When pelvic inflammatory disease alone is present, it does not usually cause vulvar itching. Only women with pelvic inflammatory disease may have a combination of vaginitis, which may cause vulvar itching. Itchy vulva is caused by vaginal inflammation or cervicitis, but not directly by pelvic inflammatory disease. In women with pelvic inflammatory disease, the infection of the internal genitalia of the pelvis often causes persistent pain in the lower abdomen, accompanied by anal swelling, lumbosacral pain and other discomfort, and women with severe infection may have fever, but the vulva is not affected by pelvic inflammatory disease.