Best Treatments for Endometritis in Women
Many women can get endometritis without knowing it. Often, you can find out about the presence of the disease only after an examination by a gynecologist. Why endometritis occurs and how to treat it effectively, ask the doctors

Endometritis is one of the most common pelvic inflammatory diseases in women. In the absence of proper therapy, the disease can go into a chronic stage and cause infertility.

In general, endometritis is an inflammation of the lining of the uterus (endometrium). The cause of the development of the disease are various infectious pathogens that enter the uterus – fungi, bacteria, viruses1. Quite often, endometritis occurs against the background of a general decrease in immunity.

Risk factors for the development of endometritis:

  • complicated childbirth;
  • any intervention in the uterine cavity (diagnostic and therapeutic curettage, abortion);
  • lower genital tract infections;
  • sexually transmitted infections (such as gonorrhea or chlamydia);
  • other microorganisms (tuberculous microbacteria, Escherichia coli, diphtheria bacillus, mycoplasma, streptococci, etc.);
  • non-compliance with the rules of intimate hygiene.

In modern medicine, acute and chronic forms of the disease are distinguished.

Acute endometritis

Occurs suddenly, often against the background of interventions in the uterus. It is characterized by vivid clinical manifestations, among which signs of intoxication of the body predominate.

Symptoms of acute endometritis:

  • a sharp increase in temperature;
  • chills;
  • pulling pains in the lower abdomen (pain can be given to the lower back, coccyx, inguinal region);
  • general weakness;
  • loss of appetite;
  • purulent vaginal discharge.

Chronic endometritis

The chronic form of the disease is usually asymptomatic and often occurs in the absence of adequate treatment of acute inflammation.2.

— The prevalence of chronic endometritis is not exactly known. According to our authors, from 1 to 70% of patients with infertility or after unsuccessful attempts to terminate a pregnancy are diagnosed with chronic endometritis. Chronic endometritis can be infectious: viruses, bacteria, sexually transmitted diseases, as well as autoimmune. After termination of pregnancy, in any case, the diagnosis of “chronic endometritis” is made, – notes Anna Dobychyna, obstetrician-gynecologist, surgeon, deputy chief physician for CER of the REMEDI Institute of Reproductive Medicine.

Symptoms of chronic endometritis

  • menstrual cycle disorders;
  • scanty light discharge before and after menstruation
  • lack of pregnancy and miscarriage.

Speaking about the treatment of endometritis, the obstetrician-gynecologist prescribes drugs based on the cause of the disease. It can be antibacterial, hormonal, metabolic therapy, physiotherapy or a complex of drugs.

The duration of treatment depends on the history. If the patient did not have interventions in the uterine cavity, abortions, then one menstrual cycle is enough to treat endometritis and prescribe appropriate hormonal preparation.

In the case of a burdened gynecological history, treatment may last 2-3 months.

1. Medicines for endometritis in women

Antibacterial therapy

At the first stage of treatment of endometritis in women, broad-spectrum antibiotics are used. Our expert Anna Dobychina notes that antibiotic therapy during pregnancy is indicated only in cases of laboratory confirmation of a microbial pathogen in the uterine cavity in a clinically significant titer.

To treat endometritis in women, a doctor may prescribe broad-spectrum antibiotics with high cell penetration. These drugs include amoxicillin, clindamycin, gentamicin, ampicillin3. Treatment is recommended to start from the first day of menstruation.

Antifungal drugs

For the prevention of candidiasis against the background of the use of antibiotics, antifungal drugs are prescribed: Nystatin, Levorin, Miconazole, Ketoconazole, Itraconazole, Fluconazole and others.

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Antiviral drugs

In the presence of a viral infection after antibiotic therapy, antiviral and immunomodulatory drugs are used, such as Acyclovir, Valciclovir, Viferon, Genferon.

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2. Candles for endometritis

The choice of vaginal suppositories depends on the symptoms and the type of pathogen. When using suppositories, the active ingredients do not penetrate the intestines, but are absorbed directly into the blood from the vagina, which reduces the risk of developing dysbacteriosis and negative effects on the liver.

In the acute phase of the disease, antibacterial suppositories are used that suppress the reproduction of pathogens. In the treatment of the chronic form of endometritis, anti-inflammatory, immunostimulating, antiseptic suppositories, such as Diclofenac, Galavit, Terdinan, Livarol, Lidaza and others, are additionally prescribed.

A wide range of different drugs are used to treat inflammation of the uterus. In the acute stage of the disease, systemic antibacterial agents are used. Suppositories are most often prescribed as an adjuvant treatment.

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3. Metabolic therapy

Metabolic therapy is the second stage of treatment, which is aimed at eliminating secondary damage, including metabolic disorders. It is recommended to use vitamins, antioxidants, hepatoprotectors and enzymes (Wobenzym, Phlogenzym).

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4. Physiotherapy

According to the obstetrician-gynecologist Anna Dobychina, in the treatment of endometritis, physiotherapy techniques have a great influence: magnets, lasers, and ultrasounds. The task of physiotherapy in this case is to improve the blood flow of the pelvic organs, improve the processes of regeneration of the endometrium, as well as increase the immune defense4.

5. Hormone therapy

Hormone therapy is used in some cases to maintain and normalize the growth of the endometrium. As a rule, in this case, combined oral contraceptives are prescribed, for example, Regulon and Novinet. When planning a pregnancy, progesterone is used.

Prevention of endometritis

To prevent endometritis in women, first of all, it is necessary to engage in the prevention of sexually transmitted diseases: reduce the number of sexual intercourse, use condoms, regularly take swabs for infections, and in case of infection, undergo timely treatment. Also an important aspect is the prevention of abortion, so you need to take the issue of contraception seriously.

– Of course, a non-developing pregnancy is quite difficult to prevent, therefore, if this happens, it is necessary to be under regular supervision and follow all the recommendations of an obstetrician-gynecologist. This will reduce the risks in the future,” notes Anna Dobychyna.

Popular questions and answers

Popular questions about endometritis in women are answered surgeon, obstetrician-gynecologist of the European Medical Center Oleg Larionov.

What causes endometritis?

– First of all, it is worth separating endometritis, not associated with pregnancy, and endometritis, which was a complication after childbirth, the so-called postportal endometritis. The difference in the microflora that causes the disease.

Endometritis after childbirth is quite common. It is caused by microflora, which normally can be in the vagina, but does not enter the sterile environment of the uterine cavity during childbirth. With postporal endometritis, there are severe pains in the lower abdomen, profuse purulent or bloody discharge from the genital tract, body temperature rises, and heart rate increases.  

Endometritis, not associated with pregnancy and childbirth, is most often the result of sexually transmitted infections. It is caused by chlamydia, gonorrhea and some other infections. Also, the cause may be medical interventions, for example, the installation of an intrauterine device, hysteroscopy with curettage of the uterus, abortion.

Why is endometritis dangerous?

– Possible consequences and complications of endometritis include: increased risk of infertility, ectopic pregnancy, chronic pelvic pain, and recurrent endometritis. Chronic endometritis can cause a violation of the normal course of pregnancy, for example, spontaneous miscarriages, premature birth, premature rupture of amniotic fluid.

How long is endometritis treated?

– Treatment of endometritis is the appointment of antibacterial drugs. Which – depends on the form of endometritis. The duration of treatment is usually 10-14 days. However, if in the treatment of acute endometritis a significant improvement has not occurred within the next 24-48 hours, then you should think about changing antibiotic therapy.
  1. Serebrennikova K.G., Babichenko I.I., Arutyunyan N.A. New in the diagnosis and treatment of chronic endometritis in infertility. Gynecology. 2019; 21(1):14-18.
  2. Plyasunova M.P., Khlybova S.V., Chicherina E.N. Comparative evaluation of ultrasound and Doppler parameters in chronic endometritis. Ultrasonic and functional diagnostics. 2014: 57-64.
  3. Zarochentseva N.V., Arshakyan A.K., Menshikova N.S., Titchenko Yu.P. Chronic endometritis: etiology, clinic, diagnosis, treatment. Russian Bulletin of an obstetrician-gynecologist. 2013; 13(5):21-27.
  4. Nazarenko T.A., Dubnitskaya L.V. Possibilities of enzyme therapy of chronic endometritis in patients of reproductive age. Problems of reproduction 2007; 13(6):25-28.

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