Pelvic inflammatory disease (PID) is an infection that passes from the vagina through neck of the womb (cervix), the womb (uterus) and up to the Fallopian tubes. The ovaries are sometimes also involved. Bacteria and other micro-organisms can find their way through the vagina and the cervix to the internal reproductive organs. A bacterial infection can cause inflammation in these organs and their surroundings. This most commonly occurs in the Fallopian tubes.

PID causes tenderness and pain in one or both sides of the lower abdomen. At the same time, it can cause fever and general discomfort. Finally, the infection can be accompanied by heavy, painful periods and sometimes a vaginal discharge.

The most common symptoms of PID include:
vaginal discharge with abnormal color, consistency or odor
abdominal pain either localized or generalized
fever (not always present)
  may range from transient to constant
  low grade to high.

Other nonspecific symptoms that may be seen with PID include:
chills
irregular menstrual bleeding or spotting
increased menstrual cramping
menstruation, absent
increased pain during ovulation
sexual intercourse, painful bleeding after intercourse
low-back pain
fatigue
lack of appetite
nausea, with or without vomiting
frequent urination
pain with urination
point tenderness.

Note: There may be no symptoms. People who experience ectopic pregnancies (pregnancies where the embryo implants in the fallopian tubes instead of the uterus) or infertility are often found to have so-called "silent" PID, which is usually caused by chlamydia infection.

Infections may spread to the bone behind the ear, although this is uncommon.
In rare cases, meningitis or a temporary facial numbing may develop.
The reduction of hearing is usually only temporary, but if cases of inflammation are recurrent it may become chronic and result in delayed language development.

A middle ear infection can usually be treated by your GP. However, if there is persistent hearing loss a specialist should be consulted.