A Complete Guide to Endometritis

Less known than endometriosis, endometritis also affects the endometrium. Indeed, endometritis is an infection of the uterus which affects this mucous membrane which develops on the uterine wall with each new menstrual cycle. Often associated with childbirth which is a common factor, endometritis can occur throughout a menstruating person's life . Although it can be treated well with appropriate antibiotics , it can, however, become chronic and affect fertility if it is not well managed. This is why we think it is essential to give it visibility. Today's article is intended to be a complete guide to understanding and recognizing endometritis , in order to better react to it.

What is postpartum endometritis?

Endometritis is a uterine infection that affects the endometrium (the lining of the uterus). It usually originates in the genitals or digestive tract and then travels up into the uterus. Symptoms are usually tenderness of the uterus, abdominal or pelvic pain, feeling unwell, and sometimes vaginal discharge. Like any infection, it can cause a high fever which requires rapid consultation because it reveals the importance of the infection. In cases of endometritis, antibiotic treatment is often recommended to stop the infection.

Endometritis that develops after childbirth is called postpartum endometritis. Postpartum endometritis is generally acute endometritis , linked to an infection that occurred during childbirth (medical intervention during childbirth, postpartum complications).

What is the difference between chronic and acute endometritis?

Endometritis can be both acute and/or chronic, depending on the duration and nature of the infection.

Acute endometritis has two characteristics: it develops quickly and presents intense inflammation of the lining of the uterus . It generally occurs after childbirth (postpartum endometritis), miscarriage , abortion or even genital or uterine surgery. This is because it is often caused by pathogenic bacteria, such as infectious agents specific to the hospital environment (nosocomial infections) or sexually transmitted infections, such as chlamydia or gonococci.

Chronic endometritis , on the other hand, is a prolonged or recurring form of endometrial inflammation . It can develop as a result of untreated acute endometritis or recurrent infections. In some cases, chronic endometritis may be due to low-grade infections, bacterial imbalances, or other non-infectious causes. It may be asymptomatic or present with symptoms that progress very differently, making diagnosis difficult. Research tends to make chronic endometritis the main cause of embryo implantation failures in the context of IVF and thus recommends various preliminary examinations to facilitate diagnosis and treatment in the event of a pregnancy plan.

While acute endometritis often requires immediate, multi-stage treatment with antibiotics to prevent serious complications, chronic endometritis takes time to diagnose and treatment can be more complex.

What is the difference between endometritis and endometriosis?

In recent years, we have heard more and more about endometriosis. If endometriosis and endometritis can be confused due to a very similar name, it is firstly because they both affect the endometrium (the uterine lining).

However, these two pathologies are very different.

Endometritis is an infection caused by germs that sensitize the endometrium, sometimes causing a more serious infection.

Endometriosis is a disease that causes the endometrium to develop outside the uterus, resulting in adhesions between organs (especially the intestines) and causing severe abdominal pain. The causes of endometriosis are multifactorial (genetic, hormonal, infectious, etc.).

Is endometritis serious?

Acute endometritis treated quickly is not dangerous and does not endanger a future pregnancy – we will talk about this in more detail later in our article. On the other hand, if the infection is not treated, it can be responsible for a miscarriage or an ectopic pregnancy, but also for sepsis, an abscess or septic shock. This is why it is important not to let it drag on if you have the feeling that something abnormal is happening: we offer you a list of the symptoms of endometritis to help you better spot it.

What are the causes and risk factors?

Endometritis, in its acute form, is therefore often associated with childbirth and more widely with medical procedures around the genital and uterine areas. But the causes and risk factors are more numerous.

Causes of endometritis

Endometritis is most often caused by a bacterial infection: it travels up into the vagina and cervix and infects the endometrium, causing it to become inflamed. How does this infection occur and spread? Here are the causes of endometritis.

Medical procedures affecting the genital area

The rise of bacteria causing endometritis may be linked to medical procedures such as curettage (during an abortion or miscarriage).

Postpartum complications

Endometritis, and specifically postpartum endometritis, is a common complication after childbirth. This, in particular after a cesarean delivery or in the event of premature rupture of the membranes. The young mother may then find herself infected by bacteria present in the hospital environment.

Sexually transmitted diseases (STDs)

Different sexually transmitted diseases and infections can cause endometritis. This is particularly the case for chlamydia or gonorrhea. These diseases have different symptoms that can help identify them. For example, the white discharge can be very different when you are infected with these diseases .

Hormonal imbalance

Beyond infectious causes, other elements can cause endometritis. This is particularly the case for hormonal imbalances, particularly those affecting the thickness of the endometrium. They can contribute to inflammation.

Menstruating people have, on a daily basis, as part of their menstrual cycle, strong hormonal variations, they can sometimes experience hormonal imbalances. Pregnancy and the postpartum period are also important times of hormonal fluctuations.

Immune Conditions

Immune system disorders can sometimes play a role in the development of endometritis. Because of this, medications that suppress the immune system, such as those used for autoimmune diseases or after organ transplantation, can increase the risk of infections.

Use of an Intrauterine device

Intrauterine contraceptive devices (formerly called IUDs) and, more broadly, any foreign body placed in the uterus can cause or amplify inflammation.

Risk factors for endometritis

As is often the case when we talk about health, luck (genetics), age and lifestyle can have an impact on illnesses and infections. This is also the case for endometritis. Certain practices contribute to increasing the risk of being exposed to endometritis.

Genetic

Endometritis, and more generally the risks of suffering from this infection, can also turn out to be genetic. The permeability of the uterus and genital tract can thus increase the risk of germ contamination, particularly from the digestive tract.

Age and life stage

This is the theme of this article, women of childbearing age are more often affected by endometritis. This is because the infection is often linked to interventions in the uterus area: childbirth/delivery by cesarean section, abortion, miscarriage/curettage.

Age of significant hormonal changes, menopause can also be a risk factor for developing endometritis.

Inadequate personal hygiene

Insufficient hygiene, especially during the menstrual period, can increase the risk of infection.

Not wearing a condom

In the context of sexual relations outside of an exclusive and tested relationship, the absence of condom use is a significant risk factor. Indeed, as we have mentioned, many endometritis are caused by sexually transmitted germs.

Smoking

Smoking has been linked to an increased risk of various infections, including endometritis.

⚡ If you are currently in the process of stopping smoking, know that you can consult an addictologist to support you: specialized in the management and treatment of addictions, this health professional can help you find solutions behavioral and medical to relieve you.

Can endometritis impact my fertility?

Yes, endometritis can impact your fertility. This being said, you should not give in to panic: acute postpartum endometritis treated quickly will generally not have an impact on your fertility in the long term.

How Chronic Endometritis Impacts Fertility

As we explained earlier in this article, chronic endometritis is endometritis that drags on for a long time and varies in symptoms. Generally, it is a poorly diagnosed or poorly treated acute endometritis that resurfaces regularly.

However, chronic endometritis has a recognized impact on fertility. Indeed, the regular infection of your endometrium by various germs makes your uterus more favorable for the implantation of an embryo. The latter becomes inhospitable and can lead to early miscarriages.

Chronic endometritis is also a known problem in the IVF community, since it is a frequent cause of embryo implantation failure. But again, don't panic: the effects of this disease are known and IVF candidates are generally subjected, before the first attempts, to a hysteroscopy, a gynecological examination allowing the state of the uterine mucosa to be observed and identify the potential presence of endometritis. If chronic endometritis is detected, it is treated using different treatments before continuing with implantation attempts.

Why you should (as much as possible) avoid worrying

In other words, yes, endometritis can have an effect on your fertility in its chronic form but this is known and considered by health professionals.

Also, don't worry:

• if you contract an acute form of endometritis , particularly postpartum endometritis: rapid treatment could limit any long-term problems;
• if you are currently in the middle of an attempt/baby project: the possibility of chronic endometritis will be discussed and considered. If you are concerned that it will not be taken into account by your healthcare professionals, you can speak with them to be reassured / to be subjected to screening examinations.

Know how to spot symptoms and warning signs

As is often the case in women's health, the symptoms of endometritis and the signs that should alert you vary greatly in terms of strength and recurrence, which makes them difficult to recognize. However, it is possible to distinguish a few of them.

Recurring symptoms of endometritis

The recurring symptoms of endometritis are:

• Pelvic pain: pain in the lower abdomen, particularly during the premenstrual period when the endometrium develops to accommodate the potentially fertilized egg, is a recurring sign of endometritis;
• Abnormal white discharge: suspicious white discharge (smelly, colored, etc.) can also be a symptom of endometritis;
• Abnormal bleeding: metrorrhagia (vaginal bleeding outside of periods) and postmenopausal bleeding are another symptom of endometritis. Any vaginal bleeding, outside of menstruation or postmenopausal, requires medical consultation;
• Fever and chills: Fever is the normal reaction to an infection (the body heats up to kill bacteria). This is often the last stage of the infection, when it is already well advanced. It is often necessary to consult without delay.
• More generally, a change in your menstrual cycle: all the symptoms mentioned above have the particularity of being able to be confused with other menstrual disorders, including PMS, endometriosis and PCOS (with the exception of fever) . Also, it is the difference with your previous cycles which will have the role of judge of the peace to know whether or not you should worry and consult. You can use a cycle tracking app to get a clear idea of ​​your recurring symptoms. In general, if these symptoms bother you in your daily life, there is no hesitation: consult.

Warning signs

Warning signs that may lead you to suspect that you may have a uterine infection such as endometritis include:

• Uterine sensitivity: pain, sensitivity, discomfort... these elements should alert you and lead you to follow your feelings.
• Unusual fatigue : Significant fatigue may be an indicator of infection. However, it is difficult, during the postpartum period, to assess one's fatigue precisely: postpartum fatigue is unfortunately associated with this period of life!
• Weakness or general feeling of malaise: you tend to have faintness, do you feel nauseous, unwell? This may be a symptom to note.

⚡If you are a young mother, you may often have pelvic pain and your fatigue is significant: these alarm signals may therefore be hidden in your daily life. Even if this seems “normal” to you, remember to discuss them with your doctor during a consultation: they will be another piece of evidence that will allow your healthcare professional to make his diagnosis.

How to get diagnosed?

If the symptoms of endometritis are confused with different diseases, this infection remains quite “easy” to detect thanks to different examinations.

1. See a doctor

Let's start with the basics: if you notice one or more of the symptoms mentioned above – including unusual white discharge, abnormal vaginal bleeding and fever, consult your doctor or gynecologist. He will examine you and suggest additional examinations, if necessary.

2. Talk about your doubts

If your medical relationship allows it (some doctors and health personnel are not very comfortable with the notion of self-diagnosis), you can discuss with him your doubts concerning possible endometritis and present the symptoms which make you think of it. Your advisor may then consider this infection or steer you away from it, if he or she considers another avenue given your medical profile.

3. Do the exams

If your doctor thinks that endometritis may be the cause of your symptoms, he will order different tests:

• A gynecological examination, called hysteroscopy: the purpose of this examination is to assess the presence or absence of endometritis within the uterine mucosa: its appearance, its location, its intensity. This makes it possible to define the conditions specific to its processing;
• A vaginal sample then allows the infection to be noted and the germs involved in the infection to be determined;
• A blood test may also be ordered to determine the stage of endometritis.

Can we prevent the onset of endometritis and how?

Although it is not possible to control a majority of the causes of endometritis (notably internal bacteria in the hospital environment), it is still possible to reduce the risks of contracting endometritis by limiting the risk factors that are in your power.

Adopt a healthy lifestyle

Eat well, drink water, sleep well, don't smoke, don't drink alcohol, play sports... You certainly know the ins and outs of a healthy lifestyle. While the latter cannot prevent you from contracting diseases, it reduces many risk factors.

Protect yourself during sexual intercourse

STDs and STIs are important causes of endometritis. Asking your partner to use a male condom during sex, especially in a non-exclusive relationship or when testing has not been done, helps protect you.

🌈 On Gapianne, we have selected condoms from the My Lubie brand for you. Ultra thin, odorless and made of natural latex, they protect you while letting you enjoy yourself!

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Adopt good intimate hygiene

The imbalance in your vaginal flora can contribute to the development and rise of bad bacteria in your cervix and then in your uterus. This is why it is essential to adopt good intimate hygiene:

• by washing daily with water or with an intimate soap with a pH adapted to your vulva. 🌈 At Gapianne, we particularly like Jho's soap-free intimate soap which cleans and soothes without attacking!

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• by eliminating douching: don’t do that!
• by eliminating scented hygiene products: do you want to pamper your vulva, especially after childbirth which damaged your flesh? Instead, opt for oily and fragrance-free products. 🌈 At Gapianne, we have selected for you the Balm from the Baûbo brand to relieve your vulva without disturbing your vaginal balance!

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What treatments and natural solutions?

Treatments for endometritis depend entirely on its causes.

Most common treatment for endometritis

In general, after diagnosis and identification of the germs that caused the endometrial infection, the treatment of endometritis requires the prescription of antibiotics vaginally for several days or even weeks. These aim to get rid of the germs responsible for the infection.

Secondly, after the antibiotic treatment, a course of probiotics is prescribed or recommended in order to replenish the vaginal flora. 🌈 At Gapianne, we have selected for you the Intestinal Flora probiotic treatment from the Miyé brand . Its key ingredients are a complex of probiotics to restore and maintain the balance of vaginal and intestinal flora, cranberry to fight urinary infections and promote intimate comfort and chicory inulin to improve digestive health during pregnancy. female cycle.

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Other treatments for endometritis

If the origin of the disorder is an STD , your sexual partner(s) must also be treated to avoid any superinfection and spread of the infection to other people.

In the event of postpartum endometritis following childbirth or abortion , a curettage may be necessary to remove the remaining placental debris causing the infection.

If the IUD contributed to causing your endometritis, an emergency medical consultation is scheduled to remove it. With your agreement and following discussions, your healthcare professional prescribes another method of contraception.

Our advice for future pregnancies

You may have understood from reading this article so far: there is no real solution to prevent endometritis or postpartum endometritis in the context of a future pregnancy. The latter is mainly linked to elements that you do not control.

That being said, we can still recommend these few points:

• Talk to your doctor if you have a previous infection: if you have experienced endometritis previously or during your previous pregnancy, you must communicate this information to the healthcare professional who will follow you. This is important information because you may have an increased sensitivity to this disease;
• Adopt a healthy lifestyle: eat well, drink well, play sports, sleep well... all these elements can only contribute to your good health and help your body fight against infections;
• Adopt good intimate hygiene: clean yourself daily with water or with soap with a pH that is respectful of your vulva and your vaginal flora.