Endometriosis and pelvic inflammatory disease, lower abdominal pain what to do

Patient's question:

Married for 1 year, always using contraception, not pregnant
2 months ago, experienced itching in the genital area and excessive discharge. After examination and tests, diagnosed with bacterial vaginosis, moderate cervical inflammation (via cervical TCT), and treated with vaginal medication. Symptoms disappeared, but mild lower left abdominal pain persisted.
10 days later, visited another hospital for examination and was told to have endometriosis and pelvic inflammatory disease, with suspicion of endometritis (no ultrasound or other tests performed). Prescribed broad-spectrum antibiotics to be taken during the menstrual period.
Currently, still experiencing mild, cramp-like pain in the lower left abdomen, sometimes with pain on the right side. The pain on the left is approximately 5 cm below the navel.

Doctor's answer:

Hello: Based on the situation you described, the several scenarios you mentioned are all possible. Therefore, it is recommended that you actively seek detailed medical examinations at the hospital for confirmation and then receive active treatment! The main symptoms of acute endometritis include fever, lower abdominal pain, increased vaginal discharge, sometimes bloody or foul-smelling, and sometimes a slightly enlarged uterus with tenderness. Chronic cases also present similarly, but may also include excessive menstrual bleeding, lower abdominal pain, and significant lumbosacral discomfort.
During treatment, in addition to primarily using antibiotics, it is also necessary to remove obvious triggers, such as removing an intrauterine device, clearing residual placental tissue or endometrial polyps in the uterine cavity. If there is an endometrial submucosal fibroid or endometrial cancer, appropriate treatment should be administered based on the situation. In cases of uterine cavity abscess, the cervical os should be dilated to promote pus drainage, and a diagnostic should be performed after the inflammation is controlled to rule out the presence of cancer. For chronic cases, physical therapy may sometimes be considered.
During acute endometritis, sexual activity must be avoided, as it can easily lead to further spread of the inflammation. Additionally, due to increased vaginal discharge, abdominal pain, lower back pain, and a sense of heaviness, the female partner's interest in sex may decline and become unenjoyable. Even after the inflammation is controlled, resuming sexual activity should not be too frequent to avoid pelvic congestion and recurrent episodes due to weakened resistance. For chronic cases, due to frequent lower back and back pain, sexual activity may exacerbate symptoms, increase vaginal discharge, worsen abdominal pain, and lumbosacral discomfort. Sexual activity should not be too frequent, and even if intercourse is forced, it may lack pleasure and climax. Alternatively, even if pleasure and climax are experienced during intercourse, post-coital pelvic congestion may cause symptoms to recur or worsen. For such cases, antibiotics should be used for treatment.