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What Is Adnexal Tenderness?

Reviewed by Dan Brennan, MD on May 05, 2021

Adnexal tenderness is a technical term for pain in the area of a woman’s uterus. Adnexa is a Latin word meaning attachment or appendages. It refers to the ovaries, fallopian tubes, and ligaments that hold the reproductive organs in place. These are all located in your lower abdomen near your pelvic bone.

Learn more about adnexal tenderness, including how to treat it.

Symptoms of Adnexal Tenderness

Pain in the same area as your reproductive organs is called adnexal tenderness. This is not a medical condition. Adnexal tenderness is usually a symptom of some other medical issue. Learning the cause of your adnexal tenderness is the first step in finding a solution to it.

Your doctor will ask if your pain is new or if it has been going on for a while. New pain is referred to as acute, particularly if it's been getting worse. Pain that has been going on for longer than 6 months is called chronic

Your pain could be sharp, dull, intermittent, or constant. You may notice it more when you move or during sex. Going to the bathroom might cause you pain. It may be mild, moderate, or severe.

Causes of Adnexal Tenderness

There are a lot of reasons that you might have pain in your pelvic area. Your reproductive organs are all there. So are parts of your urinary and digestive tracts. Any one of those systems could be the cause of pain in your lower abdomen.

Reproductive Tract Pain‌

There are common reasons for pain in your pelvis. These might be menstrual cramps or pain from ovulation. These Other causes of pain are more serious and may require immediate treatment:

Other Pelvic Pain

You may have pain in your pelvic area due to other conditions that don't affect your reproductive system. Some of the other causes of adnexal tenderness include:

  • Appendicitis
  • Diverticulitis
  • Urinary tract infection
  • Constipation
  • Kidney stones

Diagnosing the Cause of Adnexal Tenderness

There are many possible reasons for your adnexal tenderness. Your doctor will have to figure out what is causing your pain. They will ask you a lot of questions about what you are feeling and your medical history. 

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Your doctor will need to do a physical exam to try and learn where the pain is centered inside your body. This will likely include a pelvic exam.

You may need the following additional tests as well:

  • Blood and urine tests
  • Pregnancy tests
  • Tests to check for sexually transmitted infections
  • X-rays
  • Ultrasound
  • CT scan

Treating Adnexal Tenderness

Depending on your diagnosis, your doctor will give you a treatment plan. You may need to take antibiotics if you have an infection. Your doctor may suggest additional medications for pain management.

It's important to note that some of the reasons for adnexal tenderness are emergencies. These situations require immediate attention and treatment.

Appendicitis.Appendicitis is an infection of the appendix. If the appendix ruptures, the infection can spread rapidly to the rest of your body. You will need immediate surgery to remove your appendix if you have appendicitis.

Ectopic pregnancy. This is when a fertilized egg attaches to the fallopian tube instead of your uterus. Unfortunately, there is no way to carry an ectopic pregnancy to term. 

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Ectopic pregnancy can cause your fallopian tube to rupture if it is allowed to continue. This is life-threatening and causes the loss of the fallopian tube. There are a variety of ways to treat ectopic pregnancy that will ensure you can become pregnant again in the future.

Pelvic inflammatory disease. This is a severe infection of your reproductive organs. It can be a complication of some STIs or other internal infections. It can cause infertility if it isn't treated. Your doctor will need to give you antibiotics to stop the infection.

Ovarian torsion. Ovarian torsion is an uncommon condition where an ovary or fallopian tube becomes twisted. It is very painful and requires surgery to correct. Sometimes doctors can't save the ovary or fallopian tube and must remove them.

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Ovarian or fallopian cyst. Cysts are fluid-filled sacs that can develop on your ovaries or fallopian tubes. They are common and usually harmless. Most cysts go away over time. But some cysts can rupture and cause pain or bleeding. Severe bleeding needs to be treated immediately to prevent life-threatening blood loss.

If you have adnexal tenderness, talk to your doctor. They will help you figure out the cause and treat it.

WebMD Medical Reference

Sources

SOURCES:

ACOG: "Ectopic Pregnancy."

CDC: "Pelvic Inflammatory Disease (PID)."

Cleveland Clinic: "Pelvic Pain."

JOHNS HOPKINS: "Management of Ruptured Ovarian Cyst."

MAYO CLINIC: “Appendicitis," "Pelvic pain: Causes," "Pelvic pain Definition."

Taber's ONLINE: "adnexa."

Yale Medicine: "Ovarian Torsion."

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