Pelvic inflammatory disease, why does it recur so frequently?

Patient's question:

Symptom Description: Stomach pain, dark color before and after menstruation. Astragalus, carbonized polygonum, root of rubia, dodder, motherwort, agrimony, prepared rehmannia, bupleurum, cuttlebone, goji berry. What is the main treatment for this herbal prescription?
Past Treatment and Effects: The effects were not significant.
Help Needed: What could be the reason for such frequent recurrence? How should it be treated?

Doctor's answer:

The main causes of pelvic inflammatory disease (PID) and adnexitis are postpartum or post-abortion infection, infection after intrauterine surgery, direct spread of inflammation from adjacent organs, and poor hygiene during menstruation, among others. Patients with PID are prone to fatigue, lower abdominal heaviness, pain, and lower back soreness, which often worsen during exertion, sexual intercourse, or around the menstrual cycle. If you experience significant lower abdominal pain, lower back discomfort, or abnormal vaginal discharge, it is recommended to undergo an abdominal ultrasound first to confirm whether you have PID. Additionally, PID can be classified as acute or chronic, and there are certain differences in medication for the two types.

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