Disease, pelvic inflammatory (PID): This term is applied to women only. Pelvic inflammatory disease refers exclusively to ascending infection of the female upper genital tract (the female structures above the cervix). Pelvic inflammatory disease is the most common and serious complication of sexually transmitted diseases (STDs), aside from AIDS, among women. The signs and symptoms of pelvic inflammatory disease include fever, foul-smelling vaginal discharge, extreme pain, including pain during intercourse, and vaginal bleeding. Pelvic inflammatory disease can scar the fallopian tubes, ovaries, related structures and lead to ectopic pregnancies, infertility, chronic pelvic pain, and other serious consequences. The infectious microorganisms in pelvic inflammatory disease migrate upward from the urethra and cervix into the upper genital tract. Many different organisms can cause pelvic inflammatory disease, but most cases are associated with gonorrhea and genital chlamydial infections, two very common STDs. The gonococcus (Neisseria gonorrhea), which causes gonorrhea, probably travels up into the fallopian tubes, where it causes sloughing (casting off) of some cells and invades others. Women with STDs are at greater risk of developing pelvic inflammatory disease. A prior episode of pelvic inflammatory disease increases the risk because the body's defenses are often damaged during the initial bout of upper genital tract infection.