Ovarian inflammation, also known as andexitis or oophoritis, is a disease of the ovaries. The trigger of oophoritis may be an infection caused by bacteria. However, in rare cases, oophoritis is caused by viruses.
What is oophoritis?
In very few cases, oophoritis actually affects only the ovaries– Predominantly, the fallopian tubes are also inflamed, so that – in addition to oophoritis – inflammation of the fallopian tubes also occurs. Women of childbearing age in particular are among those at risk. About two-thirds of all women who are already in their teens have already had ovarian inflammation. Bacteria, mainly chlamydia, transmitted through unprotected sex can be the cause of oophoritis.
Causes
Different viruses and bacteria may be responsible for causing a woman to develop oophoritis. As a rule, chlamydia is the trigger; often the physician also detects streptococci. Occasionally, enterococci can also trigger oophoritis. In one third of all cases, gonococci are responsible for the inflammation of the ovaries. In the context of oophoritis, physicians speak of ascending or descending inflammation. The ascending inflammation, which so to speak “rises from the vagina”, is triggered by unprotected sexual intercourse and is one of the most frequent causes of oophoritis. The descending inflammation is triggered by inflamed organs (such as appendicitis), whereby this form of the disease occurs only in the rarest cases. Even more rarely, physicians speak of hematogenous inflammation. In this case, the germs – triggered by a viral flu or mumps – reach the ovaries directly through the blood.
Symptoms, complaints and signs
Women affected by oophoritis complain mainly of pain in the lower abdomen. In addition to lower abdominal pain, fever or any defensive tensions may also occur. Sometimes the patient also complains of nausea and vomiting. If those symptoms occur, medical examination should be sought immediately. However, there are also courses of the disease which do not bring any symptoms. While many women complain of flu-like symptoms, other patients only visit the doctor because they have started bleeding – outside the period.
Diagnosis and course of the disease
Before a gynecological examination is performed, a comprehensive medical history begins. The physician performs a vaginal palpation examination; ultrasound examination can also detect signs of oophoritis. For example, if there is already enlargement of the ovaries or fallopian tubes. The ultrasound examination should also provide information as to whether cysts are already present or whether fluid is sometimes also present in the abdominal cavity. If the patient reacts to the pressure, this can also be a first sign that oophoritis is present. A blood test provides information about which pathogen has triggered the oophoritis, or it is also possible to determine the pathogen by means of a vaginal swab and subsequent examination under a microscope. The germ is detected in the laboratory – with the help of special cultures. If the patient complains of severe pain or the physician finds that the ovaries are enormously enlarged, a surgical intervention must often be planned. By means of laparoscopy (abdominal endoscopy), the physician has a view of other organs and can sometimes check whether these or even the peritoneum are already affected. If the disease is treated too late or not at all, a chronic course can be the result. This means that the woman has to fight with inflammations again and again, and subsequently scars develop, so that sometimes fertility also suffers. Women who have already had three ovarian inflammations have a 50 percent chance of being infertile.
Complications
First and foremost, oophoritis causes very severe pain in the abdomen and stomach. This pain has a very negative effect on the quality of life of the affected person, and in the process can also lead to significant limitations in everyday life.Furthermore, due to the permanent abdominal pain, patients also lose their appetite and thus suffer from weight loss or various deficiency symptoms. Oophoritis can also lead to fever, vomiting and nausea, so that the patient’s ability to cope with stress is also significantly reduced. Women may also experience increased vaginal bleeding, which can also be associated with mood swings. As a rule, oophoritis does not heal itself, so that treatment by a doctor is necessary in any case. Treatment of oophoritis is usually carried out with the help of antibiotics and leads relatively quickly to a positive course of the disease. There are no particular complications for the affected person. However, without treatment, oophoritis can lead to appendicitis. The patient’s life expectancy is usually not altered by this disease.
When should you see a doctor?
Women and girls who suffer from discomfort in the lower abdomen that is not related to menstruation should see a doctor. If pain persists or increases in intensity, a doctor is needed. A feeling of tightness in the area of the ovaries or uterus, malaise, and a feeling of illness should be examined and treated. If flu-like symptoms such as vomiting, nausea or internal weakness occur, clarification of the cause is necessary. Fever as well as a decrease in physical resilience should be examined and treated by a physician. If bleeding occurs outside the menstrual cycle, this is considered a warning signal of the organism. A visit to the doctor is necessary to enable a diagnosis to be made. Bleeding when going to the toilet, loss of libido and discomfort during sexual intercourse should be discussed with a doctor. If behavioral changes occur, increased fatigue is noticed, or the individual complains of sleep disturbances, a physician should be consulted. Swelling in the lower abdomen, a decrease in physical activity and mood swings may occur as consequences of oophoritis. To prevent the limitations in everyday life from spreading further, a visit to the doctor is advisable. In case of deficiency symptoms, exhaustion as well as a decrease in weight, action is required. Since no self-healing is to be expected, medical care must be initiated.
Treatment and therapy
It is important that oophoritis is treated relatively early. Only in this way can any late consequences, such as infertility, be prevented. As a rule, oophoritis is treated by means of antibiotics; the antibiotics must be taken for about 14 days. If the course of the disease is very severe, treatment can no longer be carried out on an outpatient basis, so the patient is admitted to hospital as an inpatient. Care is taken to ensure that – if there is evidence of which pathogen was the cause of the oophoritis – immediate drug treatment is given. If bacteria such as chlamydia are involved in the oophoritis, not only the patient but also the sexual partner must be treated. Furthermore, anti-inflammatory drugs are used – also in outpatient treatment of oophoritis; sometimes pain-relieving agents can also be administered. After the acute phase is over, patients can also take advantage of sitz baths, mud packs or even short-wave heat therapies. Sometimes even the “pill” can be used to “immobilize” the ovary. In addition to conservative methods, the physician may also opt for surgery. Especially if past treatments have not been successful or if there are already complications (appendicitis or peritonitis). Also, in the case of very severe scarring, the physician – together with the patient – may agree to remove the fallopian tubes or ovaries, respectively, so that a symptom-free life can be led.
Outlook and prognosis
For hardly any disease like acute inflammation of the fallopian tube and ovaries of a woman there are so many synonyms. A distinction must be made between an acute and a chronic form of oophoritis. In general, both diseases are summarized as bacterial inflammation of the female appendages. These are treated under the medical umbrella term “adnexitis“. The prognosis for acute oophoritis is naturally different from that of the chronic form of oophoritis.Acute adnexitis is often found in young and sexually very active women. In most cases, the prognosis is favorable because acute adnexitis can heal without consequences. However, the important prerequisite for this is that the infection is diagnosed at an early stage and is not carried over. After adequate treatment, acute oophoritis can heal without consequences. The prognosis is somewhat worse if complications occur in the acute stage. Examples of this are given with an abscess on the fallopian tubes and ovary, or peritonitis. In both cases, permanent adhesion of the fallopian tubes can occur as a result of carrying over the associated symptoms. As a consequence, the affected women would have to expect permanent infertility. If not treated by a gynecologist at the first symptoms of oophoritis, the inflammation of the female appendages can become chronic.
Prevention
Oophoritis can be prevented, for example, if both partners choose to have protected sexual intercourse (using a condom). Finally, chlamydia or other bacteria transmitted during sexual acts are the main triggers.
Aftercare
In most cases, only limited measures of direct aftercare are available to the affected person with oophoritis. For this reason, the affected person must see a doctor directly at the first symptoms and signs of the disease, so that further complications or discomfort can be prevented. In the worst case, if left untreated, the affected person will suffer from complete infertility, which cannot be reversed. Therefore, the priority in this disease is early diagnosis. In most cases, oophoritis is treated by taking various medications. Care must always be taken to ensure the correct dosage and also that the medication is taken regularly in order to alleviate the symptoms. If the disease is treated by antibiotics, they should not be taken together with alcohol. Regular checks and examinations by a doctor are also very important after treatment in order to detect and treat damage to the internal organs at an early stage. As a rule, oophoritis does not reduce life expectancy if it is detected and treated early. Further measures of follow-up care are not necessary and are usually not available to the affected person.
What you can do yourself
Women who have ovarian inflammation should first follow the gynecologist’s instructions. Painkillers and anti-inflammatories must be taken as directed by the doctor for optimal healing. This can be accompanied by a whole range of natural remedies such as yarrow, horsetail or oat straw. Homeopathic preparations such as belladonna or aconitum have an anti-inflammatory effect and may also be used in consultation with the doctor. Affected women should also dress warmly and wear sturdy shoes. After sexual intercourse, which should take place with a condom in the first weeks after diagnosis, careful personal hygiene applies. Chronically ill patients should permanently pay attention to good intimate hygiene. If unusual symptoms or complaints occur during or after treatment, a visit to the doctor is recommended. The physician can monitor the course and adjust the treatment if necessary. In addition, he can consult a homeopath and other physicians if a serious underlying disease is present or the oophoritis does not subside within a few days to weeks. Patients should also take adequate rest and avoid contact with cold.
