Female pelvic pain

There are many different causes of female pelvic pain, some of which can be life-threatening while others can have long-term implications for fertility. It can be difficult to identify the underlying cause of pelvic pain as many conditions have similar symptoms and signs. All sexually active women presenting with pelvic pain should have a pregnancy test to rule out an ectopic pregnancy. Pelvic inflammatory disease (PID) is infection and inflammation of the upper reproductive tract following breach of the physical mucous barrier at the cervix. The clinical spectrum ranges from asymptomatic infection through to severe disease requiring hospitalization. PID is a common cause of female pelvic pain and can result in significant adverse sequelae including ectopic pregnancy and infertility. Because of the non-specific nature of PID, diagnosis can be challenging. In sexually active women where no alternative cause of pelvic pain has been identified, PID should be considered and empirical antibiotic treatment offered. Antimicrobial therapy should cover a broad spectrum of pathogens and reflect local epidemiology of specific infective organisms. Partners should be offered screening tests and empirical treatment, and avoid sexual intercourse until they and the index patient have completed treatment.