Many women find a disease of the female reproductive organs to be extremely stressful. The complaints are often accompanied by feelings of shame and the fear of infertility. Since pelvic inflammatory disease often takes a chronic course, the visit to the gynecologist should not be postponed even with minor symptoms.
What is pelvic inflammatory disease and who is affected?
Inflammatory diseases can occur in the fallopian tubes and ovaries, which are referred to in technical terms as salpingitis (Salpinx = Greek for trumpet, the form of which the fallopian tubes remind) and oophoritis (Oo = Greek for "egg") Whenever both structures are involved, the gynecologists usually speak of adnexitis (adnexal attachment), ie an inflammation of the appendages of the uterus.
Especially in English-speaking countries, the term PID (pelvic inflammatory disease) often appears. Among them, in addition to the pelvic inflammatory inflammation of the uterus (endometritis) is taken. The reason is that the infection is usually caused by ascending germs, which then attack all the female reproductive organs in the pelvis on their way.
The adnexitis affects predominantly sexually active women of 15-25 years; An estimated 1-2% of women fall ill in this age group. Particularly affected are smokers, women with frequently changing sexual partners, carriers of a spiral and patients who have undergone vaginal flushing or interventions in the area of the lower abdomen (eg scrapings).
How does adnexitis develop?
The cause is an infection, almost always with bacteria. Germs can reach the fallopian tube and ovaries in three ways: ascending from the vagina (ascending), descending from neighboring organs such as the cecum or rectum (descending), or washed up by the blood (hematogenous):
- Ascending Infection: This pathway is by far the most common. In about two-thirds of cases, an infection in the lower genital tract with chlamydiae or gonococci is the underlying cause. As a result of the inflammation, the barriers become more permeable to the cervix of the cervix, for example, and these and other germs can penetrate more easily. They lead to inflammation of the cervical mucosa (endocervicitis), then migrate through the uterus and then the fallopian tubes. The same is true for gynecological interventions or after births - even the natural defense mechanisms can be impaired and thus the way germs are prepared.
- Descending infection: If adjacent organs are inflamed, the pathogens can spread from there: either - for example, if the cecum is tight - by direct contact or through the lymph stream. Rarely, this can also happen during surgery (eg appendix removal).
- Hematogenous infection: This spread of blood is comparatively rare. The result is usually an infection such as tuberculosis, mumps or flu, which can lead to severe general symptoms.