Uterus is an organ that can only be found in women. It is a hollow, pear-shaped organ. Uterus is usually associated with pregnancy and menstruation. When there is something wrong with the uterus, a woman might complain of pain or discomfort to the abdomen but because there are many other organs in the abdomen, problems to the uterus might go unnoticed. Hence, it is best to ask a doctor for a thorough examination to ensure the uterus is in good shape. In this article, we will be learning about endometritis.
Endometritis is the inflammation or irritation to the lining of the uterus (endometrium). It should be confused with endometriosis. In endometriosis, there is growth of the uterus tissue outside of the uterus. Endometritis can affect adults and teenagers. Endometritis may occur at the same time as other pelvic infections. The most common causes of endometritis are infection. Typically, this happens after childbirth or miscarriage. It is also most common in long labour and Caesarean sections. Risk for endometritis is high after a pelvic procedure which is typically done through the cervix. This includes dilation and curettage (D and C), hysteroscopy, placement of an intrauterine device (IUD) and childbirth. Caesarean delivery holds 5 to 20-fold risk for developing endometritis when compared to spontaneous vaginal deliveries.
Apart from being caused by infection through pelvic procedure or childbirth, it may be caused by sexually transmitted infections (STI). Endometritis caused by STIs are usually chlamydia, gonorrhoea or a mix of normal bacteria in the vagina. In rare cases, herpes and tuberculosis may be causing endometritis. This kind of endometritis is mostly found in younger adults and teenagers. Genital chlamydia or gonorrhoea infections that are left untreated often develop into endometritis.
It is important to understand the signs or symptoms of endometritis. By knowing these, it can help a person to get early treatment and to treat the condition. Common symptoms include fever, lower abdominal pain, tenderness of the uterus area, headache, chills and fatigue. In postpartum women, the lochia (vaginal discharge after childbirth) is foul-smelling, heavy and dirty (purulent) in colour. In severe cases, endometritis may become severe to the point of sepsis that can be life-threatening. Sepsis is the body’s extreme response to infection and is characterised by fever, increased heart rate (tachycardia), increased breathing (tachypnoea) or low blood pressure (hypotension). In those sexually active individuals with endometritis, patients often complain of discomfort when urinating or bowel movement apart from the pain in the lower abdomen or pelvis area.
Since endometritis can greatly affect a person’s life and be similar to other infections, doctors usually take into account the risk factors and symptoms or signs that can be found. A complete blood test usually shows a high number of white blood cells (leukocytosis). Blood cultures may be obtained in patients suspected of sepsis and/or bacteraemia (bacteria in the bloodstream). Blood culture is done by taking samples of the cervix or endometrium through a swab. In cases suspected due to STIs, testing for the bacteria is common to be done. Patients may even be screened for HIV and syphilis. Imaging test is usually unnecessary to diagnose endometriosis but may be used in come cases such as finding the retained products of conception such as from abortion or to rule out abscess in case conventional treatment does not work.
Treatment of endometriosis usually revolves around antibiotics. Antibiotics help to eradicate the infection and to prevent complications. Antibiotics can be given through vein or oral. Antibiotics in the form of IV are usually given for endometritis due to childbirth infection. Oral form antibiotics are given when IV form is unavailable. In mild to moderate cases of endometritis suspected of STIs, oral antibiotics are typically given. There are many kinds of antibiotics that are used to treat endometritis. Thus, patients should never use antibiotics without prescription or advice from doctors. Sexual partner may also need to be treated if it is caused by STIs.
In most cases, endometritis can be treated with antibiotics. It is rare for endometritis to be associated with endometrial cancer. It is important to treat endometritis as it can cause complications such as infertility, heavy infection and septic shock. It can be scary to know that this infection may occur during childbirth but not to worry, doctors typically give antibiotics before a caesarean delivery to provide protection against possible infection. Doctors also have to make sure they are performing any pelvic procedure with appropriate technique and in good hygiene. Outside of pregnancy, endometritis can be prevented by practising safe sex practices such as using barrier contraceptives like condoms, treating STIs early and to make sure sexual partners are free from STIs.
In essence, endometritis is often marked by the pain in the lower part of the abdomen. It is a disease caused by infection and characterised by the inflammation of the endometrium. This disease is most commonly found in women after childbirth or with STIs. Antibiotics are the mainstay for treating endometritis.
