Symptoms and Causes of Adnexitis

In the female internal genital organs, the fallopian tubes and ovaries are collectively referred to as the “adnexa.” Adnexitis, therefore, denotes inflammation of the fallopian tubes and ovaries. However, inflammation of the fallopian tubes and ovaries frequently co-occurs with parametrial connective tissue inflammation and pelvic peritonitis, making clinical differentiation challenging during diagnosis. Among pelvic inflammatory conditions, salpingitis (inflammation of the fallopian tubes) is the most common. Due to their anatomical proximity, salpingitis, oophoritis (ovarian inflammation), and pelvic peritonitis often coexist and mutually influence one another. So, what are the symptoms and causes of adnexitis? Below, we address this question.

Symptoms of Adnexitis

1. Abdominal Pain

Pain severity varies depending on the stage of disease progression. In most cases, patients experience only a vague sense of discomfort initially; however, as the condition advances, distinct dull aching and a sensation of heaviness or dragging may develop in the lower back and groin areas—particularly after excessive physical exertion.

2. Abnormal Vaginal Discharge

This manifests primarily as increased vaginal discharge volume, often thick and viscous—or even purulent in nature. In severe cases, blood-tinged discharge may occur. Additionally, the increased volume of discharge containing inflammatory substances may provoke pruritus vulvae (itching of the external genitalia). Therefore, prompt medical evaluation and treatment are strongly recommended.

3. Menstrual Irregularities

These commonly include delayed menstruation. Moreover, menstrual irregularities caused by adnexitis not only involve delays but may also persist for prolonged durations. Menstrual blood may appear dark and viscous, sometimes accompanied by an unpleasant odor. Furthermore, adnexitis can lead to infertility—a hallmark clinical manifestation of this condition.

Causes of Adnexitis

1. External Factors

Following childbirth or abortion, decreased host resistance facilitates ascending infection of pathogens via the genital tract into the fallopian tubes and ovaries, subsequently spreading throughout the pelvis and triggering inflammation. The widespread use of intrauterine devices (IUDs) has also contributed to rising incidence, particularly when patients neglect personal hygiene or when insertion procedures lack strict aseptic technique. Similarly, non-sterile intrauterine procedures—including suction curettage, hysterosalpingography with iodized oil, cervical canal treatments—as well as inadequately sterilized obstetric surgeries, may introduce infection. Poor menstrual hygiene, sexual intercourse during menstruation, or unprotected intercourse with unclean partners are additional contributing factors.

2. Infectious Factors

Systemic infections elsewhere in the body, if left untreated, may allow pathogens to disseminate hematogenously, resulting in salpingo-oophoritis—commonly observed in tuberculosis. Inflammatory processes in adjacent pelvic or abdominal organs—such as appendicitis—may spread directly to involve the ipsilateral fallopian tube and ovary, potentially extending to pelvic peritonitis. Sexually transmitted infections (STIs), such as gonorrhea, may likewise cause ascending infection: Neisseria gonorrhoeae can migrate upward along mucosal surfaces, leading to salpingitis and oophoritis.

The above outlines the key symptoms and etiologies of adnexitis. We hope this information proves helpful.