How do women with chronic pelvic inflammatory disease

Patient's question:

Continuing the previous question: I had the test on the third day of my period. The results are: PROG 0.51; PRL 13.05; ESTRDL 8; TESTO 0.34; HLH 6.96; HFSH 9.05. The doctor said I don't ovulate and recommended using Premarin combined with estrogen tablets and medroxyprogesterone acetate tablets for three months. I'm only 21 years old, and I know these medications have significant side effects. Will they affect my fertility in the future? What about weight gain? Should I use traditional Chinese medicine instead to regulate my hormones? I am very anxious. Please, if you have a moment, could you answer my question? Thank you.

Doctor's answer:

Rectal Administration of Medication for Chronic Pelvic Inflammation
Chronic pelvic inflammation is often a result of inadequate or incomplete treatment of acute pelvic inflammation, or it may develop due to a weakened constitution and prolonged course in the patient. In some cases, chronic pelvic inflammation occurs without a history of acute pelvic inflammation.
　　The systemic symptoms of chronic pelvic inflammation are not prominent. Occasionally, low-grade fever, fatigue, mental lethargy, general malaise, and insomnia may occur. During periods of weakened immunity, the condition can flare up acutely. Due to scars, adhesions, and pelvic congestion caused by chronic inflammation, symptoms such as lower abdominal heaviness, pain, and lower back discomfort may arise. These symptoms often worsen after exertion, sexual intercourse, bowel movements, or around the menstrual cycle. Due to pelvic congestion, patients may experience increased menstrual flow and leukorrhea. If ovarian function is impaired, menstrual disorders may occur, and fallopian tube blockage can lead to infertility. Physical examination may reveal an anteverted uterus with limited mobility or adhesion, and thickened, with mild tenderness on either side of the uterus.
　　The treatment of chronic pelvic inflammation through rectal medication was pioneered in China. Historical records from the Han Dynasty (206 BCE–220 CE) already mention the use of rectal medication, which is now widely applied in clinical practice. The rectum of an adult measures 15–20 cm in length and has a rich blood supply. Although the rectum does not actively absorb drugs like the small intestine, it can absorb medications through passive diffusion.
　　There are three pathways through which drugs administered rectally reach the pelvic cavity. First, the drug is absorbed through the rectal mucosa and then metabolized by the liver before entering the bloodstream. Second, 50% of the drug is absorbed by the rectum and bypasses the liver, entering the systemic circulation directly via the lower abdominal veins. Third, the drug penetrates the rectal mucosa and intestinal wall, reaching the pelvic cavity through lymphatic vessels and capillaries that connect to the pelvic region.