Painful periods after cured from ureaplasma (UU)

Hello all,

I'm (24F) navigating treatment options (if that is even necessary) and wanted to ask for some input, as I'm a little lost with how to move forward. I'd especially like to ask that if there are any kind-hearted doctors/med field that are familiar with UU and what it comes with to please weight in. My issue now is not clearly tied to ureaplasma, and I would like to rule out some of my considerations via solid science and facts rather than anecdotes. My goal is to create a clear path to move forward that is not just making guesses.

Background

I've been battling ureaplasma for at least 1.5 yrs, it's very possible I've had it for longer. I started getting STD-like symptoms about a year and a half ago (inflammation, horrible itching, lots of pink-tinted discharge, BV, UTI's) and a few months after that began having extremely painful periods (something I'd never had before). Not to be mistaken for normal period cramps- I would be throwing up the entire night because of the pain.

During this time, I was treated with tetracycline one week (before I found the bible) and in January I was treated with 10 days doxy. I've had 2 negative ureaplasma tests so far since then- the first was done in doctor's office, the second was Juno bio.

I have been using vaginal suppositories about once a week and taking probiotics with various lactobacilli for feminine microbiome health since October.

Residual Symptoms

I am still having painful periods, which is my main residual symptom. I was also diagnosed with PFD and do have some cramping/pain in my pelvic region sometimes. I also have been having lots of discharge (definitely abnormal) with an almost ovulation-like consistency, sometimes pinkish tint, and smells slightly different from normal discharge. This happens infrequently, but maybe 3-4 times for a few days at a time since treatment in January.

Something noteworthy is that the cycle right after I took the 10 days of doxy, (maybe 2 weeks afterwards) my period was normal again. Since then, they have gradually been getting more painful and exactly how they were before antibiotics. The 2nd period after antibiotic course was painful, but only a small amount of vomiting. Then the 3rd was full on vomiting, diarrhea, and cramps so bad I was unable to leave the bed. This pain is almost definitely caused by inflammation- I feel so much pain and it seems that there is not enough room in my stomach/uterus for anything at all to be there. My body is effectively forcing out everything. I usually can't eat anything except soup, and nothing crunchy, hard, or cold because it causes horrible cramps.

I'm aware that this could be a separate issue, even caused/exacerbated by ureaplasma, but it does seem odd to me that it went away right after I finished my antibiotic course. I have been to 4 different doctors/gynos in the last year. I have received a transvaginal ultrasound, which showed normal results except for a "string of pearls" on one ovary. Doctors told me this was either indicating PCOS, or could be normal. My hormone levels were normal, and I did not display any other PCOS symptoms, so I was not treated for it.

Most recently one doctor said endometritis could be causing this. She also mentioned adenomyosis and endometriosis. She told me the only thing she could do for me is prescribe hormones. (Without running any tests or even pelvic exam, wasn't a great experience.) I've taken hormonal birth control before and it ruined my life for a little, so that would be an absolute last resort for me. I would like to rule out some kind of existing infection first before moving to treatment I have to take forever, for a problem I'm not sure that I have. Especially since the month after I did antibiotic treatment all other symptoms went away except the periods, which improved drastically immediately after treatment.

Concerns

My question is: is it AT ALL possible to have a negative vaginal swab but still have ureaplasma (or something related) elsewhere in the reproductive system, but still test negative? I have heard that for those that have had ureaplasma for a while, it takes longer antibiotic courses to eradicate. I have considered that perhaps these symptoms are some combination of PID/endometritis/upper level infection but cleared in the vaginal swab. I don't know if this is even possible. If it is, what antibiotic combo is recommended? My strain is azithromycin resistant.

I've also considered that my PFD is perhaps the culprit, although I have never heard of symptoms like this.

I've also considered that by some freak abnormality, I have a small enough amount of ureaplasma that it is showing negative on tests but is still causing this pain.

And I have considered that this could be endo/adenomyosis.

Loose ends

My partner hasn't been treated, since he returned 2 negative tests (first catch, in doctor's office). I plan to get him treated and if/when I take my next antibiotic course. Not sure if this affects anything, as I've heard tests are pretty accurate. It's convincing that we both have negative results.

I also haven't done pelvic floor therapy yet, and honestly that is because it is ridiculously expensive and I was doubtful it would be causing these symptoms.

Summary

I'm having painful periods but negative ureaplasma vaginal swabs. I'm not sure what I should consider treating, as doctors tell me it's most likely hormonal although my hormones levels are normal). Can I totally rule out infection? If not, what antibiotic course is recommended? And, should I consider PFD as a main contributor to my extremely painful periods?

I'm strongly considering taking antibiotics again (2-3weeks doxy) to see if it helps, because I'm desperate for relief from the pain.

Thank you all for your support! Although this is still very difficult, I am so grateful that a good amount of my symptoms have cleared. I am excited to crush this and later share what worked.