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Endometritis occurs when the endometrium, or uterine lining, becomes inflamed or irritated. This is a different condition than endometriosis; however, some symptoms associated with endometriosis, uterine fibroids and other conditions that cause lower abdominal pain or pelvic pain are present with endometritis.
An infection located in the uterus causes endometritis to occur. The condition can stem from contracting sexually transmitted diseases, such as chlamydia trachomatis or gonorrhea, or can be caused by a tuberculosis infection or a mix of normal vaginal bacteria. Endometritis occurs most frequently after experiencing a miscarriage or after childbirth. Long labors and C-sections have also been shown to be associated with endometritis.
Undergoing pelvic procedures done through the cervix also elevate risk for endometritis. Endometrial biopsy, dialation and curettage, hysteroscopy and IUD implantation, among other procedures, all carry risks for endometritis, which can occur in tandem with other pelvic infectious diseases.
There are a number of symptoms associated with endometritis and the inflammation of the endometrium. Swelling of the abdomen is common with the infection, as are abnormal uterine bleeding, vaginal discharge, pelvic pain and lower abdominal discomfort.
Constipation is also a common symptom and is often accompanied by painful or uncomfortable bowel movements. Fevers can also occur in association with endometritis, and, somewhat less frequently, feelings of uneasiness or general discomfort have been reported as symptoms.
A pelvic exam is usually the initial step in determining whether endometritis is present. Health care providers will look for tenderness in your uterus and cervix and listed to hear if bowel sounds are present. Your provider will also ask about cervical discharge, as this is a common symptom of endometrial inflammation.
In addition to a pelvic exam, your health care provider may culture the cervix for infections, such as chlamydia and gonorrhea. An endometrial biopsy may be performed where an endometrial sample is taken and tested for infection. Other exams and tests for endometritis may include an ESR (erythrocyte sedimentation rate), white blood cell count (WBC), laparoscopy and wet prep (microscopic exam of discharge).
Antibiotic treatment is often prescribed to treat endometritis and mitigate complications from the infection. Like all antibiotic treatment courses, it is essential that you complete the cycle and finish all antibiotics after undergoing a pelvic procedure. Scheduling follow-up visits with your provider is also important to ensure the infection has been resolved.
If your symptoms are severe or if they manifest directly after having a child, you may need to be admitted to the hospital. You may also be prescribed IV fluids and directed to get plenty of rest until you have recovered.
If endometritis is caused by a sexually transmitted infection, your sexual partners may also need to seek antibiotic treatment.
Antibiotics solve endometritis in most cases. However, if left untreated, the infection can result in serious complications, including infertility, pelvic peritonitis, abscess formation in the pelvis or uterine cavity, and septicemia or septic shock. In rare cases, failure to treat endometritis can lead to being diagnosed with endometrial cancer.
By itself, endometritis can be a painful condition that needs quick resolution. However, as mentioned above, the infection can lead to very serious conditions if left untreated. You should immediately contact your health care provider if you are experiencing any symptoms associated with the condition, especially if symptoms occur following childbirth, abortion, IUD placement, miscarriage or any surgery associated with the uterus.
There are steps to prevent or reduce your risk of contracting endometritis. Because the infection is commonly caused by STIs, it is recommended that sexually transmitted infections be treated as early as possible. You should also make sure sexual partners are treated if it is discovered if you have a sexually transmitted infection. Condoms and safe sex practices are also recommended to mitigate the risk of contracting endometritis.
For women undergoing a cesarean section, having antibiotics administered prior to the procedure can help prevent endometritis.
Endometritis happens when the uterine lining becomes infected, causing inflammation and pain. Endometriosis is caused by the growth and spread of tissue similar to the endometrium, or uterine lining, outside of the uterine cavity. Endometriosis can spread to other organs, including the bowel, bladder, ovaries, fallopian tubes and other areas in — and sometimes around — the pelvis.
Pelvic or abdominal pain and swelling are the most common signs of endometritis. A fever can also accompany the condition. Vaginal discharge or bleeding may be present, and the infection has been associated with constipation and uncomfortable bowel movements.
The most commonly prescribed treatment for endometritis is a course of antibiotics. This usually clears the infection. Rest and IV fluids may also be prescribed as part of the treatment plan.
Prevention against endometritis originating from sexually transmitted infection (STI) is fairly straightforward. Safe sex practices, such as condom use, are recommended to avoid STIs. If an STI is contracted, it is essential that it is treated as soon as possible to prevent further infection spread or endometritis.
For women undergoing scheduled C-sections, antibiotics may be prescribed prior to the procedure to mitigate endometritis.
Endometritis is an inflammation or irritation of the lining of the uterus (the endometrium). It is not the same as endometriosis.
Endometritis is caused by an infection in the uterus. It can be due to chlamydia, gonorrhea, tuberculosis, or a mix of normal vaginal bacteria. It is more likely to occur after miscarriage or childbirth. It is also more common after a long labor or C-section.
The risk for endometritis is higher after having a pelvic procedure that is done through the cervix. Such procedures include:
Endometritis can occur at the same time as other pelvic infections.
Symptoms may include:
The health care provider will perform a physical exam with a pelvic exam. Your uterus and cervix may be tender and the provider may not hear bowel sounds. You may have cervical discharge.
The following tests may be performed:
You will need to take antibiotics to treat the infection and prevent complications. Finish all your medicine if you have been given antibiotics after a pelvic procedure. Also, go to all follow-up visits with your provider.
You may need to be treated in the hospital if your symptoms are severe or occur after childbirth.
Other treatments may involve:
Sexual partners may need to be treated if the condition is caused by a sexually transmitted infection (STI).
In most cases, the condition goes away with antibiotics. Untreated endometritis can lead to more serious infections and complications. Rarely, it may be associated with a diagnosis of endometrial cancer.
Complications may include:
Call your provider if you have symptoms of endometritis.
Call right away if symptoms occur after:
Endometritis may be caused by STIs. To help prevent endometritis from STIs:
Women having a C-section may have antibiotics before the procedure to prevent infections.
Centers for Disease Control and Prevention website. Sexually transmitted infections treatment guidelines, 2021. www.cdc.gov/std/treatment-guidelines/default.htm. Updated July 22, 2021. Accessed August 31, 2021.
Duff WP. Maternal and perinatal infection in pregnancy: bacterial. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 58.
Eckert LO, Lentz GM. Genital tract infections: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 23.
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