What medications to take for inflammation of the appendages. The most effective suppositories for inflammation in women in gynecology: a review of the best vaginal and rectal suppositories for inflammation of the appendages and other inflammations in women

Treatment of inflammatory diseases should be comprehensive and include:

1. Etiotropic treatment aimed at eliminating the pathogen. For this purpose, antibacterial drugs, sulfonamides are used, and when the specific etiology of the disease is identified, appropriate drugs are used;
2. Increased immune defense;
3. Increasing the body’s overall resistance to infections (using biostimulant drugs);
4. Physiotherapy;
5. In certain cases, in the absence of effect from conservative therapy, surgical treatment is used.

Pharmacotherapy

In the stage of exacerbation of the inflammatory process, complex treatment begins with antibacterial therapy. Antibiotics are used more often. Groups of penicillins, cephalosporins, thienamycins, macrolides, monobactams, chloramphenicol, aminoglycosides, polymyxins, rifamycins and other groups. Drugs in this group are effective against infections caused by gram-positive bacteria (streptococci, staphylococci, pneumococci, etc.), spirochetes and other pathogenic microorganisms. They have a bactericidal effect on microorganisms in the growth phase.

The antibacterial effect is associated with the specific ability of penicillins to inhibit the biosynthesis of the cell wall of microorganisms. This group includes drugs such as: benzylpenicillin sodium salt, phenoxymethylpenicillin, oxacillin sodium salt, methicillin sodium, ampicillin, ampiox sodium, sultamicillin (unasin), amoxicillin, ticarcillin-clavulanic acid (timentin), azlocillin (securopen), carbenicillin (geopen), carfecillin, mezlocillin (baiben), cloxacillin (clobex), flucloxacillin, clonacom-R, piteracillin (psipen, piprax), bacampicillin (penbak), penamecillin (maripen).

The group of cephalosporins includes drugs such as:

• cephalexin,
• cefadroxil,
• cefazolin,
• cefapirin,
• cefuroxine,
• cefradine and others.

Also, drugs from the tetracycline group are used to treat inflammatory processes: tetracycline hydrochloride, doxycycline, monocycline and others. From the group of macrolides, oleandomycin, erythromycin, midecamycin (macropen), clarithromycin (clacid) are used. Complex preparations containing macrolides and tetracyclines are used: oletethrin, tetraolean, ericycline.

From the group of aminoglycosides, gentamicin, monomycin, kanamycin, amikacin, dibekacin, etc. are used. The group of polymexins is represented by the drugs polymexin B and polymexin M. From the group of rifamycins, rifampicin is used.

Sulfonamide drugs are also used to relieve the inflammatory process.

Sulfonamides have chemotherapeutic activity against infections caused by gram-positive and gram-negative bacteria, and some protozoan chlamydia. Their action is associated mainly with the disruption of the formation by microorganisms of growth factors necessary for their development - folic and dihydrofolic acids and other substances, the molecule of which includes para-aminobenzoic acid. Sulfonamides are captured by the microbial cell instead of para-aminobenzoic acid and thereby disrupt the course of metabolic processes in it. From the group of sulfonamide drugs, sulfadimethoxine, sulfalene, biseptol, bactrim, sulfatone, groseptol, etc. are most often used.

Biogenic stimulants include preparations of animal and plant origin that, when introduced into the body, can have a stimulating effect and accelerate regeneration processes. Biostimulants used in medical practice include preparations from plants (aloe extract), animal and human tissue (placenta suspension), as well as from estuary mud (PhiBS) and peat (peat).

Aloe extract liquid for injection- a preparation made from canned, fresh or dried aloe leaves. 1 ml is injected under the skin daily (maximum daily dose 3-4 ml), for a course of 30-50 injections.

FiBS for injections- a biogenic stimulant from distilled estuary mud. 1 ml is injected under the skin once a day, for a course of 30-35 injections.

Peloid distillate- biogenic stimulant - a product of distillation of estuary mud. 1 ml is injected under the skin once a day, for a course of 30-35 injections.

Humisol— solution of sea healing mud fractions 0.01%. Used intramuscularly and by electrophoresis. It is administered intramuscularly, starting with 1 ml daily in the first 2-3 days; if well tolerated, continue administering 2 ml 1 time per day for 20-30 days.

Placenta extract for injection- aqueous extract from cold-preserved human placenta. Inject 1 ml under the skin daily or every other day.

Enzymes- drugs that have a targeted effect on the enzymatic processes of the body. In the treatment of gynecological diseases, enzyme preparations with proteolytic action (trypsin, chymotrypsin) are used. Trypsin is an endogenous enzyme that breaks peptide bonds in a protein molecule. The use of trypsin is based on its ability to break down necrotic tissue and fibrinous formations under local influence, to liquefy viscous secretions, exudates, and blood clots. Crystalline trypsin is administered intramuscularly at 5-10 mg 1-2 times a day for a course of 6-15 injections. Trypsin is also used using electrophoresis. The action of another enzyme preparation is similar to the action of trypsin.

In order to increase specific immune protection, drugs are used that correct immune processes. For this purpose, the following drugs are used: pyrogenal, prodigiosan, levomisol, glyceram.

Pyrogenal is a lipopolysaccharide formed during the life of microorganisms Pseudomonas aeruginosa and others; has a pyrogenic effect.

Vulvitis

Treatment is complex and includes the use of local and general restoratives. Treatment indicated concomitant diseases(diabetes, pustular lesions, helminthiasis, cervicitis, etc.), during which vulvitis often develops. In case of acute vulvitis, two to three times a day, toilet the external genitalia with a warm solution of potassium permanganate (1:10000), warm infusion of chamomile, 2-3% boric acid solution, apply lotions with a solution of furatsilin (1:5000) 3-4 times per day, lubricating the vulva with 5% anesthetic ointment. For vulvitis caused by opportunistic microbes, furazolidone with polymyxin M sulfate in powder is prescribed locally. For subacute cases, sitz baths with potassium permanganate or chamomile infusion 2-3 times a day for 10 minutes are recommended.

Bartholinitis

In the acute stage, conservative pharmacotherapy: antibacterial agents (antibiotics, sulfonamides, nitrofurans, biseptol); analgesics (suppositories with belladonna, antipyrine, cefekop); Regional autohemotherapy 5-7 ml IM every other day. Local therapy: cryotherapy (30-40 minutes each; lotions with Burov’s liquid, lead water, furatsilin 1:5000). If the condition improves, physical therapy (UV rays, UHF, centimeter wave microwaves) is indicated; if there is no improvement (after 2-4 days), thermal procedures (heating pads, Sollux, Minin lamp) in combination with ointment applications (ichthyol, Vishnevsky ointment) are indicated.

Surgical treatment is performed in the presence of a gland abscess. In the chronic stage of the disease, non-drug treatment is carried out in the form of thermal procedures (mud, ozokerite, paraffin); laser therapy.

Colpitis

Pharmacotherapy. Etiotropic treatment is carried out with antibiotics and antibacterial agents after determining the sensitivity of the pathogen to them. The main method of application is local. Antibiotics are used in the form of irrigation with a mixture of penicillin 300,000 units and 5 ml of 0.25% lysozyme solution for 8 days; antibiotics are also used in the form of vaginal suppositories (penicillin or neomycin up to 100,000 units, furazolidone 0.05 g). Furazolidone is used in the form of vaginal sticks in combination with polymyxin M.

For colpitis, the use of locally estrogen-containing drugs is indicated: ointment (folliculin - 500 units, lapolin - 30 g); vaginal suppositories (folliculin - 500 units, boric acid - 0.1 g, cocoa butter - 1.5 g), or 3-5 drops of folliculin solution (1000 units) are instilled into the vagina, the course of treatment is 10-15 days. Local procedures include vaginal irrigation with solutions of potassium permanganate 1:6000, rivanol 0.5-0.1% for no more than 3-4 days. In case of a pronounced process, it is necessary to supplement local treatment with general treatment: it is possible to use Biseptol-480 orally, 2 tablets 2 times a day (morning and yesterday after meals), tetracycline 0.2 g 5 times a day, erythromycin 0.5 g 4 times a day . Biostimulants (aloe, fibs, vitreous, etc.) are also prescribed. For the purpose of immune stimulation - levamisole (Decaris) orally at the rate of 0.0025 g/kg for 3 days.

Non-drug treatment. Physiotherapy is used in the form of general ultraviolet irradiation, electrophoresis with a 1% solution of novocaine or a 10% solution of calcium chloride on the external genital area.

Endocervicitis

In the acute stage of the disease, etiotropic treatment is carried out (antibacterial, taking into account the sensitivity of microorganisms to antibiotics, sulfonamides). In the chronic form, therapy is carried out with immunomodulators (decaris, T-activin, 1 ml 0.01% solution subcutaneously). Local treatment is carried out after acute inflammatory phenomena have subsided: douching or baths with a 1-3% solution of protargol, 1-2% solution of argentum, 3% solution of hydrogen peroxide, vagotil, rivanol, furatsilin 1:5000; vaginal ointment tampons (with antibiotics, nitrofurans, glucocorticoids, antifungal drugs); instillation of emulsions into the endocervix of levosin, course of treatment for 7 days.

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Treatment of inflammatory processes of nonspecific etiology of the upper genital organs

Acute endometritis

Pharmacotherapy includes general and local treatment. General treatment includes antibacterial therapy, immunostimulating and detoxification therapy.

1. Antibacterial therapy uses broad-spectrum antibiotics; It is advisable to simultaneously prescribe a combination of at least 2 antibiotics in maximum doses, taking into account the sensitivity of the microflora. The combinations include semisynthetic penicillins (6.0 g per day), zeporin, kefzol, cefamizin (6.0 g per day), kanamycin (2 g per day), gentamicin (160 mg per day), with the most effective combinations being ceporin and oxacillin, ampicillin and gentamicin, chloramphenicol and limcomycin. Antibiotics are supplemented with sulfonamides (etazol IV in the form of a 10% solution of 10.0 ml every 12 hours), nitrofurans (orally - 0.8 g per day, IV - 0.1% solution of furagin drip 400-800 ml), metronidazole (Klion) IV 100 ml every 8 hours at a rate of 5 ml per minute for 7 days. Tetracycline group drugs are also prescribed at a dose of 0.75 g per day intravenously every 8 hours. To prevent candidiasis, nystatin is prescribed 2 million units per day, levorin 1 million units per day. When treating endometritis, antibiotics are administered in a daily dose into the uterine muscle through the posterior fornix or under the endometrium.
2. The following are used as immunostimulants: timolin - 10 mg IM once a day for 7 days; T-activin - 1 ml of 0.01% solution IM once a day for 5 days; thymogen - 100 mcg intramuscularly for 5-7 days; immunoglobulin - 5 ml IM or IV every other day, 5 doses.
3. Anti-inflammatory therapy includes derivatives of salicylic acid (aspirin), pyrazolone (analgin, butadione), paraaminophenol (paracetamol), indoleacetic (indomethacin, methindol), proteonic (ibuprofen) acids. Prescribed in therapeutic doses, 1 tablet 3 times a day.
4. Detoxification therapy. The total volume of infusion is 1250 ml per day: rheopolyglucin 400 ml, blood plasma, 10% glucose solution 400 ml, Ringer's solution 250 ml. Therapy also includes vitamins and antihistamines. Local treatment includes vacuum aspiration of the uterine cavity, gentle uterine curettage and long-term intrauterine dialysis. Irrigation of the uterine cavity is carried out with solutions of antiseptics and antibiotics (solutions of furatsilin, hydrogen peroxide, dimexide, chlorophyllipt). Physiotherapy - pulsed ultrasound, electrophoresis of copper, zinc, laser therapy, vibration massage.

Chronic endometritis

The main therapeutic factors are physiobalneotherapy. The most commonly used magnetic fields are UHF, centimeter-wave microwaves, pulsed ultrasound, electrophoresis of copper and zinc. Therapeutic mud, ozokerite, paraffin, sulfide and radon waters (baths, irrigation) are effective. Desensitizing therapy is also prescribed - diphenhydramine, suprastin, pipolfen. During menstruation, broad-spectrum antibiotics are indicated.

Salpingo-oophoritis

Acute salpingoophoritis requires complex therapy:

1. antibacterial;
2. detoxification;
3. desensitizing;
4. immunotherapy;
5. enzyme therapy;
6. non-drug treatment.

1. During antibacterial therapy, treatment is carried out simultaneously with two or more antibiotics: a combination of semisynthetic penicillins (ampicillin, oxacillin, methicillin, ampiox) - 3.5 g / day, probenecid - 1 g orally, tetracycline - 0.5 g 4 times per day for 7 days. A combination of cephalosporins is possible - 2.0 g/day, intramuscularly, then tetracycline orally - 0.5 g 4 times a day for 7 days.

The following therapeutic combinations are considered the most effective:

a) doxycycline - 0.1-0.2 g/day orally for 7 days and cephalosporins (cephaloridine) 4.0 g/day. i/m; cephaliuin - 2.0-3.0 g/day. i/m, i/v; claferan - 2.0 g/day. i/m;

b) dalacin C - 300-600 mg IV, IM after 8-12 hours, then 900-1200 mg IV after 12 hours and gentamicin - daily dose 2.4-3.2 mg/kg body weight after 6-8 hours for 6-8 days; Brulamycin - daily dose 2-3 mg/kg body weight IM, IV after 6-8 hours; kanamycin - 1.5-2 g/day. in 8-12 hours.

The main antibiotics used in the treatment of acute salpingoophoritis belong to the group of penicillins, cephalosporins, aminoglycosides, macrolides, tetracyclines, chloramphenicol and antibiotics of different groups. In complex treatment, nitrofurans are also used - 0.3 g/day, metronidazole - 0.5-1.5 g/day; biseptol - 1.92 g/day, dimexide 20% IV solution with 100.0 ml of 5% glucose solution, chlorophyllipt - 0.25% solution - 2-4 ml IV in a stream 2-4 times a day - within 5-10 days.

2. Detoxification therapy includes infusion therapy: hemodez IV drip 100 ml once every 3-4 days, glucose-vitamin solutions - 1000-1500 ml with a complex of vitamins IV drip. The general infusion calculation is 40 ml per 1 kg of body weight.

3. Desensitizing therapy. Antihistamines are used - diphenhydramine, pipolfen, suprastin, tavegil; calcium chloride preparations, gluconate - 3% solution IV drip, 200 ml; autohemotherapy 5-7 ml IM according to the schedule; histaglobulin is administered subcutaneously, 2 ml every 3-4 days.

Glucocorticoids are indicated in the acute, subacute stage - prednisolone - 5 mg / day for 5 days, then according to a scheme of increasing doses for 25 days, then the dose is adequately reduced to the original one.

4. Immunotherapy. Thymalin is used intramuscularly at 10-20 mg for 5-10 days, tactivin - subcutaneously at 1 ml for 5-10 days, thymosin - subcutaneously at 1 mcg/kg body weight for 20-30 days. , thymogen - 100 mcg intramuscularly for 5-7 days, gamma globulin 12-15 ml of 10% solution intramuscularly once every 20 days for 3-4 injections; pyrogenal and prodigiosan are prescribed after the acute process has subsided.

5. Enzyme therapy. Lysozyme is used topically 0.5% emulsion, as well as intramuscularly; Trasylol - IV drip up to 50,000 units per day for 3 days.

6. Non-drug treatment. Cryotherapy - vaginal and external abdominal hypotherampia - up to 2-3.5 hours per day. Hyperbaric oxygenation - pressure 1.5-3 atm. - for 1-1.5 hours a day, course of treatment is 6-7 procedures. Also used are exchange plasmaphoresis, ultraviolet irradiation of blood, extracorporeal hemosorption, laser therapy, reflexology.

If complications of acute salpingoophoritis occur, the formation of saccular formations of the uterine appendages (pyosalpinx, ovarian abscess, tubo-ovarian formations), surgical treatment is indicated for patients.

Chronic salpingoophoritis

Treatment with antibiotics is indicated in cases of exacerbation of the process. Painkillers (paracetamol, indomethacin, etc.) are widely prescribed; sedatives and neurotropic drugs (nozepam, phenazepam); desensitizing agents (diphenhydramine, pipolfen); tonics (eleutherococcus, pantocrine, leuzea); hormonal correction of secondary ovarian hypofunction in accordance with functional diagnostic tests; enzymes (ronidase, lidase, trypsin, chymotrypsin, caripazim).

Physiotherapy uses ultrasound, phonophoresis, medicinal electrophoresis, UHF, microwave, magnetic fields; laser therapy, therapeutic exercises, therapeutic massage and psychotherapy.

Pelvioperitonitis

It is customary to distinguish between general and local therapy for peritonitis. Surgery is the mainstay in the treatment of peritonitis. Treatment of peritonitis is staged and includes preoperative preparation, surgical intervention, and intensive postoperative intervention.

Pharmacotherapy of pelvioperitonitis corresponds to the treatment regimen for acute salpingoophoritis. With timely initiation and proper treatment, it is often possible to avoid surgical intervention.

Parametritis

Treatment of parametritis, as well as pelvioperitonitis, involves complex therapy, including antibacterial therapy, desensitizing, detoxification therapy, symptomatic treatment, and physiotherapeutic treatment. If there is no effect from conservative therapy, surgical treatment is performed.

Treatment of inflammatory processes of the genital organs of specific etiology

Trichomoniasis

Treatment of trichomoniasis should be comprehensive and include specific therapy (antitrichomoniasis drugs) in combination with broad-spectrum antibiotics, immunostimulants, biostimulants, and vitamins. Treatment should be carried out both general and local.

For specific therapy, drugs of the imidazoles group (metronidazole, flagyl, trichopolum) are used according to the scheme.

Scheme No. 1
Day 1 - 1.5 g/day in 3 divided doses every 8 hours; Day 2 - 1.25 g/day in 3 divided doses every 8 hours; 3rd day 1.0 g/day; 4th day - 0.75 g/day; Day 5 - 0.5 g/day in 2 divided doses.

Scheme No. 2
1st day 0.5 g 2 times a day; 2nd day 0.25 g 3 times a day; then 4 days in a row, 0.25 g 2 times a day

Scheme No. 3
0.25 g 2 times a day (0.5 g/day); b) nitazol (alienitrazole, tricholaval) - 0.1 g 3 times a day; c) tinidazole (fasigin, triconidazole) - 2.0 g/day once (4 tablets with meals), or 0.5 g (1 tablet) every 15 minutes for an hour (2 g/day) - for 1 day.

The treatment regimen also includes nitrofurans (furagin 0.1-0.15 g 3 times a day, furadonin 0.1-0.15 g 4 times a day - 7 days), antibiotics (tetracycline 0.3 g 5 times a day , then 0.2 g 5 times a day - up to a course dose of 10.0 g, lithacycline 0.3 g 2-3 times a day, doxycycline - 0.3 g first dose, then 0.1 g 4 times a day ).

Locally prescribed: trichopolum 0.5 g/day (in tablets, suppositories), clotrimazole (1 vaginal suppository per day - 6 days), Klion-D (vaginal tablets: 500 mg metronidazole and 150 mg miconazole - 1 tablet in the vagina - 10 days), nitazol (in suppositories, suspensions - 15 days), irrigation with antibiotic solutions (gramicidin); pimafucin (1 tablet in the vagina - 20 days), powders from drugs of the nitrofuran group.

Immunotherapy includes drugs - pyrogenal, autohemotherapy, T-activin, thymalin. Biostimulants and vitamin therapy are carried out according to the generally accepted scheme.

Gonorrhea

Treatment of gonorrhea begins with antibacterial therapy - broad-spectrum antibiotics are used: benzylpenicillin - intramuscularly at 60,000 - 400,000 units every 3 hours (per course - 4.2-6.8 million units), bicillin 1, 3, 5 - intravenously /m 600,000 units after 24 hours (per course - 3.6 million units), ampicillin 0.5 g intramuscularly after 4 hours (per course - 8.0 g), ampiox - intramuscularly - 2.0 g/ day (course 15.0-21.0 g), oxacillin - orally 0.5 g 5 times a day (course - 10.0 - 14.0), caffecillin - orally 0.5 g 3 times a day ( course 5.0-8.0 g), chloramphenicol - orally 0.5 g 4 times a day (course 6.0-10.0 g), tetracycline - orally 0.3 g 5 times a day (course 5 .0-10.0 g), doxycycline - orally 0.1 g 2 times a day (course 1.0-1.5 g), rifampicin - orally 0.3-0.6 g 1-2 times a day day (course 1.5 g-6.0 g). Sulfonamides - biseptol 2 tablets 2 times (course 16-20 tablets), sulfatone - 2 tablets 2 times a day (course - 4.2 g - 7.0 g).

Immunotherapy

There are specific and nonspecific immunotherapy for gonorrhea. Specific immunotherapy involves the use of gonovaccine. The initial dose IM is 200-400 million microbial bodies after 1-2 days, then the dose is increased by 150-300 million and brought to 2 billion microbial bodies (6-8 injections). Nonspecific immunotherapy - pyrogenal (initial dose 25-50 MTD IM, increase by 25-50-100 MTD to the maximum dose (not higher than 1000 MTD) depending on the body's response, course - 10-15 injections; prodigiosan, autohemotherapy, levamisole , methyluracil.

To accelerate the regression of inflammatory infiltrates in the affected organs, biostimulants are prescribed, the course of treatment is from 15 to 25-30 days.

Candidiasis

Treatment of patients with genital candidiasis is carried out with antifungal antibiotics and synthetic drugs: amphotericin B - 50,000 units intravenously in 500.0 ml of 5% glucose solution - daily, course - 4-8 weeks (with breaks), total dose - 1.5 - 2 million units; amphoglucamine (in tablets) - 200,000 units 2 times a day for 10-14 days; mycoheptin - orally, 200,000-250,000 units 2 times a day, for 10-14 days; nystatin - orally, 500,000 units up to 1,000,000 units, per day up to 6,000,000-8,000,000 units, course - 14 days; levorin - 400,000 units orally 2-3 times a day for 10-12 days.

Vaginal suppositories of clotrimazole, polygynax, pimafucin, vaginal tablets of terzhinan, Klion-D, vaginal cream of batrafen are used locally. For prophylactic purposes, use nizoral at a dose of 200 mg/day for a long time (2-5 months).

Non-drug therapy includes physical therapy (ultrasound, diathermy, microwave, UHF, microwaves), balneotherapy, exercise therapy, and sanatorium-resort treatment.

Mycoplasmosis (ureaplasmosis)

Treatment begins with antibiotics active against mycoplasmas: doxycycline (vibramycin) - 100 mg 2 times a day for 10 days; course - 20 g; erythromycin - 500 mg 4 times a day for 14 days; tetracycline - 0.5 g 4 times a day for 1-2 weeks, course - up to 27.0 g. Gentamicin is administered intramuscularly at 40 mg every 8 hours for 5-7 days, course 600-840 mg.

In a hospital setting, you can use intravenous morphocycline with 5% glucose solution. Ointment tampons with 1-3% tetracycline ointment, 1% erythromycin ointment, vaginal tablets, cream, clotrimazole suppositories, Klion-D are indicated locally.

Of the non-drug treatments, the most indicated are physiotherapy - inductotherapy, UHF, electrophoresis, ultrasound, phonophoresis through tetracycline, erythromycin ointment, low-frequency pulsed currents, ozokerite, paraffin.

Tuberculosis of female genital organs

Treatment includes specific and nonspecific therapy.

Specific treatment involves the use of etiotropic chemotherapy, which has a bacteriostatic effect on mycobacteria. These are first-line drugs - derivatives of GINK: tubazid (single dose 0.3-0.6 g, daily 0.6-0.9 g), ftivazid (single dose 0.5-1.0 g, daily 1.0- 2.0 g), saluzide (single dose 0.5-1.5 g, daily dose -2.0 g), PAX - (single dose 4.0-5.0 g, daily dose 9.0-15.0) ;

Second-line drugs: ethionamide (single dose 0.25-0.5 g, daily dose 0.75-1.0 g); tibon, thioacetazone (single dose 0.03-0.005 g, daily dose - 0.06-0.1 g).

The most effective combinations of chemotherapy drugs are: GINK + kanamycin + PAS (Tibon - for intolerance); GINK+PASK; GINK + rifampicin + ethambutol; GINK + rifampicin + PAS; ethambutol + rifampicin, etc. In case of significant changes in the appendages, treatment is carried out with a triple combination of drugs (isoniazid, benemecin, ethambutol). Duration of treatment is 12-18 months.

Nonspecific therapy includes enzyme therapy (lidase 64 units intramuscularly for 30-40 days, or use suppositories with ronidase). Among the antioxidants, use a 30% solution of alpha-tocopherol acetate - 1 ml IM daily, course of 50-60 injections; 30% sodium thiosulfate solution - 10 ml IV every 1-2 days (course of 40-50 injections). Hydrotubation is carried out with a solution containing 30% sodium thiosulfate solution - 10 ml, lidase - 64 units, penicillin 1 million units, novocaine 0.25% solution.

Non-drug treatment includes physiotherapy. SMT electrophoresis, phonophoresis with hydrocortisone, mud therapy, balneotherapy.

If there is no effect from conservative therapy and there are indications, surgical treatment is performed.

Inflammation of the appendages in women in medical practice is designated by the term (adnexitis or salpingoophoritis). These names hide an infectious and inflammatory process that affects the fallopian tubes and ovaries, but does not affect the uterus itself. Adnexitis occupies a leading position among gynecological diseases and is diagnosed in women at any age.

The inflammatory process develops under the influence of many provoking factors (internal and external), can occur in acute or chronic form, and be unilateral or bilateral.

The causative agents of infection during adnexitis enter the body in different ways, and the symptoms are often vague or completely absent, so a woman may not be aware of the problem for a long time. However, the latent course of the disease is dangerous because it leads to severe complications that end in infertility.

Inflammation of the appendages in women - the main causes

The cause of inflammation of the appendages in women is pathogenic and opportunistic microflora, which penetrates the appendages in different ways:

• by circulatory and lymphatic;
• from other organs affected by the inflammatory process (appendix, sigmoid colon);
• from the vagina and uterus.

That is, the penetration of pathogenic microorganisms (bacteria and viruses) into the fallopian tubes and ovaries occurs in a descending or ascending manner from nearby organs. The most severe and aggressive course of inflammation is observed when affected by gonococci, chlamydia, mycoplasmas or trichomonas, that is, pathogenic microorganisms that cause sexually transmitted infections.

Accordingly, in this case, the disease is caused by unprotected sexual contacts and. In addition, pathogenic and conditionally pathogenic microorganisms (staphylococci, streptococci, enterococci), viruses, fungi, tuberculosis and E. coli can become the causative agent of the disease.

But this is not the only cause of adnexitis; in fact, there are many provoking factors that cause inflammation of the ovaries and fallopian tubes. The most common of them:

• violation of personal hygiene standards;
• gynecological manipulations (insertion or removal of the IUD, abortion);
• diagnostic procedures in gynecology, which are accompanied by damage to the mucous membranes and contribute to the penetration of infection into the body;
• pregnancy, difficult childbirth;
• exacerbation of chronic infections (tuberculosis, pyelonephritis, tonsillitis);
• surgery to remove the inflamed appendix;
• decreased immunity due to chronic diseases ( diabetes mellitus, HIV infection, endocrine pathologies);
• hormonal imbalances;
• vaginal dysbiosis, accompanied by increased proliferation of pathogens;
• hypothermia of the body;
• severe nervous shock, regular stress

All of the above factors contribute to a decrease in the body’s defenses and trigger the development of an inflammatory process that affects the appendages.

Features of female anatomy

The appendages in women are an important part of the reproductive system. The fallopian tubes and ovaries are connected functionally and anatomically, so the inflammatory process that develops in one organ necessarily spreads to the other.

The ovaries are a paired gland that performs female body special functions. They form eggs that are ready for fertilization, and synthesize female sex hormones (estrogen and progesterone), which are responsible for the appearance and reproductive functions of a woman.

It is the ovaries that give a woman the opportunity to have offspring and maintain reproductive function. Their shape and size depend on the woman’s age, and the full functioning of this organ begins upon completion of puberty and ends with the onset of menopause.

The fallopian tubes are also a paired female organ that connects the uterus and ovaries, and is also responsible for promoting the fertilized egg into the uterine cavity for the further development of pregnancy. The mucous membrane of the tube is strong and elastic, it is assembled into numerous folds, lined from the inside with a layer of ciliated epithelium. Thanks to the wave-like movements of the epithelium and muscle contractions of the walls of the fallopian tube, the fertilized cell moves and ultimately reaches the uterine cavity.

The appendages of a healthy woman are sterile, but when pathogenic microorganisms penetrate them, an inflammatory process begins, which causes characteristic symptoms adnexitis.

Symptoms of inflammation of the appendages

Signs of adnexitis are often confused with others inflammatory diseases pelvic organs, since their manifestations are similar.

In the acute form of inflammation of the appendages, the following symptoms appear:

• pain in the lower abdomen of varying intensity - from pulling, aching, to sharp and unbearable, radiating to the perineum and leg;
• pain intensifies with physical activity, urination, defecation;
• there is a deterioration in the general condition and the appearance of signs of intoxication of the body (high temperature, chills, nausea, vomiting, weakness);
• pain during sexual intercourse, which leads to a decrease or complete absence of sexual desire;
• the appearance of copious vaginal discharge (serous, purulent), accompanied by irritation and itching of the genitals.

These specific symptoms are accompanied by general malaise, weakness, dysfunction of the digestive and urinary systems (dyspeptic disorders, pain when urinating). Sometimes, against the background of acute inflammation of the appendages, signs of pyelonephritis or cystitis appear. Severe inflammation occurs most clearly if the causative agent of the infection is gonococcus; with chlamydia, the symptoms of adnexitis are erased.

In the absence of timely and adequate treatment, the inflammatory process quickly becomes chronic and manifests itself with the following symptoms:

• violations menstrual cycle accompanied by delayed menstruation or sudden bleeding;
• dull, aching pain radiating to the lower back and perineum, intensifying at night and during menstruation;
• the nature of the pain is constant, exhausting;
• vaginal discharge (not as abundant as with acute adnexitis);
• low-grade fever (37-37.5°C);
• painful sensations during sexual intercourse;
• weakness, increased irritability.

In the chronic form of the disease, the symptoms of inflammation are erased and slightly expressed, but when any provoking factor appears (stress, hypothermia), the disease worsens again and returns in relapses. Most often, exacerbations of adnexitis occur in spring and autumn.

The danger of chronic inflammation of the appendages is that, occurring without pronounced symptoms, the pathological process continues to destroy the reproductive organs and leads to the development of severe complications.

Consequences of chronic adnexitis

After suffering inflammation, a woman often develops adhesions in the fallopian tubes. And this increases the risk of developing an ectopic pregnancy by 5-10 times, since the fertilized egg cannot pass through the narrowed lumen and begins to develop inside the fallopian tube.

When ovarian tissue is damaged, the process of egg formation is disrupted and the woman is diagnosed with ovarian infertility. In the case when inflammation “glues” the fallopian tubes and makes it impossible for the egg to pass into the uterine cavity, they speak of tubal infertility.

Acute infectious inflammation of the appendages can result in a purulent abscess, leading to melting of the tubes and ovaries. This condition requires surgery and removal of the affected organs.

Diagnostics

The gynecologist will make a preliminary diagnosis after interviewing the patient, clarifying complaints and on the basis of a bimanual examination, which is carried out simultaneously through the vagina and the anterior abdominal wall. Wherein Special attention is given to painful points, enlargement of the fallopian tubes and uterus in size.

Ultrasound and laboratory diagnostics help confirm the diagnosis and differentiate it from other pathologies with similar symptoms. Ultrasound of the pelvic organs can detect foci of inflammation and possible purulent abscesses in the pelvis, enlargement of the ovaries and fallopian tubes, indicating an inflammatory lesion. If necessary, the patient will be additionally referred to a CT or MRI.

In the laboratory, a vaginal smear is examined, and blood and urine tests are done. If pathogens of sexually transmitted diseases are sown in the microflora of secretions taken from the vagina, the woman is recommended to undergo treatment together with her sexual partner.

How to treat inflammation of the appendages in women?

Photo: Powder for preparing Amoxiclav suspension

Acute forms of adnexitis and severe exacerbations of the chronic form of the disease are treated in a hospital setting. Sluggish forms of chronic inflammation are an indication for outpatient treatment, which involves strict adherence to all medical recommendations and taking prescribed medications at home.

In acute inflammatory processes, the main method of treatment is a course of antibacterial therapy. Since the development of adnexitis can be provoked by different groups of pathogenic microorganisms, it is important to select a drug that is active against the exact pathogen that caused the disease. The following antibiotics are most often prescribed for inflammation of the appendages in women:

1. macrolide drugs (Erythromycin);
2. inhibitor-protected penicillins ();
3. 3rd generation cephalosporins (Ceftriaxone, Cefazolin);
4. nitromidazole derivatives (Metronidazole);
5. tetracyclines (Doxycycline)
6. nitrofurans and sulfonamides.

If the causative agent of the infection is pathogenic fungi, the treatment regimen includes antifungal drugs (Nystatin, Diflucan). If adnexitis is provoked by the introduction of a viral agent, antiviral agents are used.

Antibacterial therapy is supplemented by the use of analgesics and antispasmodics (their action is aimed at eliminating pain), antihistamines (reducing itching, irritation, and inflammatory manifestations). In order to accelerate tissue regeneration, biogenic agents are used - Plazmol, Humisol, and vitamin complexes are prescribed to strengthen the immune system. If dysbiosis or vaginal candidiasis develops as a result of antibacterial therapy, dental and probiotics are included in the treatment regimen.

When treating a chronic inflammatory process, the names of drugs, their dosage and duration of treatment are determined by the doctor, taking into account the individual characteristics of the patient and possible contraindications. Treatment must be completed without interrupting medication even with a visible improvement in the condition, otherwise the disease may return in relapses.

Local therapies

Local therapy involves the use of douching with antiseptic agents (Chlorhexidine, Miramistin), the use of ointments, gels or vaginal suppositories with an anti-inflammatory effect.

• Movalis and Longidaza suppositories have a pronounced therapeutic effect.
• During treatment, the doctor may prescribe vaginal suppositories with NSAIDs based on diclofenac, indomethacin.
• Suppositories with absorbable action based on terrilitin are prescribed to liquefy blood clots and break down necrotic tissue.
• Rectal suppositories based on interferons () can be used as immunomodulatory therapy.

Physiotherapy

The use of physiotherapy methods gives a good effect in the treatment of inflamed appendages. Sessions of ultraviolet irradiation, laser treatment or UHF can be prescribed only during the period of remission of the disease, but electrophoresis with medicines, ultrasound and magnetic therapy can be used in the subacute period to speed up recovery.

For chronic adnexitis during the period of remission, sanatorium and resort treatment is indicated, including healing mud, paraffin therapy, and medicinal baths.

In advanced cases, accompanied by the appearance of a purulent abscess in the fallopian tubes, surgical intervention is necessary. Today, minimally invasive techniques have the advantage. For example, with laparoscopy, the likelihood of postoperative complications is reduced to a minimum, and recovery occurs in a short time.

In the case when adnexitis is complicated by the formation of multiple adhesions, purulent abscesses and threatens the development of peritonitis, they resort to classical surgery.

Treatment of inflammation of the appendages with folk remedies

Inflammation of the appendages in women can be treated with traditional medicine. But it should be understood that such methods are only a complement to the main therapy and cannot replace drug treatment.

In case of acute inflammatory process, use folk remedies is unacceptable; treatment with herbs and heating is possible only for chronic adnexitis in order to prolong remission.

Dry heating

For the procedure you will need 3 kg of table salt and hops.

1. First, you need to heat the salt in a dry frying pan and pour it into a thick canvas bag.
2. Then prepare the hops. The plant material must be moistened and placed in this form in a second canvas bag, distributed inside it in a layer 3 cm thick.
3. After this, the woman should lie down on a bag of warm salt, positioning herself in such a way as to warm the lower abdomen and the area of ​​​​the inflamed appendages.
4. At the same time, the second bag of hops should be placed on the lumbar region, and covered with a warm blanket on top.
5. Warming up should be continued until the salt has cooled completely.

The procedures are done every evening before bed for a week. If necessary, the course of warming up can be repeated after a three-day break.

Warming up with wormwood

Wormwood has pronounced antiseptic and anti-inflammatory properties, therefore folk medicine This herb has long been used to treat inflammatory processes. In our case, to warm up the appendages, you need to pour water into a large metal bucket, boil it and put the dry wormwood into it.

After this, the woman should sit over the bucket, having first checked the temperature of the rising healing steam so as not to get burned. The warming up procedure should last at least 20 minutes. If you repeat it for a week, the symptoms of inflammation will go away and your overall health will improve.

Decoction

This anti-inflammatory drug is intended for oral administration. It is prepared from equal quantities of peony, buckthorn and Chernobyl roots (4 tbsp each), burnet root and elecampane (3 tbsp each). This collection is poured into a canvas bag; to prepare a decoction, 2 tbsp is taken from it. l. dry raw materials, pour 500 ml of boiling water and leave for 30 minutes. I drink the decoction warm, adding a little natural flower honey to improve the taste.

In addition, at home you can do douching using a decoction of chamomile, St. John's wort, calendula, oak bark, sage and other herbs with antiseptic and anti-inflammatory effects.

Before using folk remedies, be sure to consult with your doctor and do the procedures only in the absence of exacerbation.

Inflammation of the appendages in women is an infectious pathology, and the process affects the ovaries or fallopian tubes, but not the uterus itself. Penetration of the infectious agent into the body occurs in various ways.

The disease can proceed without symptoms for a long time, sometimes characterized by the appearance of pain in the lower abdomen and menstrual irregularities. Treatment is aimed at destroying the pathogen and restoring the function of the uterine appendages.

Causes

Why do women experience inflammation of the appendages, and what is it? In medicine, this disease is called salpingoophoritis. If the inflammation affects only the fallopian tubes, then salpingitis is diagnosed. An inflammatory process that affects only the ovaries is called oophoritis.

The development of the inflammatory process in the uterine appendages occurs under the influence of pathogenic and conditionally pathogenic microorganisms. There are two types of disease:

• specific adnexitis caused by diphtheria bacteria, tuberculosis bacillus, gonococci;
• nonspecific salpingoophoritis, caused by viruses, fungi, E. coli, streptococci, staphylococci, mycoplasmas, chlamydia and other microorganisms.

Penetration of infection into the uterine appendages can occur in the following ways:

• ascending (pathogenic microbes from the vagina penetrate the uterus, bypassing the cervical canal, into the tubes, and then can enter the ovaries);
• descending (there is already inflammation in the abdominal cavity, which gradually spreads to healthy tissue);
• hematogenous (microbes enter the fallopian tubes and ovaries with blood from other internal organs).

The likelihood of inflammation of the appendages increases with the action of provoking factors on the body:

• hypothermia;
• weakened immunity;
• using a contraceptive method such as an intrauterine device;
• unprotected sex;
• childbirth or abortion.

can occur in three forms:

• acute;
• chronic;
• latent (asymptomatic, or sluggish).

The disease can be diagnosed at any age. Both young girls who are not sexually active and older women who have reached menopause turn to doctors for help.

Symptoms of inflammation of the appendages

In the case of inflammation of the appendages in women, the presence of certain symptoms depends on certain factors:

• pathogenicity of the ingested microorganism, its type;
• on the course of the disease, whether it is an acute process, with pronounced symptoms, or chronic, with erased, barely noticeable symptoms;
• the girl’s body’s ability to resist microorganisms and fight the inflammatory process, from the state of the immune system.

In acute form women complain of the following symptoms:

• tense abdomen in the lower regions;
• , sometimes radiating to the legs or lower back;
• increased body temperature (it can reach 39 degrees);
• changes in the menstrual cycle (sudden bleeding or delayed menstruation);
• vaginal discharge that is different from normal (it may be greenish-purulent or yellowish, thick or foamy).

An incompletely cured disease in the acute period can develop into chronic inflammation of the appendages, the symptoms of which depend on the period of remission or exacerbation. Every second woman with chronic adnexitis experiences the following pathological changes:

• menstrual irregularities;
• sexual function disorder;
• concomitant diseases of the urinary organs (,), etc.

During the period of exacerbation, all symptoms characteristic of acute adnexitis resume.

Chronic adnexitis

Chronic adnexitis develops as a result of untimely or poor-quality treatment of the acute form of the disease; it occurs with periodic seasonal exacerbations. This form of inflammation of the appendages is characterized by the presence of dull, aching pain in the lower abdomen, radiating to the vagina and lumbar region. Palpation of the abdomen determines moderate pain.

Due to structural and functional transformations in the ovaries (lack of ovulation, hypoestrogenism), chronic inflammation of the appendages in women is accompanied by menstrual irregularities, which are manifested by oligomenorrhea (scanty periods), polymenorrhea (heavy periods), algomenorrhea (painful periods). Patients may also complain of a lack or decrease in sexual desire, pain during intercourse.

Diagnostics

The above symptoms may also be present in other diseases of the genital organs, so only a gynecologist can make an accurate diagnosis after examining the patient, collecting anamnesis, and the results of laboratory and instrumental studies:

• Ultrasound of the uterus and appendages;
• PCR diagnostics (vaginal smear), which allows you to identify sexually transmitted infections;
• colposcopy (examination of the vagina and its walls);
• bacterial sowing;
• tomography;
• laparoscopy.

Signs of inflammation of the appendages can be determined by the results of a blood test. During inflammatory processes, the blood formula changes significantly. In addition, during a gynecological examination at an appointment with a gynecologist, a woman feels severe pain in the ovaries and uterus.

Consequences

Any inflammation of the appendages is dangerous because the following complications are possible:

• development into a chronic form;
• infertility as a result of the adhesive process, which causes obstruction of the fallopian tubes and anovulation;
• quite high risk of ectopic conception;
• purulent complication (tubo-ovarian formation) - purulent melting of the ovaries and tubes, followed by an abscess.

Prevention

1. Visit a gynecologist regularly, do not resist an examination in the chair, and take smears.
2. Avoid hypothermia by dressing appropriately for the weather, changing clothes after swimming, and avoiding sitting on cold objects.
3. If termination of pregnancy is necessary, do it early or with the help of medications, or a mini-abortion (avoid curettage).
4. Cure teeth, intestines and other foci of chronic infection.
5. Use barrier methods of contraception.
6. Treat gynecological diseases in a timely manner.
7. Follow the rules of healthy eating.
8. Follow the rules of intimate hygiene.
9. Avoid douching.
10. Avoid stress.

Thus, inflammation of the appendages is a serious disease that requires timely treatment, which involves strict compliance with medical instructions.

Treatment of inflammation of the appendages

When diagnosing inflammation of the appendages, treatment in women should be comprehensive: a combination of medications with physiotherapy, gynecological massage, osteopathy, and physiotherapy.

The main point in the treatment of inflammation is antibiotics. They are selected with a wide spectrum of action and maximum half-life. In addition, the woman herself needs to monitor her lifestyle ( proper nutrition, abstinence from sexual activity, physical education, you should give up smoking and alcohol).

The disease cannot be neglected, since the inflammatory process soon becomes chronic, which leads to infertility.

Antibiotics for inflammation of the appendages

Antibiotics for inflammation of the appendages are the first and main condition that must be met for a favorable outcome of the disease. How to treat inflammation of the appendages, the dosage and number of doses for each individual woman is determined by a specialist, but we will give you the most commonly prescribed pairs of medications:

1. Nitroimidazole derivatives (for example, Metronidazole) to eliminate anaerobic flora that can live in an oxygen-free environment, such as gonococci (the causative agents of gonorrhea);
2. Inhibitor-protected penicillins (Amoxiclav), 3rd generation cephalosporins (Ceftriaxone), macrolides (Erythromycin), etc., which affect aerobic (living in an oxygen environment) flora;
3. Antifungal drugs (eg, Diflucan, Nystatin).

For the first three to four days until the condition normalizes, all these drugs are administered by injection. Then you can switch to tablet forms and reduce the dose.

Concomitant treatment

In addition to the prescription of antibacterial drugs, detoxification therapy is carried out (intravenous infusions of saline solutions, glucose, hemodez, rheopolyglucin and others in a volume of 2 - 3 liters).

Relief of pain and reduction of the inflammatory process is carried out using tablets. These are Diclofenac, Ibuprofen, Ketarol and other drugs. Be sure to prescribe vitamins C and B, as well as allergy pills.

When relieving an acute process and in the treatment of chronic inflammation of the appendages outside of exacerbation, physiotherapy is widely used: copper and zinc electrophoresis according to the phases of the menstrual cycle, electrophoresis with lidase or iodine, ultrasound, high-frequency pulsed currents (CMT, DDT). Also used in rehabilitation treatment are immunomodulators, autohemotherapy, injections of aloe, FIBS, Longidase, etc. For chronic adnexitis, sanatorium-resort treatment is indicated - mud, paraffin, medicinal baths and douching.

Suppositories for inflammation of the appendages

To reduce signs such as inflammation, pain, swelling, and temperature, special suppositories are used that can relieve inflammation. They can also prescribe suppositories that can strengthen the immune system, and this is very important for any illness. Also, such drugs cleanse the body of harmful substances.

All suppositories are prescribed by a doctor, but in any case such treatment will be additional.

Folk remedies

At home you can use some folk recipes:

1. Take 4 teaspoons finely chopped buckthorn, Chernobyl and peony roots, add 3 teaspoons of burnet and elecampane roots. After this, pour 2 tablespoons of the resulting mixture with half a liter of boiling water. Boil for half an hour over low heat, and then let cool for half an hour. Afterwards, strain and you can add a little honey for taste. You should take the product half a glass 3-4 times a day.
2. One tablespoon chopped dry boron uterus grass pour a glass of boiling water. Leave for 2 hours. Strain. Take 1/3 cup 3 times a day half an hour before meals. The course of treatment is 1 month. After a month's course of treating adnexitis with boron uterus, it is advisable to drink another infusion for 2 months - from the grass of the field grass. 1 tbsp. l. pour a glass of boiling water over the herbs, leave for 4 hours, strain. Drink 1 tsp. 30 minutes before meals 4 times a day.
3. Buldenezh should be collected at the very beginning of flowering (until insects infest them). A tincture of them has excellent antiseptic, anti-inflammatory and analgesic properties. Liter jar filled with balls-inflorescences, poured with vodka and sent for 15 days in a dark, cool place. This tincture is rubbed on the lower abdomen, and the inflorescences are applied in the form of compresses.
4. Take flowers of coltsfoot, sweet clover, centaury in equal proportions. Mix, after crushing, pour boiling water, let it brew for an hour, then strain the broth through cheesecloth and drink half a glass twice a day. During treatment, abstinence from sexual intercourse is recommended.

Remember that folk remedies are only a supplement and cannot in any way replace drug therapy prescribed by a specialist.

In female representatives, inflammatory processes affecting the appendages and ovaries are most often provoked by infectious pathogens and, for the most part, require the use of antimicrobial drugs as treatment. Inflammation usually begins to develop due to decreased resistance of the body under the influence of hypothermia or due to the penetration of bacteria, fungi and viruses into the ovaries.

For inflammation of the appendages in women, after establishing an accurate diagnosis, antibiotics must be immediately introduced into the drug regimen. Even if at this moment there are studies that determine the type of pathogen, the initial stages of therapy can be carried out without clarification. It must be remembered that antibacterial pharmaceutical drugs will have a positive effect only in the case of an acute form of ongoing inflammation. In some cases, antimicrobial drugs can be used in cases of exacerbation of the chronic form of the disease.

Features of adnexitis

Inflammatory processes occurring in the appendages are primarily dangerous due to possible subsequent complications:

• inability to get pregnant;
• suppurative processes that form in the ovary and affect the peritoneum;
• against the background of suppuration, pelvioperitonitis is formed, which can only be eliminated through surgery.

The presence of an acute form of adnexitis or oophoritis can be assumed when pain appears in the lumbar region or lower abdomen. Pain may occur when visiting the toilet, and the discomfort is accompanied by general weakness and increased temperature. A woman who experiences such signs needs an immediate examination, a vaginal smear to conduct a bacterial culture and determine the nature of the microflora. This approach will allow you to most accurately select tablets and other forms of drugs for therapy.

On initial stages While the research results are unknown, injections of drugs with a wide range of effects can be used to relieve the inflammatory process of the ovaries. Their advantage lies in the ability to destroy not just one, but simultaneously many types of bacteria that provoke pathologies of the genitourinary system. The main rule is that the selected drugs must be active against chlamydia, mycoplasma, and ureaplasma - these are the organisms that most often cause the development of diseases.

Important point. The next stage after receiving the results of laboratory tests is a possible adjustment of the therapeutic regimen if it is determined that another drug would be the best option to eliminate the pathogen.

When choosing antibiotics for inflammation of the appendages, you need to follow some rules. There are certain principles of treatment using antimicrobial drugs:

• To avoid adverse side effects and polypharmacy as much as possible, the established diagnosis is verified by PCR and ELISA.
• When determining the dose of medications for inflammation of the ovaries and appendages, the patient’s body weight is taken into account.
• When selecting antibiotics, preference should be given to antimicrobial substances that can remain in the blood for a long period. If the drug is cleared from the plasma too quickly, the required concentration cannot be achieved active substance, which gives pathogens a certain head start.
• The therapeutic regimens being developed should not harm the patient’s health; therefore, before treating ovarian inflammation and determining how to do it, bacteriological studies are carried out.
• In case of complications, it is recommended to combine antibiotics, selecting agents with different mechanisms of action on the pathogen and different periods for removing the infection from the body.
• After stopping the pathological process, one cannot ignore prophylaxis aimed at preventing the formation of adhesions and restoring intestinal motility. You should also check the integrity of the endocrine system after treatment.
• The progress of treatment is monitored through tests, which helps prevent failure of the liver.
• If inflammation of the appendages is advanced, it is advisable to prescribe injections and take drugs with a more powerful effect. These include the group of Cephalosporins, Lincomycin or Fluoroquinolone.

If within several days of treatment the victim’s condition does not change for the better, there is no progress in both symptoms and test results, it is necessary to either change medicine, or increase the dosage.

Read also on the topic

Modern suppositories for the treatment of adnexitis

Antibiotics for inflammation

Drugs for the treatment of inflammatory processes in the appendages must meet a number of requirements. They are expected to be highly effective against pathogens that cause pathology, easy penetration into the site of the disease, the least possible toxicity and a good level of interaction with prescribed anti-inflammatory substances. Treatment is usually complex, carried out with a combination of antibiotics and NSAIDs - non-steroidal anti-inflammatory drugs. Prescription of NSAIDs is necessary to prevent damage from developing inflammation.

Regarding antibiotics, the following medications are usually prescribed:

• Tetracyclines, despite the fact that most of the pathogens present during inflammatory processes in the appendages, have become quite resistant to this group of drugs over time. It should also be noted that tetracyclines have a considerable list of side effects. At the same time, tetracyclines well eliminate the possibility of the pathogen to actively reproduce and are effective against gonococci, streptococci and staphylococci, mycoplasmas, spirochetes, chlamydia and others. Experts prefer to use Doxycycline, which is highly effective with few negative side effects. It quickly leaves the body and is effective not only for adnexitis, but also for chlamydia.
• If you make a list of the most effective medications for adnexitis, macrolides will be next on the list. This group of antibiotics is not subject to breakdown in gastrointestinal tract, the drugs have a long half-life, which ensures their accumulation in the body and accelerates recovery. The most popular products are Sumamed with Klacid.
• In gynecology, the fluoroquinolone group is good because resistance in pathogens to such drugs develops very slowly, so even with long-term treatment, frequent changes of antibiotics are not required. If the patient does not have concomitant pathologies for which the use of fluoroquinolones is prohibited, such drugs are best used for adnexitis. Pefloxacin, Norfloxacin or Ofloxacin may be prescribed.
• Other synthetic antibacterial agents that have a wide spectrum of action and are good at destroying aerobes include Metronidazole and Tinidazole from the group of nitroimidazoles.
• Additional prescribed uterine drugs for inflammation of the uterus and ovaries include Erythromycin, which is good at destroying mycoplasmas and chlamydia.
• In case of severe complicated inflammation of the appendages, experts prescribe a group of Aminoglycosides, which are also relevant in the event of the pathology spreading to other organs. There are four generations of such antibiotics. The first includes Streptomycin and Neomycin, the second - Gentamicin. The third generation is represented by Amikacin, Sizomycin, Tobramycin, and the fourth generation includes Izepamycin.
• A substitute for all the above names of antibiotics against inflammatory processes in the appendages is the group of Cephalosporins. Depending on the activity, drugs are divided into four generations. The first generation of narrow spectrum includes Cephalexin and Cefazolin, the second generation includes Cefaclor or Cefuroxime. The third generation consists of broad-spectrum drugs Cefixime, Ceftibuten, Ceftazidime. The fourth generation includes Cefpirome and Cefepime.

Important nuance . For inflammation of the appendages, drugs will help better if they are administered by injection - intravenously or intramuscularly. When the therapy begins to demonstrate a positive result, the specialist prescribes tablets or suspensions, and vaginal suppositories can also be used.

Suppositories for inflammation of the ovaries

Antibiotics for ovarian inflammation can be in the form of vaginal suppositories, and this practice is widespread in the field of gynecology. Conventionally, suppositories are divided into two groups - those that inhibit the activity of bacteria, viruses and fungi, and those that act anti-inflammatory and soothing. Let's look at which antibiotic suppositories of the first group are used most often and summarize the names in a table:

Name of suppositories	Active substance	a brief description of	Peculiarities
Hexicon	Chlorhexedine	Suppositories are used to treat inflammation of the ovaries in women, their use is contraindicated at the age of less than 12 years; when carrying a child, strict monitoring is required and prescribed only when absolutely necessary	Suppositories are administered in the morning and evening, the duration of treatment is seven days. Possible side effects include itching and allergic reactions.
Depantol	Chlorhexedine	It is prescribed if the ovaries become inflamed; it can be used by pregnant women. Suppositories are contraindicated in childhood	One suppository inserted into the vagina twice a day. Duration of treatment is 10 days, allergic manifestations are possible
Klion-D	Metronidazole	It is forbidden to use in the first trimester, if breastfeeding, for diseases of the circulatory system	It is administered at night, the treatment period is 10 days. Side effect: headache, burning sensation and itching
Polygynax	Neomycin, Nystatin, Polymyxin B	Antibacterial medicine against inflammation of the appendages in women, not used in the first three months of pregnancy, during breastfeeding and in case of intolerance to the components	It is recommended to use the drug at night in the amount of one capsule. Duration of therapy – 12 days
Clindacin	Clindamycin	Highly effective antibiotic	One suppository at night, duration of treatment 3-5 days
Terzhinan	Ternidazole, Nystatin, Prednisolone, Neomycin Sulfate	A complex drug, there are almost no contraindications. Do not use in case of individual intolerance to the components; when carrying and breastfeeding a child, use only when absolutely necessary	Duration of treatment is 10 days
Betadine	Iodine	Prescribed for fungal or viral inflammation, not indicated in the first three months of pregnancy	Application – once every 24 hours, the duration of treatment is individual, depending on the condition of the victim

The drugs considered have a detrimental effect on pathological microorganisms and reduce the symptoms of inflammatory processes. If we consider how to treat inflammation of the appendages in women, based on the second group, we should note the most popular Diclofenac and Indomethacin. They belong to anti-inflammatory non-steroidal drugs and cannot be used while carrying a child. Contraindications for use include allergic reactions, problems with liver function, gastric ulcers and diseases of the circulatory system.

Suppositories are not prescribed for inflammatory pathology if the patient’s age does not exceed 14 years. Suppositories are used rectally, once every 24 hours, after defecation. The duration of treatment is determined by the treating specialist depending on the patient’s condition.

Treatment during pregnancy

Separately, you should consider what antibiotics to treat in women carrying a child. In general, antimicrobial drugs are not indicated during pregnancy, since they can negatively affect both the condition of the fetus and the health of the mother. When breastfeeding, there is also a risk of the active ingredient penetrating into the milk. The risk of negative consequences is especially high when using antimicrobial agents during the first three months of pregnancy. If symptoms of inflammation of the appendages occur medicinal preparations may be prescribed taking into account the following factors:

• It is not customary to take tetracyclines during pregnancy, since they are able to cross the placental barrier, then accumulating in the tissues of the fetus. The expected risk for the child is pathology in the formation of his skeleton.
• Certain macrolides are also contraindicated for pregnant women. Clinical studies have proven the negative effects of Clarithromycin. The least harm will be caused if the diseases in women are treated with medication, Erythromycin, Josamycin or Spiramycin prescribed by the attending physician. If the inflammation is particularly severe, the pregnant patient may be prescribed Azithromycin.
• Fluoroquinolones are not prescribed at all when pregnant.

Only the attending physician can determine whether taking antibiotics is advisable and sets the dose and duration of their use. But in any case, when using antibiotics, a number of side effects and contraindications are possible. So, with an overdose of Macrolides and Fluoroquinolones, problems with stool may occur, nausea appears, and heart rate changes. Tetracyclines should not be used in cases of renal failure and leukopenia.

Drug interactions should also be considered. If the patient takes fluoroquinolones, she is prohibited from drugs that contain calcium, bismuth, aluminum and magnesium. Concomitant use of NSAIDs can cause seizures and problems with the central nervous system. Tetracyclines should not be mixed with barbiturates, as their toxicity increases markedly. Tetracyclines also inhibit the effects of oral contraceptives. Macrolides and aminoglycosides are not combined. The attending specialist informs the patient about other features of the interaction of antibiotics and other substances.

Higher medical education, venereologist, candidate of medical sciences.

The uterine appendages - the fallopian tubes and ovaries - are located in the pelvis on either side of the uterus. Infectious agents enter the appendages from the vagina or uterus. Inflammation more often can be caused by staphylococcus, gonococcus, chlamydia. Separate inflammation of the tube and ovary is observed very rarely; usually the inflammatory process involves the tube and ovaries.

Causes of inflammation of the appendages.

Oophoritis is an inflammation of the ovaries, often combined with inflammation of the fallopian tubes (salpingitis). The cause of the disease can be a variety of microorganisms; as a rule, they occur in combination and are often resistant to antibiotics. The inflammatory-changed fallopian tube fuses with the ovary, forming a single inflamed formation. The formation of pus in the fallopian tube leads to the destruction of ovarian tissue.

Symptoms of inflammation of the appendages.

Acute inflammation is manifested by pain in the lower abdomen and lumbar region, high body temperature, chills, and impaired urination. In the chronic stage, patients are bothered by pain in the lower abdomen, menstrual irregularities, discharge from the genital tract, and with exacerbations - deterioration in general condition. When pus breaks through into the abdominal cavity, a serious complication develops - inflammation of the peritoneum (pelvioperitonitis). A serious complication is the formation of adhesions in the abdominal cavity, and, as a result, infertility.

Treatment of inflammation of the appendages.

Treatment is selected depending on the causative agent of the disease. In case of an acute process, rest, ice on the lower abdomen (in the first days), painkillers, antimicrobial drugs (usually at least two) are necessary. At the same time, restorative therapy and physiotherapy are prescribed. If drug therapy is unsuccessful, surgical treatment is performed.

Modern reliable methods for treating even chronic inflammation have been developed, including a course of antibiotic injections (gentamicin) directly into the ovaries, anti-inflammatory vaginal tampons and injections into the ovary of an enzyme (lidase) that resolves adhesions.

MEDICINES USED IN TREATMENT (AS PRESCRIPTED BY A GYNECOLOGIST)

Antibacterial drugs
Azithromycin (Sumamed)
Amoxiclav
Hexamethylenetetramine (Urotropin)
Gentamicin (Garamycin, Gentosep)
Doxycycline (Doxibene, Doxinate, Medomycin, Unidox Solutab)
Clindamycin (Dalacin, Klimitsin, Klindafer, Klinda-fer, Clindacin, Klinoxin)
Metronidazole (Klion, Trichobrol, Trichozol, Trichopol, Flagyl)
Nalidixic acid (Nevigramon, Negram)
Ofloxacin
Roxithromycin (Rulid)
Cefotaxime (Claforan, Taksim)
Ceftriaxone (Megion, Oframax, Rocephin, Cefaxone)
Ciprofloxacin (Aquacipro, Arflox, Afenoxin, Ifi-cipro, Quintor, Quipro, Liproquin, Medociprin, Microflox, Proxacin, Procipro, Recipro, Tseprova, Ci-plox, Cyprinol)
Vitamin preparations
Vitamin C (Biovital vitamin C, Redoxon, UPSA C, Ce-
lascon) VitaminE Rutin
Painkillers
Acetylsalicylic acid (Asalgin, Aspilite, Aspirin, Aspirin Upsa, Fortalgin)
Metamizole sodium (Analgin, Baralgin, Veralgan, Maxigan, Nospaz, Spasvin, Spazmalgon, Tempalgin)

Home remedies for treating inflammation of the uterine appendages (adnexitis, oophoritis, salpingitis):

Boil fresh cabbage leaves in milk. Pour the contents into a suitable vessel and, sitting on it, take a steam bath. The procedure is repeated until the inflammation stops.

For inflammation of the appendages, drink juice obtained from 1 whole raw potato on an empty stomach. average size(about 0.3 cups of juice). Before drinking, mix the juice well so that the settled starch becomes suspended. The course of treatment should be carried out in late summer, autumn and winter until March.

Herbs and herbs for inflammation of the uterine appendages (adnexitis, oophoritis, salpingitis):

Take equal parts by weight of sweet clover herb, centaury herb and coltsfoot flowers. Pour 1 tablespoon of the mixture with 1 glass of boiling water, leave for 1 hour and strain. Take 0.3 cups 6 times a day for 3-4 weeks for inflammation of the appendages.

Take equal parts of sweet clover grass and coltsfoot flowers. Brew 1 tablespoon of the mixture with 1 glass of boiling water and leave for 1 hour. Drink 3-4 tablespoons 5 times a day. The course of treatment for inflammation of the uterine appendages is 2-3 weeks with complete abstinence from sexual activity.

Take equal parts of coltsfoot leaf, sweet clover herb, chamomile flowers, calendula flowers and centaury herb. Pour 2 tablespoons of the mixture into 0.5 liters of boiling water and leave for 2 hours. Take 0.3 cups 6 times a day before meals and between meals for 1-2 months. During treatment, complete abstinence from sexual activity is necessary. Used for inflammation of the ovaries and infertility.

Take by weight 2 parts of wild mallow flowers and oak bark, 3 parts of sage leaf, 5 parts of chamomile flowers. Prepare a decoction of 2 tablespoons of the mixture per 1 liter of water. Use for douching and vaginal tampons for inflammation of the uterine appendages.

Pour 1 bucket of boiling water over 50 g of juniper berries and stems, leave for 2 hours and strain. Use for baths for inflammation of the uterine appendages.

Pour 2 tablespoons of cinquefoil herb with 2 cups of boiling water and leave for 1 hour. Drink on an empty stomach and before each meal, 0.5 cups 4 times a day. At night, douche with a more concentrated infusion: pour 5 tablespoons of the herb into 0.5 liters of boiling water and leave for 1 night in a thermos.

Treatment of ovarian inflammation with folk remedies

For about 20 minutes, you should hold your hands and soles of your feet in a vessel filled with a very liquid clay solution. This solution can be used 2 or 3 times.

Regarding full baths, Vanga gives the following recommendations: “You need to make a fairly large round hole in the ground. Fill it with water and good clay. Mix the clay and water well to form a light liquid mass, place the patient there so that only his head remains free.”
Of course, this bath can only be done outdoors in the warm season. In cool weather, take baths on warm water, without updating the clay, 6 – 7 times (twice a week). After the bath, put the patient to bed, cover him well and let him drink a hot infusion of herbs. Such baths are useful primarily for treating the lower abdomen, kidneys, hips, and legs. The duration of the bath is from 30 minutes to one hour, depending on the specific case and the patient’s tolerance of the procedure.

A decoction of bergenia rhizomes: pour 10 grams of chopped bergenia rhizomes with one glass of boiling water, boil for half an hour in a water bath, strain while hot, cool. Use for daily douching.

A decoction of chamomile, oak bark, cinquefoil, cinquefoil and knotweed: mix 20 grams of chamomile flowers, 10 grams of oak bark, 10 grams of cinquefoil root, 30 grams of cinquefoil leaf, 50 grams of knotweed. Pour two tablespoons of this mixture into one liter of water and boil for 15 minutes. Use for douching and tamponing when leucorrhoea appears.

A decoction of yarrow, sage, rosemary and oak bark: mix 20 grams of yarrow herb, 20 grams of sage leaves, 20 grams of rosemary leaves, 40 grams of oak bark. Pour this mixture into three liters of water, boil for half an hour in a water bath, strain. Do two vaginal douches daily.

Infusion of calendula flowers: pour three grams of calendula flowers into one glass of boiling water. Leave for one hour, strain. Use for douching daily.

Infusion of nettle, St. John's wort, mistletoe, oak, chamomile, rose and lungwort: mix 10 grams of nettle, 10 grams of St. John's wort herb, five grams of mistletoe, five grams of oak bark, five grams of chamomile flowers, five grams of rose petals and five grams of lungwort root. Pour one and a half liters of boiling water over this mixture and boil in a water bath for 20 minutes. Leave for half an hour. Do hot irrigation twice a day.

Infusion of various herbs: mix 20 grams of oak bark, 20 grams of daisy leaves, 20 grams of mistletoe herb, 20 grams of nettle, 10 grams of shepherd's purse and 10 grams of water pepper. Pour two tablespoons of this mixture into one liter of boiling water. Leave for 2 – 3 hours. Use hot for douching. Douche 3 – 4 times a day.

Nettle juice: Dissolve one teaspoon of juice from fresh nettle leaves in one quarter glass of water. Drink this dose three times a day 20 minutes before meals.

Decoction of St. John's wort herb: pour one tablespoon of St. John's wort herb with one glass of boiling water and simmer for 15 minutes over low heat, strain. Drink one quarter glass three times a day for a week.

Decoction of viburnum flowers: brew one tablespoon of viburnum flowers with one glass of boiling water, boil for 10 minutes. Drink one tablespoon three times a day for two weeks.

Infusion of knotweed herb, horsetail, centaury and cinquefoil: mix 10 grams of knotweed herb, 10 grams of horsetail herb, 30 grams of centaury herb, 50 grams of cinquefoil herb. Pour one tablespoon of this mixture into one glass of boiling water. Leave for one hour, strain. Drink in sips throughout the day.

Licorice root tincture: 100 grams of dry crushed licorice roots, pour half a liter of vodka. Leave for a month, shaking the contents periodically, strain, and squeeze out the rest. Take 30 drops twice a day - afternoon and evening - for inflammation of the ovaries.

Tea from viburnum berries: pour one tablespoon of viburnum berries with one glass of boiling water, leave, strain. Take one quarter glass four times a day half an hour before meals for inflammation of the female genital organs.

Before treatment, you must first cleanse the intestines, but not with castor oil, and stay in bed if possible, especially when you have a fever. Place an ice pack on your stomach.

It is not so difficult to get rid of acute inflammation, you just need to be treated carefully, but chronic inflammation can only be healed, since in the right case, for example a cold, it makes itself felt again. For chronic inflammation, it is best to take mud baths. Women benefit from hot douching and complete abstinence from sexual intercourse until the pain disappears.

To calm the pain, it is good to lubricate (but do not rub!) the lower abdomen with ichthyol or ichthyol ointment (1:3), and insert ichthyol-glycerin tampons into the vagina.

It is beneficial to eat as much pumpkin as possible in all types. It is especially good to mince raw pumpkin, squeeze out the juice and drink. A decoction of corn cob hair also helps, and the cobs must be completely ripe.

With long-term consumption of yogurt, the likelihood of internal and external inflammatory processes is sharply reduced. You can drink yogurt at any time of the year.

Boil the forest hay and let the patient sit over the steam. Repeat the procedure every day until inflammation in the ovaries disappears.

Stand over the steam rising from unwashed sheep wool poured into boiling water.

Boil a head of cabbage, pour in fresh milk and sit over the steam.

Sit over the steam coming from boiled black radishes, drizzled with olive oil.

Inflammation of the female genital organs is accompanied by a vascular-tissue reaction to the influence of pathogens that cause inflammation of a particular organ. The causes of inflammation are a variety of microbes, most often streptococci, staphylococci, gonococci, E. coli, tubercle bacilli, fungi, and viruses. They enter the genitals during sexual intercourse and other means. In acute inflammatory processes, pain is observed in the lower abdomen, often radiating to the lower back, sacrum and hips; temperature increase; purulent discharge.

Folk remedies for treating inflammation of the female genital organs:

20 g of bay laurel per bucket of water. Use for sitz baths for diseases of the uterus and bladder.

Pour a tablespoon of St. John's wort herb with a glass of boiling water, boil for 15 minutes, strain. Drink 1/4 cup 3 times a day with inflammation of the genital organs.

Pour a tablespoon of dried and crushed walnut leaves into a glass of boiling water. Leave for 4 hours. Drink in a day.

Take 1 part of sweet clover herb and 10 parts of coltsfoot herb. Pour a tablespoon of the mixture into a glass of boiling water. Leave in a water bath for 15 minutes, cool and strain. Drink 1/2 glass 3 times a day with inflammation of the appendages.

Take the juice of fresh aloe leaves orally, a dessert spoon 2-3 times a day before meals. for inflammation of the female genital organs.

There is an effective infusion for vulvitis, which can be prepared within an hour. It will relieve both pain and unpleasant tickling. All other remedies for inflammation of the labia take from a week to a month to prepare. Grind the thick-leaved root, pour 200 ml of boiling water and cover the vessel with a lid. Leave to sit at room temperature. After an hour, you can make lotions. The more often the procedures are performed, the faster the itching will go away.

Pass the raw pumpkin through a meat grinder, squeeze the juice out of the pulp and consume it in large quantities. for inflammation of the female genital organs.

Pour 1 cup of boiling water over a teaspoon of blueberry leaves, leave for 30 minutes, strain. Use for external treatment of wounds, ulcers, as well as for douching as an astringent, antiseptic and anti-inflammatory agent for inflammation of the female genital organs.

Prepare an infusion of small-leaved linden flowers at the rate of 2–3 tablespoons of raw material per 2 cups of boiling water. Take orally. For external use, pour 4-5 tablespoons of flowers with 2 cups of boiling water and leave. Apply infusion for inflammation of the female genital organs.

Barberry helps well: pour 1/2 teaspoon of dry roots into a glass of water, boil for 30 minutes, strain and take 1 teaspoon 3 times a day for inflammation of the female genital organs.

Use for inflammation of the female genital organs jasmine flowers and leaves. Take yasnotka both internally and externally - in the form of douching for inflammation of the genital organs. Infusion for internal use: pour 2–3 tablespoons of the herb into 0.5 liters of boiling water in a thermos (daily dose), leave to infuse. For external use, double the amount of herb.

Pour a tablespoon of yarrow herb into 1 cup of boiling water and boil for 10 minutes. Drink 1/3 glass 2-3 times a day before meals. Infusions and decoctions of yarrow are used as a hemostatic agent and accelerate blood clotting during external and internal bleeding (uterine bleeding from inflammatory processes and fibroids, intestinal, hemorrhoidal).

Flowers of sweet clover, herb of centaury, flowers of coltsfoot - equally. Pour a tablespoon of the mixture into a glass of water, boil for 15 minutes and strain. Take 1/3 cup 6 times a day with inflammation of the ovaries.

Pour 10 g of corn stalks with stigmas into 200 ml of boiling water. Prepare a decoction. Take 1 tablespoon every 3 hours. Apply for women's diseases as a hemostatic, sedative, diuretic and choleretic agent.

Pour 10 g of herb tripartite into a glass of water at room temperature, boil in a water bath for 15 minutes, strain and cool. Take a tablespoon 3 times a day with uterine bleeding and inflammation of the genital organs.

In inflammatory processes of the female genital organs, against leucorrhoea A decoction of thorn roots is used. Pour 5 g of roots or bark of branches with 1 glass of water and boil for 15 minutes. Drink in small sips, like tea. For douching, the broth is diluted with boiled water 1:1.

In folk medicine of Belarus, juniper berries are popular for inflammation of the appendages. They are collected in the second year of life, when they turn black and are covered with a bluish coating. One tablespoon of berries is poured into 300 ml of boiling water, simmered all night in a cooling oven, but you can also infuse it in a thermos for at least six hours. Drink 100 ml 3 times a day half an hour before meals. I would just like to point out that juniper is undesirable for chronic kidney diseases. It is also not suitable for long-term use. After four, maximum five weeks, if there is no improvement, you need to move on to other means.
And they can be different. Potentilla anseri was tested. A water infusion is prepared from the herb - 2 tablespoons per 2 cups of boiling water. After an hour, you can start drinking half a glass 4 times a day, in the morning on an empty stomach, then before each meal. At night, douching is done with a more saturated steam:
5 tablespoons per 0.5 liter of boiling water, leave all day in a thermos.

Wintergreen is used to treat not only prostatitis in men, but also women’s diseases - inflammatory processes in the uterus, obstruction of the tubes. The herb is brewed like tea - a pinch per glass, this is approximately a teaspoon. It wouldn't hurt to add a little St. John's wort. Napar tastes very pleasant, with a delicate aroma. They drink it 3 glasses a day for a long time, for 3 to 4 months.
In combination with wintergreen, it is recommended to do a therapeutic enema of chamomile infusion after a cleansing enema, with intervals between them of 30 - 40 minutes. A tablespoon of chamomile is infused for half an hour in 100 ml of boiling water, allowed to cool to human body temperature, filtered and after administering the enema, lie on its side until the infusion is completely absorbed inside. If it doesn’t work, then repeat. After just a few procedures, painful, aching pain disappears.

According to some reviews, inflammation of the appendages is completely cured by this method. Prepare a herbal mixture from wormwood, speedwell, chamomile flowers, taking 5 parts of each, adding 1 part of yellow clover, mixing everything thoroughly. Five tablespoons of this collection are poured into 1 liter of boiling water and left for 25 minutes. Before this they have time to do a cleansing enema. Two glasses of the decoction are immediately drunk hot at night. 300 ml with a temperature of 37.5 ° C is used shortly before bedtime for douching, and after that 150 ml is administered rectally into the rectum, lying on the side. Already the first few procedures will bring relief, but you need to be treated until complete recovery for 2 months, doing all this 2 - 3 times a week.

Prepare the following collection: Small centaury, grass 35.0 Coltsfoot, flowers 35.0 Sweet clover, officinalis, flowers 30,
2 tbsp. spoons of the dry crushed mixture into a thermos with 2 cups of boiling water, leave for 1-2 hours, strain and drink 1/3 cup 5-6 times a day for 3-4 weeks for inflammation of the appendages.

During the treatment period it is necessary to abstain from sexual activity.

Prepare the following collection: Chamomile, flowers 35.0 Chernobyl, herb 30.0 Veronica officinalis, herb 30.0 Sweet clover, herb 5.0
5 tbsp. spoons of the collection, pour 1 liter of boiling water into a thermos, leave for 1-2 hours (during this time, do a cleansing enema), strain and drink 2 glasses of hot broth at night. Use 300 ml of decoction for vaginal douching (introduce warm - temperature 37.5°C). Use 150 ml of the decoction for an enema (after administration, lie on your right side). Perform procedures 2-3 times a week. The course of treatment for inflammation of the appendages is 2 months.