Patient's question:
Before, two days after my period ended, it started again. It has always been light. It wasn't until last weekend that I went for a maternity and child health check-up here. The doctor did an ultrasound for me and said it was appendicitis, but I didn't feel any discomfort in my body, no pain in my stomach, just that my period didn't end. The doctor prescribed me two boxes of medicine: progesterone capsules and amoxicillin capsules. I took them for six days and finished them. But now my period still hasn't ended. Why is this? How long do I need to take this medicine to see improvement? I'm currently thinking about whether I should go to the maternal and child health hospital here in the afternoon to see the doctor. I hope the doctors can tell me.Doctor's answer:
Hello! First of all, I wish you a speedy recovery! Let me talk to you about the issue of "adnexitis." Adnexitis refers to inflammation of the fallopian tubes and ovaries. However, inflammation of the fallopian tubes and ovaries often occurs concurrently with parametritis and pelvic peritonitis, and it can be difficult to distinguish during diagnosis. As a result, parametritis and pelvic peritonitis are also included in the scope of adnexitis. Among pelvic organ inflammation, tubal inflammation is the most common. Due to the close anatomical relationship, tubal inflammation, ovarian inflammation, and pelvic peritonitis often coexist and mutually influence each other. It is often the case that an acute inflammatory process precedes a chronic one, although sometimes the acute phase is not apparent, and chronic conditions are usually detected at the time of discovery.1) Causes of Adnexitis
1. Postpartum or post-abortion, due to weakened immunity, pathogens can ascend through the reproductive tract and spread to the fallopian tubes, ovaries, and the entire pelvic cavity, causing inflammation.
2. With the widespread use of intrauterine devices (IUDs), patients may develop infections if they neglect personal hygiene or if surgical procedures are not performed strictly.
3. Unsterilized intrauterine procedures, such as aspiration, hysterosalpingography, cervical canal treatment, and infections from obstetric surgeries with poor sterilization.
4. Lack of attention to menstrual hygiene, such as sexual intercourse during menstruation or with unclean partners.
5. Untreated infections in other parts of the body can lead to tubal-ovarian inflammation through hematogenous spread, often seen in tuberculosis.
6. Inflammation in nearby pelvic or tubal organs, such as appendicitis, can directly spread to cause tubal-ovarian inflammation and pelvic peritonitis, typically affecting one fallopian tube and ovary.
7. Sexually transmitted diseases, such as gonorrhea, can cause tubal and ovarian inflammation after infection, as the gonococci can ascend along the mucous membranes.
2) Treatment of Adnexitis
1. The key to treating acute adnexitis lies in selecting effective antibiotics, ensuring sufficient dosage and adequate duration—do not stop treatment once symptoms improve, but strive for complete eradication.
2. Chronic adnexitis is more challenging to treat. A combination of Chinese and Western medications, as well as physical therapy, may be effective. Simply using antibiotics is often ineffective; anti-inflammatory and adhesion-resolution drugs, such as intramuscular administration of trypsin, may be necessary. Hormone therapy, herbal medicine for promoting blood circulation, and physical therapy can also be considered.
3) Home Remedies for Adnexitis
Take equal parts of licorice root, fried bupleurum, peony root, and rhubarb. Grind into a fine powder, take 3 grams per dose, mixed with boiling water, three times daily. This formula helps regulate liver Qi and is suitable for chronic adnexitis.
4) Prevention of Adnexitis
The key to prevention lies in maintaining good personal and menstrual hygiene. If inflammation causes significant fallopian tube hydrops or tubal-ovarian cysts, surgical treatment may be necessary. For infertility caused by tubal blockage, tubal reconstruction surgery can be performed. In cases of recurrent acute chronic tubal-ovarian inflammation and pelvic peritonitis, where drug treatment is ineffective and the patient is older, surgical intervention may also be considered. Additionally, due to the stubborn nature of this condition and its tendency to recur, patients often experience significant psychological stress. Therefore, it is essential to maintain confidence, stay in a positive mood, exercise regularly, and strengthen physical fitness to enhance disease resistance.
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