Persistent Pelvic Pain: Causes, Diagnosis, and Treatment Options

Question
I am a 23 yr old female. Starting in October 2009, I started with severe groin pain, my doctor did a urine test and it came back positive for a UTI. Started me on antibiotics, didn't feel any better by the next day. Went back to the doctor a few days later, he did gonorrhea and clymidia cultures, came back negative, doctor put me on a flagyl and doxycycline. He also did a number of blood test, and everything came back negative. He diagnosed me with a fallopean tube infection. A couple of months later I felt good, but I started with green discharge. Didn't go to the doctor for about a year after that started b/c I felt okay. Just went about 3 weeks ago about the discharge. The doctor did another gonorrhea and clymidia culture again it came back negative and he put me back on a flagyl and doxycycline. At that time I also had pelvic pain which was my main reason for going. The flagyl and doxycyline helped a little with pain and a tiny bit with the discharge. I went back to the doctor yesterday b/c the pelvic pain was back but it was a different type of pain. It was crampy like a bad period cramp and a little burning and stinging, it hurts some when I urinate. He put me on a penicillan antibiodic and says I might have some nerve damage because of the burning and stinging and put me on an antibiotic for that. Today I am not feeling that much better, the pelvic pain is bothering me b/c the more I do the more it hurts. The doctor said yesterday he thinks I might have Stept B, or some sort of bacterial infection. He is my regular internest, have not been to a gynocologist. What do you think could be going on, and do you think my doctor is on the right track with diagnosing me? I am so tired of feeling bad. Do you think my pelvic pain is something I need to be worried about? The last time he did a pelvic exam which was about 3 weeks ago he said my tubes looked good and he couldn't find any reason for the pain, and my pelvic ultrasound came back good. What could possibly be going on, and what would you advice me to do if this medication I'm on now doesn't work?

Answer
pelvic pain is a tough problem.... he is treating you for a urinary infection and for PID-pelvic inflammatory disease.  If this treatment doesn't help, then further workup is needed to look for the other causes (there are many) of pelvic pain- endomtriosis, ovarian cysts, interstitial cystitis and others.

Good luck with it......