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Recurrent/untreated chlamydia infection... PID risks?
In July 2011 I tested positive for chlamydia, and my boyfriend and I both treated and followed all the rules (abstaining for a week after treatment, safe sex, etc). We had been together and loyal for 2 years at that point, so one of us brought it in. Six months later, the test was performed again and it came back negative. For my annual exam in Oct. 2012, I thought I was screened but just found out I wasn't, so my status after December 2011 is unknown. I am not due for my annual this year til October, but had recently been feeling some lower pelvic pain (I'm bad at locating the pain but it seemed to be cervix), discharge that looked different from day to day (sometimes totally normal, sometimes pink-tinged as if it had blood, sometimes yellow), and pain during deep penetration. I occasionally had minor spotting between periods, but I'm on Loryna (generic Yaz) birth control pills, and sometimes if I am a few hours off it can make me spot so I wrote that symptom off. Anyways, I went to the doctor and she did a pelvic exam... said everything looked good... and I also did a full STD panel screen. All negative except chlamydia. So almost two years have passed since my last chlamydia screen, so I've potentially had untreated chlamydia for two years. Boyfriend and I got our 1g Zithromax today and will be abstaining for at least a couple weeks, then using condoms after that. I will be rescreening in July.

My question ultimately is, what is the likelihood that I have PID? Considering the fact that I have had mild, but noticeable lower pelvic pain... I am wondering if I should push the issue with my doctor, because she seems dismissive of the symptoms I mentioned. I know there are plenty of cases of asymptomatic PID, and I'd like to avoid any (further?) damage to my reproductive system. Should I request an ultrasound to see if they can identify any scarring? I don't particularly want to do a laproscopy but if it's for my health I definitely will... just don't want to ask her for it and come off as a hypochondriac.

Also, if my boyfriend and I are totally safe or maybe even abstain until my follow-up, would I test positive for chlamydia again if it is PID? In other words, would a positive result be a definitive PID diagnosis? If negative, does it mean I'm definitely clear of PID?

Sorry for the length, and thanks for any feedback!
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To clarify... I know that in the case of PID the infection is in the upper reproductive organs, so a cervical swab is not necessarily indicative of what's north of it. So would 3 months be enough time for the bacteria to recolonize the cervix to give a positive result? If it is a negative result but I still have the same pain symptoms should I just ask for them to treat me for PID?

If, say, a few weeks from now I still have symptoms when they should be cleared should I call back and tell them I want to treat for PID?
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Can't tell you what your chance of PID is but your Dr would have been able to see something from the exam, but also you have to think of the possibility of a false positive. If not then someone went outside the relationship. It would be very odd for you and him not to have symptoms for 2 years and then again for no symptoms really for another 2 years.
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