urine
  • Lower abdomen or lower back pain
  • Turbidity in urine
  • Presence of WBCs in urine


Proper antibiotics are required at the earliest. Urgency is necessary. Any delay in treatment may lead to spread of infections to other reproductive organs.

PID spreads very fast and damages the reproductive organs. It may lead to deposition of fibrous tissues in fallopian tubes causing their obstruction.

It is recommended that you get an early appointment with your gyne and start with the right medication as soon as possible.

Take Care,

Buddy M.D.

Medical Advice (Q&As) on “Signs and Symptoms of PID

  1. Sandy

    Thank you for your response.
    What would symptoms be for a obstruction of the fallopian tube?

    I had my last normal period February 9-13, no period for March. There was heavy bleeding for 5 days starting 2 days after IUD removal and now I just started spotting today, April 7th. Only notice it when I wipe, not enough to get on panty liner. It is of light pink color. Could it be a start of a period?

    I have also had a huge headache all day but that decreased with Ibuprofen and rest. I have not had an increase in pain since spotting started.

    I would like to know what may be signs I should go back to the ER? I am going to get on the phone first thing in the morning to try to get an appointment with a Gyne earlier than the 2 weeks. But if unsuccessful, I do not want to “ignore” things that could be an emergency situation.

    1. Buddy M.D. Post author

      Fallopian tube is the passage through which the egg travels to reach the uterus. Also, the fusion of the egg and the sperm usually occurs in the fallopian tube. So, if the obstruction is severe, it may lead to infertility.

      Otherwise, obstructed fallopian tubes are usually asymptomatic. Sometimes, however, they may give a mild pelvic pain.

      The light pink discharge from the vagina may be an indication of ovulation. It is common for some women to have such a discharge at times of ovulation.

      Other causes of such a discharge are:
      Pregnancy. Light pink colored discharges are often one of the earliest signs of pregnancy.
      Malignancies like that of the cervix. When did you get your last pap smear done?

      You need to get examined for a diagnosis.

      1. Sandy

        Last full pap was over 2 years ago. I have had 3 pelvic exams in the last month with no pain in cervix or uterus that I noticed. I just have a constant pain under left pelvic bone.

        I am going to do my best to see someone prior to scheduled appointment in 2 weeks.

  2. Kate

    Hello Doc, I went for a pelvic scan 8 days of my cycle & the result reads: the uterus is anteverted, measuring about 848 48 x 42)mm in it. Longitude, transverse & ap diameter respectively. The endometrial plate is thin & intact no sign of cysts. At the posterior aspect of the uterus is an hypoechoic well defined rounded structure measuring 32mm X 37 mm in size. Both ovaries are well demonstrated with follicles, the biggest is about 10mm x 9mm. No fluid in pouch of Douglas. Please, I want to know if it can stop me from conceiving. Thanks

  3. Wendy

    In my ultrasound result, I was told that my endometrial cavity is preserved concerning the uterus but a cyst in the right ovary. Also in the impression they said features are keeping with right ovarian cyst and PID what does all these mean? I was having abdominal pain in the right side and also in the upper quadrant of the abdomen.

    1. Buddy M.D. Post author

      You have some infection, somewhere in your reproductive organs. You need to take antibiotic treatment for this.

      Cysts in the ovary are common. They results when there are slight hormonal/ emotional fluctuations in the body.

      Most of these cysts regress on their own in 2 to 3 cycles.

  4. Hannah

    I have been suffering for nearly one year with lower pelvic pressure. It’s like a dull ache, and constantly there. It’s not painful just uncomfortable.
    I had a surgical dnc, as I was suffering from a missed miscarriage, this was about one month before the pain started.
    Within the last year, I have also developed an increased amount of clear vaginal discharge, back ache which is constant, nausea, increased frequent urination, pain during intercourse and slightly irregular periods.
    I’ve had many swabs over the year, all negative, except the last one I had which showed aneorobic bacteria.
    I have no sti. I’ve been treated with dioxcyclin and metranzdole over 7 times this past year, which first provided temp relief but now does nothing. Doctors have given up now. Is there anything else I can do/try? I’m at my wits end? Do you think it sounds like pid? I’ve had an ultrasound which was okay and a cystoscopy that too was fine. If it’s chronic pid… is there any better antibiotics give a go? Thankyou.

    1. Buddy M.D. Post author

      This does sound like a PID picture.

      The treatment is antibiotics. May be you’ll need to collect your vaginal secretions and sent it for culture to decide which antibiotic would work.

      You may talk to your doctor about this.

  5. Malu

    Had pain lower abdomen went for ultra sound fluid was detected in the pod, is this the reason am not conceiving but I was given antibiotics. Help.

    1. Buddy M.D. Post author

      Fluid there usually suggest PID, that is, an infective in your reproductive tract. hence, your doctor has given you antibiotics.

      Problem in conception needs to be investigated. Are your tubes patent? Was any test done to visualize them? Are your menses on time and regular?

  6. Dorkiss

    I have lower abdominal pain sometimes feel pains da moment I sit ..my nipples hurts and pains during sex..am on antibiotics now Buh dunno if it gonna work for me..is der anything I could do to get rid of the PID permanently

    1. Buddy M.D. Post author

      Complete course of appropriate antibiotics is usually enough to get rid to PID.

      If you’re getting it recurrently, the cause needs to be reasoned out. It could be unprotected sex, compromised toilet hygiene, use of condoms etc.

  7. Abigail

    Hi I went for an ultrasound and was diagnosed with PID and before that I missed my period accompany with tender breast ,back pain and frequent unrination what to do please really tired of all what am seeing about the disease not letting one to conceive pls help out here

    1. Buddy M.D. Post author

      Can you share your detailed ultrasound report?

      You appear to be having some infection in your pelvic area. it’s very likely that this infection is interfering with conception.

      PIDs are treated by taking appropriate antibiotics. Some cases require surgical drainage of pus, if collected.


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