Endometritis

Endometritis is inflammation, infection or irritation of the endometrium (the lining of your uterus) caused by an infection. It can be acute (starts suddenly and lasts a short time) or chronic (lasts a long time). Acute endometritis can happen after childbirth, a miscarriage, or surgery on your uterus or cervix. Chronic endometritis is more common after menopause or if you have an infection like chlamydia or gonorrhea.

Most cases of endometritis aren’t life-threatening. Antibiotics usually treat the infection.

Symptoms of endometritis

Symptoms of endometritis include:

• Fever
• Pelvic pain or lower abdominal pain
• Spotting, irregular bleeding or heavy bleeding
• Foul-smelling or irregular vaginal discharge
• Pain when you poop
• Feeling sick or unwell

You may notice more or less vaginal discharge than usual. The discharge may have traces of blood in it or smell bad.

Endometritis causes

Endometritis happens when bacteria enter your uterus and cause an infection. This most often happens after childbirth or a procedure involving your uterus or cervix. Less commonly, it can happen because of a sexually transmitted infection (STI), such as chlamydia or gonorrhea. Sometimes, bacteria that normally live in your vagina can also cause endometritis.

Your body’s response to the infection causes inflammation and your symptoms.

Risk factors

You may be at higher risk for endometritis if you recently gave birth, especially if you:

• Had an infection during labor
• Your water broke a long time before delivery
• Tested positive for Group B strep during pregnancy
• Had a C-section delivery
• Had multiple cervical checks during labor

You may also have a higher risk after procedures involving your uterus or cervix, such as:

• Dilation and curettage (D&C)
• Pregnancy termination
• Endometrial biopsy
• Hysteroscopy
• Having an IUD placed (can increase risk for bacteria entering your uterus)

Complications

Endometritis can be dangerous if it’s not treated. Antibiotics usually clear the infection when treatment starts early. Some complications of untreated endometritis are:

• Infertility
• Pelvic infection
• Pelvic or uterine abscesses (pockets of pus)
• Sepsis

How doctors diagnose endometritis

Your provider will ask about your symptoms and do a pelvic exam. They may also recommend one or more of the following tests:

• Tests of vaginal or cervical fluid to check for bacterial infections or sexually transmitted infections (STIs)
• An endometrial biopsy to remove a small tissue sample from your uterus
• Blood tests to look for signs of infection or inflammation
• Imaging, like pelvic ultrasound, CT scan or MRI
• Laparoscopy to get a closer look at your uterus and pelvis

How is it treated?

Endometritis is treated with antibiotics. If you’ve just given birth or have a serious infection, treatment may involve intravenous (IV) fluids and rest.

In most cases, you’ll feel better after you finish the antibiotics. Infection and inflammation usually go away after treatment.

When should I see my healthcare provider?

Call your healthcare provider if you have symptoms of endometritis, especially if you’ve recently:

• Given birth
• Had a miscarriage or abortion
• Had surgery on your uterus or cervix
• Got an IUD

Can you prevent endometritis?

As untreated STIs often cause endometritis, the best prevention is to:

• Use condoms during sex.
• Treat STIs promptly.
• Get regular screenings for STIs.
• Ask your sexual partners to get regular screenings for STIs.

You should also get antibiotics for chorioamnionitis during labor and delivery, or antibiotics after a C-section.

What is the difference between endometritis and endometriosis?

Endometritis and endometriosis are two different conditions. Endometriosis is when pieces of your uterine lining grow in places other than your uterus. Endometritis is an infection or inflammation of the lining of your uterus.