Pelvic inflammatory disease. PID is an infection of the uterus, Fallopian tubes, ovaries, or all of these structures, and it is usually caused by sexually transmitted bacteria such as gonorrhea and chlamydia. These bacteria cause inflammation of the cervix, and then they, as well as vaginal bacteria, may move through the cervix up into the pelvic organs. Pelvic infection may also be caused by a complication of pregnancy such as incomplete abortion or by bacteria introduced during gynecological surgery. The consequences of PID can be severe; for example, scarring can lead to chronic pelvic pain, infertility, or a tubal pregnancy. There may be other symptoms of infection—such as discharge, spotting between periods or heavier than usual periods, fever, chills, and nausea—or pain may be the only symptom.

Pregnancy in a Fallopian tube (ectopic pregnancy). When a fertilized egg becomes implanted in the Fallopian tubes instead of in the lining of the uterus, there will be pain, and the tube may rupture, causing significant bleeding and possibly even death. Any sexually active woman with pelvic pain should promptly seek medical care to rule out this medical emergency.

Trichomoniasis. Although trichomoniasis, a vaginal infection, does not usually cause symptoms higher up in the genital tract, occasionally pelvic pain occurs with trichomoniasis for unclear reasons. The other, more common, symptoms of trichomonas infection—such as inflammation and itching of the vulva, discharge, and a fishy odor—may also be present.

*28\213\8*