What is the reason for amenorrhea and lower abdominal pain?

Patient's question:

I had a cesarean section four years ago. In mid-July of this year, I had an anesthesia-free micro-tube visual abortion in China. After the surgery, I have not had my period. Moreover, since late August, I have been experiencing severe lower abdominal pain, to the point where it has become difficult for me to urinate and defecate. When I went to the hospital for a check-up, they ruled out surgical adhesions and confirmed no inflammation of the uterus or vagina. The doctor suspected appendicitis during a manual examination and administered azithromycin, which relieved the pain after about four days. However, in the following months, I still did not have my period. Now, I suspect that the lower abdominal pain and amenorrhea are related. Because during these months of amenorrhea, I have been experiencing lower abdominal pain for a few days each month. I don’t know what condition this could be, or what to do about the amenorrhea. In mid-October, I went abroad, and I am currently overseas.

Doctor's answer:

Your condition is considered to be caused by pelvic inflammatory disease.
Hello, based on your description, it is likely that your condition is caused by pelvic inflammatory disease. It is recommended to actively undergo anti-inflammatory treatment to prevent the inflammation from worsening, which could even lead to pelvic adhesion and cause infertility.

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