What are the symptoms of chronic pelvic inflammatory disease?

Chronic pelvic inflammatory disease affects many women, and as a common gynecological disease, it can also have many impacts on women, causing pelvic congestion or lower abdominal distension, as well as symptoms of low back pain, and sometimes even irregular menstruation or infertility.

1. Symptoms

(1) Chronic pelvic pain. Scar adhesions caused by chronic inflammation and pelvic congestion often cause lower abdominal distension, pain, and lumbar pain. It often worsens after fatigue, long periods of standing, sexual intercourse, and before and after menstruation. In severe cases, it will affect work.

(2) Infertility and ectopic pregnancy Adhesion and obstruction of the fallopian tube can cause infertility and ectopic pregnancy. The incidence of infertility after acute pelvic inflammatory disease is 20% to 30%. And as the disease progresses, the infertility rate shows an upward trend.

(3) Menstrual abnormalities Endometritis often presents with increased leucorrhea, irregular menstruation, heavy menstrual bleeding, dysmenorrhea, and sexual discomfort. Pelvic congestion can cause increased menstrual flow. Ovarian dysfunction can cause menstrual disorders.

(4) Systemic symptoms are often not obvious, sometimes only a low-grade fever and fatigue. Due to the long course of the disease, some patients may experience symptoms of neurasthenia, such as lack of energy, general discomfort, insomnia, etc. When the patient's resistance is poor, acute or subacute attacks are likely to occur.

2. Physical signs

General signs: the uterus is often retroverted, with limited movement or adhesions; or the fallopian tube is thickened and tender; or a cystic mass is palpable; or there is sheet-like thickening and tenderness beside the uterus, etc.

(1) If it is endometritis, the uterus will be enlarged and tender. If it is salpingitis, the fallopian tube will be felt on one or both sides of the uterus, and it will be slightly tender.

(2) If it is hydrosalpinx or tubo-ovarian cyst, a cystic mass will be felt on one or both sides of the pelvic cavity, and movement will be restricted.

(3) If it is pelvic connective tissue inflammation, the uterus is often retroverted and flexed, with limited movement or adhesion fixation. There are patchy thickening and tenderness on one or both sides of the uterus. The uterosacral ligaments are often thickened, hardened, and tender.