Chronic endometritis: symptoms and treatment

Chronic endometritis is a chronic inflammatory disorder that affects the inner layer of the uterus. It is caused by various infectious agents — viruses and bacteria. This disease is very dangerous for the health of women, because of its progression in the genital organ, the growth and rejection of the endometrium are disrupted. This, in turn, leads to disruption of the menstrual cycle, uterine bleeding, miscarriage and infertility. But if the pathology is diagnosed in time and cured, the work of the female genital organs will be normalized and it will be possible to become pregnant.



The uterine cavity normally should be sterile — it should not contain various infectious agents (this is a necessary condition for the onset of pregnancy). In the vagina, on the contrary, there are quite a lot of bacteria. Between these organs is the cervix, which does not allow bacteria from the vagina to penetrate into the uterus. If, for some reason, infectious agents penetrate into the genital organ, acute or chronic inflammation of the endometrium immediately begins to progress. The consequences of such a pathological process, if left untreated, can be deplorable.

Usually, chronic endometritis is diagnosed in women who are in reproductive age and actively have sex. But it is also worth noting that pathology can begin to develop in those women who do not have sexual intercourse.

An increased risk of progression of chronic endometritis is observed:


  • after endometrial biopsy;
  • after miscarriage or medical abortion
  • after the diagnostic curettage;
  • in women who have established themselves an IUD;
  • if there is bacterial vaginosis or candidiasis
  • in women who already had a pregnancy, and after birth they had complications of an infectious nature (for example, postpartum endometritis)
  • if there is a history of STDs: mycoplasmosis, gonorrhea, chlamydia, syphilis, etc.
  • if there is chronic inflammation of the cervix. Because of inflammation, this site can not fully perform its functions and prevent the penetration of microbes from the vagina into the uterus;
  • if there are polyps in the genital organ

It should be noted that in almost one-third of women, doctors can not establish the true cause of the progression of chronic endometritis.

Etiology

As stated above, chronic endometritis is provoked by infectious agents that enter the uterine cavity. Most often, inflammation of the endometrium arises from pathological activity:


  1. gonococci
  2. Treponema;
  3. genital herpes virus
  4. cytomegalovirus
  5. a fungus of the genus Candida;
  6. Chlamydia;
  7. ureaplasmas;
  8. mycoplasma;
  9. Koch sticks.

Recently, doctors increasingly diagnose chronic endometritis in patients, which provokes more than one type of microorganism, but several.

Sometimes pathology can occur due to staphylococci and streptococci. These microorganisms are considered conditionally pathogenic, since they can live in the human body for a long time and do not cause any changes. But due to some reasons (a decrease in the reactivity of the body, the presence of foci of infection, etc.), they can become more active and provoke an inflammation of the endometrium.

Symptoms

Chronic endometritis is a rather insidious disease, because for a long time it can not give absolutely no symptoms. Most often the symptoms are so weak that the woman herself can not pay attention to them.

Symptoms of the disease:


  • aching pain in the lower abdomen, which are more likely to occur with physical exertion, but their appearance is also possible at rest. It can be said that this is not a characteristic symptom, as it can indicate other diseases of the female reproductive system
  • pain during sexual contact
  • vaginal discharge. Can be brown, yellow-green and transparent. Color largely depends on the causative agent of pathology;
  • violation of the loop. This symptom most of all worries women, and it is after its manifestation that the majority consult a doctor. They may not be monthly or irregular. It is not excluded the appearance of bloody discharge from the vagina in the middle of the cycle. Pregnancy does not come.

Symptoms of chronic endometritis usually appear gradually. First, there is pain in the abdomen and during sex. Later all these symptoms are added. It is worthwhile not to hesitate and immediately go to the doctor for advice and diagnosis, since the pathology is very dangerous and if it is not cured, then in the future you can not get pregnant.

Endometritis and Pregnancy

Chronic endometritis is a pathology that can become a serious obstacle to a long-awaited pregnancy. The thing is that microorganisms penetrating into the cavity of the genital organ, provoke inflammation of the endometrium. Inflamed tissues can not serve as a «platform» for the implantation of a fertilized egg. Also, the affected endometrium can simply tear off an already attached embryo. But do not immediately think that chronic endometriosis is a verdict. You can get pregnant, but only if you first cure the disease.

If you do not start treating pathology in a timely manner, the chances of a possible pregnancy are significantly reduced (down to infertility). Also, it will be observed:





  1. inefficiency of IVF (even with this method pregnancy does not occur)
  2. habitual miscarriage of pregnancy. Pregnancy comes, but the affected endometrium itself rejects the embryo.

Diagnostics

If symptoms appear that indicate a possible progression of chronic endometritis, it is necessary to contact the gynecologist as soon as possible to confirm or deny the diagnosis. For this purpose:


  • ultrasound of the uterus and its appendages;
  • hysteroscopy

To clarify the cause of the development of the disease, as well as identify a true pathogen, prescribe such diagnostic techniques:


  1. seeding material that was obtained with hysteroscopy
  2. ELISA;
  3. PCR diagnostics;
  4. a smear on the flora.

If a woman can not become pregnant for a long time, she is also prescribed to give a blood test for determining the concentration of hormones.

Treatment

Treatment of chronic endometritis should be started as soon as the doctor has been accurately diagnosed. The treatment plan is developed taking into account the severity of the course of the disease and the characteristics of the patient’s body. The standard treatment plan includes:


  • antibiotics
  • Antivirus;
  • Vitamins
  • proteolytics
  • funds that normalize microcirculation
  • hormonal means

In order to reduce unpleasant symptoms, the patient is also prescribed physiotherapy procedures. Special attention is paid to hormonal drugs, as they allow to normalize the menstrual cycle. They take money for 3-6 months. It is worth noting that after stopping medication, a woman can become pregnant. This occurs against the background of a «withdrawal syndrome.»




Pregnancy can begin to be planned only after the woman has completed a full course of treatment for the disease and all symptoms will disappear from her. It is worth noting that after the completion of the doctor necessarily appoints repeated examinations — a biopsy, ultrasound and a smear.