Salpingitis

Overview

Salpingitis is an infection and inflammation of the fallopian tubes, the tubes that connect the ovaries to the uterus in people with female reproductive organs. It usually happens when bacteria travel from the vagina or cervix upward into the fallopian tubes. Salpingitis is a type of pelvic inflammatory disease (PID), which is a broader term for infections of the female reproductive organs.

Salpingitis is one of the more common pelvic infections in people with a uterus and fallopian tubes, especially in those under 25 who are sexually active. Exact numbers are hard to know because some cases have no symptoms.

It can affect anyone with female reproductive organs, especially those who are sexually active. Risk is higher in people under 25, people with multiple sexual partners, and those who have previously had a pelvic infection.

Symptoms

Common symptoms

• Dull or sharp pain in the lower belly
• Unusual vaginal discharge with a strong smell
• Pain during sex
• Bleeding between periods or after sex
• Fever
• Pain when urinating
• Feeling sick or tired

Symptoms in children

• Salpingitis is extremely rare in children. If a child has pelvic or abdominal pain, fever, or unusual vaginal discharge, they should be seen by a doctor as soon as possible.

Symptoms in older adults

• In older adults, salpingitis is uncommon. Symptoms may include lower belly pain, fever, or unusual discharge, but sometimes the only sign is new pelvic pain or bleeding. Older adults may also feel unusually confused or unwell as a sign of infection.

Causes

Main causes

• Bacteria entering the fallopian tubes from the vagina or cervix
• Sexually transmitted infections, most often chlamydia and gonorrhoea
• Other bacteria from the gut that can spread to the pelvic area
• Infections after a gynaecological procedure, such as inserting an intrauterine device (IUD) or surgery

Risk factors

• Being under 25 and sexually active
• Having multiple sexual partners
• Previous sexually transmitted infection
• Previous pelvic inflammatory disease
• Frequent vaginal douching
• Using an intrauterine device (IUD) for contraception

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if you have pelvic pain with a fever, unusual discharge, or pain during sex.

Book a routine appointment if:

• If you are sexually active and have any pelvic pain, especially after a new partner, talk to your GP or local sexual health clinic.
• If you have had a recent gynaecological procedure and feel tender or unwell, get checked even if symptoms are mild.

Diagnosis

Your doctor will ask about your symptoms, medical history, and sexual history. They may do a pelvic examination to check for tenderness or discharge in the pelvic area.

Tests that may be done

• Swab from the inside of the cervix or vagina to test for chlamydia and gonorrhoea
• Urine test to rule out a urinary tract infection
• Blood tests to look for signs of inflammation
• Pelvic ultrasound to see if the fallopian tubes are swollen or if there is an abscess

What to expect at your appointment

Although a pelvic exam can feel uncomfortable, it usually only takes a few minutes. Your doctor will explain what they are doing and you can ask them to stop at any time. If the diagnosis is uncertain, you may be referred to a specialist in women's health (gynaecologist).

Treatment

Salpingitis is treated with antibiotics. Because it is often caused by more than one type of bacteria, doctors usually prescribe a combination of antibiotics to cover the most common causes. It is very important to finish the entire course, even if you feel better.

Self-care at home

• Take the whole course of antibiotics exactly as prescribed
• Rest and avoid heavy exercise until symptoms improve
• Drink plenty of fluids
• Use a heat pack on your lower belly to ease pain, but make sure it is not too hot
• Avoid sex, tampons, and douching until symptoms are gone and your doctor says it is safe

Medical treatments

Antibiotics are the main treatment. They may be given as tablets or, if your infection is severe, as injections in hospital. Your partner or recent sexual partners may also need treatment to prevent reinfection. If you have an intrauterine device (IUD), your doctor may consider removing it if the infection is severe or if it is not improving with antibiotics.

When is surgery considered?

Surgery is rarely needed. It may be considered if an abscess (a collection of pus) forms in the fallopian tube or ovary, or if the infection does not respond to antibiotics.

Living with this condition

During treatment, you may feel tired and uncomfortable. Give yourself time to rest and follow your doctor's advice. You may need to take time off work or school for a few days. Pain usually improves within two weeks, but it can take longer.

Lifestyle tips

• Use condoms consistently to reduce the risk of further pelvic infections
• If you smoke, try to quit — smoking may increase the risk of ectopic pregnancy in people with a history of pelvic infection
• Keep up with regular check-ups if you have had an STI

Diet and exercise

Gentle movement, like walking, can help you stay comfortable while you recover. Eating balanced meals with plenty of fruits and vegetables supports your immune system. Avoid heavy exercise until your pain and fever have settled.

Mental health and emotional wellbeing

A pelvic infection can be emotionally difficult. You may feel worried about your fertility, ashamed about the diagnosis, or anxious about telling a partner. These feelings are normal. Speaking to a counsellor or a trusted professional can help.

Prevention

Not always, but many cases are preventable. Using condoms during sex, limiting sexual partners, and getting tested for STIs if you have a new partner can greatly reduce your risk. If you are diagnosed with an STI, tell your recent partners so they can also be treated.

Vaccines

There is no vaccine specifically for salpingitis, but staying up to date with recommended vaccines can help protect your general health.

Screening programmes

Regular STI testing is not a routine screen for everyone, but if you are under 25 and sexually active, some guidelines recommend yearly chlamydia screening. Ask your doctor about what is right for you.

Complications

If left untreated

• Scar tissue in the fallopian tubes that can block them and cause infertility
• Ectopic pregnancy — a pregnancy that implants outside the womb, which can be dangerous
• Chronic pelvic pain that lasts for months or years
• Formation of an abscess around the tube or ovary (tubo-ovarian abscess)

Long-term outlook

With prompt diagnosis and treatment, most people recover fully and have no long-term problems. The risk of complications is low if you complete your antibiotics and attend any follow-up appointments. Even if complications happen, options are available, and you will not be alone in managing them.

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