Endometritis is an inflammatory condition of the the lining of the uterus, and it’s usually due to an infection. The uterus, or womb, is a major reproductive organ in women. It’s where the fetus develops during pregnancy.
Endometritis is usually not life-threatening, but it’s important to get it treated. It will generally go away when treated with antibiotics. Untreated infections can lead to complications with the reproductive organs, problems with fertility, and other general health problems.
Causes and Risk Factors
Endometritis is generally caused by infection. Infections that can cause endometritis include:
- sexually transmitted infections (STIs), such as chlamydia and gonorrhea
- infections resulting from the mix of normal vaginal bacteria
All women have a normal mix of bacteria in their vagina. Endometritis can be caused when this natural mix of bacteria changes after a life event. You’re at risk of getting an infection that can cause endometritis after a miscarriage or after childbirth, especially following a long labor or a cesarean delivery.
You’re also more likely to get endometritis after a medical procedure that involves entering the uterus through the cervix. This can provide a pathway for bacteria to enter. Medical procedures that can increase your risk of developing endometritis include:
- placement of an intrauterine device (IUD)
- dilation and curettage (uterine scraping)
Endometritis can occur at the same time as other conditions in the pelvic area, such as an inflammation of the cervix called cervicitis. These conditions may or may not cause symptoms.
Endometritis typically causes the following symptoms:
- abdominal swelling
- abnormal vaginal bleeding
- abnormal vaginal discharge
- discomfort when having a bowel movement
- general feeling of sickness
- pain in the pelvis, lower abdominal area, rectal area
Your doctor will conduct a physical exam and a pelvic exam. They’ll look at your abdomen, uterus, and cervix for signs of tenderness and discharge. The following tests may also help diagnose the condition:
- taking samples, or cultures, from the cervix to test for bacteria that can cause an infection, such as chlamydia and gonococcus (the bacteria that causes gonorrhea)
- removing a small amount of tissue from the lining of the uterus to test, which is called endometrial biopsy
- a laparoscopy procedure that allows your doctor to look more closely at the insides of your abdomen or pelvis
- looking at the discharge under a microscope
A blood test can also be done to measure your white blood cell (WBC) count and erythrocyte sedimentation rate (ESR). Endometritis will cause elevations in your WBC count and your ESR.
You can experience complications and even severe illness if the infection isn’t treated with antibiotics. Possible complications that can develop include:
- pelvic peritonitis, which is a general pelvic infection
- collections of pus or abscesses in the pelvis or uterus
- septicemia, which is bacteria in the blood
- septic shock, which is an an overwhelming blood infection that leads to very low blood pressure
Septicemia can cause sepsis, which is a severe infection that can get worse very quickly. It can lead to septic shock, which is a life-threatening emergency. Both require fast treatment in a hospital.
Endometritis is treated with antibiotics. Your sexual partner may also need to be treated if a doctor finds out that you have an STI. It’s important to finish all of the medication prescribed by your doctor.
Serious or complex cases may need intravenous (IV) fluids and rest in a hospital. This is especially true if the condition follows childbirth.
The outlook for someone who has endometritis and gets it treated promptly is generally very good. Endometritis usually goes away with antibiotics without any further problems. However, problems with reproduction and severe infections can occur if the condition isn’t treated. These can lead to infertility or septic shock.
You can reduce your risk of endometritis from childbirth or another gynecological procedure by making sure your doctor uses sterile equipment and techniques during delivery or surgery. Your doctor will also most likely prescribe antibiotics for you to take as a precaution during a cesarean delivery or right before a surgery starts.
You can help reduce the risk of endometritis caused by STIs by:
- practicing safe sex, such as using condoms
- getting routine screening and early diagnosis of suspected STIs in both yourself and your partner
- finishing all treatment prescribed for an STI
Talk to your doctor if you’re experiencing the symptoms of endometritis. It’s important to get treatment to prevent any more serious complications.