Could Bad-Smelling Discharge and Lower Back Pain Mean a Pelvic Infection? A Complete Guide to Diagnosis and Treatment
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Subtitled in English
When does vaginal discharge need to be checked?
Vaginal discharge is common and is not always a sign of illness. But discharge that lasts, has an unusual smell, does not clear up after a short course of treatment or comes back quickly, especially if it comes with fever or pain, should be properly looked into rather than treated casually.
Which kinds of discharge should be taken seriously
- Discharge that looks, smells or feels unusual for you
- Pain in the pelvis or lower abdomen
- Fever
- Pain during sex, or unusual bleeding between periods
- Discharge that does not clear up with a short course of treatment, or comes back quickly
A pelvic infection is not diagnosed from a list of symptoms alone. A pelvic exam is an important part of the assessment: the doctor checks whether the cervix, the uterus or the adnexa (the ovaries and fallopian tubes) are tender (painful when pressed).
What is pelvic inflammatory disease (PID), and what are the risks for fertility?
A pelvic infection, or PID, happens when an infection travels up from the cervix and affects the uterus, the fallopian tubes and the tissues around them.
If this infection is not treated promptly and completely, it may affect fertility, raise the risk of ectopic pregnancy or cause long-term (chronic) pelvic pain. Even mild cases, or cases with few symptoms, may lead to these problems, so pain that feels bearable is not a good reason to put off getting checked.
Can lower back pain be linked to a pelvic infection?
With a pelvic infection, pain is usually felt mainly in the pelvis or lower abdomen, and lower back pain on its own is not used to make the diagnosis. Even so, when lower back pain appears together with bad-smelling discharge that does not respond to treatment, it should be assessed alongside the other signs.
When lower back pain is assessed, orthopedic or nerve-related causes, such as sciatica and spinal stenosis (narrowing of the spinal canal), are also considered, as well as factors such as sitting for long periods, poor posture or excess weight.
How is a pelvic infection treated, and when is a hospital stay needed?
The choice of medicine, how it is given and the decision about a hospital stay depend on each person’s situation and should be made by the treating doctor. The main points to keep in mind during treatment are:
- Treatment usually lasts about two weeks and should not be stopped after a few days.
- Treatment may include an injected medicine followed by medicine taken by mouth.
- In more severe cases, such as a high fever, feeling very unwell, vomiting or not responding to treatment by mouth, treatment through a vein (IV) and a hospital stay may be needed.
- A clear improvement is expected within about three days; if not, you should be checked again.
- The prescribed course should be finished, even if the symptoms get better sooner.
The name of the medicine, the dose and whether a treatment suits a particular person should be decided based on an examination and the treating doctor’s judgment.
What does persistent discharge have to do with checking the cervix?
When discharge does not clear up with the usual treatments, besides looking for its cause, your doctor may also check your cervix and review your screening history: when your Pap test (Pap smear; in the UK, a smear test) and HPV (human papillomavirus) test were done, what they showed, and whether a closer look at the cervix is needed.
Precancerous changes of the cervix (CIN) usually cause no symptoms, which is why they are found through screening rather than by their symptoms. Unusual or bad-smelling discharge does not, by itself, mean HPV, precancerous changes or cancer; it is simply one of the reasons a medical check is needed.
The right approach is to find and treat the cause of the persistent discharge and, at the same time, make sure your cervical screening is up to date. You can read more about the role of HPV on its own page.
When should you get urgent care?
If unusual discharge comes with severe symptoms, do not put off getting checked.
Get urgent care: Severe pelvic pain, a high fever or heavy bleeding needs prompt medical assessment.
Frequently asked questions about pelvic infection (PID)
No. The prescribed course should be completed, even if you feel better sooner. Stopping treatment early may mean the infection is not fully cleared.
If a pelvic infection is not treated promptly and completely, it may affect fertility and raise the risk of ectopic pregnancy. That is why getting checked and finishing treatment matter.
In many cases, checking your sexual partner, and treating them if needed, is part of managing the infection, to lower the chance of it coming back. The final decision depends on the cause of the infection and on the treating doctor’s judgment.
No. Persistent discharge has many possible causes and, on its own, is not a sign of HPV or cancer. Even so, the cause of the discharge should be looked into, and it is a good idea to review your cervical screening status as well.
If you have persistent discharge, checking your screening status is one of the steps. The “Screening & Pap smear” page explains which test is needed, at what age and how often.
References: the evidence behind this article
Supports the statement: “Criteria for diagnosing pelvic infection; a two-week course of treatment; criteria for injected treatment and hospital admission; improvement expected within three days; risk of infertility even in mild forms.”
Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines: Pelvic Inflammatory Disease (PID). cdc.gov. Accessed 2026.
Supports the statement: “Symptoms of pelvic infection; one injection plus two weeks of medicine by mouth; complications if left untreated; symptoms that need urgent care.”
NHS. Pelvic inflammatory disease (PID). nhs.uk. Accessed 2026.
Supports the statement: “Precancerous changes usually cause no symptoms and are found through screening; bad-smelling or increased discharge and unusual bleeding are among the signs that should prompt a visit to a doctor.”
World Health Organization. Cervical cancer fact sheet. who.int. Accessed 2026.
Each row links one statement in this video to its original source.
Author
Gynecologic oncologist and faculty member; author and translator of books on women’s health, gynecologic cancers and research education.
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