What are the symptoms of pelvic inflammatory disease?

Pelvic inflammatory disease is a relatively common disease among female friends. After this disease occurs, patients will feel abnormal conditions in their bodies. The most common symptom is lower abdominal pain, and occasionally headaches. If these symptoms appear at the same time, you must go to the hospital for relevant examinations in time. In this way, you can find out the cause of your illness as soon as possible and avoid worsening of the condition after it occurs.

Clinical manifestations

There are two types of pelvic inflammatory disease: acute and chronic :

1. Acute pelvic inflammation

The symptoms are lower abdominal pain, fever, increased vaginal discharge, and persistent abdominal pain that worsens after activity or sexual intercourse. If the condition is severe, there may be chills, high fever, headache, and loss of appetite. Those who develop the disease during menstruation may experience increased menstrual flow and prolonged menstruation. If pelvic inflammatory disease forms a pelvic abscess, it may cause local compression symptoms. Compression of the bladder may cause frequent urination, painful urination, and difficulty urinating; compression of the rectum may cause rectal symptoms such as tenesmus. Further development of acute pelvic inflammatory disease can cause diffuse peritonitis, sepsis, septic shock, and in severe cases can be life-threatening.

2. Chronic pelvic inflammation

It is caused by the failure to thoroughly treat acute pelvic inflammatory disease or the patient's poor physical condition and prolonged course of the disease. The symptoms of chronic pelvic inflammatory disease are lower abdominal distension, pain and lumbar and sacral soreness, which are often aggravated by fatigue, after sexual intercourse, and before and after menstruation. The second is abnormal menstruation and irregular menstruation. When the disease lasts for a long time, some women may experience symptoms of neurasthenia such as lack of energy, general discomfort, and insomnia. It often takes a long time to heal and recurs repeatedly, leading to infertility and fallopian tube pregnancy, seriously affecting women's health.

Endometrial biopsy revealed histologic evidence of endometritis, transvaginal ultrasonography or magnetic resonance imaging revealed tubal wall thickening, luminal fluid, with or without concurrent pelvic effusion, or tubo-ovarian abscess, and laparoscopy revealed abnormal findings consistent with PID.

For patients with a history of acute pelvic inflammatory disease and symptoms and signs, diagnosis is usually not difficult. However, sometimes patients have many symptoms but no obvious history of pelvic inflammatory disease or positive signs. At this time, the diagnosis of chronic pelvic inflammatory disease must be made with caution to avoid making a hasty diagnosis and causing mental burden to the patient. Sometimes pelvic congestion or varicose veins within the broad ligament can also produce symptoms similar to chronic inflammation. Chronic pelvic inflammatory disease and endometriosis are sometimes difficult to distinguish. Endometriosis causes more obvious dysmenorrhea, and the feeling of typical nodules will help with diagnosis. Laparoscopy can be performed when differentiation is difficult. Hydrosalpinx or tubo-ovarian cysts need to be differentiated from ovarian cysts. In the former, in addition to a history of pelvic inflammatory disease, the mass is sausage-shaped, with a thin cyst wall and adhesions around it; while ovarian cysts are generally more round or oval in shape, with no adhesions around them and are free to move. Pelvic inflammatory adnexal masses are adhered to the surrounding area and are immobile, which can sometimes be confused with ovarian cancer. Inflammatory masses are cystic while ovarian cancer is solid. B-mode ultrasound examination can help to differentiate them.