How to get rid of ovarian inflammation. Causes and symptoms of ovarian inflammation

One of the most common diseases in women is inflammation of the ovaries. It can manifest itself as an acute or chronic disease. However, factors such as hypothermia, overwork, various stressful situations, negative emotions and other extragenital diseases are considered to be more common causes of the appearance and exacerbation of ovarian inflammation.

The most characteristic manifestation of this disease is pain, which is localized in the lower abdomen, but it can also manifest itself in the lumbar or sacral spine. Pain during inflammation can occur periodically, less often it worries constantly.

However, in any case, a woman has a question: how to cure inflammation of the ovaries and is it even possible? There is an opinion that with inflammation of the ovaries, this disease cannot be completely cured, and at the slightest hypothermia, the pain again begins to disturb the woman. Note that pain can often continue even in the absence of an inflammatory reaction, moreover, it can intensify not only with hypothermia, but also with emotional overload and stressful situations. In addition, inflammation of the ovary can affect the functioning of the uterus and appendages, which may be accompanied by menstrual dysfunction.

Treatment of ovarian inflammation

So, how to cure ovarian inflammation without the intervention of chemicals? At first glance, this decision is somewhat incorrect, and we recommend that you still consult your doctor to determine an accurate diagnosis, however, along with the treatment prescribed by your doctor, you can also consult with him about treatment with folk remedies.

Other ovarian diseases

Before curing the ovaries, we also advise you to read the article: “Why do the ovaries hurt? ", which will help you determine more accurately the nature of the disease.

After inflammation of the ovaries (dysfunction), very often among women one can find diseases such as chronic oophoritis, andnexid or ovarian dysfunction.

• Oophoritis means inflammation of the ovary, namely the paired organ of the female genitourinary system. As a rule, inflammation can be transmitted to the ovary through the fallopian tube. The causative agents of oophoritis can be the following infections: chlamydia, trichomonas, etc. Acute oophoritis always begins suddenly, starting with sharp pain in the woman’s lower abdomen. In this case, urination becomes painful and difficult. There is also discharge of pus from the vagina. Common symptoms include high temperature, fever, headache and muscle-joint pain.
• Chronic andnexid is no less dangerous disease and has similar symptoms as in the previous disease. With this disease, white, watery discharge appears, and the menstrual cycle may also be disrupted. The disease is also accompanied by high fever and menstrual irregularities.
• With ovarian dysfunction, the main symptom is irregular, scanty or heavy menstruation, as well as severe premenstrual syndrome. Very often, this disease can cause miscarriage in pregnant women.

In addition to these diseases, there is also such a disease as ovarian cyst, and it is presented in more detail in this article: “”, in addition, women often ask how to treat adhesions in the pelvic area, you can read about this in this article : " ".

Folk remedies against female diseases

Before you cure the ovaries with folk remedies, we advise you to consult a specialist who will help you identify the disease. These products can only strengthen women's health and normalize the menstrual cycle.

• Nettle leaves (3 parts), chamomile flowers (1 part) and oak bark (1 part) and knotweed grass (5 parts) are excellent for female diseases. Take 2 tablespoons of pre-chopped herb in a coffee grinder or meat grinder and pour boiling water (0.5 l). After this, pour the infusion into a thermos and leave overnight. You can take the infusion 3-4 times a day, 1/3-1/4 cup before meals. The course of treatment can last no more than 2-3 months.
• An infusion of bird cherry flowers, lavender herb, oak bark, wormwood herb (1 part each), strawberry leaves (2 parts each), rose hips (3 parts each) also helps well with inflammation of the ovaries. The preparation of the infusion is the same as in the previous one.
• Pass oak bark (6 parts), oregano herb (4 parts) and marshmallow root (1 part) through a meat grinder. The preparation of the infusion is the same as before.

Inflammation of the ovaries is fraught with considerable danger, because for a woman’s reproductive health such a disease can end very badly.

If you believe the statistics, about 20% of women who encountered this pathology were subsequently unable to get pregnant or experienced considerable difficulties in this regard.

Therefore, for any manifestation of symptoms of inflammation, an urgent consultation with a gynecologist is required, because the outcome of the disease directly depends on the timeliness of treatment.

What is ovarian inflammation in a woman?

Inflammation of the ovaries (or oophoritis) is an inflammatory process affecting the paired female reproductive glands, which is often accompanied by simultaneous salpingitis - inflammation of the uterine (fallopian) tubes. Moreover, both one of the ovaries (with unilateral inflammation) and both (with bilateral inflammation) can become inflamed.

Causes of the disease

The cause of inflammation can be the causative agent of chlamydia, trichomoniasis, gonorrhea, mycoplasmosis or even tuberculosis, it can also be caused by opportunistic microflora (streptococci, staphylococci, E. coli, candida, etc.).

If you have pain in the lower abdomen, you should immediately consult a doctor

However, not only bacteria can provoke the disease or its exacerbation, but also hypothermia, childbirth, the use of an IUD, surgical termination of pregnancy, unprofessional diagnostic or surgical manipulations in the genitals.

Typically, inflammation is not the root cause, but a consequence of the spread of an existing infection in the body from the fallopian tubes, cervical canal or uterus. Less commonly, pathogens penetrate the gonads through lymph and blood (for example, with appendicitis, tuberculosis, tonsillitis, or even untreated caries).

When the disease occurs, the infectious process gradually spreads from the uterine cavity to the fallopian tubes. As a result of this, the fallopian tube begins to thicken, lengthen, pus is released and adhesions form. If the disease is not cured at this stage, the ovaries will be the next to be involved in the inflammatory process. As a result, the fallopian tube and ovary become fused. It happens that during inflammation, pathological changes begin to spread to the surrounding peritoneum.

Symptoms and signs

It is immediately necessary to distinguish between the types of ovarian disease. Oophoritis can develop in acute, subacute or chronic form, each of which has its own course.

Acute inflammation

The acute form is characterized by the presence of the following symptoms:

• frequent urination, accompanied by pain and severe pain;
• continuous one- or two-sided pain in the lower abdomen, radiating to the sacrum or lower back;
• a sharp increase in temperature (up to 39°C), fever and general malaise;
• the presence of bleeding between menstruation;
• sharp severe pain during sexual intercourse;
• sometimes copious serous or purulent discharge.

In this case, the ovaries are significantly enlarged and painful upon examination. If you have been diagnosed with acute inflammation of the ovaries, you require urgent hospitalization and a course of treatment in a hospital.

Subacute

This form is observed quite rarely; it usually occurs with mycosis or tuberculosis infection.

If treatment of the acute form is not started in a timely manner, or if it is not completed, acute inflammation becomes protracted and chronic.

During periods of exacerbation of inflammation, patients experience:

1. dull, aching pain in the groin, lower abdomen and vagina. Moreover, the pain intensifies before the onset of menstruation, against the background of colds or during hypothermia;
2. sexual dysfunction (decreased libido, pain during sexual intercourse);
3. scanty but constant discharge (leucorrhoea);
4. disruption of the menstrual cycle and ovarian function;
5. failure to become pregnant even if you have regular sex life.

During a gynecological examination, the ovaries are slightly enlarged and sensitive to palpation. In addition, usually chronic inflammation of the ovaries also affects the neuropsychic state of a woman: irritability, insomnia appear, performance decreases and fatigue quickly sets in.

Diagnostics

The symptoms of oophoritis are quite vague, and in the acute form they are similar to other diseases: appendicitis, endometriosis, cyst, peritonitis, etc. Therefore, diagnosis is often difficult.

To make a reliable diagnosis, you should consult a doctor who will identify your existing disease based on the following factors:

• study of medical history (previous inflammations, STIs, abortions, complications during childbirth, etc.) and symptoms of the present disease (nature and location of pain, presence and abundance of discharge, general well-being);
• laboratory test results (increased levels of white blood cells in smears and blood and urine tests);
• Ultrasound of the pelvic organs;
• gynecological examination (enlarged and painful ovaries, impaired mobility of the uterine appendages);
• bacteriological examination, PCR diagnostics, RIF, ELISA (help to identify the causative agent of inflammation, the presence of hidden infections). If subacute inflammation is suspected, additional studies are carried out;
• hysterosalpingoscopy (shows the presence of gross anatomical changes in the fallopian tubes that occur in chronic conditions);
• Laparoscopy is one of the most informative diagnostic methods (it makes it possible to directly examine the uterus, fallopian tubes and ovaries for an accurate diagnosis). In chronic oophoritis, laparoscopy reveals infection of the fallopian tubes, disturbances in their patency, the presence of adhesions and other formations (pyosalpinx, pyovar), and adhesions in the pelvis.

Treatment

The choice of treatment method directly depends on the stage of the disease, its causes and the nature of the symptoms.

Acute cases are treated exclusively in a hospital with bed rest. In the first days of treatment, antibiotics, painkillers, sulfonamides and restoratives are used. At the subacute stage, certain physiotherapeutic procedures are added to the above treatment with caution. For chronic inflammation of the ovaries, various types of physio- and balneotherapy are used.

It is worth noting that chronic forms of oophoritis take much longer and more difficult to treat and often cause complications that require surgical intervention.

Antibiotics

The main method of treatment is the prescription of antibiotics, the choice of which is determined by the properties of the existing pathogen and its sensitivity to the selected antibiotic.

It is very important that the dose of antimicrobial drugs fully ensures their maximum concentration at the site of inflammation. Thus, to treat inflammation, antibiotics with a longer half-life are used, and in severe cases, various combinations of antibiotics are used.

The main method of treatment is the prescription of antibiotics

For inflammation of the appendages caused by microbes (streptococcus, staphylococcus, enterobacteria), treatment begins with the administration of penicillin with the simultaneous administration of aminoglycosides.

If the presence of anaerobic flora is suspected, metronidazole is used; in severe cases it is prescribed intravenously, in less severe cases - orally. The use of a number of antihistamines (suprastin, diphenhydramine, etc.) is also indicated to avoid intoxication.

With candles

Treatment with suppositories is usually carried out for anti-inflammatory purposes and is prescribed in addition to the main one. To do this, use candles with propolis, walnut extract or oak bark. However, remember that it is impossible to get rid of inflammation only with suppositories. If you have chronic inflammation, we recommend treatment with suppositories for preventive purposes, especially if you are prone to thrush.

How to treat with folk remedies

Once the diagnosis is made and the pathogen is identified, the gynecologist will prescribe an individual course of treatment for you. However, drug therapy is usually complemented by non-drug therapy.

There are many traditional methods of combating inflammation, which you can use both for prevention and as an addition to the main treatment. However, it is important to know that the treatment of acute and chronic stages is significantly different. So, in the acute stage, cold compresses, washing with arnica tincture, taking a bath with medicinal clay, etc. are used.

In the chronic stage, it is necessary to wrap the stomach, lumbar back, and take warm baths with the addition of chamomile or yarrow once a day. Taking a bath with wildflowers and mud baths will also be beneficial.

For pain relief, use a warm pillow stuffed with wildflowers (it can be heated in the oven), which must be applied to the lower abdomen during the day.

A pillow filled with wildflowers and heated by the sun will help reduce pain.

In the acute stage of the disease, yarrow tea will help. To prepare it, 1 tbsp. Dried yarrow pour a glass of hot water, let it brew for 7-10 minutes and drink.

For oophoritis, you can also mix 20 g of sweet clover herb, coltsfoot flowers and centaury herb. Then brew 1 tbsp. medicinal mixture in a glass of boiling water and leave for 1 hour. After this, the broth should be filtered and it is ready for use. You need to take it 6 times a day, 1/3 cup, for 3-4 weeks.

The following recipe will help not only with this pathology, but also with uterine cancer. Pour 50 g of wintergreen leaves into 0.5 liters of vodka and leave for 14 days somewhere in a dark place. Take the finished infusion, 30–40 drops, 3 times a day.

Illness during pregnancy

During pregnancy, a woman's immunity is reduced and she is very susceptible to all kinds of infections. The same applies to inflammation, which could be asymptomatic before pregnancy, but will certainly manifest itself during pregnancy.

Pain in the lower abdomen and leucorrhoea are a dangerous sign. And the first thing a woman needs to do is to determine which pathogen caused the disease, because not only the course of pregnancy itself, but also the life of the fetus depends on this.

Pain in the lower abdomen and leucorrhoea are a dangerous sign

So, for example, if the cause is Treponema pallidum or gonococci (the causative agents of syphilis and gonorrhea), then the woman is advised to terminate the pregnancy.

If the problem is opportunistic microorganisms (candida, gardnerella, etc.), then the doctor must prescribe specially selected antibiotics that correspond to the duration of pregnancy and the type of pathogen. However, whatever the reason, the inflammatory process significantly increases the risk of unfavorable course and outcome of pregnancy.

If during pregnancy the inflammation does not worsen, but direct infection occurs, this can lead to intrauterine infection of the fetus. And even if the fetus is healthy, there is a risk of infection during childbirth, so doctors often recommend a cesarean section in such situations.

Sex with ovarian inflammation

With oophoritis, gynecologists, as a rule, do not recommend having sex. In addition, due to inflammation, women usually feel an unpleasant heaviness or even sharp pain in the lower abdomen during sexual intercourse. In addition, patients often experience a decrease in sexual activity and a lack of sexual desire.

Avoid hypothermia, overwork, stress, observe the rules of personal hygiene and do not forget about periodic examinations with a gynecologist. Then you won’t be afraid of any inflammation. Be healthy!

Inflammatory processes that occur in the female genital organs are dangerous because they can quickly spread throughout the entire system, causing serious changes in the structure of tissues, disrupting the natural state of the uterus and appendages. In women, inflammation of the uterus and ovaries is often the cause of ectopic pregnancy, infertility and other complications. Early diagnosis and treatment of such pathologies can prevent the disease from becoming chronic. If unusual discharge or pain in the lower abdomen appears, it is necessary to clarify the diagnosis as early as possible.

The ovaries are endocrine glands that produce female sex hormones, estrogens and progesterone. Hormonal imbalance can cause breast tumors, disruption of the cycle and nature of menstruation, and the onset of early menopause. The consequences of hormonal disorders are serious diseases of the uterus.

Inflammation of the ovaries (oophoritis) disrupts the functioning of the entire reproductive system. The process can affect only one organ (unilateral inflammation) or spread to both (bilateral). Often this disease is accompanied by inflammation of the fallopian tubes (salpingitis). In this case, adnexitis occurs, simultaneous inflammation of the ovaries and tubes. At the first stage, the inflammatory process occurs only in the mucous membrane, but then spreads to the tissue.

Causes and types of ovarian inflammation

The cause of inflammation of the ovaries is infection. Depending on the nature of the infection that causes the disease, two types of oophoritis are distinguished: nonspecific and specific.

Non-specific. The causative agents of infection are opportunistic microbes. They are always present in the human body and are activated when the immune system is weakened, hypothermia, or stress. Such microbes are staphylococci, streptococci, E. coli, and Candida fungi.

Specific. Inflammation is caused by sexually transmitted infections (syphilis, chlamydia, trichomoniasis, gonorrhea), as well as tuberculosis pathogens.

Inflammation of the ovaries can occur as a result of the following processes:

• penetration of infection from the external genitalia through the cervix, uterine cavity and fallopian tubes;
• infection from the intestines and urinary organs due to non-compliance with personal hygiene rules;
• spread of infection to the ovaries due to intestinal inflammation or appendicitis;
• infection during abortion, installation of an intrauterine device, surgery on the pelvic organs;
• transmission of infection through blood or lymph from other organs susceptible to inflammation (for example, with sore throat).

Addition: The occurrence of oophoritis is facilitated by factors such as weakened immunity, hypothermia, uncontrolled use of certain medications, overwork, stress, and lack of nutrition.

Video: Causes and prevention of ovarian inflammation

Forms and symptoms of the disease

Inflammation of the ovaries in women can exist in acute, subacute and chronic forms. In this case, the symptoms are similar, but expressed to varying degrees.

Acute inflammation. It has pronounced signs that usually force a woman to urgently consult a doctor.

Subacute inflammation. This form occurs in patients with tuberculosis. The signs of the disease are the same as in the acute form, but they are more difficult to recognize, since they are masked by the symptoms of the underlying disease.

Chronic inflammation. If a woman does not consult a doctor in a timely manner, the treatment is not completed, the disease can become chronic, in which the symptoms are smoothed out. There are periods of temporary improvement, followed by exacerbation of the disease.

Symptoms of the acute form of the disease

Signs of acute inflammation are:

1. Severe pain in the lower abdomen, on one side or both. The pain is felt not only in the ovarian area, but also spreads to the groin area. Aching pain appears in the sacrum and lower back. Painful sensations intensify before menstruation, as well as during hypothermia.
2. Increased body temperature, chills. It is not possible to bring down the temperature using conventional antipyretics. There are temperature fluctuations.
3. Headache, aches in joints and muscles.
4. Frequent and painful urination.
5. Copious discharge from the genitals. They can be transparent, white, yellow, brown, green, or mixed with blood or pus.
6. Presence of bleeding between periods.
7. Menstrual irregularities.
8. Digestive disorder.
9. Painful sensations during sexual intercourse.
10. Insomnia, irritability, fatigue.

Palpation of the ovaries is difficult due to their swelling and pain.

Features of the chronic form of inflammation

If inflammation becomes chronic, it periodically worsens. Usually the cause is colds or infectious diseases, physical or mental stress, digestive disorders, and diseases of the genitourinary system. If a woman smokes or drinks alcohol frequently, the risk of exacerbations increases.

In some cases, relapses of the disease do not occur; the woman is only worried about discharge and irregular menstruation. This course of ovarian inflammation is typical, for example, with gonorrhea. However, gradually thickening of the walls of the fallopian tubes occurs, and the formation of adhesions in the ovaries.

With a unilateral process, the pain is localized at the site of inflammation. If it occurs on the right side, then the symptoms of oophoritis may be confused with the symptoms of appendicitis. A thorough diagnosis of the disease is required.

Often inflammation that occurs on one side spreads to the second ovary. In women suffering from chronic inflammation of the ovaries, a common symptom is the presence of constant scanty discharge (leucorrhoea). Typically, patients consult a doctor for examination and treatment if pregnancy does not occur.

Consequences of ovarian inflammation

The greatest danger is represented by bilateral chronic inflammation of the ovaries. Its symptoms are not as pronounced as in the acute form. The woman periodically feels healthy, but the treatment is not completed. As a result, ovarian dysfunction (impaired hormone production) may occur. This condition is characterized by a woman’s inability to ovulate and become unable to conceive. In this case, there is an irregular onset of menstruation, fluctuations in their intensity and duration.

Ovarian dysfunction and hormonal disorders can cause diseases of the mammary glands, as well as pathological changes in the tissues of the uterus, including the occurrence of malignant tumors. Inflammation causes complications such as obstruction of the fallopian tubes, miscarriage, ectopic pregnancy, inflammatory diseases of the kidneys and intestines.

Diagnosis of oophoritis

It is not always possible to establish the presence of oophoritis only on the basis of symptoms, since a similar picture is observed in diseases such as appendicitis, ectopic pregnancy, peritonitis, tumor diseases of the uterus and ovaries. To clarify the diagnosis, it is necessary to know about the presence and methods of treatment of previous diseases, the nature and time of occurrence of ailments, the presence of complications in a woman during childbirth, abortions, and intrauterine procedures. The localization of pain, the nature of the discharge, and the existence of other signs of inflammation are clarified.

During a gynecological examination the presence of swelling and tenderness of the ovaries, changes in the mobility of the appendages are revealed.

Lab tests blood, urine and vaginal smears can determine the presence of an inflammatory process by the increased content of leukocytes.

Ultrasound examination of the pelvic organs is done to clarify the nature of the disease.

Bacteriological analysis smear Allows you to determine the type of opportunistic microorganisms and their sensitivity to various antibiotics.

ELISA(enzyme immunoassay) - determining the type of infection by the presence of corresponding antibodies in the blood. The method allows you to roughly assess the nature of the infection. Used to detect chlamydia, mycoplasmosis, trichomoniasis and other hidden infections.

PCR(polymerase chain reaction) is a method that allows you to determine with 100% accuracy the type of viruses that caused inflammation by their DNA (including detecting human papillomavirus, herpes, the causative agent of tuberculosis, chlamydia and others).

Hysterosalpingoscopy. The method is used to detect structural changes resulting from inflammation. The organs are filled with a special liquid, and then, using ultrasound, they monitor its progress through the pipes and determine their patency.

Laparoscopy. Allows you to examine the uterus, tubes, ovaries. The most effective diagnostic method. An optical device with a camera is inserted through a small hole in the abdominal wall.

Treatment of oophoritis

The treatment method depends on the form of the disease and the type of infection that causes it.

In the acute form, treatment is carried out in a hospital setting. The woman must remain on bed rest. Cold compresses are applied to the lower abdomen. Antibacterial, painkillers, antipyretics, and restorative drugs are used. Antibiotics for treatment are selected depending on the sensitivity of the infectious agent.

In the subacute form of the disease, quartz irradiation of the area of ​​inflammation is used. For chronic inflammation, drug treatment is used, as well as physiotherapy and medicinal baths.

The following methods are used:

1. Hirudotherapy- treatment with leeches to remove adhesions, relieve swelling and inflammation.
2. Electrophoresis- administration of drugs through the skin using a weak direct electric current.
3. Gynecological massage. Allows you to eliminate adhesions, increase the tone of the uterus, and restore its normal location.
4. Magnetotherapy– treatment with a low frequency magnetic field. Has an anti-inflammatory, analgesic effect.
5. Laser therapy, IR, UV irradiation- optical methods for eliminating microorganisms.

Note: If inflammation of the ovaries occurs as a result of a sexually transmitted infection, then both sexual partners should be treated simultaneously. Sexual contact should be avoided at this time.

When treating advanced chronic diseases, one has to deal with the presence of complications requiring surgical intervention.

Video: Complications of ovarian inflammation

To prevent oophoritis, it is necessary to promptly treat any inflammatory processes in the body, strengthen the immune system, lead a healthy lifestyle, use condoms, and undergo regular gynecological examinations.

Inflammation of the ovaries ( oophoritis) is an acute or chronic pathological process that affects the tissue of the female reproductive glands, causing a disorder in their function. In the vast majority of cases, this disease does not develop independently, but in combination with the inflammatory process within the fallopian tubes ( so-called adnexitis). In foreign literature, acute inflammation of the ovaries is usually combined with inflammation of the fallopian tubes ( salpingitis) into one common clinical syndrome – inflammation in the pelvis.

In most cases, inflammation of the ovaries and uterine appendages occurs due to the penetration of various infectious agents, more often pathogens of sexually transmitted diseases. For this reason, oophoritis and salpingitis usually develop in young women under the age of 25 who are sexually active and do not use barrier methods of contraception ( condoms).


Inflammation of the ovaries, provoked by pathogenic bacteria or viruses, is a dangerous and serious illness that causes reproductive disorders ( infertility), as well as hormonal imbalances due to changes in endocrine activity ovaries. With an aggressive course of the disease, local or widespread purulent complications may occur, posing an immediate threat to the woman’s life.

Interesting Facts

• the inflammatory process in the area of ​​the ovaries and fallopian tubes is one of the most common causes of female infertility;
• inflammation of the ovaries quite often occurs against the background of the asymptomatic course of some sexually transmitted diseases ( chlamydia);
• inflammatory process in the pelvic area is more common among young women;
• isolated damage to the ovaries by an infectious or inflammatory process practically does not occur;
• inflammation of the ovaries can occur in response to an inflammatory process in other organs;
• hormonal disruptions increase the likelihood of infectious agents entering the upper parts of the female reproductive system;
• stress is a factor that significantly weakens the protective potential of the female body and increases the risk of damage to the fallopian tubes and ovaries.

Anatomy of the uterine appendages

The female genital organs are conventionally divided into upper and lower sections. This division simplifies the systematization of the clinical manifestations of some sexually transmitted infections, and also allows for a better understanding of the mechanisms of penetration of pathogenic agents.

The lower parts of the female genital organs are represented by:

• Vulva. The vulva is the labia minora and majora, which serve as the entrance to the vagina, clitoris, and urethral opening.
• Vagina. The vagina is a tubular, muscular-elastic organ that performs sexual, reproductive, protective and excretory functions. Normally, the vaginal environment is not sterile and is formed by Doderlein's bacilli and a number of other saprophytic ( non-pathogenic) microorganisms. Thanks to this, the vagina has its own microflora, which helps protect it from the entry and development of any infections.
• Cervix. The cervix is ​​the part of the uterus located between the vagina and the uterine cavity. A canal passes through the cervix, which is normally closed and contains cervical mucus, which protects the overlying structures from infection.

The upper parts of the female genital organs are represented by:

• Ovaries. The ovaries are paired female sex glands, which are located in the pelvic cavity and perform reproductive and hormonal functions. Produce steroid sex hormones ( estrogen and progesterone). The process of egg maturation occurs in the ovaries.
• Uterus. The uterus is a muscular organ located in the pelvic cavity. Performs reproductive function ( carrying a pregnancy) and menstrual ( detachment of the inner mucosa). Through the fallopian tubes, the uterus connects to the abdominal cavity, and through the cervical canal to the vagina and the external environment.
• Uterine ( fallopian) pipes. The fallopian tubes are a paired organ that is located in the pelvic cavity and connects the uterus to the abdominal cavity. Fertilization of the egg occurs in the lumen of the fallopian tubes, and their main function is the transport of the embryo or egg into the uterine cavity.

The fallopian tubes do not fit tightly to the ovaries, and there is a small space between them. The connection between these two organs is formed by the fimbriae of the fallopian tubes ( small pointed growths), one of which ( ovarian fimbria) is in direct contact with the ovary.

The ovaries are supplied with blood by the ovarian artery, which originates from the abdominal aorta, as well as by branches of the uterine artery. Venous blood flows through the ovarian vein, which forms the ovarian plexus, into which blood from the fallopian tubes also flows. Knowledge of the characteristics of the blood supply allows us to better understand the possible mechanisms of penetration of infectious agents to the ovaries.

The ovaries are innervated by branches of nerves from the lower hypogastric plexus. The ovaries are not covered by the peritoneum, but are in fairly close contact with it. These facts are of great importance for understanding the mechanisms of pain during the development of the inflammatory process.

Next to the ovaries is the bladder, intestinal loops, appendix, and rectum. These formations may not be directly adjacent to the ovaries, but in some conditions they can serve as the initial source of infection or inflammation.

Causes of ovarian inflammation

The most common cause of inflammation in the ovaries is infection. However, this is far from the only reason that can provoke this disease. The inflammatory process is a protective mechanism that occurs in response to the action of any damaging factor and is aimed at reducing damage. Based on this, it can be assumed that the inflammatory response can occur in response to many pathological situations.


Inflammation of the ovaries can occur in the following situations:

• Infections. In the vast majority of cases, the inflammatory process in the ovaries occurs due to infection, which can be bacterial, viral or fungal in nature. Most often, oophoritis is associated with sexually transmitted diseases, but it can also occur with tuberculosis and with some nonspecific infectious processes. It should be understood that the infection rarely affects only the ovaries and usually affects either the uterus, or the fallopian tubes, or both organs at the same time and only after that it affects the ovaries. However, in some cases, the infection can penetrate into the ovaries and from other organs through direct contact with the infectious-inflammatory focus or through the introduction of pathogenic agents along with the bloodstream.
• Mechanical damage. Trauma to the ovaries, fallopian tubes or uterus can cause an inflammatory process that can engulf the ovaries, as well as significantly weaken local immunity and become a factor predisposing to infection.
• Inflammation of neighboring organs. The entry of biologically active pro-inflammatory substances into the ovaries can trigger some inflammatory reaction.
• Necrosis and inflammation of neoplasms ( tumors). With the development of some tumors, a necrotic process may occur, which can trigger an inflammatory reaction.

Sexually transmitted infections

In most cases, the inflammatory process in the pelvic cavity, covering the fallopian tubes and ovaries, is associated with sexually transmitted infections. Most often, the disease is associated with a bacterial infection caused by gonorrhea or chlamydia, but other pathogenic agents may also occur.

Oophoritis can be caused by the following pathogens:

• Gonococci. Gonococci are the causative agents of gonorrhea, one of the most common sexually transmitted diseases. These microorganisms penetrate the reproductive system during unprotected sexual contact with an infected partner. Initially they affect the lower parts of the reproductive tract, but when local or general immunity is weakened, as well as when a number of predisposing factors develop, they can penetrate the uterine cavity, move to the fallopian tubes and cause infection of the ovaries.
• Chlamydia. Chlamydia is the causative agent of chlamydia, a common sexually transmitted disease characterized by a latent course. Like gonorrhea, this disease is transmitted during unprotected sex, but unlike gonorrhea, chlamydia rarely causes any very bothersome symptoms. For this reason, this infection is often diagnosed already at the stage of development of various complications, including oophoritis.
• Trichomonas. Trichomonas vaginalis are the causative agents of trichomoniasis, a sexually transmitted infection, which, according to the World Health Organization, is the most common among people. Just like chlamydia, trichomoniasis of the lower genital tract quite often occurs asymptomatically or with minor clinical manifestations. This creates the preconditions for the spread of the infectious process into the uterine cavity and its appendages. Trichomoniasis extremely rarely affects the ovaries, however, the damage to the fallopian tubes it causes can, one way or another, cause an inflammatory reaction in the female reproductive glands with disruption of their function.
• Mycoplasmas. Mycoplasmas are small bacteria that can cause mycoplasmosis. These microorganisms are opportunistic, in other words, they are capable of causing disease only if there is a significant disturbance in the general condition of the woman and if her local or general immunity is reduced. They are transmitted during sexual contact, as well as through some types of household contact. Mycoplasmosis is characterized by a chronic, asymptomatic course. Penetration into the upper parts of the reproductive system is accompanied by the appearance of signs of severe damage to the genital organs.

In most cases, these pathogens penetrate the area of ​​the fallopian tubes and ovaries in an ascending manner from the lower parts of the genitourinary system. This happens gradually and under a certain set of circumstances.

Initially, the infectious process affects the external genitalia ( labia minora and majora and adjacent glands), as well as the urethra and vagina. It should be noted that normally the vagina is populated by Doderlein's bacilli, which form its normal environment and perform a protective function, as they do not allow pathogenic microorganisms to colonize this organ. However, in some situations, the vaginal microflora and its protective potential may be disrupted, which creates the preconditions for the development of infection.

Risk factors for infection of the lower genital organs are:

• incorrect use of antibiotics;
• vaginal douching;
• lack of personal hygiene;
• stress;
• diseases of the immune system;
• frequent change of sexual partners;
• unprotected sex.

The spread of infection from the vagina to the uterine cavity is difficult, since between them there is the cervix with a narrow canal filled with mucus, impenetrable to most microorganisms. The formation of this mucus depends on hormonal levels, as well as on the condition of the cervix and vagina. With significant inflammatory processes, as well as after any intrauterine manipulation, the cervical barrier may be disrupted.

Risk factors for the spread of infection to the upper parts of the female reproductive system are:

• abortion;
• therapeutic or diagnostic curettage of the uterus;
• installation of intrauterine contraceptives ( spirals);
• spontaneous abortion;

All these factors are due to the fact that the expansion of the cervical canal and the removal of the mucous plug opens the way for infectious agents located in the vaginal cavity.

Subsequently, the infectious process covers the mucous membrane of the uterus, and then the fallopian tubes and ovaries. In some conditions, pathogenic agents can cause the formation of purulent infectious and inflammatory foci in the uterine appendages, which is fraught with serious disruption of the general condition and is associated with a high risk of developing systemic complications.

Additionally, the hematogenous route of penetration of infectious agents into the ovaries is considered. This is due to the peculiarities of the blood supply to the ovaries, which receive part of the arterial blood from the branches of the uterine artery. Thanks to this, pathogens that can remain in the human blood for a short or long time can be introduced into the ovaries along with the bloodstream from the lower parts of the reproductive system.

Viral lesion

It is assumed that the inflammatory process in the ovaries can be triggered not only by bacteria, but also by viruses. There are a number of studies that indicate that at least two sexually transmitted viral infections can cause inflammation in the area of ​​the uterine appendages.

Inflammation of the ovaries can be caused by the following pathogens:

• Herpes simplex virus type 2. Herpes simplex virus type 2, also known as genital herpes, can enter the body through defects in the skin, as well as through the mucous membranes of the genitals during unprotected sexual contact with an infected person. It has the ability to integrate into human cells, making a complete cure impossible. Due to its scanty symptoms, genital herpes is a fairly common infection. During the activation period, the virus causes local foci of necrosis of the mucous membrane, which provokes an acute inflammatory reaction.
• Cytomegalovirus. Cytomegalovirus comes from the same family as the herpes simplex virus. It can affect many organs, including the genitourinary system. In most cases it is not particularly dangerous, but against the background of reduced immunity it can cause serious complications. It can cause inflammation of the pelvic organs, either alone or in combination with a number of other pathogens ( usually bacterial in nature).

It should be understood that the possibility of viral damage to the ovaries has not yet been fully proven, and there is a possibility that viruses penetrate the area of ​​the uterine appendages only after the occurrence of the inflammatory process caused by the initial infection.

Separately, it is necessary to mention the human immunodeficiency virus ( HIV), which does not independently affect the upper parts of the female reproductive system, but due to its ability to weaken the immune system, creates the preconditions for infection by other pathogens. In addition, against the background of HIV infection, especially at the stage of acquired immunodeficiency syndrome ( AIDS), optimal conditions are created for infection of the genital organs, including the ovaries, not only by aggressive pathogenic microorganisms, but also by opportunistic pathogens, which are normally harmless to humans.

Tuberculous lesion

Tuberculosis is a common infectious disease caused by Mycobacterium tuberculosis. In most cases, this disease affects the lungs, but in some cases, lesions may form in other organs.

Typically, tuberculosis infection occurs by inhaling sputum particles containing the tuberculosis bacillus ( airborne transmission), however, penetration of the pathogen is possible through consumption of contaminated food ( milk and dairy products), as well as through the skin ( rarely). In conditions of reduced immunity or impaired body resistance, the tuberculosis bacillus begins to multiply and develop in the tissues of the lungs, provoking a specific inflammatory reaction. As a result, a primary complex is formed, from which pathogens, along with the bloodstream, can enter the bones, kidneys, eyes, skin and genitals.

The penetration of Mycobacterium tuberculosis into the genital organs is due to the peculiarities of their blood supply. Since the fallopian tubes and ovaries receive blood from the branches of the uterine and ovarian arteries, at the places of their intersection ( so-called anastomoses) the speed of blood flow slows down, and this creates ideal conditions for bacteria to penetrate these organs. The hematogenous route of spread is associated with predominantly bilateral damage to the uterine appendages.

Infection with tuberculosis through sexual contact is considered impossible, since the vaginal environment is extremely unfavorable for Mycobacterium tuberculosis. However, if the pathogen comes into contact with injured or inflamed mucous membranes of the lower parts of the reproductive system, primary infection of the genital organs may occur.

The main problem of tuberculous lesions of the fallopian tubes and ovaries is that this disease in the vast majority of cases is asymptomatic. Women rarely seek medical help due to this infection. This leads to the development of various complications and irreparable structural and functional damage against the background of a long course of the disease.

Mechanical damage to the uterine mucosa and fallopian tubes

The inflammatory process, as mentioned above, is a kind of protective reaction of the body, which is aimed at reducing the damaging effects of any traumatic factor. Thus, an inflammatory reaction in the area of ​​the uterine appendages can be triggered not only by a bacterial or viral infection, but also by mechanical damage.

Mechanical damage to the ovaries and fallopian tubes is possible in the following situations:

• Blows to the abdominal area. Exposure to a short but strong impulse can cause contusion of many internal organs, including the uterus, fallopian tubes and ovaries. Under the influence of a damaging factor, local structural damage may occur, and partial or complete destruction of blood vessels may occur with impaired local circulation. To minimize the consequences, the body triggers an inflammatory response, which in some cases can cause even more severe damage.
• Penetrating wounds in the abdominal area. Penetrating wounds to the abdominal area can cause damage to the upper parts of the female genital organs, which can cause an inflammatory process. In addition, most penetrating wounds are potentially infected.
• Surgical interventions on the abdominal and pelvic organs. Any surgical intervention, no matter how minimally invasive it may be, injures internal organs to one degree or another. Strong pressure on the genitals through surgical instruments, cutting or cauterization can provoke an inflammatory reaction. In addition, do not forget about foreign materials that may end up in the surgical area ( suture material, various prostheses, stents, gases and solutions) and also cause inflammation.
• Invasive gynecological procedures. Gynecological procedures that involve instrumental effects on the internal genital organs ( abortions, curettage) are associated with some trauma, which directly provokes an inflammatory response. In addition, they reduce local immunity and create preconditions for the penetration of infectious agents.

Intrauterine devices, which are a common method of contraception, are also one of the factors that almost triples the risk of infectious and inflammatory complications in the pelvic organs. This is due to the fact that the spiral weakens local immunity and promotes infection with sexually transmitted infections and, in addition, can itself act as a carrier of pathogenic bacteria.

Inflammation of neighboring organs

Damage to the ovaries may be associated with an inflammatory process affecting neighboring organs. Most often this is caused by the passage of bacteria from the primary infectious focus through the wall of the organ, but it can also occur for a number of other reasons.

The ovaries can be involved in the inflammatory process when the following organs are affected:

• Colon. Inflammation of the large intestine, known as colitis, usually occurs due to an imbalance between normal and pathogenic intestinal microflora ( pathogenic bacteria begin to predominate). In some cases, the intestinal wall may become depleted, and ulcers and even through holes may form in it ( which leads to the development of peritonitis and is extremely dangerous). In addition, the inflammatory process in the intestines is accompanied by swelling, slowing of blood flow and dysfunction. Under the influence of these factors, there is a risk of pathogens passing through the intestinal wall to neighboring organs - the peritoneum, ovaries and fallopian tubes, and other parts of the intestine.
• Appendix. Inflammation of the appendix ( appendicitis) is one of the most common surgical pathologies. There are several theories explaining the mechanism of development of this disease, but regardless of the initial cause, the developing inflammatory reaction affects the entire thickness of the muscular wall of the organ and covers part of the serous membrane covering it. The resulting pathological reaction is quite massive, and upon contact with other organs it can also affect them.
• Bladder. Bladder infection ( cystitis) in some cases can cause an inflammatory process in the ovaries. However, in the vast majority of cases, the ovaries are involved in the inflammatory process not due to contact with the bladder, but due to parallel damage to the internal genital organs and bladder by sexually transmitted infections.
• Peritoneum. The peritoneum is the serous membrane that covers most of the abdominal organs and lines the walls of the abdominal cavity itself. Despite the fact that the ovaries are not covered by the peritoneum, an infectious-inflammatory process on the surface of the peritoneum can cause damage to the ovaries. However, much more often the opposite happens, and inflammation of the ovaries causes local inflammation of the peritoneum - pelvioperitonitis. It should be understood that peritonitis ( inflammation of the peritoneum) is an extremely serious condition that requires immediate medical treatment.

It should be noted that the inflammatory process, which covers several nearby organs, can cause them to stick together and form adhesions, which causes severe functional disorders. In addition, with significant activity of the inflammatory reaction, the formation of pathological fistulas is possible ( channels) between neighboring organs ( for example, between the rectum and vagina or uterus).

Symptoms of ovarian inflammation

The clinical manifestations of ovarian inflammation are quite varied, but they are nonspecific, as they are similar to the symptoms of diseases of other pelvic organs.

Symptoms of ovarian inflammation are formed by the inflammatory reaction itself, which, one way or another, changes the function and structure of the organ, as well as by infectious agents, which in most cases are the cause of oophoritis.


Inflammation of the ovaries is accompanied by the following symptoms:

• pain in the lower abdomen;
• increased body temperature;
• disruption of the gastrointestinal tract;
• menstrual irregularities;
• painful sexual intercourse;
• hormonal disorders;
• infertility;
• pain in the upper abdomen;
• muscle tension in the anterior abdominal wall.

Pain in the lower abdomen

Pain in the lower abdomen is the main symptom of acute inflammation of the ovaries and fallopian tubes. Pain occurs due to a slight increase in the organ's size due to edema, as well as due to the effect of pro-inflammatory biologically active substances on sensitive nerve endings. Since the ovaries are innervated by the branches of the hypogastric nerve plexus, the resulting pain sensation is usually of a pulling, aching nature. When the visceral ( covering organs) peritoneum, the intensity of pain increases slightly, and reflex vomiting may occur. If the infectious-inflammatory focus covers the parietal ( parietal) peritoneum, the pain intensifies significantly, becomes sharp, and reflex muscle tension occurs.

The duration of pain varies depending on the activity of inflammation and the treatment received. Usually the pain is present for at least 2 - 3 days, but no more than 3 - 4 weeks.

Increased body temperature

An increase in body temperature is a nonspecific reaction of the body that occurs in response to the penetration of any foreign protein. Fever is aimed at creating conditions that are unfavorable for the pathogenic agent, but optimal for the functioning of the immune system. Body temperature rises as a result of the influence of a number of biologically active substances formed at the site of inflammation on the structures of the central nervous system. These substances can be fragments of pathogens, particles of foreign proteins, as well as pyrogenic substances ( substances that can increase body temperature), formed during immune reactions.

There are three stages of fever development:

• Temperature rise. The rate of temperature rise depends on the nature and properties of the pathogen. With a sharp rise, a feeling of chills occurs, which indicates the activation of heat-saving mechanisms ( decreased sweating, goose bumps, contraction of peripheral blood vessels). Body temperature increases due to increased thermogenesis ( muscle tremors, accelerated nutrient metabolism).
• Plateau stage. At the plateau stage ( maintaining body temperature) the feeling of chills disappears and body temperature stabilizes. Depending on the pathogen, body temperature during inflammation of the ovaries can rise to 37.5 - 38 or even 39 degrees. If complications develop, body temperature may exceed 39 degrees.
• Decrease in temperature. The decrease in body temperature can occur either gradually or abruptly. Body temperature decreases after eliminating the effect of pyrogenic substances, when taking certain medications, as well as when the body is severely depleted.

Disorders of the gastrointestinal tract

Inflammation of the ovaries or other parts of the upper genital tract can cause various gastrointestinal disorders.

The following disorders of the gastrointestinal tract may occur:

• Nausea and vomiting. Nausea and vomiting occur reflexively, in response to intense painful stimulation of the hypogastric nerve plexus. In addition, nausea is one of the possible consequences of increased temperature and general intoxication of the body. Vomiting is usually mild and not associated with food intake. Profuse vomiting that does not bring relief indicates the possible development of complications ( peritonitis).
• Diarrhea. Diarrhea occurs due to intoxication of the body, as well as due to irritation of the intestines by an inflammatory focus.
• Urge to defecate. Frequent urge to defecate occurs due to irritation of the ampullary part of the rectum by an inflammatory focus in the genitals and in the area of ​​the peritoneum located in the pelvis.

Pathological discharge from the genital tract

Normally, discharge from the genital tract is a small amount of clear or whitish odorless mucus, the release of which is not accompanied by any unpleasant sensations.

In the presence of infectious and inflammatory foci within the upper or lower genital organs, various pathological vaginal discharges often occur, indicating an illness. The nature of the discharge depends on the nature and properties of the pathogen, as well as on the location of the lesion and the body’s resistance.

It should be understood that discharge can form in the vagina, cervix and uterine cavity. An infectious-inflammatory process limited to the fallopian tubes or ovaries is extremely rarely accompanied by discharge from the genital tract, since much more often in this case pathological fluids drain into the pelvic cavity.

The following options for pathological discharge from the genital tract are possible:

• Purulent discharge. Purulent discharge is a specific sign indicating the bacterial nature of the pathogens. They are a yellowish-green viscous liquid, the amount of which can vary depending on the severity of the process and the aggressiveness of the pathogen. Purulent discharge is characterized by an unpleasant smell of rotten fish. When anaerobic microflora joins, purulent discharge becomes foamy, since these microorganisms produce gas, which foams the pus.
• Serous discharge. Serous discharge is characteristic of viral infection of the cervix and uterus. They arise due to vasodilation and the release of part of the plasma from the bloodstream during an inflammatory reaction. Typically, such discharge is transparent or slightly yellowish, odorless.
• Bloody issues. Bloody discharge occurs when blood vessels melt by pathogenic agents or when their integrity is destroyed during an inflammatory reaction. Bloody discharge is usually scanty, not abundant, represented by dark blood, and occurs regardless of the menstrual period. The discharge may be accompanied by pain in the lower abdomen.

Menstrual irregularities

The menstrual cycle is a periodic change in a woman's genital organs aimed at maintaining readiness for conception. This process is regulated by hormones of the ovaries, hypothalamus and pituitary gland.

The menstrual cycle is based on the periodic renewal of the uterine mucosa and the maturation of the egg. This happens in several phases, each of which is regulated by certain hormones. First, detachment of the uterine mucosa occurs ( endometrium), which is accompanied by bleeding. Subsequently, under the influence of sex hormones, regeneration of the mucous layer begins in the uterine cavity, and a dominant follicle is formed in the ovaries. Subsequently, by the time of ovulation, when the follicle ruptures and the level of estrogen and progesterone increases, the uterine mucosa thickens significantly, and the egg released from the follicle ( which at this stage is more correctly called a first-order oocyte) migrates through the fallopian tubes into the uterine cavity. If fertilization does not occur during this period, then this cycle is repeated again.

With inflammation of the ovaries, the menstrual cycle may be disrupted for the following reasons:

• damage to the uterine mucosa;
• decreased levels of sex hormones due to ovarian dysfunction;
• ovulation disorders;
• disruption of endometrial regeneration.

With inflammation of the ovaries, the following types of menstrual irregularities are possible:

• lack of discharge during menstruation;
• scanty discharge during menstruation;
• heavy discharge during menstruation;
• long menstrual cycle;
• pain during menstruation.

Painful sexual intercourse

The inflammatory process in the pelvic cavity is often accompanied by pain during sexual intercourse. This is usually associated with damage to the vagina, but can also occur with damage to the upper parts of the reproductive system.

Pain during sexual intercourse is associated with excessive vaginal dryness, which occurs either due to inflammatory damage to the vagina itself, or due to a decrease in the level of the sex hormone estrogen. As a result, due to insufficient hydration, friction increases and pain occurs during sex. This leads to a woman's decreased sexual desire ( libido decreases), mood is disturbed, and depression may develop.

Hormonal disorders

Hormonal disorders due to inflammation of the ovaries do not always occur, but in some situations they are quite possible. They arise due to structural and functional changes in the organ, which leads to a decrease in the synthesis of sex hormones ( estrogen and progesterone).

Since one normally functioning ovary is capable of maintaining the level of sex hormones within the physiological norm, hormonal disorders occur only when the organ is damaged bilaterally or when the only functioning ovary is affected.

Hormones are known to regulate many physiological processes in the human body. When the level of sex hormones decreases, sexual and reproductive function disorders occur, as well as disorders of the central nervous system ( mood changes, depression, manic-depressive states), of cardio-vascular system ( heart rhythm disturbances, high blood pressure) and from the side of metabolism ( obesity occurs, cholesterol levels increase). Of course, some of these manifestations can develop only in the case of a protracted inflammatory process accompanied by hormonal imbalance.

Infertility

Infertility is one of the most common consequences of the inflammatory process in the area of ​​the uterine appendages and often acts as the main reason for women seeking medical help.

Infertility with ovarian damage is associated with impaired egg production, as well as developing hormonal disorders. However, much more often, infertility occurs due to damage to the fallopian tubes, which in the vast majority of cases accompanies oophoritis. Due to the inflammatory reaction, the fallopian tubes narrow, functional and structural changes occur in them, which lead to partial or complete obstruction of the egg and sperm.

Muscle tension in the anterior abdominal wall

Tension of the muscles of the anterior abdominal wall occurs when the parietal ( parietal) peritoneum. Muscle contraction occurs reflexively, in response to strong painful stimulation emanating from the inflammatory focus. Thanks to muscle tension, the tension and irritation of the peritoneum is reduced, which allows for some relief of pain.

In addition to the symptoms listed above, the inflammatory process localized in the ovaries and fallopian tubes may be accompanied by a number of other signs, which in most cases arise already at the stage of development of complications.

Inflammation of the uterine appendages may be accompanied by the following signs of a complicated course:

• Pain in the upper abdomen and right hypochondrium. A painful sensation in the right hypochondrium, which arose against the background of pain in the lower abdomen, temperature and other signs of damage to the woman’s reproductive system, indicates the occurrence of perihepatitis - inflammation of the liver capsule ( Fitz-Hugh-Curtis syndrome). It is characterized by some dysfunction of the liver, increased levels of liver enzymes, and sometimes yellowness of the skin and mucous membranes.
• Swelling of the abdomen on the affected side. The occurrence of abdominal swelling on the side of the affected ovary, which can be determined visually or during palpation, indicates the development of a tubo-ovarian abscess - a cavity filled with purulent contents. It is a potentially dangerous condition that requires surgical treatment.

Diagnosis of ovarian inflammation

Diagnosis of ovarian inflammation is a difficult task due to the fact that this disease has symptoms similar to some other ailments, and also due to the fact that the inflammatory reaction is extremely rarely limited to the ovaries alone, involving the fallopian tubes, uterus and other parts of the genitalia in the process systems. This creates additional difficulties when diagnosing the disease.

Before starting any diagnostic procedures, a conversation is held with the doctor, during which the main symptoms, the time of their onset, intensity, and main characteristics are clarified. Data are collected on previous surgical operations and on known acute and chronic diseases. The doctor finds out whether the menstrual cycle is regular, when the last menstruation was, what is the amount of discharge during menstruation, whether menstruation is accompanied by pain or discomfort.

An inflammatory process in the area of ​​the uterine appendages is suspected if the following signs are present:

• pain in the lower abdomen;
• pathological discharge from the genital tract;
• increased body temperature;
• hormonal disorders;
• menstrual irregularities;
• recent sexually transmitted diseases;
• frequent change of sexual partners;
• age up to 25 years;
• non-use of barrier contraception methods ( condoms);
• the presence of an intrauterine device;
• recent intrauterine procedures ( abortion, curettage, installation of a spiral).

However, a diagnosis cannot be made based on these signs alone. A more detailed examination is required using various methods of instrumental and laboratory diagnostics.

Diagnosis of oophoritis is based on the following procedures:

• gynecological examination;
• Ultrasound of the pelvic organs;
• microbiological research.

Gynecological examination

A gynecological examination involves visual examination of the external genitalia, vagina and vaginal part of the cervix. This procedure is performed while the woman is in a gynecological chair with her legs apart. The doctor inserts a special instrument into the vagina, called a vaginal speculum, which allows you to move apart the walls of the organ, perform a visual examination and take the necessary materials for further tests.

With isolated inflammation of the ovaries, a gynecological examination does not reveal any abnormalities. However, since in the vast majority of cases with this disease, other parts of the reproductive system are involved in the infectious-inflammatory process, upon examination a number of nonspecific signs are determined.

During a gynecological examination, the following signs are revealed:

• redness of the vaginal mucosa;
• swelling of the vaginal mucosa and vaginal part of the cervix;
• the presence of ulcers on the surface of the vaginal mucosa;
• the presence of purulent or foamy discharge in the vaginal cavity or in the posterior vaginal fornix;
• traces of pathological discharge at the mouth of the cervical canal.

After the examination, a bimanual examination is performed, during which the doctor inserts the index and middle fingers into the woman’s vagina and feels the cervix. With the other hand, the doctor palpates the upper edge of the uterus through the abdominal wall. Carrying out this procedure, the doctor can assess the mobility of the uterus, the degree of softening of the cervix, determine the area of ​​pain, and identify any space-occupying formations.

By bimanual palpation in women with a fairly thin anterior abdominal wall, the ovaries can be palpated, which in case of inflammation are enlarged and painful.

Ultrasound of the pelvic organs

Ultrasound examination of the pelvic organs is an extremely informative method that allows you to determine the degree of damage to internal organs without surgical intervention.

An ultrasound examination of the pelvic organs reveals the following changes:

• Increase in size of the ovaries. During the inflammatory reaction, swelling occurs, which leads to an increase in the size of the organ. The normal dimensions of the ovaries are on average 25 mm wide, 30 mm long, and 15 mm thick.
• Thickening of the fallopian tubes. Since the inflammatory process that engulfs the ovaries, in most cases also involves the fallopian tubes, ultrasound reveals signs of salpingitis ( inflammation of the fallopian tubes). Normally, the fallopian tubes are almost invisible during ultrasound examination, but due to the thickening of the wall during inflammation, they become noticeable.
• Smoothness of the surface of the ovaries. Normally, the surface of the ovaries is slightly bumpy due to the developing follicles. When ovarian function is impaired, as well as due to edema, the surface of the organ is smoothed.
• Strengthening the echo structure. Strengthening the echostructure of the ovaries occurs due to the formation of areas of fibrosis in the thickness of the ovaries.
• Signs of inflammation in the uterine cavity. The inflammatory process in the uterine cavity is a common symptom that accompanies oophoritis. This is revealed by ultrasound by thickening of the endometrium, areas of fibrosis in the uterine cavity, as well as hypoechoic formations in the wall of the organ.

It should be noted that ultrasound examination can be performed using two methods – through the anterior abdominal wall and through the vagina. The latter method is more sensitive and informative.

Laparoscopy

Laparoscopy is a minimally invasive diagnostic method that allows direct visualization of the surface of the ovaries, and which allows some therapeutic operations to be carried out immediately.

Laparoscopy is carried out by introducing a camera and some manipulators into the abdominal cavity through small punctures in the anterior abdominal wall. Thanks to gas injection ( for diagnostic operations - oxygen, for surgical interventions - carbon dioxide) and the presence of an optical system with lighting, the doctor can directly examine the organs of interest to him. This procedure is carried out in a sterile operating room under general anesthesia.

When diagnosing inflammation of the uterine appendages, laparoscopy is the “gold standard”, as it allows you to quickly establish a diagnosis, determine the degree of structural changes in organs, and also carry out the necessary surgical intervention. In addition, after this study, patients quickly return to their normal activities.

Laparoscopy allows you to identify the following signs of damage to the uterine appendages:

• pus in one of the fallopian tubes;
• fresh ( easily separated) adhesions in the area of ​​the uterine appendages;
• sticky ( fibrous exudate) on the surface of the ovaries and fallopian tubes;
• an increase in the size of the ovaries;
• bleeding of the ovaries when pressed.

In addition to examining the pelvic organs, other abdominal organs are also examined during laparoscopy in order to exclude other possible pathologies, as well as to determine the extent of the inflammatory reaction.

Despite all the advantages of laparoscopy as a method for diagnosing oophoritis and other inflammatory diseases of the upper genital tract, its use as a routine examination method is irrational. This is due, firstly, to the rather high cost of the procedure, and secondly, to a number of risks and possible side effects.

Microbiological examination

Microbiological examination of the contents of the cervical canal, vaginal cavity or uterine cavity is an extremely informative method of laboratory diagnosis. This procedure allows you to determine the nature of the pathogen and, based on this data, plan treatment.

The following methods for detecting and identifying pathogenic agents exist:

• Bacterioscopic method. Bacterioscopy is based on the study of stained smears obtained by placing the material under study on a glass slide under a light microscope. This method allows you to detect gonococci, chlamydia, trichomonas, and some other pathogens. In addition, microscopy of smears can assess the degree of inflammatory reaction.
• Bacteriological method. The bacteriological method makes it possible to extremely accurately identify pathogens and determine their sensitivity to antimicrobial drugs, but it requires a lot of time. A bacteriological study is carried out by inoculating pathological material obtained from the patient onto special media, which are placed in a thermostat for several days. At the same time, pathogenic bacteria begin to actively multiply, which allows them to be identified in the future by a number of signs.

Treatment of ovarian inflammation

Treatment of ovarian inflammation is a complex of therapeutic measures aimed at eliminating pathogenic agents, reducing the inflammatory response, and also restoring the normal function of the reproductive system.

Drug treatment

Drug treatment is based on the use of pharmacological drugs that can destroy pathogens, as well as drugs that have anti-inflammatory and immunomodulatory effects.

Drugs used to treat ovarian inflammation

Pharmacological group	Main representatives	Mechanism of action	Mode of application
Antibiotics	Amoxicillin with clavulanic acid	It disrupts the synthesis of bacterial cell walls, thereby causing their death. Clavulanic acid inhibits bacterial enzymes ( beta-lactamases), capable of breaking down this antibiotic.	The drug is prescribed orally, intramuscularly or intravenously, depending on the severity of the patient’s condition. The dosage is selected individually. Usually prescribed 500 mg 3 times a day for 14 days.
	Ceftriaxone	Disturbs the synthesis of bacterial cell wall components. Resistant to beta-lactamase.	It is prescribed intramuscularly or intravenously. Used in a daily dose of 1 – 2 grams for 14 days.
	Ciprofloxacin	It is a broad-spectrum antibiotic. Inhibits enzymes responsible for the synthesis of bacterial genetic material, which causes cell death.	Can be administered orally and intravenously. Used in a dose of 250–500 mg 2–3 times a day for two weeks.
	Gentamicin	It blocks the 30S ribosomal subunit, thereby disrupting protein synthesis.	Administered intramuscularly or intravenously at a dose of 3 mg per kilogram of body weight per day in 2–3 doses for 10–14 days
	Azithromycin	Blocks the 50S ribosomal subunit, slowing down the reproduction of bacteria and disrupting protein synthesis.	It is prescribed intravenously in the form of droppers in a dose of 250–1000 mg.
	Doxycycline	It disrupts protein synthesis by disrupting ribosome function.	Taken orally or intravenously at a dose of 100–200 mg.
Anti-inflammatory drugs	Ibuprofen	Inhibits the enzyme cyclooxygenase, which is involved in the breakdown of arachidonic acid to prostaglandins - biologically active substances that stimulate the inflammatory response. Reduces body temperature. Has a pronounced analgesic effect.	Orally or rectally at a dose of 1200–2400 mg per day in 3–4 doses after meals.
	Diclofenac		It is taken orally at a dose of 75–150 mg or rectally at a dose of 50 mg 2 times a day.
	Meloxicam		It is administered orally at a dose of 7.5–15 mg once a day after or during meals.
Antihistamines	Clemastine	Blocks histamine receptors ( pro-inflammatory substance), thereby reducing vasodilation at the site of inflammation, reducing swelling, and normalizing capillary permeability.	Orally 1 mg 2 times a day.
Immunomodulators	Interleukin-1 beta	Stimulates the synthesis of immune cells, enhances the protective potential of lymphocytes and neutrophils.	Intravenous drip at a dose of 15 – 20 ng/kg.
	Interferon alpha-2	Prevents the penetration of viral particles into cells, activates the synthesis of antibodies, enhances the phagocytic activity of immune cells. It disrupts the synthesis of viral genetic material in cells.	Prescribed rectally in a dose 500,000 IU 2 times a day for 7 – 10 days.
Combined oral contraceptives	Diana-35	Have a contraceptive effect ( due to suppression of ovulation and changes in the endometrial mucosa), and also contribute to the normalization of ovarian secretory activity.	The drug is taken orally, one tablet per day, starting from the first day of the menstrual cycle. One package is designed for one menstrual cycle and contains 21 tablets.
Detoxification agents	Glucose solution	By increasing the volume of circulating blood, it accelerates renal filtration and stimulates the elimination of toxic substances from the body.	It is prescribed intravenously in the form of droppers.

These medications should only be taken as prescribed by a doctor, since taking them incorrectly can not only be ineffective, but can also cause a number of serious complications and side effects.

Surgery

Surgical treatment of ovarian inflammation is indicated only in cases where drug therapy is either ineffective or does not allow achieving the proper level of sanitation of the infectious-inflammatory focus.

Surgery is necessary in the following situations:

• Tuboovarian abscess. The presence of an accumulation of pus in the area of ​​the uterine appendages is a direct indication for surgical intervention, since until this pus is completely drained, drug treatment is not sufficiently effective. To treat this complication, laparoscopic access is preferable, as it is less traumatic and allows for faster recovery after surgery. However, in case of massive accumulation of pus or in the presence of adhesions in the abdominal cavity, a classic laparotomy may be required ( incision of the anterior abdominal wall).
• Peritonitis. An infectious and inflammatory process involving the peritoneum requires immediate surgical intervention, as it is a life-threatening condition. To treat peritonitis, they resort to laparotomy access, as it allows for better and larger sanitization of the abdominal cavity.

In some cases, if the infectious-inflammatory process is too massive, if it cannot be treated, or there is a risk of organ rupture and spread of infection, more radical surgery may be required, which may involve removing part or all of the ovary, fallopian tube, or even the uterus.

Traditional methods of treatment

Traditional methods of treating oophoritis, based on the use of various medicinal plants, can increase the body's protective potential and speed up the recovery process. However, it should be understood that traditional medicine cannot eradicate pathogens and, accordingly, is ineffective at the stage of acute infection.

The following traditional medicine recipes can be used as additional therapy:

• Blackcurrant infusion. To prepare the infusion, you need to mix 4 tablespoons of black currant leaves with 2 tablespoons of yarrow herb, horsetail and barberry, and then pour 2 cups of boiling water and leave for one and a half to two hours. You should drink half a glass every 2 to 3 hours.
• Oat infusion. To prepare the infusion, you need to mix 4 teaspoons of seed oats with 3 tablespoons of birch leaves, 2 tablespoons of peppermint leaves, honey and lemon. The resulting mixture must be mixed and poured with 2 cups of boiling water, then left for 60 minutes. The resulting solution should be consumed 100 ml every 2 – 3 hours.

Prevention of ovarian inflammation

Prevention of ovarian inflammation includes:

• Timely diagnosis. Timely diagnosis of infectious and inflammatory diseases of the upper and lower reproductive system can reduce the risk of complications.
• Timely examinations. Timely and periodic examinations by a gynecologist make it possible to diagnose diseases at the initial stage, which greatly facilitates and speeds up treatment.
• Protection against sexually transmitted infections. Since the main cause of ovarian inflammation is sexually transmitted infections, it is extremely important to use barrier contraception methods ( condoms), which reduce the risk of transmission of sexually transmitted diseases.
• Treatment of infections of neighboring organs. Timely treatment of infectious foci in organs located near the ovaries can reduce the risk of their involvement in the inflammatory process.
• Healthy lifestyle. To prevent oophoritis, exposure to toxic substances should be avoided ( alcohol, nicotine), cold, exhaustion. It is necessary to eat right and practice physical exercise, as this helps strengthen the immune system and helps normalize the function of the entire body.

Pain in the ovaries - causes, symptoms and what to do?

The first sign that inflammation of the ovaries (female reproductive glands) has begun is a severe nagging pain in the right or left lower abdomen. If a girl experiences feelings of this nature, she should immediately seek treatment. The consequences of gynecological disease are serious - early menopause, long-term infertility. Every woman needs to know what the inflammatory process in the ovaries is and how to recognize it.

What is ovarian inflammation

To understand what oophoritis is in gynecology (as doctors call inflammation), you need to understand its nature. Oophoritis is provoked by pathogens that rise from the fallopian tubes or cervical canal. Sometimes infection of the ovary occurs through blood or lymph, then even banal caries or tuberculosis can become the causative agent. Symptoms of oophoritis are often confused with other diseases, so diagnosis of inflammation includes ultrasound, blood tests, urine tests, and smears.

Oophoritis can be unilateral (only the right or only the left ovary) and bilateral (both ovaries are inflamed). It can manifest itself in acute (subacute) and chronic forms. Accompanied by a violation of the correct location of the pelvic organs, enlarged ovaries, adhesions, up to an ovarian cyst. There are concomitant diseases: with acute and chronic adnexitis, the appendages become inflamed, with salpingitis – the uterine cavity, the tissue of the fallopian tubes.

Causes

The causative agents of infection are the viruses of chlamydia, trichomoniasis, gonorrhea, tuberculosis, mycoplasmosis, inhabitants of the pathogenic microflora of the female genital organs (streptococci, candida, E. coli). The disease can be triggered by external factors: hypothermia, complications after infectious diseases, abuse of antibiotics, hormonal drugs, injuries during a gynecological examination of a woman, the use of an intrauterine device.

Symptoms

Signs of inflammation of the ovaries and appendages in women in its acute and chronic forms differ. The acute form of the disease is characterized by:

• pain, pain when urinating due to infection of the cervical canal;
• pain in the lower abdomen due to adhesions in the ovarian tissues;
• fever, weakness due to infection;
• dull pain in the lower abdomen during sexual intercourse due to damage to the fallopian tubes;
• disruption of menstruation due to the formation of a persistent focus of inflammation in the pelvis;
• purulent discharge or leucorrhoea.

Symptoms of ovarian inflammation in women in its chronic form (chronic oophoritis):

• dull, aching, nagging pain in the lower abdomen, in the vagina, which intensifies before and during menstruation, during hypothermia, during sexual intercourse;
• leucorrhoea;
• erratic menstruation;
• difficulty conceiving;
• decreased sex drive;
• causeless irritability;
• insomnia, anxiety;
• high fatigue, decreased performance.

How to treat ovarian inflammation

The sooner a woman begins treatment, the higher the chance of overcoming the disease without complications. You need to take care of prevention and go to the gynecologist as soon as the first symptoms of oophoritis, salpingitis, and adnexitis appear. He will prescribe an ultrasound for the woman, look at the results in the photo, and conduct tests, including culture for bacteria from the vagina. Features of treatment depend on what stage the inflammation is at, what causes it, and how it proceeds. It is extremely dangerous if the disease is detected in a pregnant woman. This is a threat to the life of the woman and the fetus.

Chronic

Treatment of the disease comes down to pain relief, restoration of reproductive function and the formation of beneficial microflora of the woman’s genital organs, which has an anti-inflammatory and antimicrobial effect. The doctor prescribes anti-inflammatory drugs, immunomodulators, physiotherapy - mud therapy, mineral baths, gynecological massage, acupuncture. Treatment of chronic ovarian inflammation takes a long time and sometimes requires surgical intervention.

Acute

Exacerbations of adnexitis and oophoritis are treated in a hospital. It is important to suppress the pathogen as quickly as possible before the disease enters the chronic stage, so antibiotics (based on the results of flora culture) and anti-inflammatory are prescribed. Droppers are used against intoxication, and general strengthening agents are administered - vitamins, antioxidants. To restore sexual microflora, a probiotic is given. Therapy necessarily includes painkillers.

How to treat ovarian inflammation in women

Drug treatment includes drugs of several groups - anti-inflammatory, to increase immunity, painkillers, antiviral (antimicrobial), physiotherapy. An antibiotic for inflammation of the ovaries in women is prescribed selectively, based on culture results. During the treatment period, a woman should avoid sexual intercourse and alcohol. The woman undergoes the examination together with her sexual partner, and if necessary, he is also prescribed treatment.

Pills

To relieve inflammation of the tissue of the fallopian tube or ovary, drugs are prescribed according to one of the following regimens: Ceftriaxone or Cefotaxime with Metronidazole plus inhibitors, or Ofloxacin or Ciprofloxacin with Metronidazole plus Doxycycline. It is advised to take vitamins E and C, painkillers - Tempalgin, Pentalgin, Analgin, Spazmalgon, Aspirin. Gynecologists use other pills for ovarian inflammation:

• Amoxiclav;
• Azithromycin or Sumamed;
• Biseptol;
• Urotropin;
• Trichopolum;
• Clindamycin;
• Gentamicin;
• Negroes;

Candles

If necessary, the doctor can prescribe topical medications to the woman - suppositories. Depending on the situation, two types are used - anti-inflammatory and antimicrobial (antiviral). Suppositories are characterized by an almost complete absence of side effects, only sometimes patients complain of itching or burning. Chronic inflammation cannot be cured with suppositories alone.

The following types of suppositories have a strong therapeutic effect for oophoritis:

• Hexicon - inhibits the causative agents of oophoritis, is a prophylactic against thrush;
• Betadine is an antimicrobial, antiviral, bactericidal agent, characterized by a gentle effect on the mucous membrane of the genital organs due to the base - gelatin, water;
• any suppositories with indomethacin, propolis, oak bark or walnut - soothe, relieve inflammation, pain and other discomfort from oophoritis.