What Is Endometritis?

Endometritis is inflammation or irritation of the lining of the uterus (endometrium). It is different from endometriosis. An infection usually causes the inflammation associated with endometritis. It is the most common infection after the delivery of a baby.

Endometritis is not life-threatening but requires treatment right away. When not treated with antibiotics, endometritis can lead to severe complications, including infertility.

This article will provide an overview of endometritis, including the symptoms, causes, and treatments.

Endometritis Symptoms

Endometritis does not always cause symptoms. When it does, the most common symptoms of endometritis include:

• Swelling of the abdomen
• Abdominal pain
• Abnormal vaginal bleeding
• Abnormal vaginal discharge
• Constipation
• Pain with bowel movements
• Fever
• Not feeling well 

Causes

Endometritis is caused by an infection of the uterus. Infections that can lead to endometritis include:

• Chlamydia
• Gonorrhea
• Streptococcus pyogenes and Staphylococcus aureus

The risk of endometritis increases when you undergo a procedure that involves entering the uterus through the cervix. This increases the risk of bacteria or other pathogens (disease-causing organisms) entering the uterine lining and causing endometritis. 

Risk factors of endometritis include:

• Miscarriage: Spontaneous pregnancy loss
• Childbirth
• Long labor
• Cesarean section (C-section): Surgical delivery of a baby
• Dilation and curettage (D&C): A procedure to scrape away endometrium, performed through the cervix
• Endometrial biopsy: Taking a sample of the endometrium to analyze in the lab
• Hysteroscopy: Inserting an instrument through the vagina and cervix to see inside the uterus
• Intrauterine device (IUD) placement

Diagnosis

Endometritis must be diagnosed and treated by a healthcare provider. They will start by asking you about your symptoms, including when they started and if they have been worsening.

As part of the evaluation, the healthcare provider will take your vital signs and perform a physical exam, including an abdominal exam and often a pelvic exam.

If the provider conducts diagnostic tests, they may include:

• Bacterial cultures: A sample may be taken from your cervix to test for sexually transmitted infections (STIs).
• Wet prep: Wet prep involves taking a sample of vaginal discharge and viewing it under a microscope.
• Blood tests: Your healthcare provider will likely order a blood sample drawn for a white blood cell count (WBC). If elevated, this test suggests an infection or inflammation in the body.

Treatment

Because endometritis can lead to serious complications, quick diagnosis and treatment are essential. Endometritis is treated with antibiotics.

If endometritis is diagnosed after the delivery of a baby, especially after a cesarean section, a common treatment regime includes Cleocin T (clindamycin) and aminoglycoside. 

This type of treatment is usually given intravenously in the hospital. However, for less severe infections, you can take oral antibiotics. When taking an antibiotic, it is important to finish the entire prescription and attend all follow-up appointments. 

If your case of endometritis is caused by a sexually transmitted infection (STI), such as chlamydia or gonorrhea, it’s important to alert all sexual partners so that they can get tested. 

Prognosis 

The prognosis for endometritis is very good when it is treated with antibiotics. Antibiotic therapy usually cures this infection.

If left untreated, however, endometritis can cause the following complications:

• Infertility
• Pelvic infection (pelvic peritonitis)
• Uterine abscess (a pocket of infection in the uterus)
• Septicemia (a bloodstream infection)
• Septic shock (a life-threatening whole-body reaction to an infection)

Septicemia is a serious infection in the bloodstream and can lead to septic shock. Septic shock is a life-threatening emergency. 

Prevention

You can't always prevent endometritis, but it is possible to lower your risk. Chlamydia and gonorrhea are possible causes of endometritis. To reduce your risk of contracting an STI, practice safer sex with condoms and regular testing.

If you are having an invasive procedure involving the uterus, ask your healthcare provider if you will need antibiotic therapy before the procedure.

Summary

Endometritis is the inflammation or irritation of the uterus and is usually caused by an infection. Infections that may lead to endometritis include chlamydia, gonorrhea, and common vaginal bacteria that get into the uterus. The risk of endometritis increases anytime you undergo a procedure that accesses the uterus through the cervix.

Symptoms of endometritis may include abdominal swelling and pain, vaginal bleeding, vaginal discharge, and fever. Endometritis may lead to serious complications if not treated with antibiotics. Antibiotic therapy usually cures endometritis.