Pelvic Inflammatory Disease: Symptoms and Next Steps

Pelvic Inflammatory Disease (PID)

I had intercourse with my boyfriend on February 2, and my next period was expected on February 10, but it still hasn't arrived.
I went to the clinic for a pregnancy test, which came back negative.
I've been experiencing a dull ache in my lower abdomen for about a week, thinking it was premenstrual syndrome.
Yesterday, I visited the doctor, who prescribed me vaginal suppositories.
However, this morning I noticed a thick white-green discharge that is odorless, and throughout the day, the discharge has been minimal, not resembling the brown, foul-smelling discharge the doctor mentioned.
Today, I have noticeable pain on both sides of my pelvis, a dull ache in my abdomen, and my body temperature is noticeably elevated.
Should I finish the antibiotics before returning for a follow-up, or should I see the doctor tomorrow? Thank you.

Du, 20~29 year old female. Ask Date: 2019/02/12

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On February 2nd, I had intercourse with my boyfriend, and my next period was expected on February 10th, but it still hasn't arrived.
I went to the clinic for a pregnancy test, which came back negative.
I've been experiencing a dull ache in my lower abdomen for about a week, thinking it was premenstrual syndrome.
Yesterday, I visited the doctor, who prescribed a vaginal suppository for me.
However, this morning I noticed a thick white-green discharge that is odorless, and throughout the day, the discharge has been minimal, not resembling the brown, foul-smelling discharge the doctor mentioned.
Today, I have noticeable pain on both sides of my pelvis, a dull ache in my abdomen, and my body temperature is significantly elevated.
Should I finish the antibiotics before returning for a follow-up, or should I see the doctor tomorrow?
Answer: The noticeable pain on both sides of your pelvis, the dull ache in your abdomen, and the elevated body temperature may indicate pelvic inflammatory disease.
It is advisable to see the doctor tomorrow for an examination.

Reply Date: 2019/02/12

More Info

Pelvic inflammatory disease (PID) is a serious condition that can result from infections in the reproductive organs, often caused by sexually transmitted infections (STIs) such as chlamydia and gonorrhea. Understanding the symptoms and knowing the next steps is crucial for effective management and treatment.

From your description, it seems you are experiencing several concerning symptoms, including delayed menstruation, abdominal discomfort, and changes in vaginal discharge. The presence of white-greenish discharge without a foul odor is noteworthy, but the fact that you are also experiencing pelvic pain and elevated body temperature raises the possibility of an infection, potentially PID.

Given that you have already taken a pregnancy test that returned negative, it is important to focus on the other symptoms. The pelvic pain you are experiencing, especially if it is localized to one side, could indicate inflammation or infection in the reproductive organs. The fact that you have been prescribed a vaginal suppository suggests that your doctor is addressing a potential infection, but the symptoms you describe warrant further investigation.

Here are some recommendations based on your situation:
1. Complete the Course of Antibiotics: If your doctor has prescribed antibiotics, it is essential to complete the entire course as directed, even if you start feeling better. Stopping antibiotics prematurely can lead to a resurgence of the infection and contribute to antibiotic resistance.

2. Monitor Symptoms: Keep a close eye on your symptoms. If you notice any worsening of your condition—such as increased pain, fever, or changes in discharge (like a foul odor or significant color change)—you should seek medical attention promptly.

3. Follow-Up Appointment: It is advisable to schedule a follow-up appointment with your healthcare provider, especially since you are experiencing significant discomfort and changes in your symptoms. If your symptoms do not improve or worsen after completing the antibiotics, further evaluation may be necessary. This could include pelvic examinations, ultrasound, or additional tests to rule out other conditions such as ovarian cysts or ectopic pregnancy.

4. Avoid Sexual Activity: Until you have been evaluated and treated, it is wise to refrain from sexual intercourse. This can help prevent further irritation or infection and protect your partner as well.

5. Hydration and Rest: Ensure you are staying hydrated and getting plenty of rest. This can help your body recover and may alleviate some discomfort.

6. Seek Immediate Care if Necessary: If you experience severe pain, heavy bleeding, or other alarming symptoms, do not hesitate to seek immediate medical attention. PID can lead to serious complications, including chronic pelvic pain, infertility, and ectopic pregnancy if left untreated.

In summary, while it is important to follow your doctor's advice regarding medication, it is equally crucial to remain vigilant about your symptoms. If you feel that your condition is not improving or if you have new concerns, do not hesitate to reach out to your healthcare provider for further evaluation. Your health and well-being are of utmost importance, and timely intervention can make a significant difference in your recovery.

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