hello madam, thank you for consulting us, since you are having PID (pelvic inflammatory disease), its symptoms include lower abdominal pain, painful sex,. as per your question regarding continuation of intercourse,: Sex can reintroduce bacteria that can cause a new infection, so you should refrain from having sex again until you are treated completely for the infection. plus the pain is inevitable till the infection persists. Removal of IUDs in women diagnosed with acute PID is not mandatory. However, caution should be exercised if the IUD remains in place, and close clinical follow-up is mandatory. but since your USG shows quite a bulky uterus and you have been on IUD since 2 years and in need to chance the IUD sooner, i would suggest you to remove the IUD as a better option. once the infection is completely treated you can get a new IUD inserted. get treated for the PID as soon as possible as it can cause many complication, take care and get well soon.