Symptoms of adnexitis

Symptoms of adnexitis vary depending on the form of the disease, which can be acute, subacute, chronic, unilateral or bilateral.

Among the diseases of the internal organs of the female reproductive system, one of the most common pathologies is adnexitis - inflammation of the uterine appendages, that is, the ovaries, fallopian (uterine) tubes and the ligaments that support them.

The cause of adnexitis is infection. These are various pathogenic and opportunistic microorganisms, including staphylococci and streptococci, peptococci, enterococci, Mycoplasma genitalium and Mycoplasma hominis bacteria, gardnerella, candida, pathogens of chlamydia, gonorrhea, tuberculosis, E. coli, etc. The infection can be brought in from outside during sexual contact or abortion, and from the bloodstream or with lymph it can get into the uterine appendages from any inflammatory focus in the body.

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Symptoms of acute adnexitis

The following symptoms of acute adnexitis are a signal of an inflammatory process that has begun in the uterine appendages:

• aching-stabbing pain in the lower abdomen (in the pelvic area);
• increased body temperature (up to +38-38.5°C and higher);
• weakness, increased sweating, chills, fever;
• tachycardia and dizziness;
• muscle and/or headaches;
• lower back pain;
• serous or purulent vaginal discharge;
• abnormal vaginal bleeding not associated with menstruation;
• urinary disorders;
• increased levels of leukocytes in the blood and increased ESR.

The clinical picture of acute adnexitis is complemented by constant pain behind the entire abdominal wall and its intensification with movement or palpation; abdominal tension (as with acute appendix or intestinal colic).

Symptoms of subacute adnexitis

The subacute inflammatory process is characterized by the manifestation of less pronounced symptoms over a longer period of time – from several days to several weeks.

The symptoms of subacute adnexitis differ from those of acute adnexitis only in their intensity. That is, the pain in the lower abdomen weakens, body temperature decreases, although the state of health remains consistently unsatisfactory. Attacks of weakness, headaches, pulling pains in the lumbar region and aching pains in the groin area are observed. Dull pain often radiates to the sacrum and becomes more noticeable with hypothermia or physical exertion, during intimacy, before and during menstruation. The menstruation itself becomes more intense in terms of the volume of discharge and pain syndrome. With subacute adnexitis, the presence of discharge from the vagina and cervical canal in the form of mucous or serous leucorrhoea is noted.

As gynecologists note, against the background of weakened immunity and the lack of timely treatment, periodically fading symptoms of subacute adnexitis become a “springboard” for the development of the chronic form of this disease.

Symptoms of chronic adnexitis

Inflammatory diseases of the internal genital organs often have a chronic form, and inflammation of the uterine appendages is no exception.

Chronic adnexitis is most often either a consequence of insufficient therapeutic intervention in subacute adnexitis, or a manifestation of a latent (hidden) form of this pathology.

Key symptoms of chronic adnexitis:

• almost constant subfebrile body temperature (in the range of +37-37.5°C);
• periodically occurring dull pain localized in the lower abdomen, lumbar and groin areas;
• painful sensations during intimacy;
• disruption of the normal menstrual cycle;
• pathological vaginal discharge.

Subfebrile temperature is a sign of a sluggish inflammatory process. Pain is caused not so much by inflammation of the ovaries and fallopian tubes, but by the process of formation of adhesions - dense fibrous strands that connect healthy tissues together, leading to obstruction of the fallopian tubes. Pain during intercourse is also a result of adhesions that disrupt the physiological mobility of neighboring organs.

And such a symptom of chronic adnexitis as a violation of the menstrual cycle is associated with the fact that inflammation of the ovaries has disrupted the alternation of their physiological phases (follicular, ovulatory and luteal). The consequences of this are manifested in the form of irregularity of menstruation and changes in their duration and intensity.

Since the uterine appendages consist of two paired organs - two fallopian tubes and two ovaries located on both sides of the uterine body, the inflammation may have different localizations. At the same time, as clinical practice shows, the symptoms of right-sided adnexitis and the symptoms of left-sided adnexitis differ only in that the pain is felt more strongly on the right or left side of the abdomen, respectively. However, with very severe pain syndrome, it can be very difficult to establish the exact localization. And the symptoms of bilateral adnexitis - acute and chronic - are described above.

Symptoms of exacerbation of chronic adnexitis

The causes of relapse of the inflammatory process in the uterine appendages are individual. This may be hypothermia, metabolic disorders, vitamin deficiency, and stress. Symptoms of exacerbation of adnexitis are manifested in the form of increased pain in the groin and lower abdomen; increased temperature (up to +38-39°C), fever and weakness; dry mouth; nausea and vomiting; increased heart rate; urination disorders; diarrhea and flatulence. Moreover, sharp pains during exacerbation of chronic inflammation of the appendages are caused not only by adhesions, which can affect the tissues of other pelvic organs.

Doctors warn: if adnexitis is not treated, a “scenario” cannot be ruled out in which the purulent exudate accumulated in the inflammation site can go beyond its limits and cause acute inflammation of part of the pelvic peritoneum – pelvic peritonitis. And this is mortally dangerous.

Symptoms of adnexitis during pregnancy

The specific state of the woman's immune system during pregnancy leads to a decrease in the body's resistance to various infections. This allows pathogens to more actively attack "weak spots", primarily the pelvic organs and genitourinary system. Symptoms of adnexitis during pregnancy also include pain in the lower abdomen, increased body temperature, impaired urination, deterioration of general health and vaginal discharge (exudative or purulent).

The most dangerous variant is acute or subacute adnexitis that occurs in the first trimester of pregnancy. This disease - like any other inflammatory process in the early stages of gestation - can provoke a miscarriage. Or it can give a complication in the form of negative morphological and functional changes in the placenta, which result in placental insufficiency and lead to a violation of the intrauterine development of the fetus.

Gynecologists name the consequences of inflammation of the uterine appendages among the main causes of spontaneous abortion and infertility in women and recommend paying attention to the symptoms of adnexitis, which should prompt you to see a doctor without delay.