Endometritis disease. What is endometritis and how to treat it. Signs of acute pathology
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The inner lining of the uterus is called the endometrium. The endometrial layer consists of two layers that differ from each other in morphological characteristics - basic and functional.
When menstruation begins, the surface layer is destroyed and excreted from the body with menstrual blood. After the end of menstruation, a new functional layer is formed from the cells of the basal layer, and the cycle repeats again.
This is a protective reaction of the body, which is aimed at preventing the development of infectious processes in the reproductive organs.
If the functional layer is not rejected and removed during menstruation, it develops, the symptomatic manifestation of which depends on the intensity of the inflammatory processes.
What is endometritis
Endometritis is an inflammatory process in the mucous membrane of the reproductive organ in women, which develops due to the influence of pathogenic microorganisms or septic infection.
What is endometritis, read also.
The disease can occur in acute or chronic form. In the first case, the symptoms appear more clearly, while the chronic form of the pathology is practically not accompanied by a clinical picture.
The disease becomes chronic if acute endometritis is treated incorrectly or if there is no treatment for a long time.
As for the prevalence of this disease, it occurs in more than half of women of reproductive age.
NOTE!
If the inflammatory processes progress, they can spread to the muscles of the uterine walls, and in this case, doctors talk about metroenometritis or endomyometritis.
The development of the disease is facilitated by damage to the mucous layer, and if a woman’s immune system does not work fully or a particularly aggressive infectious flora penetrates into the uterine cavity, there is a risk of damage to the entire uterine tissue.
The photo below schematically shows a healthy uterine cavity and an inflamed one (endometritis).
Symptoms of the disease
As a rule, an acute process in the endometrium begins to manifest itself a few days after the penetration of infectious pathogens.
Intensity depends on several factors:
- the nature of the pathogenic agent;
- the area that is affected;
- presence of underlying diseases;
- functioning of the immune system;
- woman's age;
- predisposing conditions for the development of pathology.
The most severe illness occurs , abortions (curettage) and against the background of the presence of an intrauterine device in the uterus.
Diagnosis of the disease
In order to establish a diagnosis of endometritis, the patient must undergo :
- collection of complaints and medical history;
- gynecological examination with collection of material for laboratory tests;
- general blood analysis;
- vaginal smear;
- bacterial culture of vaginal discharge;
- PCR to determine the pathogen;
- enzyme immunoassay to determine antibodies to pathogens;
- Ultrasound of the pelvic organs to diagnose compaction of the endometrial layer, identify purulent or blood clots, as well as to visualize adhesions and inflammatory processes;
- hysteroscopy;
- biopsy.
Use of folk remedies
So is it possible to treat endometritis using traditional methods?
NOTE!
Endometritis is a fairly serious pathology that must be treated with medication, and traditional medicine in most cases remains ineffective and can only relieve the negative symptoms of the disease.
But if a woman nevertheless decides to treat the disease with the help of traditional medicine, she should approach this issue as responsibly as possible and select the means individually.
Most folk remedies contain components that can provoke the development of allergic reactions, so women who are predisposed to allergies need to be especially careful when choosing treatments.
For treatment with folk remedies the following are chosen:
- agents that have an antimicrobial effect;
- immunomodulatory agents;
- sedatives;
- phytohormones;
- anti-inflammatory drugs - both systemic and local.
If the treatment for acute endometritis was chosen incorrectly, this may cause it to progress to the chronic stage.
So, apply:
- compresses;
- douching;
- tamponation;
- hirudotherapy.
Are used:
- honey and bee products;
- healing clay for compresses;
- hog uterus;
- bergenia root;
- fireweed;
- ivy;
- oak leaves;
- sage;
- celandine;
- St. John's wort;
- red brush;
- calendula;
- tansy;
- aloe;
- chamomile;
- nettle;
- wintergreen;
- acacia and many others.
Traditional treatment
Since endometritis is an infectious-inflammatory disease, it is mandatory to use it for treatment.
In addition, to cure this disease, the following are used:
- hormonal drugs;
- immunomodulators;
- vitamins;
- symptomatic remedies;
- drugs aimed at general strengthening of the body.
Widely applied .
What treatment will be prescribed and how long it will last depends on the form of the disease.
Acute form
Antibacterial therapy:
- an individual treatment regimen may include taking Amoxicillin course from a week to 10 days;
- cephalosporins, in some cases supplemented with Metrogil;
- Doxycycline, course duration up to 2 weeks;
- Metronidazole, standard course 10 days;
- fluoroquinolones apply within a week;
- Sparfloxacin prescribed according to an individual scheme;
- Terzhinan usually prescribed for prophylactic purposes until the causative agent of the disease is identified;
- Vilprafen prescribed in a course of up to 2 weeks;
- Derinat– the dosage is selected based on the woman’s weight.
A local anesthetic, Instillagel, is also prescribed.
Hormonal agents:
- Regulon;
- Rigevidon;
- Noinet.
These drugs help restore the cyclic change of the endometrium.
Immune drugs:
- Lycopid;
- Viferon;
- Immunal;
- Timalin.
It is especially important to prescribe these drugs to women after 40 years of age, since their local immunity may decrease during menopause or due to the approach of this period.
In addition, they prescribe:
- Wobenezim– to improve vascular permeability;
- Actovegin– to accelerate metabolic processes and improve tissue regeneration.
Symptomatic and general restoratives:
- Nurofen or Ibuprofen– for pain relief and as anti-inflammatory agents;
- Flucostat– with a fungal infection;
- analgesics– for severe pain (no more than 7 days).
All patients are required to be prescribed a course of vitamins, as well as physical therapy.
The most effective physiotherapeutic methods are:
- ozone therapy;
- UHF;
- electrophoresis;
- ultrasound;
- magnetotheraia;
- mud therapy;
- balneotherapy;
- laser therapy.
In especially severe cases, it is possible to prescribe surgical treatment, laser excision is most often used for this purpose.
Chronic form
Antibacterial therapy is prescribed after the pathogen is identified:
- Doxycycline - if the provocateur is chlamydia;
- Acyclovir - for viral infection;
- Flucostat – in the presence of fungal agents;
- Cephalosporins;
- Metronidazole.
Anti-inflammatory solutions that have an antiseptic effect at the site of inflammation:
- Furacilin;
- Chlorhexidine;
- Lidaza;
- Calendula;
- Novocaine.
Drugs to improve metabolic processes:
- aloe extract;
- Actovegin;
- vitreous body.
Hormonal drugs:
- Utrozhestan and others.
When prescribing hormones, the doctor must take into account the patient’s age and the severity of the disease. Instructions for their use should also be discussed with him.
Chronic endometritis often requires surgical treatment, which is prescribed in the presence of adhesions and complicated forms of the disease.
Injections into the uterus
For intrauterine injections the following are used:
- antibiotics;
- anti-inflammatory drugs.
The duration of such therapy is from 3 to 7 weeks.
Injections into the uterus are advisable for both acute and chronic illness.
If infertility occurs due to endometriosis, uterine injections are made with lysing enzyme preparations that eliminate the adhesive process.
Possible consequences
Lack of proper therapy for endometriosis can lead to the following negative and dangerous consequences:
- inflammation of the fallopian tubes and ovaries;
- overgrowing of the uterine cavity with adhesions;
- accumulation of pus in the uterine cavity;
- peritonitis and sepsis are dangerous complications that can lead to death;
- infertility;
- complicated pregnancy.
Effect on pregnancy
Potentially, endometritis provokes infertility, but if the disease is at an early stage, conception is possible.
During , complicated by endometritis, increases the risk of bleeding, as well as infection of the child during childbirth. Therefore, it is absolutely necessary to treat the disease before conception occurs.
NOTE!
Quite often, with endometritis, pregnancy termination occurs, and a frozen pregnancy can also be diagnosed.
Diet for endometriosis
- legumes;
- fried foods;
- fat meat;
- Rye bread;
- chocolate;
- cabbage;
- sausages;
- spicy foods and seasonings.
Diet for endometritis should include more cellulose, which is found in cereals, Omega-3 acids - found in fish and seafood, vitamins and minerals.
Often, as a result of difficult childbirth, complicated abortions, infertility, miscarriage, and various gynecological interventions, women are faced with a diagnosis of endometritis. Currently, the vast majority of cases of the disease, if treated in a timely manner, can be successfully treated and are completely cured.
Endometritis– inflammation of the inner mucous layer of the uterine body (endometrium). The development of inflammation in the endometrium is provoked by viruses and various opportunistic microorganisms: gonococci, E. coli, staphylococci, streptococci, chlamydia and trichomonas. This disease is quite common and is often accompanied by inflammation of the muscle tissue of the uterus.
Description and types of endometritis
With this disease, the internal mucous membrane in the uterine cavity, which is very important in the functioning of the female body, is affected, its most fragile and sensitive upper layer - the endometrium. There are many factors for the occurrence of the disease, as well as its varieties.
According to the form of manifestation, the disease occurs in:
- Acute, which mainly manifests itself immediately after infection with pathogenic bacteria or pathogenic viruses as a result of mechanical damage and is characterized by severe symptoms.
- Subacute, which can develop as a complication of acute endometritis. Typically occurs in patients with weak immune systems. At this stage, the disease develops into a chronic form. It is urgent to start treatment, because it is the subacute form of E. that can lead to female infertility. During treatment, the doctor prescribes antibiotics, complex preparations from medicinal plants, and physiotherapeutic procedures.
- Chronic (latent) form. Chronic E. develops as a result of infection with infections that are transmitted through sexual contact. The patient may not be aware of her problem. The disease is often discovered after a comprehensive infertility examination.
According to the etiological principle, everything forms of endometritis divided into:
- Specific. This disease, which affects the mucous layer of the uterus, is caused by strictly defined types of microorganisms - tuberculosis bacteria, herpes simplex viruses, pathogens of toxoplasma, mycoplasma, gonococci, candida, protozoa, cytomegaloviruses, fungal flora. Also the causative agents of ailments are diseases that are sexually transmitted.
- Nonspecific. All other forms of disease in the uterine cavity, when it is not possible to detect a specific pathogenic pathogen of opportunistic microflora, are nonspecific.
Causes of endometritis
There are quite a large number of causes of infection of the uterine cavity by various bacteria. Often the cause of the disease is minimally invasive diagnostic procedures, so you can catch the disease even while staying in a medical institution.
Infection is promoted by:
- Poor personal hygiene.
- Non-regular sexual partners. Often, the infection enters the uterine cavity from the vagina during casual sexual intercourse and unprotected sexual intercourse with a carrier of the infection.
- Weakened immune system.
- Gynecological interventions. Abortions, therapeutic and diagnostic curettages, probing of the uterine cavity can become a factor of inflammation.
- Hysteroscopy or endoscopic interventions. When performing microsurgical manipulation for the purpose of diagnosis, it is also possible to get inflammation of the uterine cavity.
- Mechanical injury to the integrity of the uterus and cervix during childbirth. Sometimes, after labor is completed, the placenta is not born and the doctor has to scrape it out, damaging the inner lining of the uterus.
- Deep postpartum tears in the cervix.
- Dishormonal disorders.
- Concomitant chronic diseases.
- Installation of the IUD. Often, after the installation of intrauterine contraceptives, as a result of injury to the cervix, the inner mucous layer of the uterine body becomes inflamed.
- Physical intimacy during menstruation without protection. Sexual contact during menstruation, even with a healthy partner, can become a factor in the development of endometritis.
- Chronic stress conditions.
Main symptoms of endometritis
The disease in the initial stages can occur latently, without the manifestation of pronounced symptoms, so a woman cannot detect endometritis in a timely manner and consult a doctor for treatment. This is precisely what threatens serious consequences - female infertility, thickening of the walls of the uterine cavity, or the formation of intrauterine adhesions. Severe symptoms are characterized by an acute form of endometritis.
Symptoms of manifestation acute endometritis :
- Increase in body temperature to 38-40° C.
- Mild pain in the lower abdomen of an aching or pulling nature, radiating to the sacrum or lower back.
- Bleeding from the uterus.
- Changes in the menstrual cycle. Observed during the transition from acute to chronic form.
- Copious vaginal discharge. Cloudy discharge resembling clots and containing blood and pus with an unpleasant characteristic odor.
- Deterioration in general health.
Symptoms when chronic endometritis :
- Vaginal discharge. In this form, they correspond in smell and color to the causative agents of the disease. With trichomoniasis, the discharge is profuse and foamy green in color. With gonorrhea - cloudy yellowish-green mucous discharge.
- Changes in the length of the menstrual cycle. Heavy and prolonged periods are observed, more than seven days.
- Spotting at the beginning and after the menstrual cycle.
- Slight or, conversely, heavy discharge during menstruation.
- Repeated spontaneous cases of termination of pregnancy before the natural term.
- A woman’s inability to conceive a child for a long time (infertility).
- A weak and fleeting feeling of pain in the lower abdomen.
- Increased body temperature, often subfebrile, within 37.2° C.
Diagnosis of endometritis
When you first contact the doctor, based on clinical signs and a medical history, a presumptive diagnosis of endometritis is established. At this stage, the doctor asks about all the symptoms that worry the patient.
In addition to this information, a number of activities and laboratory tests are also carried out:
- On a gynecological chair, the uterus is examined and the discharge is assessed by smell, quantity, color.
- Examination of a vaginal smear for bacterial culture. Based on the results of bacteriological examination of a vaginal smear, it is possible to more accurately determine the infectious causative agent of the disease and its reaction to various medications.
- Collection and immunohistochemical examination of a vaginal smear. It is carried out to detect infection and the number of leukocytes in the smear.
- Blood test - general analysis.
If necessary, and to establish an accurate diagnosis, additional examinations are carried out:
- Diagnostic intrauterine curettage.
- Histological examination of the endometrium. To confirm the diagnosis of changes in the mucous membrane (the inner mucous layer of the uterine body).
- Ultrasound examination of the uterus and appendages of the female genital organ.
- Endoscopic examination.
- Enzyme-linked immunosorbent test for antibodies (ELISA). The test also helps identify sexually transmitted diseases.
- PCR diagnostics. Polymerase chain reaction is a highly accurate research method used to identify numerous specific infections.
This diagnosis of E. is quite sufficient, however, at different stages of the disease different diagnostic methods will be carried out. Patients with this disease and in order to avoid the likelihood of developing complications of a septic nature in the form of pelvioperitonitis, peritonitis, undergo treatment in medical institutions in a hospital setting.
Features of treatment of endometritis
The treatment regimen for the disease depends on the results of the examination. With properly selected treatment, this disease can be completely healed in a week, and women who are faced with the disease will have a chance to become pregnant and give birth to completely healthy babies. As a rule, treatment is carried out with broad-spectrum antibiotics.
For successful treatment, drug treatment is used in combination with physiotherapeutic treatment, vitamins and agents that improve microcirculation, and, if necessary, hormonal drugs are prescribed. As an addition to traditional therapy prescribed by a gynecologist, traditional medicine is used in timely treatment.
Treatment of endometritis with drugs.
When treating E., a qualified doctor first of all prescribes antibiotics, which help relieve inflammation and reduce discharge. In addition, antibacterial therapy, which is best performed in the early stages of detection and course of the disease. Patients are often prescribed protected drugs.
If the disease is not very severe, the doctor may prescribe antibiotics, during which the woman can even continue breastfeeding the child. If the pathology is severe, you will still have to stop breastfeeding and undergo treatment with strong antibiotics.
Drugs, as a rule, are prescribed in the form of tablets, administered as droppers or intravenous injections, as well as local remedies to get rid of itching and burning sensation in the vaginal area.
In addition to antibiotics, an experienced doctor may prescribe the use of antifungal drugs in parallel.
Basic medications for the treatment of endometritis:
- Antispasmodics. A group of medications that eliminate painful attacks of spastic pain. In a hospital setting, the patient is administered the drug twice a day. Medicines reduce pain in the lower abdomen and sacral spine.
- Antibiotics. In the early stages of the development of the disease, antibiotics with a diverse range of effects are prescribed. In a medical facility, these drugs are administered by injection. When treated at home, they are prescribed in tablet form.
- Antifungal medications. If necessary, the prescription of antibiotics is combined with the simultaneous use of antifungal drugs, due to the possible risk of developing candidiasis.
- Antipyretic. Such drugs are prescribed when the patient has an elevated body temperature.
- Agents that relieve swelling of the mucous membrane. To block histamine in the body, fairly effective and safe decongestant drugs are prescribed. These medications help reduce the size of the uterus, relieve inflammation and tissue swelling.
Treatment of endometritis with topical medications
If the disease was caused by an infection that is transmitted through sexual contact, in this case, in addition to antibiotics, the doctor prescribes topical medications. Suppositories and medicinal substances in the form of suppositories help to quickly get rid of secretions and destroy pathogenic microorganisms directly at the source of infection.
Suppositories and ointments used in the treatment of endometritis:
- Preparations with the active substance – chlorhexidine, the action of which is aimed at combating bacteria, viruses and fungal diseases. Effectively used in the treatment of endometritis caused by microorganisms of the genus Trichomonas, opportunistic bacteria Gardnerella and chlamydia. Medicines in the form of suppositories are given twice a day. In the morning and in the evening before bed.
- Combined candles, universal action. These drugs are effective against pyogenic bacteria, fungi of the genus Candida, microorganisms of the genus Trichomonas and Gram (+) bacteria. Such a wide variety of effects of drugs is due to the substances contained in the suppositories. To cure E., medications are given two times a day for ten days.
- Drugs prescribed after ultrasound examination and confirmation of the presence of adhesions and severe inflammation in the uterine cavity. The drugs have antioxidant, pronounced immunomodulatory, anti-inflammatory effects. Thanks to the components included in the preparations, swelling of the uterus is reduced and adhesions are destroyed.
- Combined vaginal capsules. The suppositories contain antimicrobial and antifungal substances. The main advantage of the product is that its components do not cause disruption of the beneficial microflora of the vagina. Suppositories are used for E. caused by Gram (+) and Gram (-) microorganisms.
- Vaginal suppositories, actively used in gynecological practice. Thanks to the substances contained in their composition, the drug has a pronounced antimicrobial, antifungal, antiprotozoal effect, and also helps to accelerate the process of formation of the stratum corneum. The drug is used in the treatment of acute and chronic forms of E., the causative agent of which is infections transmitted through sexual intercourse.
- Suppositories containing iodine, which has an inhibitory effect on the growth and reproduction of pathogenic and opportunistic microorganisms. The drug is characterized by antiseptic, antifungal, disinfectant and antiprotozoal effects, and has a wide spectrum of antimicrobial activity. The medicine is effective against E., the development of which is provoked by fungus, viruses and bacteria (including Staphylococcus aureus and Escherichia coli), as well as protozoa.
Physiotherapy for endometritis
In case of E., for therapeutic effects on certain organs or on the entire body, the use of physiotherapy is an important component of treatment, because it helps to improve the conductivity of drug therapy and the rapid recovery of the patient.
Physiotherapeutic treatment methods are prescribed to reduce pain (analgesic methods), relieve inflammation in the uterine mucosa and restore the structure of the endometrium (reparative and regenerative methods), and activate local immunity (immunostimulating methods).
Physical methods of treating patients with endometritis:
- UHF therapy. An anti-exudative technique that affects the body with a high-frequency electromagnetic field and helps reduce the inflammatory process.
- Reparative and regenerative methods. The method involves carrying out procedures using laser therapy with infrared radiation on the area of the projection of the uterus, paraffin therapy - using medical paraffin, iodine-bromine baths, radon baths, hydrogen sulfide, as well as peloid therapy procedures - limiting the release of fluid and swelling of tissues, promoting the development of connective tissue and treatment with ozokerite therapy.
- The analgesic method is ultraviolet irradiation (UVR). Medium wave ultraviolet irradiation in erythemal doses. UVR of the vaginal mucosa leads to the death of most pathogenic microorganisms. The method will be especially effective if the cause of the disease is vaginosis.
- Immunostimulating methods: LOC therapy, heliotherapy, thalassotherapy treatment, SUV irradiation in suberythemal doses, air bath treatment.
- Interference therapy. The essence of the method is the effect on the human body of two medium-frequency currents, which form the so-called interference low-frequency current, while having a positive effect on tissue. This therapy raises the pain threshold and due to this, subjective pain irritation disappears.
- Laser therapy. Exposure of the tissue of the mucous layer of the uterus to radiation of light waves of a certain length increases local immunity, improves microcirculation and promotes rapid healing of damaged tissue. Laser radiation also has a certain bactericidal effect, causing the death of pathogenic microorganisms.
- Magnetotherapy. An alternative medicine method using the influence of a magnetic field on the human body reduces inflammation and swelling, improves microcirculation, increases metabolic processes in the mucous layer of the uterus, promoting rapid healing and restoration of damaged tissue. In addition, local immunity and other cells of the immune system are activated, and the protective forces of the female body are increased.
- Ultrasound therapy (UT). Exposure to ultrasound at a certain frequency causes a number of changes in the tissues of the body, promoting the activation and acceleration of metabolism. Microcirculation and tissue trophism also improve, connective tissue loosens, which prevents the formation of adhesions.
- Electrophoresis. The treatment procedure is aimed at penetrating the drug deep into the tissue under the influence of an electric current using copper, iodine, zinc, and 10% calcium iodide solution to treat pain.
Although relatively harmless, physiotherapeutic procedures still have some contraindications that should be taken into account when prescribing.
The use of physiotherapeutic treatment of endometritis is absolutely contraindicated in the following cases:
- acute period of the disease;
- purulent E. (metroendometritis);
- pelvioperitonitis;
- during pregnancy;
- uterine bleeding;
- neoplasms (tumors in the affected area);
- polycystic ovary syndrome;
- when the internal mucous layer of the uterine body (endometrium) grows outside the uterine cavity.
In other cases, the use of physiotherapeutic treatment is decided by the attending gynecologist and physiotherapist.
Hormonal treatment
In view of the fact that the cause of inflammation of the internal functional lining of the uterus can be not only infections and bacteria, but also a violation in the processes of development and rejection of the mucous layer, the attending physician may prescribe hormonal medications (usually oral contraceptives) for three to six months. .
Taking combined oral contraceptives helps restore the menstrual cycle, and after a woman stops taking OCs against the background of the so-called contraceptive pill withdrawal syndrome, pregnancy can quite often occur.
Treatment with folk remedies
When treating E., gynecologists often prescribe traditional medicine to eliminate vaginal discharge. However, it should be remembered that if this disease was caused by quite dangerous microorganisms and viruses, then it will not be possible to cure endometritis without special help and taking medications.
With O.E. You cannot use treatment only with traditional medicine. Traditional medicine for the treatment of the disease suggests douching with infusions or decoctions of medicinal herbs.
Recipes from traditional healers:
- Coltsfoot grass. Tannins contained in the plant have a pronounced antibacterial and anti-inflammatory effect. To prepare the decoction, pour 50 grams of crushed raw materials into one liter of boiling water and leave for four hours. After this, strain and take one tablespoon four to five times a day.
- Bay leaf. To carry out the treatment procedure, you will need 20 grams of dry raw materials. Pour the plant into a deep enamel container, add water and boil for about five minutes. Let the broth cool a little and sit on a bucket, wrapped in a terry sheet. Carry out the procedure before bedtime for two weeks. The decoction is excellent for inflammation of the genitourinary system.
- Stinging nettle leaves. The plant suppresses the inflammatory process, has an antimicrobial effect, stimulates metabolism in the body and improves the contractile activity of the muscular walls of the uterus (myometrium). To prepare the medicine, pour one tablespoon of crushed raw materials into one liter of boiling water and leave for three hours. Strain the broth and take one tablespoon of the broth four times a day, 30 minutes before meals and before bed.
- Sea buckthorn oil. This is an old and quite effective method. It is necessary to soak a cotton swab wrapped in a sterile bandage with sea buckthorn oil. Place the tampon overnight. The duration of treatment is two weeks. The oil relieves inflammation and helps heal cervical tissue.
- Herb St. John's wort. To prepare the decoction, you need to pour 20 grams of dry raw material into half a liter of boiling water and simmer for about ten minutes over low heat. Strain the finished product and take 1/2 tbsp three times a day.
- Blueberries. A decoction of the berries of the plant inhibits the development of inflammation, has an astringent, antimicrobial and slight diuretic effect. To prepare the potion, pour one hundred grams of dried berries of the plant into one liter of cold water, bring to a boil and boil for ten minutes. Cool the broth and consume 1/2 tbsp. (100 milliliters) 3 r/day.
- Forest hay. You need to place an armful of hay in a bucket and fill it with five liters of water. Bring to a boil and remove from heat. Place the patient on a bucket and wrap herself in a blanket. You need to sit until the broth cools. The duration of treatment is two weeks.
- Dried fern leaves. You need to pour 20 grams of raw material with 280 milliliters of cold water and boil for two minutes. Strain the finished broth and consume 70 milliliters three to four times a day. The duration of treatment is two weeks.
- Citrus fruits. Wash well and thoroughly dry one large orange and one lemon each. Grind tropical fruits in a blender or grind in a meat grinder. Add ten drops into the resulting mass. onion juice and 10 grams of sugar. Cover the jar with a lid and shake well. Take the drug one teaspoon three to four times a day. The duration of treatment is three weeks.
Endometritis and pregnancy, after childbirth
It is impossible to become pregnant with endometritis, endure a normal pregnancy and give birth to a healthy child. Moreover, if the disease is not cured in a timely manner, then the developed pathology can lead to incurable infertility. With the development of E., the complex processes of conception and implantation of the embryo into the mucous membrane that covers the inner surface of the uterus are disrupted, and this makes the mechanism of development and gestation impossible.
During pregnancy This disease is one of the most dangerous, so you cannot treat this problem irresponsibly. At the first signs of the disease, you should immediately consult a doctor and have endometrial scrapings tested. If the diagnosis is confirmed, it is necessary to immediately begin treatment, and if the doctor prescribes antibiotic therapy, one cannot refuse, otherwise, as the disease develops, the consequences can be extremely dire - the fetus will die.
To increase the chances of successful conception, in the future you need to undergo treatment with hormonal therapy, which will have a beneficial effect on the normal course of pregnancy.
E. after childbirth is a common complication after a difficult delivery, and is usually diagnosed using ultrasound.
The causes of postpartum E. are considered:
- Complication of a normally developing pregnancy (preeclampsia).
- A prolonged labor period, especially if the child has been without amniotic fluid for a long time.
- Birth of a large baby, malpresentation of the fetus.
- Narrow birth canal.
- A woman gives birth after her forty-first child.
- Childbirth at an early age - before the age of nineteen.
- Placental abruption prematurely.
- Infection of a woman in labor with an STD.
Is it possible to have sex with endometritis?
It is not recommended to enter into intimate relationships with endometritis, because this can not only provoke complications during the course of the disease, but also cause infection of the sexual partner. During sexual intercourse, the integrity of the mucous plug secreted by numerous glands is disrupted - a barrier that blocks the entrance to the uterine cavity and prevents infection of this area from the external genitalia and the environment. If you do not use a mechanical means of protection (condom), infection from an unhealthy partner can enter the uterus and cause E..
Intimacy with endometritis can be complicated:
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- Spread of microbial infection to neighboring organs and throughout the body.
- The occurrence of adhesions and nodes in the fallopian tubes leads to infertility. This creates an obstacle to the movement of the egg into the uterus and makes it impossible to get pregnant and carry a child to term normally.
- The appearance of polyps in the uterus.
- Germination of the mucosal layer into the muscle tissue of the uterus (myometrium) and beyond the uterine mucosa, directly into the abdominal cavity. With adenomyosis, scars form in the uterus, which prevent the conception of a child. In addition, spotting and pain during sexual intercourse are constantly observed.
- Cysts form. Constant inflammation leads to the formation of benign neoplasms in the uterus or ovaries.
- The danger of pregnancy failure (miscarriage) in the early stages and the likelihood of premature birth.
- Malfunctions of the menstrual cycle.
Prevention of endometritis
Preventive measures for this disease are aimed at eliminating factors predisposing the occurrence of the inflammatory process and the penetration of pathogenic microorganisms into the uterine cavity, and if this does happen, at their speedy elimination.
Measures to prevent endometritis include:
- Timely treatment of infections transmitted through sexual intercourse.
- Treatment of complications that arise during childbirth.
- Refusal of artificial termination of pregnancy (abortion).
- Regular gynecological examinations and examination of the microflora of a woman’s vagina after childbirth and before medical procedures.
- A woman’s attentive attitude towards herself: maintaining personal hygiene of the genital organs, promptly contacting a qualified obstetrician-gynecologist.
- Lead a healthy lifestyle (HLS), prevent diseases and improve health.
- Using condoms during sexual intercourse.
- Strengthen the immune system.
Uterine endometritis is an unpleasant disease that women face after childbirth, abortion and other gynecological interventions. Thanks to medical advances, he is being successfully treated. Therefore, if such a diagnosis is made, do not despair. What is endometritis: symptoms and treatment of the disease in women in our article.
In contact with
Endometritis is an inflammatory process that occurs in the inner mucous membrane of the uterus. In some cases, other layers of the uterus are also affected. It occurs due to hormonal changes and low body resistance to various infections.
The most common cause is damage to the lining of the uterus. The culprits for her injury are:
- douching;
- hysteroscopy;
- probing;
- miscarriage;
- sex during menstruation.
May be caused by:
- coli;
- chlamydia;
- staphylococcus;
- dysbacteriosis;
- promiscuous sex life.
It is not uncommon for women to confuse diseases such as endometritis and endometriosis. What is the difference between them? The first disease involves an inflammatory process in the uterine cavity, the second does not depend on inflammatory processes; when it is formed, the endometrial layer grows, which spreads even to areas where it should not exist.
And if endometritis can be cured once and for all, with the right approach, then in the second option, treatment is long and may not always be successful.
In the initial stages of the disease, the symptoms are not pronounced. The primary signs of endometritis are similar to a cold or fatigue, so they are often ignored.
There are two classifications of endometritis manifestations: acute and chronic. Acute appears after mechanical damage, and chronic develops as a result of infection with sexually transmitted infections.
Acute endometritis can appear after childbirth or abortion. Declares itself in the form:
- constant headaches;
- decreased appetite;
- temperature rise to thirty-eight degrees;
- pain in the lower abdomen;
- frequent urge to urinate;
- purulent discharge with an unpleasant odor;
- uterine bleeding.
Symptoms are observed for ten days. With proper treatment, complete recovery occurs.
The chronic form is different:
- aching pain in the lower abdomen;
- elevated temperature;
- purulent discharge;
- prolonged menstruation;
- menstrual irregularities;
- infertility.
Develops against the background of an untreated acute form. Causes serious consequences that can cause miscarriage or infertility.
If you notice any of the listed symptoms, you should immediately consult a doctor. Detecting the disease at an early stage is easier to treat and prevent complications.
Diagnosis of the disease
Diagnosis begins with a complete gynecological examination. Swabs are taken for research and blood is taken for analysis. An ultrasound scan of the uterus is performed. It allows you to examine any lesions of the fallopian tubes, clots of pus, or compactions.
Examination of the patient on a gynecological chair makes it possible to analyze the approximate amount, smell, and color of vaginal discharge.
Treatment of endometritis begins with collecting information about the patient’s well-being. Symptoms are collected and analyzed.
Timely detected disease can be treated on an outpatient basis under the strict supervision of a gynecologist. If endometritis has progressed to a more complex stage, then hospitalization is necessary.
Main treatments include:
- antibacterial therapy;
- taking broad spectrum antibiotics;
- blood purification;
- cleansing the uterine cavity.
To treat endometritis in women, anti-inflammatory drugs are prescribed, as well as drugs that boost general immunity. A vitamin course and a healthy diet won't hurt. Spicy, fried, and too salty foods should be excluded from the diet.
Chronic endometritis requires more in-depth and long-term treatment. A particularly effective technique is the introduction of drugs into the mucous membrane of the uterus. In this way, it is possible to achieve the strongest concentration of the drug at the site of inflammation.
In some cases it may be necessary surgery. Its purpose is to separate the formed adhesions. This method is practiced in the complete absence of effect from medications.
After completion of treatment, it is necessary to prescribe physiotherapy. It increases the outflow of mucus and pus from the uterine cavity. It is absolutely painless and comfortable.
Laser ray is directed to the wound and promotes its rapid healing. Eliminates swelling and inflammation.
G hydrotherapy– consists of a complex of therapeutic baths with the addition of bischofite and pine extract. The water temperature is thirty-five degrees. The procedure helps to get rid of pain and spasms.
Is it possible to get pregnant with endometritis?
Chronic endometritis and pregnancy are difficult to compatible concepts. The chances of bearing a healthy child are minimal. Since bacteria and infections present in the vagina negatively affect the embryo.
In rare cases, the egg is able to attach to the affected area, but throughout the pregnancy there is a risk of miscarriage. Most often this happens in the first trimester, but it also happens later.
The onset of pregnancy does not prevent the development of the inflammatory process. At the same time, it passes to the fetus.
IVF is a complex process and requires a serious approach. Chronic endometritis is one of the contraindications to its implementation.
Only after treatment and restoration of endometrial function is it possible to conceive and bear a healthy child using IVF.
An individual treatment program is drawn up for each patient, based on symptoms and diagnosis. Its duration depends on the body and the severity of the disease. But even with the best forecasts, this will take several months.
If the disease provokes the development of pathologies, then fertilization in this way becomes impossible.
Endometritis of the uterus is a disease that entails unpleasant consequences. Its timely diagnosis allows for a complete recovery, without the possibility of relapse. To prevent a serious stage of development, you should regularly visit a gynecologist for examination.
More information about uterine endometritis in the video:
In contact with
PCR diagnostics. The test is used to identify various specific infections. Carried out to diagnose sexually transmitted diseases.
Linked immunosorbent assay. This blood test also helps in identifying sexually transmitted diseases.
Treatment of acute endometritis
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What combinations of antibiotics are used?
Combination of penicillins and beta-lactam antibiotics:
Augmentn 1.2 g (intravenously) 4 times a day + unasin 1.5 g (intramuscular) 4 times a day.
Combination of second generation cephalosporins with nitroimidazoles and aminoglycosides
Cefazolin 1 g. (intramuscular) 3 times a day + netrogil 0.5 g 3 times a day (intravenously) + gentomycin 0.08 g (intramuscular) 3 times a day.
The optimal dosage, treatment regimen and duration of antibacterial therapy are determined individually by the attending gynecologist. The optimal choice is determined by the following factors: the state of the woman’s immunity, the type of infection, the stage of the disease, the dynamics of the process.
In some cases, rinsing the uterine cavity with antiseptic solutions is required. This is necessary to remove the purulent contents of the uterus, flush out toxins and reduce the activity of the infectious process. The possibility and necessity of this procedure is determined individually by a gynecologist.
Fighting intoxication
With endometritis, the volume of affected tissue is large, therefore the amount of toxins released by bacteria is large. Once in the bloodstream, toxins have a damaging toxic effect on all structures of the body. Therefore, it is necessary to take all measures to quickly remove toxins circulating in the blood. For this purpose, various solutions are used, used in the form of droppers (saline solution, rheopolyglucin, refortan, albumin). Along with droppers, it is possible to use antioxidant drugs (vitamin C).
Immunostimulation
Antibacterial and detoxification therapy can only help the body cope with the disease. Only the immune system is able to fight infection. Therefore, it is necessary to create favorable conditions for this struggle. This requires treatment in a hospital setting, where conditions have been created for bed rest and a balanced diet.
Also, in order to increase the protective properties of the body, vitamin preparations (vitamin C and B vitamins) are used, as well as drugs that stimulate non-specific immunity:
- Thymalin or T activin 10 mcg daily, course of treatment is 10 days
- Viferon in the form of rectal suppositories from 500 thousand units, 2 times a day, the course of treatment is 5 days.
Chronic endometritis, causes, symptoms, diagnosis and treatment
As a rule, this disease occurs as a result of unfinished acute endometritis. It is more often observed with long-term dysbacteriosis of the genital tract, with chronic forms of sexually transmitted diseases. However, in some cases it can also occur as a result of complications after a cesarean section (it can be caused by suture material remaining for a long time in the uterine mucosa), or with a poorly performed abortion (due to the remains of fetal tissue in the uterine cavity).How does chronic endometritis develop?
More often, its acute forms develop into chronic endometritis. At the same time, against the background of treatment, the main symptoms subside. However, moderate pain, menstrual irregularities, and moderate vaginal discharge remain for a long time.Symptoms of chronic endometritis
- Irregular menstrual cycle
- Heavy bleeding during menstruation
- The appearance of bleeding during the intermenstrual period
- Pain in the lower abdomen not associated with the phase of the menstrual cycle
- Spontaneous abortions (miscarriages) may occur in the early stages
Diagnosis of chronic endometritis![](https://i2.wp.com/polismed.com/upfiles/other/images-art/endometrit/endometrit8.jpeg)
- A visit to the gynecologist - the gynecologist will be interested in whether you have had acute endometritis, pelvic organ surgery, abortion, curettage or endoscopic surgery in the past.
- A gynecological examination may reveal a moderate increase in the size of the uterus, scanty discharge from the uterine cavity (external os of the cervical canal). When palpated, the patient may complain of increased pain in the lower abdomen.
- Ultrasound of the pelvic organs. This study will reveal a disturbance in the structure of the endometrium and an increase in the size of the uterus.
- Diagnostic curettage – allows you to remove the endometrium of the uterus for examination. In the future, this will make it possible to study the structure of the endometrium, isolate the infectious agent and determine its sensitivity to antibacterial drugs.
- Blood PCR will help identify sexually transmitted diseases that may cause chronic inflammation of the uterine mucosa
Treatment of chronic endometritis
Treatment of this unpleasant disease is possible only after the causative factor has been determined. If it is an infection, then the basis of treatment will be the use of antibacterial drugs to which the microbe is sensitive. Before prescribing antibacterial therapy, an antibiogram is performed and the sensitivity of the infection to various antibiotics is determined.If the cause is the presence of suture material in the uterine cavity, then it is necessary to consider, together with your gynecologist, the possibility of its removal.
In the event that the cause is chronic vaginosis, it is necessary to restore the normal microflora of the vagina with the help of live cultures of beneficial bacteria (hilak forte, linex, acylact) and normalize the immune system.
For all types of chronic endometritis, drugs from the group of immunomodulators, vitamin preparations and drugs that stimulate regenerative processes in damaged tissues (Actovegin) are prescribed.
Why does postpartum endometritis develop?
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The development of postpartum endometritis is promoted by:
- violation of the integrity of the cervical barrier;
- violation of the integrity of the endometrium;
- prolonged labor;
- manual examination of the uterine cavity;
- maternal injuries during childbirth;
- decreased maternal immunity.
Under normal conditions, the entrance to the uterine cavity is protected by the narrow lumen of the cervical canal. In addition, the glands of the mucous membrane of this section secrete special mucus, which blocks the lumen of the cervical canal, also preventing the penetration of infection. Most microorganisms cannot penetrate this barrier ( with the exception of especially dangerous ones, such as gonococci).
During childbirth, the lumen of the cervical canal increases several times, and the relative concentration of mucus in it decreases, which significantly weakens the protective properties of the cervical barrier and promotes the penetration of bacterial flora from the environment into the uterine cavity.
Violation of the integrity of the endometrium
Under normal conditions, the endometrium is a well-supplied mucous membrane, which also contains cells of the immune system - macrophages ( absorbing and destroying foreign microorganisms), lymphocytes, histiocytes and others. This to a certain extent prevents the attachment and development of pathological bacteria in the organ cavity. After childbirth, the area of the inner surface of the uterus to which the placenta was attached is a wound surface of large diameter, in the area of which there are practically no protective properties. As a result, bacteria can multiply freely, leading to the development of endometritis.
The final restoration of the endometrium occurs within 4 to 6 weeks after birth. This entire period is potentially dangerous from the point of view of the development of infectious complications.
Prolonged labor
Prolonged labor is considered to be labor that lasts more than 18 hours for primiparous women and more than 13 hours for multiparous women. In addition to the immediate danger to the fetus, this situation also poses a danger to the mother, since the long anhydrous period ( after the amniotic fluid has passed but before the baby is born) and the open canal of the cervix contribute to the penetration and development of infection in the uterine cavity.
Manual examination of the uterine cavity
Within 15–20 minutes after the birth of the baby, the uterus contracts again and the placenta is born ( that is, the release of the placenta and membranes from the uterine cavity). If this period is prolonged or proceeds with any disturbances ( for example, the doctor found tears or deformation of the placenta, indicating that part of it may remain in the uterus), the doctor performs a manual examination of the uterine cavity to remove any remaining placenta. Although this manipulation is performed with sterile gloves and in compliance with all aseptic rules, the risk of infection and the development of endometritis increases several times.
It is worth noting that if fragments of the placenta remain in the uterus, this will also lead to the development of endometritis in the postpartum period.
Injuries to the mother during childbirth
During childbirth, various damage to a woman’s internal organs may occur ( cervical rupture, uterine rupture), which lead to disruption of the barrier function of the organ, and also require additional surgical interventions ( suturing the wound), contributing to the development of endometritis.
Decreased maternal immunity
Immune suppression ( protective properties of the body) of the mother during pregnancy is a natural process that prevents the development of immune reactions against the fetus. The negative side of this process is a decrease in the body's resistance to pathogenic microorganisms, which contributes to the development of various infectious processes, including endometritis.
Can endometritis develop after a cesarean section?
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A cesarean section usually lasts no more than 30–40 minutes and is an artificial delivery in which the fetus is removed through an incision in the anterior wall of the uterus. Although the operation is performed in a sterile operating room in compliance with all rules of asepsis ( preventing microorganisms from entering the surgical wound), certain bacteria can still enter the uterine cavity ( for example, from the respiratory tract of a woman in labor or medical personnel, from the skin of a woman in labor if it is poorly treated, and so on), which can lead to the development of endometritis.
Caesarean section can be performed routinely or for emergency reasons, and the course of the operation and the risk of developing postoperative endometritis are different in both cases.
Differences between planned and emergency caesarean section
Criterion | Planned surgery | Emergency surgery |
Indications |
| Placental abruption, the threat of uterine rupture during labor and other pathologies of labor that pose a danger to the life of a woman or child. |
Operation deadline | Before the onset of labor. | Usually after the onset of labor. |
Operation technique | An incision in the uterus is made in a horizontal direction, along the muscle fibers of the organ, which promotes rapid healing of the wound. The length of the incision usually does not exceed 12 cm. | The incision is often made in the longitudinal direction to prevent injury to the fetus when removing it. The length of the incision can exceed 12 cm. |
Risk of developing postoperative endometritis | No more than 5%. | From 25 to 85%. |
It is worth noting that antibiotic prophylaxis in the preoperative period ( that is, the administration of antibiotics several days before surgery) is impossible, since most antibiotics penetrate the placental barrier and can have a damaging effect on the fetus. At the same time, the use of broad-spectrum antibiotics for at least 7 days after surgery significantly reduces the risk of developing endometritis both during planned and emergency caesarean section.
Is it possible to get pregnant with endometritis?
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At the beginning of pregnancy, a number of key processes occur, the normal course of which is important for the further development of the fetus. During conception, male reproductive cells ( spermatozoa) penetrate the uterine cavity, and then into the fallopian tubes, where one of them merges with the female reproductive cell ( egg). The resulting cell ( zygote) begins to divide, while gradually moving into the uterine cavity. On days 8–9 after conception, implantation of the future embryo occurs ( blastocysts) into the functional layer of the endometrium ( mucous membrane lining the inner surface of the uterus). On the surface of the blastocyst, finger-like protrusions are formed, which penetrate deep into the endometrium and perform fixation and nutritional functions ( endometrial glands produce nutrients). The functional layer of the endometrium thickens under the influence of the hormone progesterone until it completely surrounds the attached blastocyst.
With the development of endometritis, the above processes are disrupted, as a result of which the development of the fetus becomes impossible. The mechanisms of pregnancy disorders differ in different forms of the disease.
From a clinical point of view, there are:
- acute endometritis;
- chronic endometritis.
Acute endometritis
It is an inflammation of the endometrium of an infectious nature. Infection ( bacterial, viral, fungal or other nature) affects as a functional layer ( usually discharged during menstruation), and the basal layer responsible for regeneration ( recovery) endometrium.
The development of acute endometritis is accompanied by swelling of the endometrium and impaired microcirculation in it. This is manifested by the expansion of blood vessels and an increase in the permeability of their walls, which leads to the release of the liquid part of the blood from the vascular bed and the formation of exudate ( inflammatory fluid rich in proteins), often purulent in nature. There is a pronounced infiltration of the endometrium with leukocytes ( neutrophils, lymphocytes) – protective cells of the immune system that fight foreign microorganisms. Under these conditions, the process of fertilization is impossible, since sperm are destroyed in the uterine cavity without reaching the egg. If fertilization does occur, the blastocyst will not be able to attach to the wall of the uterus due to the development of the inflammatory process, leukocyte infiltration and constant release of exudate.
Chronic endometritis
It is usually the result of untreated acute endometritis and is characterized by a long-term, sluggish inflammatory process in the uterine mucosa. Clinical manifestations of chronic endometritis can be very scarce, which is why a woman may try to get pregnant for a long time ( to no avail), without even suspecting the presence of this disease.
Chronic endometritis is characterized by:
- Fibrosis – proliferation of connective tissue ( cicatricial) tissue in the lining of the uterus.
- Lymphoid infiltration - accumulation of a large number of lymphocytes in the basal layer of the endometrium.
- Atrophy of the glands - a decrease in the number and death of endometrial glands, which is manifested by its thinning.
- Formation of cysts - proliferation of the uterine mucosa ( which can be observed in chronic endometritis) leads to compression of the excretory ducts of the glands, resulting in the formation of cavities filled with the secretions of these glands.
- Formation of adhesions ( synechia) – connective tissue bridges between the walls of the uterus and in the fallopian tubes, which are formed due to a chronic inflammatory process.
- Impaired sensitivity to hormones - occurs due to the fact that in the uterine mucosa the concentration of receptors for steroid sex hormones decreases ( including progesterone, which “prepares” the endometrium for blastocyst implantation).
- Frequent bleeding - develop due to impaired regenerative abilities and weak contractile activity of the uterus.
What is the difference between endometritis and endometriosis?
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Endometritis is an infectious inflammation of the mucous membrane of the uterine cavity ( endometrium), which develops as a result of the penetration of foreign microflora from the outside. Despite the possibility of developing dangerous complications ( such as infertility), acute endometritis responds quite well to antibiotic treatment.
With endometriosis, migration and proliferation of endometrial tissue is observed in various parts of the human body. Under normal conditions, the endometrium is present only in the uterine cavity and is represented by two layers - functional and basal, which change depending on the phase of the menstrual cycle. Under the influence of hormones ( progesterone and estrogens) the endometrium is prepared for implantation of the embryo ( there is a growth of the functional layer, the appearance of a large number of glands, and so on). If pregnancy does not occur, the concentration of estrogen and progesterone in the blood decreases, which leads to the rejection of the functional layer of the endometrium, that is, to menstruation, after which its gradual restoration begins ( due to the basal layer).
With endometriosis, endometrial cells can be located in almost any organ ( however, usually these are the walls of the uterus and the pelvic organs - the bladder, ovaries and others). They are subject to the same cyclical changes as the endometrium in the uterine cavity ( that is, they grow under the influence of sex hormones), which will determine the clinical picture of the disease.
Main differences between endometritis and endometriosis
Criterion | Endometritis | Endometriosis |
Cause of occurrence | Penetration of infection into the uterine cavity. The development of endometritis can be promoted by:
| There are several theories about the development of the disease, but the specific cause is unknown. Possible causes of endometriosis may be:
|
Development mechanism | The proliferation of bacterial flora leads to the development of an inflammatory process characterized by damage and dysfunction of the endometrium. | Endometrial tissue can grow into various organs, disrupting their anatomical integrity and functional activity. |
Main clinical manifestations |
| The clinical picture is determined by the organ in which the endometrial tissue grows. Endometriosis can manifest itself:
|
Principles of treatment | Adequate and timely antibacterial therapy can lead to complete cure. | The main treatment method is surgical removal of the overgrown endometrial tissue ( if possible). Drug treatment ( hormonal drugs) is recommended for use in the postoperative period to prevent complications. |
Is it possible to cure endometritis with folk remedies?
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In the treatment of endometritis the following is used:
- Infusion of coltsfoot. The tannins contained in the plant have a pronounced anti-inflammatory and antibacterial effect. To prepare the infusion, add 50 grams of crushed coltsfoot herb to 1 liter of boiled water and leave for 4 hours. After this, strain thoroughly and take 1 tablespoon orally 4 to 5 times a day.
- Infusion of nettle leaves. Nettle has anti-inflammatory and antimicrobial effects, improves metabolism in the body and increases the contractile activity of the myometrium ( muscular layer of the uterus). To prepare the infusion, pour 1 tablespoon of crushed nettle leaves into 1 liter of boiling water and leave for 2 to 3 hours. Strain and take 1 tablespoon of infusion orally 4 to 5 times a day, half an hour before meals and before bed.
- Blueberry decoction. It has anti-inflammatory, astringent, antimicrobial and weak diuretic effects. To prepare a decoction, add 100 grams of dried blueberries to 1 liter of cold water, bring to a boil and boil for 10 minutes. Cool at room temperature and take half a glass orally ( 100 ml) 3 times a day.
- Infusion of yarrow and St. John's wort. Yarrow has an anti-inflammatory and wound-healing effect, while St. John's wort increases the physical endurance of the body. To prepare the infusion you need to take 1 tablespoon of each ingredient ( in crushed form) and pour 500 ml of boiling water. Leave for 2 hours, then strain and take 50 ml ( a quarter glass) 3 times a day.
- Plantain tincture. The substances that make up this plant have anti-inflammatory and antimicrobial effects ( active against staphylococci, streptococci and some other microorganisms). To prepare the tincture, 2 tablespoons of chopped plantain herb are poured into 200 ml of vodka and infused in a dark place for 2 weeks. Before use, strain and take 1 tablespoon 3 times a day. The duration of treatment is no more than 1 month.
- Douching the vagina with a decoction of oak bark. Oak bark contains tannins that have an astringent and anti-inflammatory effect. In addition, it contains flavonoids - biologically active substances that prevent tissue damage during various inflammatory processes. To prepare the decoction, you need to pour 100 grams of crushed oak bark with 500 milliliters of boiled water and bring to a boil over low heat. Boil for 20 minutes, then cool at room temperature, strain thoroughly and add another 1 liter of boiled water. Use the resulting decoction warm for douching ( rinsing) vagina. For this purpose, you can use a regular medical bulb or a special syringe.
Is there a way to prevent endometritis?
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Endometritis is an infectious inflammatory disease that affects the lining of the uterus ( endometrium). Under normal conditions, bacteria cannot penetrate the uterine cavity, since this is prevented by the narrow lumen of the cervix and the cervical mucus contained in it. In addition, the normal vaginal microflora also prevents the development of foreign microorganisms.
The development of endometritis is possible only after the integrity of the described barrier is violated, which is observed during various medical procedures ( abortion, digital vaginal examination, caesarean section), during natural childbirth or with vaginosis ( replacement of normal vaginal microflora with pathogenic microbial associations). In this case, foreign bacteria enter the surface of the endometrium, causing the development of the inflammatory process and clinical manifestations of the disease.
Prevention of endometritis involves:
- Maintain personal hygiene. Regular hygiene of the external genitalia prevents the development of vaginosis and reduces the risk of pathogenic microorganisms entering the uterine cavity.
- Protected sexual intercourse. Using physical methods of protection ( condom) not only prevents unwanted pregnancy, but also helps protect against various sexually transmitted diseases ( chlamydia, gonorrhea and others).
- Timely treatment of infectious diseases. Adequate treatment of sexually transmitted infections begins with the use of broad-spectrum antibiotics ( for example, ceftriaxone 1 gram 1 time per day intramuscularly). After receiving the results of the antibiogram ( a study that determines the sensitivity of specific bacteria to a particular antibiotic) the most effective antibacterial drug should be used until complete recovery, and also for at least 3–5 days after the disappearance of clinical manifestations of the disease.
- Study of vaginal microflora before medical procedures. This study should be performed before hysteroscopy ( examination of the uterine cavity using a special apparatus), abortion, natural childbirth and other events that increase the risk of infection of the uterine cavity. If a pathogenic microflora is detected, the study is postponed and antibacterial drugs are prescribed. Before performing the planned manipulation, a repeated study of the vaginal microflora is indicated.
- Prophylactic use of antibiotics. After a cesarean section, complicated labor, abortion, or other medical procedures associated with an increased risk of infection, it is recommended to take broad-spectrum antibiotics for at least 5 days. This will prevent the development of pathogenic bacterial flora that could enter the uterine cavity. In the absence of pregnancy, antibiotic prophylaxis can be prescribed before the planned procedure.
- Ultrasonography ( Ultrasound) in the postpartum period. This study is carried out for women whose childbirth occurred with any complications. Although ultrasound cannot diagnose endometritis in the early stages, it can detect blood clots and placenta remnants ( the placenta and membranes that are usually released from the uterus after the baby is born) in the uterine cavity. These complications are highly likely to lead to the development of postpartum endometritis, so when they are identified, adequate treatment is necessary ( from prescribing drugs that increase contractile activity of the uterus to instrumental removal of placenta residues).
- Regular observation by a gynecologist. Women of reproductive age are recommended to visit a gynecologist for preventive purposes at least 2 times a year. In this case, it is necessary to take a general blood test and a general urine test, an analysis of the vaginal microflora, and perform an ultrasound of the pelvic organs. A set of these simple tests will allow you to promptly suspect the presence of an infectious disease and prescribe adequate treatment, which can prevent the development of endometritis. It is worth noting that the risk of developing endometritis is highest during the first month after the installation of intrauterine contraceptives ( spirals). Such women are recommended to visit a gynecologist weekly for 1 month after the procedure, and then once every 2 to 3 months.
- Adequate treatment of acute endometritis. Treatment of acute endometritis should be carried out with antibacterial drugs for at least 10 days ( sometimes more). Adequate, timely and sufficiently long-term antibiotic therapy can prevent the transition of acute endometritis to chronic, which is difficult to treat and is often accompanied by infertility.
What can be the complications and consequences of endometritis?
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With endometritis, the infection can spread in several ways, namely:
- By contact - with the direct transfer of microorganisms from the mucous membrane of the uterus to neighboring organs.
- By lymphogenous route - as part of lymph, which flows from the uterus to the sacral and lumbar lymph nodes and further ( through the thoracic lymphatic duct) enters the systemic circulation.
- By hematogenous route - when infection enters the blood through damaged blood vessels.
- Metroendometritis – transition of the inflammatory process from the mucous membrane to the muscular layer of the uterus.
- Lymphadenitis – inflammation ( and often suppuration) regional lymph nodes that have become infected.
- Metrothrombophlebitis – inflammation of the uterine veins as a result of penetration of pathogenic microorganisms into them.
- Cervicitis – inflammation of the cervix.
- Vaginitis – inflammation of the vaginal mucosa.
- Salpingitis – inflammation of the fallopian tubes.
- Oophoritis – inflammation of the ovaries.
- Peritonitis – inflammation of the peritoneum ( thin serous membrane covering the internal organs of the abdominal cavity).
- Sepsis – a generalized infectious process that develops as a result of the penetration of a large number of pathogenic microorganisms and/or their toxins into the blood and without urgent medical care leading to the death of a person.
- Pyometra – accumulation of pus in the uterine cavity, occurring due to impaired patency of the cervix.
- Chronication of the inflammatory process. With untreated acute endometritis, it can become chronic, which is characterized by a less obvious clinical picture, but more serious and dangerous changes in the uterine mucosa.
- Development of the adhesive process. As the disease progresses, special cells appear at the site of inflammation - fibroblasts, which begin to produce collagen fibers ( main component of scar tissue). From these fibers adhesions are formed, which are dense strands that “glue” the tissues together. As they grow, they can squeeze and squeeze various organs ( bladder, intestines) or disrupt the patency of the uterus and fallopian tubes, which will lead to corresponding clinical manifestations ( urinary disorders, constipation, infertility).
- Infertility. The inability to conceive and bear a child is the most common consequence of chronic endometritis. With this disease, changes occurring in the uterine mucosa ( inflammation, cellular infiltration by leukocytes, impaired microcirculation and so on), make it impossible for the embryo to attach to the wall of the uterus and its further development, resulting in any pregnancy ( if it does come) will end in early miscarriage. The development of adhesions in the uterus and fallopian tubes can also lead to infertility, since male reproductive cells ( spermatozoa) will not be able to reach the female reproductive cell ( eggs) and conception will not occur.
- Menstrual irregularities. Inflammatory changes in the uterine mucosa lead to disruption of the organ's sensitivity to hormones ( estrogens, progesterone), which normally regulate the menstrual cycle. In this regard, there may be a delay in menstruation, polymenorrhea ( prolonged and heavy blood loss during menstruation), metrorrhagia ( bleeding from the uterus not associated with the menstrual cycle) and so on.
Is it possible to have sex with endometritis?
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Endometritis is an inflammatory disease that develops as a result of the penetration and proliferation of pathogenic microorganisms in the uterine mucosa ( endometrium), and sexual intercourse may be one of the causes of this disease. Under normal conditions, the only entrance to the uterine cavity ( through the cervix) is blocked by a mucus plug ( mucus is secreted by numerous glands in this area), which prevents the penetration of infection from the external genitalia and the environment. During sexual intercourse, the integrity of this barrier is violated. If you do not use mechanical means of protection ( condoms), infection from a sick partner can penetrate the uterine cavity and cause endometritis.
Having sex with endometritis can be complicated:
- Re-introduction of infection. Treatment of endometritis involves the use of antibacterial drugs to completely destroy pathogenic microflora in the uterine cavity. If you have sex during this time, there is a high probability of reinfection. In this case, the treatment will be ineffective, and acute endometritis may become chronic. In addition, surviving microorganisms will become resistant to the antibiotics used, which will further complicate further treatment of the disease.
- Spread of infection to neighboring organs. During sexual intercourse, the integrity of the cervical barrier is disrupted, as a result of which the infection can spread to the external genitalia, leading to inflammation of the cervix, vagina and other external genitalia. In addition, contractions of the uterus during orgasm can contribute to the spread of infection into the fallopian tubes and abdominal cavity with the subsequent development of salpingitis ( inflammation of the fallopian tubes), oophoritis ( ovarian inflammation) and pelvioperitonitis ( inflammation of the pelvic peritoneum).
- Partner infection. Since the cause of endometritis is pathogenic microflora, during unprotected sexual intercourse the partner may become infected, as a result of which he may also develop an infection of the genital organs - balanitis ( inflammation of the glans penis), posts ( inflammation of the foreskin), balanoposthitis, gonorrhea and so on.
- Pain during sexual intercourse. Endometritis is characterized by congestion of the endometrium, impaired microcirculation and its cellular infiltration. In addition, the infectious process often spreads to the external genitalia, which is accompanied by their increased sensitivity ( hyperesthesia). As a result of this, the slightest touch to the inflamed organ can be felt by a woman as severe painful irritation.
- Bleeding. As already mentioned, the inflamed mucous membrane of the uterus is characterized by swelling and plethora. This occurs due to the fact that a large amount of biologically active substances is released at the site of inflammation ( histamine and others), which cause dilation of small blood vessels and increased permeability of the vascular wall. The vessels become more fragile, as a result of which the slightest injury can lead to massive and prolonged bleeding.
- Pregnancy. During endometritis, the development of pregnancy is almost impossible, since inflammatory changes in the uterine mucosa prevent conception and development of the fetus. However, if conception occurs ( what is possible during treatment), pregnancy may end in spontaneous abortion ( miscarriage), since the developing fertilized egg will not be able to attach tightly to the inflamed endometrium.
Is physiotherapy used for endometritis?
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Physiotherapy involves the use of physical energy ( sound, light, heat and others) for the purpose of therapeutic effects on individual organs or on the body as a whole.
For endometritis, physiotherapy helps:
- normalization of microcirculation in the endometrium;
- reducing swelling of the uterine mucosa;
- activation of the body's protective properties;
- normalization of the menstrual cycle;
- elimination of pain syndrome;
- reducing the risk of complications.
- interference therapy;
- UHF therapy ( ultra high frequencies);
- ultrasound therapy ( UZT);
- laser therapy;
- ultraviolet irradiation ( Ural Federal District).
The essence of this method is the impact on the body of two currents of medium frequency, as a result of which in the human body ( at the point of intersection of these currents) a so-called interference low-frequency current is formed, which has a positive effect on tissue. An interference current with a frequency of up to 10 hertz irritates the receptor nerve endings in the uterine tissue, causing an increase in the tone and contractile activity of the myometrium ( muscular layer of the uterus), improving blood supply and trophism ( nutrition) all layers of the organ. This type of therapy also increases the pain threshold, thereby eliminating the subjective sensation of pain.
One procedure takes about 10 – 20 minutes. The general course of treatment is no more than 15 days.
Interference current is contraindicated during the period of acute inflammatory process in the endometrium.
Magnetotherapy
The positive effects of magnetic therapy include anti-inflammatory, decongestant and healing effects. When exposed to a constant magnetic field, microcirculation improves and the intensity of metabolic processes in the uterine mucosa increases, which promotes rapid healing and restoration of damaged tissue. In addition, local immunity is activated, the activity of lymphocytes and other cells of the immune system is stimulated, resulting in an increase in the nonspecific defenses of the female body.
One procedure lasts 20 – 40 minutes. The course of treatment is 15–20 days. Treatment with a constant magnetic field is contraindicated in the presence of uterine bleeding ( including during menstruation).
UHF therapy
The essence of this method is to expose the patient’s tissue to a high-frequency electromagnetic field. The energy generated in this case is absorbed by the liquid tissues of the body ( blood, lymph) and is released in the form of heat, that is, a certain organ is warmed up. Exposure to a high-frequency electromagnetic field leads to dilation of blood vessels, facilitating the release of immune cells into the site of inflammation. This method also helps to subside the acute inflammatory process, and therefore is used for acute endometritis.
The duration of one procedure is 5 – 15 minutes. It is not recommended to use UHF therapy for more than 14 days in a row, as this promotes the formation of adhesions in the area of inflammation ( under the influence of a high-frequency magnetic field, fibroblasts are activated - cells that synthesize collagen fibers, from which scar tissue is subsequently formed). For the same reason, the use of UHF should be avoided for chronic endometritis.
Electrophoresis
The principle of this method is based on the movement of particles of a certain substance in an electric field. 2 electrodes are applied to the surface of the patient’s body - negatively charged ( cathode) and positively charged ( anode). Both of them are surrounded by special gauze pads, on one of which ( usually on the cathode side) the drug is applied. The cathode and anode are installed in the desired area of the body so that the organ that needs to be affected is located directly between them. When an electric current is applied, the drug begins to move from one electrode to another, while penetrating deep into the tissues that are in its path.
For endometritis, electrophoresis with copper, zinc, iodine, 10% calcium iodide solution and other drugs is used. To treat pain, you can administer a 2% solution of novocaine. The duration of the procedure is 15 – 20 minutes. The course of treatment should not exceed 15 days.
Ultrasound therapy
Under the influence of ultrasound of a certain frequency, a number of changes occur in the tissues of the body. Firstly, ultrasound causes micro-oscillations of cellular structures, which promotes the activation of intracellular enzymes and acceleration of metabolism ( metabolic process). Secondly, under the influence of ultrasound, tissue temperature increases ( by about 1ºС). All this leads to improved microcirculation and tissue trophism, accelerated metabolism and loosening of connective tissue ( which prevents the formation of adhesions).
The duration of one UT procedure is 8 – 10 minutes. Duration of treatment is from 10 to 15 days.
Laser therapy
The principle of the therapeutic effect of a laser is based on the emission of light of a certain wavelength. The effect of this radiation on the tissue of the uterine mucosa improves microcirculation, increases local immunity and promotes rapid healing of damaged tissue. The laser also has a certain bactericidal effect, that is, it causes the death of pathogenic microorganisms.
The duration of continuous laser exposure during one procedure is 5–10 minutes ( depending on radiation power). The course of treatment is 10 – 15 days.
Ultraviolet irradiation
Ultraviolet irradiation of the vaginal mucosa causes the death of most pathogenic microorganisms. This method is especially effective if the cause of endometritis is vaginosis ( a pathological condition characterized by the replacement of normal vaginal microflora with foreign microbial associations).
One UV treatment usually lasts from 3 to 10 minutes. The course of treatment is 10–14 days.
Despite the relative harmlessness, physiotherapeutic procedures have a number of contraindications that must be taken into account when prescribing them.
Physiotherapy is absolutely contraindicated:
- during pregnancy;
- if there is a suspicion of a tumor disease in the area of influence;
- with concomitant endometriosis ( proliferation of endometrial tissue outside the uterine cavity).
What is the classification of endometritis?
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Article outline
The endometrium is a special layer lining the inner cavity of the uterus. According to its structure, it is divided into basal (recovered after the menstrual cycle) and functional (rejected during menstruation). Despite the fact that many women do not know what it is, it is the mucous layer that largely determines the course of pregnancy, the health of the reproductive system and overall well-being.
The main function of the endometrium of the uterus is the formation of optimal conditions and environment for the attachment of the fertilized egg inside the uterus. With an altered state of the endometrium (thickening or thinning), there is a high probability of disturbances in the course of pregnancy, including the threat of miscarriage.
Cycle day | Thickness standard, cm | Average thickness, cm |
4-8 | 0,3-0,6 | 0,5 |
8-11 | Up to 0.8 | 0,5-0,8 |
11-15 | Up to 1.1 | 0,7-1,4 |
15-19 | 1-1,6 | 1,1 |
19-24 | Up to 1.4 | 1,0-1,8 |
24-27 | Up to 1.2 | 1,0-1,8 |
Any deviations indicate endometrial diseases that have arisen for various reasons.
Causes of a thin layer
Among the thickness deviations is a thin layer (). The disease is expressed in the form of insufficient development of the lower or upper mucous membrane of the uterus and prevents the normal attachment of the egg after fertilization.
Occurs as a result:
- Diseases of the genitourinary system;
- Hormonal disorders;
- Circulatory disorders;
- Hereditary factors;
- Inflammation;
- Abortion;
- Surgical operations;
- A number of other factors.
Symptoms may not appear in the initial stages of the disease, and disorders can only be identified as a result of a gynecological examination.
Manifestations of endometrial diseases:
- Age-related delay of menstruation;
- Pain during menstruation;
- Pathologies and disorders of the menstrual cycle (impaired duration and cyclicity, scanty or heavy discharge);
- Undeveloped hair on the external genitalia;
- Weakly expressed secondary sexual characteristics;
- Lack of orgasm;
- Miscarriages;
- Pregnancy does not occur for a long time.
A thin layer disrupts the possibility of normal pregnancy and provokes complete infertility. To exclude such possibilities, therapy should be carried out in the early stages of the disease.
Thickening of the layer (hyperplasia) is characterized by a benign course and may be accompanied by the appearance of polyps. Deviations in thickness are detected during a gynecological examination and prescribed examinations.
If there are no symptoms of the pathology, and infertility is not observed, treatment may not be prescribed.
Forms of hyperplasia:
- Simple. Glandular cells predominate, leading to the appearance of polyps. Treatment uses drugs and surgery.
- Atypical. Accompanied by the development of adenomatosis (malignant disease).
Thickening of the layer occurs as a result of:
- Constant stress;
- Low level of gestagen;
- Liver disorders;
- Surgical operations on the endocrine glands;
- Late term abortions;
- Sexually transmitted diseases;
- Diseases and disorders of the endocrine system;
- Development of tumors;
- Inflammation;
- Disturbances in the production of hormones;
- Taking contraceptives for a long time.
Manifestations of hyperplasia:
- Clots during bleeding;
- Changes in the rhythm of the menstrual cycle;
- The abundance and duration of menstrual flow are unstable;
- During sexual intercourse, blood is released.
Types of pathologies and their symptoms
Endometrial diseases are divided into several types, taking into account pathologies.
- . It occurs as a result of hormonal disorders and leads to the formation of the endometrium in tissues and organs that are uncharacteristic for its location. Accompanied by aching pain, bleeding, discharge after menstruation, blood from the anus and in the urine, and lower back pain. Diagnostics includes examinations, urine and blood tests, ultrasound, and biopsy. A complex treatment is used to restore the mucous layer to normal thickness.
- Endometritis. Characterized by inflammation in the uterine mucosa. It occurs as a result of infectious diseases, including genital diseases, and can be provoked by surgical operations and childbirth. Accompanied by discharge of blood with pus, pain in the lower abdomen, and intoxication of the body. Treatment includes detoxification therapy, the prescription of anti-inflammatory and antibiotic drugs, bed rest, and abstinence from sexual activity. For disorders caused by abortion, curettage is prescribed. Duration of treatment is up to ten days. If you do not consult a doctor in a timely manner, peritonitis, sepsis, infertility, and adhesions may develop. More details in the article ““.
- Oncology. The development of metastases leads to damage to tissues and organs and can cause death. The causes vary, including taking contraceptive medications. In the early stages, symptoms may not appear. Complex treatment includes surgery. To reduce risks, you should undergo a comprehensive examination twice a year.
- Polyps. Benign neoplasms that disrupt the thickness of the endometrial layer. Identified by examination and hysteroscopy. The development of the disease is not accompanied by characteristic symptoms; various methods, including traditional ones, are used for treatment.
- Endometrioid cyst. Located on the ovaries, it is diagnosed during examination and ultrasound examination. It is removed surgically; for postoperative rehabilitation, both medications and folk remedies are used.
How to diagnose
To establish a detailed and accurate diagnosis, various laboratory tests are prescribed to confirm or deny assumptions. Studies may include urine and blood tests, a vaginal smear, and to exclude errors, ultrasound and histological examinations are prescribed. During the examination, the condition of the endometrium is assessed and any pathological processes and abnormalities are identified.
Please note: patients undergo histology only after the disappearance of symptoms indicating an exacerbation of pathological processes.
To assess the condition of the endometrium and find out its thickness, the following research methods are used:
- Anamnesis collection and analysis;
- Gynecological examination;
- Transvaginal ultrasound No.
- Blood test (detailed);
- Hysteroscopy;
- Tests to detect infections of the uterine cavity.
If, as a result of a preventive examination, an increase in the size of the endometrium or its redness is detected, it is necessary to adhere to bed rest.
For mild pathology, antispasmodic and painkillers are prescribed, a special diet must be followed, and cold compresses must be applied to the lower abdomen.
Endometrial treatment is carried out in several ways:
- Conservative (medication). Medicines are prescribed taking into account the stage of the disease, the patient’s age, and whether pregnancies are planned in the future.
- Surgical. Used in cases of advanced disease.
- Folk remedies. In this case, it is imperative to consult a doctor and choose a course of treatment taking into account all existing factors and contraindications. The disease can be treated using plantain, rose hips, nettle, yarrow, and calendula. These and a number of other herbs help stop bleeding. If the blood thickens, hirudotherapy may be prescribed.
It is worth remembering that the choice of therapeutic method should be prescribed exclusively by the attending physician, since any independent intervention, according to statistics, is 70% fraught with the development of adverse complications.