Symptoms of chronic endometritis and methods of treating pathology

The most common gynecological diseases include chronic endometritis.

The pathology is characterized by minor symptoms, but its development leads to extremely undesirable complications, one of which is infertility.

The modern level of medical care in most cases makes it possible to successfully treat women with endometrial inflammation, and the earlier therapy is started, the lower the risk of serious consequences.

Endometritis - what is it?

The endometrium refers to the layer located on the inner walls of the uterus. It consists of an outer (functional) layer and a lower basal one. The main job of the endometrium is to secure the fertilized egg in it after fertilization.

Therefore, all the physiological changes that occur in it throughout the cycle are aimed specifically at preparing the walls for implantation of the zygote. A gradual change in the endometrium occurs throughout the cycle.

After the end of menstruation, it begins to grow and thicken, and during menstruation, its physiological rejection occurs.

Normally, the unchanged endometrium is physiologically protected from pathogenic microorganisms.

But under certain conditions that negatively affect the uterus, this protection weakens, and the infection easily penetrates deep into the functional layer, which leads to the development of inflammation.

At first, it usually manifests itself with acute symptoms, and it is at this stage of the disease that it must be actively and correctly treated. If this is not done, acute inflammation will become sluggish, that is, endometritis will become chronic.

The chronic form of endometrial inflammation is predominantly detected in young patients, that is, at the age when it is desirable to give birth to children. And in most cases, the diagnosis is made when a woman consults a doctor about not being pregnant for a long time. The disease often becomes the main cause of repeated miscarriages, complications during and after childbirth.

Causes leading to chronic endometritis

The main cause of the disease is infection of the uterus from the inside by microorganisms that can cause inflammation. They can be specific, such as chlamydia, mycoplasma, fungi, viruses.

• Nonspecific endometritis occurs if the endometrium is infected as a result of “ordinary” flora (Escherichia coli, coccal bacteria, Proteus) coming into contact with it from the external genitalia and vagina.
• As already mentioned, the endometrium is naturally protected from microbes, so their penetration into the walls of the uterus is possible only if this protection is broken.
• And this often happens when there is mechanical injury to the internal walls of an organ during:

• abortions;
• therapeutic and diagnostic manipulations - hysteroscopy, biopsy, douching;
• a woman's use of an intrauterine device;
• caesarean section;
• complicated childbirth with manual separation of the placenta.

The vulnerability of the functional layer increases with hormonal imbalances, in women with polyps and submucosal fibroids.

Patients at risk for the development of sluggish endometritis include:

• frequent abortionists;
• having a history of endocrine diseases;
• with disruption of the immune system, which may be caused by HIV infection, autoimmune processes, chemotherapy, long-term antibacterial treatment;
• frequently changing partners and having sex on menstrual periods;
• with bacterial vaginosis.

Psychosomatics plays a certain role in the development of pathology. It has been established that prolonged and frequently repeated stress contributes to the transition of acute endometritis to chronic.

Clinical picture

Slow inflammation of the endometrium manifests itself:

• cycle disruption. A woman’s periods may be insignificant, scanty or, conversely, abundant; there is often a delay; during menstruation, discomfort appears in the pelvic organs, and during exacerbation, pain;
• periodic uterine bleeding;
• secretion of mucus with pus, ichor;
• pain during intimacy.

Not all symptoms of chronic endometritis manifest themselves clearly; usually there are 1 or 2 clearly manifested clinical signs of the disease, the rest are erased or are not always disturbing.

Classification of the disease

Depending on the nature of the pathology, it can be:

• moderate degree (activity). General signs of pathology are expressed, signs of endometrial inflammation are clearly visible during ultrasound. A biopsy determines changes indicating active inflammation;
• sluggish. Symptoms are mild, ultrasound shows pathological changes, and biopsy reveals low-active inflammation;
• inactive or otherwise in remission. With this variant of the course, there are no pronounced symptoms, and endometritis is detected only by microscopic examination of biomaterial from the mucous layer of the uterus.

According to the localization of inflammation in the walls of the organ, chronic endometritis can be:

• focal - inflammation is detected only in certain areas of the endometrium;
• diffuse - pathological foci cover the entire endometrium or its main part.

Endometritis is a superficial lesion of the layer. When the infection spreads deeper, the muscle layer is captured, in this case they speak of endomyometritis.

Diagnostics

The diagnosis of chronic endometriosis is made based on:

• interviewing the patient - identifying symptoms and complaints, medical history;
• inspection. With long-term inflammatory reactions in the endometrium, it is possible to palpate lumps, determine the enlargement of the uterus; often with this disease, cysts and polyps form;
• instrumental research. Ultrasound, hysteroscopy, and curettage are prescribed to collect biomaterial for histology.

If all of the above procedures indicate chronic endometriosis, then a number of further studies are necessary:

• inoculating smears to determine the type of pathogen and establish its sensitivity to antibiotics;
• ELISA test allows you to determine antibodies to cytomegalovirus and herpes viruses;
• PCR diagnostics;
• blood test for hormones.

Complex diagnostics allows not only to determine the activity of low-grade inflammation, but also determines concomitant diseases, which is necessary to prescribe the most effective therapy.

Features and tactics of treatment of endometritis

The goal of treatment of chronic endometritis:

• elimination of the main pathogens;
• reduction of pathology symptoms;
• normalization of the menstrual cycle;
• restoration of the normal structure of the uterus, the onset of pregnancy depends on this.

It is necessary that the treatment of chronic endometritis be well-chosen and comprehensive.

The standard treatment regimen includes the following nuances.

1. Use of antibacterial medications or antiviral medications. With active chronic endometritis, patients are usually prescribed 2-3 antibiotics. And most often, one of the drugs is administered intramuscularly or prescribed in tablets, and the second is injected through a catheter into the uterine cavity.
2. Treatment with antifungal agents if it is determined that the inflammation is caused by fungi.
3. Taking immunomodulators.
4. Surgical intervention to eliminate adhesions in the uterus and remove polyps. The operation is necessary for women in cases where pregnancy is planned.
5. Taking medications that stimulate endometrial restoration. These can be hormonal agents, enzymes, medications that improve the condition of blood vessels and normalize metabolic processes.

In addition to drug therapy, patients are prescribed physiotherapy. UHF, electrophoresis, magnetic therapy. Sanatorium-resort treatment may be recommended in those health resorts where water and mud therapy, therapy with slightly alkaline mineral water are used.

Treatment of endometritis is most often long-term. During therapy, changes occurring in the uterus are assessed using repeated instrumental examinations.

Is it possible to cure a disease with traditional medicine?

For endometritis in the chronic stage, drug therapy must be prescribed by a doctor. Traditional recipes can also provide invaluable benefits, but you need to understand that their use does not lead to the destruction of pathogenic microorganisms, and therefore it is impossible to completely cope with the disease with their help.

Alternative treatment for endometritis should complement the main one. The use of herbal remedies increases the overall resistance of the body, improves biochemical reactions, and normalizes the functioning of the immune system.

Course use of herbal infusions shows good results in the treatment of endometritis in the chronic stage.

1. Take pine buds, cherry and May nettle leaves, lavender, marsh cudweed, rhizomes of leuzea and marshmallow, white sweet clover herb, wormwood in equal volume, chop and mix thoroughly. To prepare one serving, you need to pour 2 tablespoons of the resulting mixture into a thermos, pour two glasses of boiling water and leave overnight. After straining, drink the drink one-third of a glass up to 5 times a day. The duration of the course is 8 weeks.
2. Mint leaves, viburnum bark, motherwort root, thyme, chamomile flowers, mantle leaves and shepherd's purse are mixed in equal quantities and crushed. The healing infusion is prepared in the same way as the collection described above; it should be taken one third of a glass 3-4 times a day for one and a half to two months.

A decoction of St. John's wort has a positive effect on the condition of the endometrium. To prepare it, pour a glass of boiling water over a spoonful of plant leaves, heat over low heat for 5-10 minutes, infuse and filter. It is necessary to consume the decoction in a quarter cup, the frequency of administration is three times a day for 3-4 weeks. However, its use is not recommended for arterial hypertension.

Inflammatory processes can be reduced by tampons with sea buckthorn oil, which should be inserted into the vagina every evening before bed for at least 10 days.

To enhance the effect of treatment, women with endometritis should adhere to a healthy diet, give up bad habits, and normalize the state of their nervous system.

Infertility as a complication of chronic endometritis

In the chronic form of endometritis, the structure of the functional layer does not change for the better, as a result of which the process of fixation of the zygote is disrupted.

The main causes of infertility and miscarriage due to endometritis are:

• atrophy (depletion) of the endometrium of the uterus;
• malfunction of receptors located in the mucous layer. As a result of this failure, the uterus ceases to adequately respond to the level of cyclically changing hormones;
• adhesions in the uterine cavity;
• complications. Most often, inflammation of the ovaries and vaginal walls, sclerosis of the fallopian tubes.

In patients with chronic endometritis, conception can occur if the receptors still retain their functions. But this does not guarantee successful pregnancy, since changes in the endometrium can cause fading of pregnancy and miscarriage.

Complete restoration of reproductive function is possible if a woman promptly consults a doctor for treatment. Therefore, it is impossible to delay a visit to the gynecologist in case of menstrual irregularities, pain or other changes in well-being.

Preventive actions

Endometritis is easier to prevent than to treat.

Following the following recommendations helps to significantly reduce the risk of developing inflammation in the uterus.

1. Compliance with hygiene standards. Regular and properly performed washing of the genitals reduces the risk of upward penetration of microbes into the uterine cavity.
2. During intimacy with a fickle partner, you need to use protective equipment. Barrier contraception (condoms) minimizes the transmission of sexually transmitted infections.
3. Diseases that arise as a result of unprotected sexual intercourse must be treated promptly.
4. Before medical gynecological examinations, it is necessary to examine the microflora of the vagina. If inflammation and infection are detected, appropriate treatment is carried out before diagnostic and treatment procedures.
5. After a difficult birth with complications, it is necessary to do an ultrasound. The study allows timely detection of pathological changes in the endometrium.
6. It is recommended that women of any age be examined by a gynecologist at least 2 times a year.
7. Acute endometritis must be treated immediately and completely.

Conclusion

Chronic endometritis is a fairly serious disease, dangerous in terms of the development of complications, which especially concerns women who want to have children. Treatment of the disease requires a correct assessment of all pathological disorders, therefore, if alarming symptoms appear, you should contact a qualified gynecologist as soon as possible.

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Source: https://adella.ru/health/chronicheskij-endometrit.html

Treatment of chronic endometritis - how the pathology manifests itself

Chronic endometritis develops against the background of an untreated acute form of pathology. Diagnosed quite often. It occurs most often in women of childbearing age. Characterized by periods of exacerbation and remission.

What is chronic endometritis

Chronic endometritis is an inflammatory process, the area of ​​localization of which becomes the basal layer of the endometrium. The pathology is caused by the penetration of fungi, bacteria, and viruses into it.

How it manifests itself

The clinical picture is poorly expressed. The constant weakness accompanying the condition is attributed to fatigue, so the woman is in no hurry to see a specialist.

During the period of exacerbation, the disease manifests itself in such conditions as:

• scanty/heavy menstrual flow, intermenstrual spotting, delays;
• pain during frictions;
• the appearance of unpleasant-smelling discharge, the presence of purulent inclusions is possible;
• fast fatiguability;
• increased body temperature, chills;
• recurrent miscarriage;
• pain in the projection area of ​​the uterus.

There are also ultrasound signs of the disease. This:

• thickening of endometrial tissues on days 5–8 of the cycle reaches 6–7 mm, while the norm is no more than 3–4 mm;
• premature thinning of the mucosa;
• the presence of hyperechoic inclusions in the lower endometrial layer;
• diffuse/focal formations in the myometrium;
• pathological dilatation of the veins of the uterus;
• disturbance of blood flow (determined by Doppler ultrasound).

Symptoms

When inflammation is chronic, there are no signs of an acute form. Symptoms of chronic course are:

• A constant but slight increase in body temperature. The woman feels overwhelmed, tired, and her performance decreases.
• Menstrual irregularities. The patient notes lengthening/shortening of the cycle, changes in the volume of menstrual flow, metrorrhagia, spotting before and after menstruation. Such symptoms are caused by fibrosis of the connective tissue, which leads to disruption of cyclical processes in the endometrium, poor contractility of the uterus and deviations in the process of platelet aggregation.
• Pain syndrome. Pain is felt in the projection area of ​​the uterus, in the lumbar region. It is possible that it develops during the emptying of the intestines, as well as during sex.
• Discharge. Vaginal leucorrhoea becomes profuse, mucous, and smells unpleasant. May include purulent components.
• Fertility disorders. A woman becomes unable to bear a child or cannot become pregnant at all.

How to treat chronic endometritis

Treatment tactics depend on the current clinical picture. As a rule, when the pathology worsens, a woman is offered hospitalization.

Medication

Treatment is aimed at solving the following problems:

• elimination of infection;
• boosting the immune system;
• normalization of metabolic processes.

Important! It is mandatory to take oral contraceptives.

Since the cause of chronic endometritis is a bacterial infection, the woman is prescribed antibacterial and antiviral agents.

  Leeches for endometritis - the use of hirudotherapy

During the period of exacerbation and the appearance of pronounced symptoms, the patient is prescribed 2–3 types of antibiotics. In this case, a woman can receive two drugs intravenously, by drip or orally, the third is intended for intrauterine sanitation. The drug is injected into the uterine cavity through a thin catheter.

The final stage is the restoration of natural processes in endometrial tissue. To achieve the goal, a woman is prescribed:

• hormonal contraception;
• drugs containing progesterone;
• hemostatic agents.

Important! To eliminate the inflammatory process, suppositories with indomethacin and dicrofenac can be used.

Surgical

In the chronic form, surgery is practiced relatively infrequently. The indication is the presence of polypous formations and adhesions in the uterine cavity in preparation for a planned pregnancy.

Removal is carried out using an electrocoagulator during the gesteroscopy procedure.

Treatment with folk remedies

Chronic inflammation can be treated with herbs.

• It is necessary to combine equal volumes of pine buds, nettle and cherry leaves, sweet clover herb, wormwood, lavender, cucumber, roots of Leuzea and marshmallow. Grind. Take 2 tbsp. mix and brew with boiling water. Leave warm all night. Filter. Drink one third of a glass up to 5 times a day for 60 days.
• 1 tbsp. pour dry St. John's wort with boiling water (200 ml) and simmer in a water bath at low boil for 15 minutes. Let cool, strain. Take 50 ml three times a day. Contraindication: arterial hypertension.
• Tampons with sea buckthorn oil. Course duration is 10 days. Put tampons on all night.

Before starting treatment, you should definitely consult a doctor.

Is it possible to cure chronic endometritis?

Timely diagnostic tests can detect the disease at an early stage, which significantly improves the prognosis for recovery.

When identifying pathology, it is important to draw up the “correct” treatment regimen, taking into account all factors:

• degree of endometrial damage;
• activity of the ongoing process;
• the presence of developed complications;
• type of pathogen.

Doctors carry out multi-stage treatment of the disease. In the absence of acute symptoms, the course of therapy can be completed on an outpatient basis, i.e. at home.

How long does it take to treat

Everything is individual and the duration of therapy depends on many factors, in particular, the degree of development of inflammation and the general health of the patient.

It is worth noting that complete recovery occurs in rare cases. But timely medical care allows a woman to experience the joy of motherhood.

How does chronic endometritis develop?

The main reason for the chronicity of the disease is the lack of adequate treatment for acute inflammation of the endometrium.

Against the background of drug therapy, the characteristic symptoms fade away, but the inflammatory process remains not completely eliminated. Minor pain syndrome, menstrual irregularities, and pathological vaginal discharge are diagnosed over the next few months.

  Endometritis - treatment regimen and symptoms, therapy after childbirth

Causes

The initiators of an acute form of inflammation of the lining layer of the uterus are pathological microorganisms that penetrate into its cavity from the vagina. But this is only possible if the cervical canal is open and there is endometrial trauma.

Factors that provoke inflammation include:

• violation of aseptic rules when performing abortions/diagnostic curettages;
• spontaneous miscarriage, as a result of which unremoved pieces of embryonic tissue remain in the uterine cavity - an ideal base for the proliferation of pathogenic microorganisms;
• forced expansion of the cervical canal during the procedure of hysteroscopy or hysterosalpingography;
• procedure for placing an intrauterine device;
• frequent vaginal irrigation;
• complex, prolonged labor;
• sexual relations during menstruation.

Less common reasons are:

• probing the body of the uterus;
• separation of the “baby seat” after completion of childbirth manually;
• impaired immune defense;
• IVF procedure and artificial insemination.

Diagnostic methods

When diagnosing a chronic form of endometritis, the gynecologist is based on the patient’s complaints and the results of a gynecological examination.

The specialist fixes the slightly enlarged softened uterus. When trying to palpate an organ, a woman experiences pain. Pain is also felt when palpating the vaginal vaults, which signals the development of adnexitis.

Additionally assigned:

• general blood analysis;
• examination of the obtained smears;
• bacteriological examination of vaginal discharge;
• PCR;
• Ultrasound of the pelvic organs;
• hysteroscopy (if necessary accompanied by diagnostic curettage).

Types (classification)

The classification of the disease is based on various factors. Depending on the type of pathogen, the following forms of chronic endometritis are distinguished:

• nonspecific - development is due to the active reproduction of its own opportunistic microflora;
• specific - caused by the penetration of pathogenic bacteria from outside.

The morphological characteristics accompanying the disease also form the basis of the classification. Within this gradation, it is customary to distinguish the following types of chronic endometritis:

• atrophic – characterized by atrophy of the glands;
• hypertrophic – accompanied by excessive growth of the endometrium;
• cystic - the form is characterized by the proliferation of fibrous tissues with the subsequent formation of cystic formations.

Depending on the strength of the inflammatory process, there are:

• moderate – signs of inflammation are present on ultrasound, there are characteristic symptoms;
• sluggish – manifestations of the disease are minimal, detected only during transvaginal ultrasound;
• chronic inactive - signs of inflammation can only be diagnosed by examining endometrial cells under a microscope.

Additional classification:

• according to the degree of prevalence - focal and diffuse;
• according to the depth of the lesion - superficial and deep.

Do's and Don'ts

Doctors do not give any specific prohibitions or recommendations to their patients when a chronic form of endometritis is detected.

But since the disease occurs against the background of reduced immune defense, to strengthen it, the woman is advised to reconsider her diet. It is advisable to increase the content of fresh vegetables and fruits to compensate for the deficiency of vitamins and microminerals.

Important! During the period of exacerbation of the disease, you need to minimize any physical activity and refuse to visit baths and saunas.

Forecast

Complete recovery occurs in rare cases. The main direction of treatment is to eliminate signs of the inflammatory process and restore the patient’s fertile abilities. Timely therapy prevents the development of infertility.

  What drugs are used to treat endometritis?

Complications of endometritis

Typical complications of chronic endometritis include:

• development of ectopic pregnancy;
• endometrial diseases;
• pathological processes in the pelvic organs;
• cystic and other formations in the ovarian tissues.

Important! The course of pregnancy against the background of the disease is difficult.

Prevention

Specific preventive measures that can prevent the development of endometritis have not been developed by medicine. Experts advise eliminating factors from life that can cause the development of an inflammatory process in endometrial tissue. Desirable:

• refusal of casual sex, unprotected sex is especially dangerous;
• refusal of artificial termination of pregnancy.

It is extremely important to observe the rules of personal intimate hygiene. It is also necessary to regularly visit a gynecologist for preventive purposes.

Chronic endometritis and IVF

Carrying out in vitro fertilization against the background of a chronic form of inflammation of endometrial tissues is often unsuccessful. The reason is a violation of the structure of the endometrium, which is an obstacle to the full attachment of the implanted embryo.

Before IVF, to increase the effectiveness of the procedure, a woman may be prescribed:

• long-term hormonal support;
• taking phlebotonics and anticoagulants;
• use of immunostimulants.

If necessary, physiotherapeutic procedures are prescribed.

About pregnancy during pathology

Conception against the background of chronic endometritis proceeds safely, since the ovulation process is not disrupted. Difficulties begin after the fertilized egg enters the uterine cavity: it cannot be successfully implanted into the tissue of the modified endometrium.

Even if cell attachment does occur, there is a risk of spontaneous miscarriage and the development of intrauterine fetal pathologies. The reason is the insufficient supply of the embryo with the substances necessary for full development.

Carrying out treatment before pregnancy significantly increases the likelihood of its successful completion.

Important! Approximately 25% of difficult births and cesarean sections result in the development of postpartum endometritis.

What does the remission stage mean?

Remission means the absence of symptoms characteristic of the disease. It is during this period that the onset and successful development of gestation is possible.

What to do during an exacerbation

An exacerbation is accompanied by the appearance of the entire spectrum of pathological symptoms - an increase in body temperature to high levels, chills accompanying fever, and severe pain in the lower abdomen.

If clinical manifestations of inflammation appear, you should immediately consult a doctor and undergo a course of treatment.

Reviews

Olga, 30 years old

The diagnosis was confirmed after several consecutive miscarriages. This happened 7 years ago. I was treated for a long time and tried a lot of things. I was able to get pregnant only 6 months ago.

Elena, 35 years old

I couldn’t get pregnant for a long time, so my husband and I decided on IVF. During the preliminary preparation, a chronic form of endometritis was diagnosed, which was the cause of infertility. She completed a course of treatment. Result: the onset of natural pregnancy. True, you have to spend a lot of time preserving it, but the baby is worth it.

The chronic form of endometrium requires mandatory treatment. Completing the course allows you to avoid the development of serious complications.

Source: https://endometriy.com/endometrit/hronicheskij-chto-eto

Chronic endometritis: symptoms and treatment, is it possible to get pregnant, prognosis

• Inflammatory diseases of the female reproductive system are a common gynecological problem.
• In approximately 40% of cases of secondary infertility, the cause is chronic endometritis.
• More often, the disease is a consequence of untreated acute endometritis caused by trauma, infection of the endometrium during childbirth, abortion, and intrauterine interventions.

The asymptomatic course of the chronic inflammatory process greatly complicates diagnosis.

Often, pathology is detected by chance, during a preventive examination.

Causes

1. Chronic endometritis is an inflammation of the basal layer of the endometriumwhich is caused by a bacterial, fungal, viral or protozoal infection.

2. Against the background of chronic inflammation, the physiological cycle of development and rejection of the functional layer of the endometrium is disrupted, which is manifested by menstrual irregularities .
3. With chronic endometritis, uterine bleeding, recurrent miscarriage, and infertility may occur.

4. Prerequisites for the development of the inflammatory process may be injuries to the uterine mucosa and the presence of an infectious agent.

Inflammation begins and proceeds acutely and becomes chronic. In this case, clinical manifestations fade, the influence of infection is reduced to a minimum.

• Depending on the nature of the pathogen, inflammatory reactions can be specific or nonspecific .
• Specific endometritis is caused by pathogenic microorganisms that penetrate the uterine cavity from the overlying or underlying parts of the reproductive system.
• Chronic nonspecific endometritis is caused by representatives of opportunistic flora that normally live in the vagina, on the surface of the skin, and the rectal mucosa.
• This disease can develop against the background of an intrauterine device, HIV, or the use of hormonal drugs.
• More often, the chronic form of the disease occurs when infected with mycoplasma, E. coli, chlamydia, and some strains of the human papillomavirus.
• Provoking factors:

• intrauterine interventions, medical abortion, curettage of the uterine cavity, biopsy, embryo transfer, hysteroscopy;
• complicated childbirth;
• introduction of an intrauterine device, its prolonged use;
• vaginitis, colpitis, cervicitis, cervical erosion without treatment;
• surgical treatment of diseases of the pelvic organs;
• sexually transmitted diseases.

In approximately 30% of cases, the cause of the disease cannot be determined.

Infection of the injured uterine cavity leads to the development of an acute inflammatory process; when the disease passes into the chronic stage, the role of infection sharply decreases.

At this stage, physiological and structural disorders predominate , leading to disorders of the menstrual cycle and reproductive function.

According to the course of the disease, they are distinguished:

1. Often recurrent form.
2. Chronic inflammation in a phase of stable remission.
3. Exacerbation.

Depending on the morphological changes of the endometrium, there are:

• hypertrophic;
• atrophic;
• cystic endometritis.

Changes of the atrophic type lead to exhaustion and fibrosis of the mucous membrane. It is this form of pathology that most often leads to uterine infertility.

With hypertrophic endometritis, the functional layer of the endometrium grows excessively; the cystic variation is characterized by fibrosis and the formation of cystic cavities.

The ICD-10 code for chronic endometritis is N71.9.

More about endometritis and methods of its treatment:

How to identify: symptoms, signs, pain, discharge

1. The symptoms of the disease are nonspecific and mild , so many women do not take them seriously.
2. Manifestations of malaise are sometimes attributed to the consequences of overwork, inappropriate posture during intimate contact, and diseases not associated with lesions of the reproductive system.

3. In chronic endometritis the following are observed:

• menstrual irregularities (scanty or too heavy discharge during menstruation, spotting during the intermenstrual period, delayed menstruation);
• pain in the lower abdomen that appears during physical activity before menstruation;
• discomfort or pain during sexual intercourse;
• purulent or mucous discharge with an unpleasant odor;
• general weakness, increased fatigue;
• increased body temperature in the evenings, at night;
• chills;
• miscarriage.

With mild chronic endometritis, there may be no subjective complaints at all. The disease is detected during an examination for infertility.

Outside of exacerbations, a woman may be bothered by the following symptoms:

• discomfort or pulling sensations in the lower abdomen before menstruation;
• irregular periods;
• heavy discharge after menstruation.

Pain in chronic endometritis is usually aching or pulling , tolerable, sharp sensations can appear during intimacy.

The color, consistency, and amount of discharge vary greatly; they can be brown, greenish-yellow, mucous, or purulent.

Why it’s dangerous: possible consequences, complications

• The most common complication of inflammatory diseases of the reproductive organs is infertility .
• If pregnancy does occur, chronic endometritis is a prerequisite for its complicated course.
• Against the background of pathology, polyhydramnios or oligohydramnios , disturbances of fetoplacental blood flow, and intrauterine infection of the fetus are possible.
• Inflammatory processes in the uterus are risk factors for the development of other pathologies:

• ectopic pregnancy;
• endometrioid disease;
• hyperplastic diseases of the endometrium;
• inflammatory and purulent-inflammatory diseases of the pelvic organs;
• ovarian tumors and cysts.

Diagnostics

1. If you suspect possible damage to the reproductive organs, you should contact a gynecologist .
2. The earlier the disease is detected, the higher the chances of successful treatment and restoration of reproductive function.

3. To diagnose chronic endometritis, the following are carried out:

• microscopic examination of a vaginal smear;
• bacterial culture from the endocervix;
• determination of hormonal activity of the ovaries;
• PCR;
• Ultrasound of the uterus and appendages.

, a hysteroscopic examination and endometrial biopsy may be prescribed .

Ultrasound reveals pronounced changes in the thickness of the endometrium and blood vessels of the uterus, expansion of the uterine cavity, adhesions, cords and other connective tissue formations.

Methods for diagnosing endometritis:

Treatment regimen

Therapy for chronic endometritis is carried out in several stages with periodic monitoring of the effectiveness of treatment.

Complex therapy includes:

1. Elimination of infection.
2. Strengthening the immune system.
3. Normalization of metabolic processes.
4. Treatment with hormonal drugs.

More often, gynecologists are faced with chronic inflammation of bacterial origin.

Drugs

The course of treatment begins with antibacterial drugs; treatment of chronic endometritis with antibiotics Metronidazole, Cefotaxime, Amikacin .

Antibiotics are administered intravenously using droppers. Infusions are carried out 2 times a day. Amikacin is used as an intramuscular injection.

To normalize the menstrual cycle, patients are prescribed contraceptives .

The drug is selected individually, taking into account age, general health and other characteristics of the body. The minimum duration of a course of hormonal therapy is 3 months.

To restore normal metabolic processes in the endometrium, the patient is prescribed a course of antioxidant and metabolic drugs and vitamin therapy .

Additionally, physiotherapeutic treatment is prescribed; the complex of procedures may include: phonophoresis, laser therapy, magnetic therapy, electrophoresis.

The greatest effect is observed after a course of electrophoresis with copper and zinc ions and microwave therapy.

The effectiveness of treatment is assessed according to several criteria:

1. Removal of the infectious agent.
2. Normalization of the menstrual cycle.
3. Elimination of symptoms of inflammation.
4. Restoring fertility.

How to cure with folk remedies

Inflammation of the uterus can be treated with herbal infusions .

To prepare the collection, take pine buds, cherry leaves, nettles, sweet clover grass, wormwood, lavender, cudweed, Leuzea roots, and marshmallows in equal parts.

Plant materials are crushed and mixed. Brew two tablespoons of the mixture in 0.5 liters of boiling water and leave in a thermos for at least 12 hours. Take a third of a glass 3-5 times a day. The course of treatment is 2 months.

In equal parts, take chamomile flowers, viburnum bark, mint, motherwort, thyme, shepherd's purse, and mantle leaves, chop and mix. Prepare and take the infusion according to the scheme indicated above.

For maximum effect, two courses of treatment with different preparations must be carried out sequentially.

For endometritis, you can take a decoction of St. John's wort . 1 tbsp. Pour a glass of boiling water over the chopped herbs and boil for 15 minutes. Strain the cooled broth, take a quarter glass three times a day.

St. John's wort is contraindicated in cases of exacerbation of inflammation, as well as in patients suffering from hypertension.

To treat inflammation, you can use tampons with sea buckthorn oil .

Used in a course for 10 days. It is better to coordinate treatment with traditional methods with your doctor.

The patient should be patient and complete the entire recommended course .

Is it possible to get pregnant: pregnancy before and after recovery

One of the most pressing symptoms of chronic endometritis is reproductive dysfunction, which can manifest itself as inability to conceive or miscarriage.

IVF attempts in such patients often end in failure. In the early stages of a chronic inflammatory process, pregnancy is possible, but in most cases it occurs with complications.

• After treatment, the chances of getting pregnant and giving birth to a healthy baby increase significantly.
• Inflammatory processes in the uterus are incompatible with IVF.
• If chronic endometritis is detected, before IVF, both a course of treatment according to the standard regimen and mandatory prevention of post-inflammatory complications are prescribed.

After treatment, the chances of a successful embryo transfer increase, but it is impossible to guarantee the success of the procedure in advance.

When pregnancy occurs, the expectant mother is under close medical supervision and regularly undergoes a course of preventive therapy to prevent complications.

Increased medical supervision is also required when pregnancy occurs against the background of endometritis. There is no treatment for the pathology at this time; therapy is aimed at maintaining the pregnancy.

What to do to prevent the disease

1. The chronic inflammatory process in most cases is preceded by an exacerbation of endometritis.
2. Among preventive measures, timely and correct treatment of inflammatory diseases of the reproductive system.

3. The risk of developing the disease is reduced by strictly following the doctor’s recommendations when using an intrauterine device and preparing for diagnostic and therapeutic procedures in the uterine cavity.
4. Important compliance with the rules of intimate hygiene and hygiene of sexual life.

Patients with chronic endometritis rarely achieve complete recovery. But the course of treatment helps to achieve a state in which it is possible to conceive, carry and give birth to a healthy child.

Source: https://beautyladi.ru/xronicheskij-endometrit/

How to treat chronic endometritis of the uterus

The danger of inflammation of the inner lining of the uterus lies in the high risk of reproductive dysfunction. Chronic endometritis is one of the most common causes of infertility (about 40% of all cases).

The main causes of the pathology are due to infection and trauma to the endometrium during any intrauterine interventions.

The difficulty of accurate diagnosis is explained by the mild and asymptomatic course of the disease: signs of chronic endometritis are minimal, so detection of the disease can be accidental - during a preventive ultrasound. Treatment should be comprehensive and long-term, especially in cases of impaired reproductive function.

Causal factors of the disease

A prerequisite for the occurrence of an inflammatory process is infection of the inner surface of the uterus. At the first stage of the disease, endometritis is acute, and as the inflammation subsides, the disease passes into the chronic stage, characterized by a minimal set of symptoms. The immediate causes of pathology are the following microbes:

• nonspecific (opportunistic microorganisms from the vagina, skin and rectum);
• specific (viral and bacterial types of microbes that enter the vagina and uterus through sexual contact).

Most often chronic endometritis occurs when infected with chlamydia, mycoplasma, viruses, and E. coli. An important factor in the appearance of endometritis are provoking risk factors:

• any types of diagnostic and therapeutic intrauterine interventions (medical abortion, spontaneous miscarriage, diagnostic scraping, taking a biopsy from the cervical canal or endometrium, hysteroscopy, embryo transfer during IVF);
• insertion and long-term wearing of an intrauterine device;
• frequent vaginitis and colpitis without effective treatment;
• cervicitis and cervical erosion of viral origin;
• surgeries in the vagina, cervix and pelvic organs;
• complications during childbirth.

The causes of acute inflammation in the uterus are microbial infection. The chronic inflammatory process is a consequence of acute endometritis, but the significance of the microbial factor is sharply reduced: with low-symptomatic chronic pathology of the endometrium, anatomical and physiological disorders predominate, leading to deterioration of menstrual and reproductive function.

Variants of the inflammatory process

Depending on the cause, chronic endometritis is divided into 2 types:

• nonspecific option;
• specific inflammation.

According to the course of the inflammatory process, they are distinguished:

• chronic inflammation of the uterus in a phase of stable remission;
• exacerbation of chronic endometritis;
• often recurrent variant of chronic inflammatory disease of the endometrium.

Prognostically more important is the morphological classification, dividing intrauterine pathology into the following options:

• atrophic endometritis, characterized by thinning and fibrosis of the uterine mucosa;
• cystic appearance, in which cystic cavities are formed against the background of fibrous changes and blockage of the endometrial glands;
• hypertrophic type, when the inflamed endometrium grows.

The atrophic variant most often leads to the uterine form of infertility in chronic endometritis, and other types of the inflammatory process provoke gynecological diseases.

Symptoms of pathology

Mild chronic endometritis is a consequence of autoimmune, fibrous-adhesive and atrophic processes in the uterine cavity. Symptoms are scanty: a woman may not have any complaints. The only problem is the inability to conceive a child. It is this complaint that can become the main symptom of chronic endometritis, which will be identified during examination.

With endometritis against a background of a high degree of activity, the doctor will identify the following symptoms typical for exacerbation:

• pain in the abdomen that occurs periodically in the form of severe pain;
• unpleasant vaginal leucorrhoea;
• increase in temperature in the evening and at night;
• menstrual irregularities;
• problems with intimacy (pain during intercourse);
• miscarriage (the outcome of a successful conception is a frozen pregnancy and spontaneous abortion).

With chronic endometritis, without exacerbation, symptoms are minimal. Most often a woman is worried about:

• scanty irregular periods;
• pulling sensations in the lower abdomen before menstruation;
• increased vaginal discharge after menstruation.

The main and most relevant symptom of chronic endometritis is impaired fertility, manifested by infertility, miscarriage or unsuccessful IVF attempts.

Diagnosis of chronic inflammation of the uterus

Timely detection and treatment of the inflammatory process in the uterine cavity is the best prevention of uterine infertility. The diagnosis of chronic endometritis can be made based on the following studies:

• microscopy of vaginal smears and assessment of bacterial cultures from the endocervix;
• PCR diagnosis of specific infections;
• determination of hormonal function of the ovaries;
• ultrasound scanning of the uterus and appendages;
• hysteroscopic examination;
• endometrial biopsy during uterine endoscopy.

Reliable ultrasound criteria for chronic endometrial pathology are:

• pronounced thickening or thinning of the mucous membrane;
• uneven contour and heterogeneous structure;
• uneven, “jagged” line of closure of the anterior and posterior uterine walls;
• expansion of the uterine cavity due to exudate or cystic formations;
• the presence of small bubbles in the deep basal layer of the endometrium;
• cords, adhesions and synechiae in the uterine cavity;
• changes in the vessels of the uterus (dilation of veins, impaired blood flow in the arteries).

Adenomyosis and chronic endometritis look very similar during ultrasound examination, so the doctor needs to accurately separate these variants of gynecological pathology in order to choose the optimal treatment tactics.

Principles of treatment

The treatment regimen for chronic endometritis must be comprehensive and consistent: the doctor will definitely prescribe step-by-step therapy with constant monitoring of the effectiveness of the treatment measures. The specialist knows how to treat uterine pathology, so you need to trust the doctor and strictly follow medical recommendations. Treatment of chronic endometritis in women includes the following steps:

• Removing the infection;
• Immunotherapy;
• Restoration of endometrial metabolic processes;
• Hormonal therapy.

If a microbial factor is identified, it is necessary to conduct a course of antibacterial or antiviral therapy. A prerequisite for successful treatment is the choice of a drug that has optimal sensitivity to microorganisms. If necessary, the doctor will recommend suppositories for local action on pathogenic vaginal microflora.

The best option for increasing general and local immune protection is the use of rectal or vaginal suppositories (Genferon, Viferon, Galavit). The drugs will help remove the viral infection and have a positive effect on the immune system.

To improve nutrition and restore metabolism in the uterine mucosa, it is necessary to use complex therapy, including the following therapeutic options:

• vitamin therapy;
• the use of drugs with metabolic and antioxidant effects;
• physiotherapy (electrophoresis, phonophoresis, magnet, laser exposure).

The doctor will definitely prescribe oral hormonal contraceptives, which perform 2 tasks - prevent pregnancy and improve ovarian function.

The minimum duration of a course of hormone therapy is 3 months.

After this, it is necessary to create optimal conditions for conception, for which the specialist will recommend gestagenic drugs (Duphaston, Utrozhestan) for the 2nd phase of the menstrual cycle.

Criteria for the effectiveness of therapy for chronic inflammation of the uterus:

• elimination of all symptoms;
• complete removal of specific microbes;
• obtaining a normal image during ultrasound scanning;
• normalization of the regularity and abundance of menstruation;
• the onset of a desired pregnancy.

Complications and consequences

Any type of inflammation in the uterus can lead to infertility. This complication is the most common and dangerous consequence of chronic endometritis. In addition, you should be wary of the following problems:

• formation of hyperplastic diseases of the endometrium (polyp, cystic hyperplasia, adenomatosis);
• uterine leiomyoma;
• endometrioid disease;
• purulent-inflammatory foci of infection in the pelvic organs (oophoritis, salpingitis, adnexitis, parametritis);
• ovarian cysts and tumors;
• ectopic pregnancy;
• complications during gestation (intrauterine infection, impaired blood flow in the placenta, oligohydramnios, polyhydramnios, premature birth)

You need to know the dangers of chronic endometritis in order to do everything possible to prevent the disease.

Preventive actions

Effective measures to prevent chronic endometritis are:

• timely and complete treatment of colpitis, cervicitis and cervical erosion;
• maintaining sexual hygiene;
• following the doctor’s recommendations when wearing an intrauterine contraceptive device;
• proper preparation for any gynecological diagnostic and therapeutic procedures;
• maintaining and maintaining normal immune defenses.

As doctors' reviews show, it is extremely difficult to completely and permanently get rid of chronic endometritis.

Carrying out a full and comprehensive course of treatment will help create conditions for the desired pregnancy to occur: it is impossible to cure chronic endometritis 100%, but it is quite possible to conceive, carry and give birth to a baby.

The main condition is not to postpone therapy until later, because the time factor plays a negative role in successfully getting rid of uterine pathology.

Source: https://gynecologyhelp.ru/endometrit/hronicheskij.html