Endometritis

Written by Debra Stang | Published on July 9, 2012
Medically Reviewed by George Krucik, MD

What Is Endometritis?

Endometritis is a condition that causes inflammation of the lining of a woman’s uterus. The uterus, or womb, is a major reproductive organ in women, consisting of a body and a cervix, and is where the fetus develops during pregnancy. The lining of the uterus is called the endometrium.

Endometritis is usually not serious. 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. Problems with fertility can prevent a woman from getting pregnant in the future.

What Causes Endometritis?

Endometritis is caused by infection such as:

  • chlamydia
  • gonorrhea
  • tuberculosis
  • infections resulting from the mix of normal vaginal bacteria

Endometritis is more likely to occur after childbirth or following a miscarriage, especially after a long labor or cesarean delivery. Any medical procedure that involves entering the uterus through the cervix increases your risk for developing endometritis by providing a pathway for bacteria to enter.

Endometritis can occur at the same time as other infections in the pelvic area, such as cervicitis (inflammation of the cervix). These infections may or may not cause symptoms of their own.

Who Is at Risk for Endometritis?

All women have a normal mix of bacteria in their vagina. The risk of endometritis increases when this natural mix of bacteria changes after a life event. It is more likely to occur after the following events:

  • miscarriage
  • childbirth, especially following a long labor or a cesarean delivery
  • medical procedures that involve entering the uterus through the cervix, such as
    • hysteroscopy
    • placement of an intrauterine device (IUD)
    • dilation and curettage (uterine scraping)

The risk does not appear to be related to age, ethnicity, birth control pills, condom use, or sex during menstruation(Ross, 2004).

What Are the Symptoms of Endometritis?

Endometritis typically causes the following symptoms:

  • abdominal swelling
  • abnormal bleeding from the vagina
  • abnormal discharge from the vagina
  • constipation or discomfort when having a bowel movement
  • fever
  • general feeling of sickness
  • pain in the pelvis or lower abdominal area

How Is Endometritis Diagnosed?

A doctor will conduct a physical exam and a pelvic exam. He or she will look at the abdomen, uterus, and cervix for signs of tenderness and discharge. The following tests may also help to diagnose the condition:

  • taking samples (cultures) from the cervix to test for infectious agents such as chlamydia and gonococcus (causes gonorrhea)
  • removing a small amount of tissue (biopsy) from the lining of the uterus
  • a laparoscopy procedure to allow a doctor to look more closely at the insides of the abdomen or pelvis
  • looking at the discharge under a microscope (wet prep)
  • a blood test to measure white blood cell (WBC) count and erythrocyte sedimentation rate (ESR)—endometritis will cause elevations in WBC count and ESR

Potential Complications of Endometritis

Complications and severe illness may occur if the infection is not efficiently treated with antibiotics. These include

  • infertility
  • pelvic peritonitis (general pelvic infection)
  • collections of pus (abscesses) in the pelvis or uterus
  • septicemia (bacteria in the blood)
  • septic shock (an overwhelming blood infection that leads to very low blood pressure)

Septicemia is a rare and severe infection that gets worse very rapidly. The death rate is high. Septic shock is also a life-threatening emergency. Both require fast treatment in a hospital.

How Is Endometritis Treated?

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 is 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.

What Can Be Expected in the Long Term?

The outlook is generally very good. The condition usually goes away with antibiotics without any further problems. Problems with reproduction and severe infections can occur if the condition is not treated. These can lead to infertility or septic shock.

How Can Endometritis Be Prevented?

You can reduce your risk of endometritis during childbirth, abortion, or another gynecological procedure by:

  • making sure a doctor uses sterile equipment and techniques during delivery or surgery
  • taking antibiotics 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 for suspected STIs in both yourself and your partner
  • finishing all treatment prescribed for an STI
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