Causes of chronic endometritis of the uterus. All about endometritis: treatment and symptoms, complications and prevention. Treatment with folk remedies

Endometritis affects the mucous membrane of the uterus, its most upper layer- endometrium. There are a lot of reasons for the appearance of this disease, as well as types.

Varieties of endometritis:

• Spicy. It appears immediately after infection with a virus or bacteria. It is characterized by pronounced symptoms.
• Chronic. The patient may long time do not suspect that the patient. Often the disease is diagnosed after an examination for infertility.
• Specific. Caused by specific pathogens, more precisely ailments, sexually transmitted diseases. In this case, the symptoms are pronounced.
• Not specific. called conditionally pathogenic microflora, which has grown due to hypothermia or a decrease in immunity.

Causes of endometritis

List of causes of endometritis:

1. Curettage or abortion. After scraping, scraps of mucous and blood clots may remain in the uterus. This is what causes inflammation.
2. Hysteroscopy. During such a diagnostic procedure, you can also get inflammation of the endometrium. The fact is that the mucous membrane is injured by the probe. Conditionally pathogenic microorganisms from the blood can enter the wounds.
3. Intrauterine device. Very often, after the installation of the spiral, the endometrium becomes inflamed. This is due to the fact that the device injures the cervix.
4. Sex during menstruation. A lot of infections are transmitted through the blood. Even after sexual contact with a healthy partner, endometritis can develop during menstruation. This is due to the fact that cervical canal ajar and bacteria penetrate the uterus much faster.
5. Childbirth followed by curettage of the placenta. Quite often, after childbirth, the placenta is not born, as it has grown to the uterine cavity. In this case, the doctor scrapes it out, violating the integrity of the inner layer of the uterus. The resulting wounds are the entrance gate for infection.
6. Messy sex life . Very often, the infection enters the uterine cavity from the vagina. This happens with unprotected intercourse with a carrier of the infection.

The main symptoms of endometritis

The list of symptoms of acute and chronic endometritis:

• Temperature. In acute endometritis, an increase in temperature up to 40 ° C can be observed. In chronic cases, subfebrile temperature is often present in the region of 37-37.2 ° C.
• Vaginal discharge. In the acute course of the disease, abundant purulent and cloudy discharge with a characteristic odor are observed. In chronic endometritis, they differ in color and smell, depending on the causative agent of the disease. With trichomoniasis, the discharge is thick and green. Gonorrhea produces cloudy, whitish, frothy mucus.
• Changes in the menstrual cycle. They are observed after the flow of an acute form into a chronic one. Chronic endometritis is characterized by long periods, more than 7 days. At the beginning and at the end of the cycle there are spotting.
• Lower abdominal pain. In acute endometritis, the pain is aching, which can radiate to the sacrum. Back aches often. In chronic endometritis, it is weak and passes quickly.
• Uterine bleeding. This is often seen in acute endometritis after cleansing by abortion. In some cases, uterine pyometra is possible. It's a collection of pus.

Features of the treatment of endometritis

Before treating endometritis, consult your doctor. This disease can be treated with both drugs and folk remedies. The recipes of healers and traditional healers are an addition to the therapy prescribed by the gynecologist. In acute endometritis, you can not be treated only with folk remedies!

Treatment of endometritis with folk remedies

Folk recipes for the treatment of endometritis:

1. Bay leaf. For the procedure, you will need 20 g of dry leaves. It is necessary to take an enameled bucket and pour the leaves into it. After that, it is worth boiling the grass in a container for 2-5 minutes. Allow the liquid to cool slightly and sit on the bucket, wrapping yourself in a towel. This remedy is excellent for inflammation of the genitourinary system. Carry out the procedure at night, for 14 days.
2. Sea buckthorn oil. It's quite old and effective way, which was used by our grandmothers. It is necessary to take a piece of a sterile bandage and put cotton wool inside. Tie in a knot and soak it with sea buckthorn oil. Leave the tampon on all night. The course of treatment is 10-12 days. The oil reduces inflammation and promotes healing of cervical tissues.
3. St. John's wort. Interesting and effective recipe. It is necessary to pour 20 g of dry grass into 500 ml of boiling water and simmer over low heat for 10 minutes. Further, the agent is filtered and taken half a glass three times a day.
4. forest hay. You need to take a bunch of hay and put it in a bucket. Pour in 5 liters of water and put on fire. Bring to a boil and remove from heat. Put the patient on a bucket and wrap with a towel. You need to sit until the liquid has completely cooled. The course of treatment is 14 days.
5. Fern. Purchase dry fern leaves from the drugstore. It is necessary to pour 20 g of dry raw materials with 280 ml of cold water and boil for 2 minutes. After that, strain the broth and take 70 ml 3-4 times a day. Continue treatment for 10-15 days.
6. Citrus. Take one large lemon and an orange. Wash tropical fruits thoroughly and dry them. Grind in a meat grinder or in a blender. Enter 10 drops onion juice and 10 g of granulated sugar. Close the jar and shake it. Take the drug in a teaspoon. For a day you need to take 3-4 tablespoons of the medicine. The course of treatment is 18 days.

Treatment of endometritis with drugs

Review medical preparations for the treatment of endometritis:

• Antispasmodics. These types of medications are used to reduce pain. In a hospital with acute endometritis, Spazmalgon and No-Shpu are used in injections. The drugs are administered twice a day. This significantly reduces pain in the lower abdomen and in the sacrum.
• Antibiotics. In general, antibiotics are prescribed in the very first stages. a wide range actions. In the hospital it injectables such as Ceftriaxone, Ceftazidime. If the treatment is carried out at home, then antibiotics are prescribed in tablets: Doxycycline, Ofloxin, Ormax, Metronidazole.
• Antifungal drugs . Often, antibiotics are combined with antifungal drugs, as there is a risk of developing candidiasis. In combination with them, they take Nystatin, Fluconazole, Futsis.
• Antipyretic drugs. given if the patient has heat. It is best to use the drugs Ibuprofen, Aspirin, Paracetamol.
• Decongestants. For this purpose, antihistamines are prescribed. Cetrin, Edem, Loratadin are considered quite effective and safe. These drugs help reduce the size of the uterus, relieve inflammation and swelling of the tissues.

Treatment of endometritis with topical medications

Overview of suppositories and ointments for the treatment of endometritis:

1. Hexicon. The active substance of this drug is chlorhexidine, which is effective against bacteria, viruses and fungi. It is used to treat endometritis provoked by Trichomonas, gardnerella, chlamydia. Candles are placed twice a day. One in the morning and one before bed.
2. Terzhinan. Combined candles, which contain Ternidazole, Neomycin, Nystatin and Perdnisolone. This drug can be considered universal, as it is effective against Staphylococcus aureus, fungi of the genus Candida, trichomonads and gram-positive bacteria. Such a wide spectrum of action is due to the substances that make up the candles. Enough two candles a day for 10 days to cure endometritis.
3. Longidaza. The drug is prescribed after ultrasound, when the presence of adhesions is confirmed and severe inflammation in the uterine cavity. The composition of the drug contains hyaluronic acid and mannitol. Thanks to these components, uterine edema is reduced and adhesions are destroyed.
4. Polygynax. It is too combination drug which contains antimicrobial and antifungal components. The suppositories contain nystatin, neomycin and polymyxin. The main advantage of the drug is that its components do not violate the beneficial microflora of the vagina. Candles are used for endometritis caused by gram-positive and negative microorganisms.
5. Ginalgin. Candles widely used in gynecology. They contain metronidazole and chlorquinaldol. Thanks to these substances, suppositories are effective against fungi and bacteria. This drug used to treat acute and chronic endometritis provoked by STIs.
6. Iodoxide. Candles contain povidone-iodine, which inhibits the growth and reproduction of pathogenic and opportunistic microorganisms. Candles differ in antibacterial and antiseptic action.
7. Klion-D. Effective suppositories containing metronidazole and miconazole. Accordingly, they are used for endometritis, provoked by fungi and bacteria, as well as protozoa.

Consequences of endometritis

Complications of endometritis:

• spikes. Due to the inflammatory process, the layers of the endometrium are layered one on one. This may affect the deeper layers in the uterus - the myometrium. This is fraught with the occurrence of adhesions and nodes. Adhesions may appear in the fallopian tubes, which prevents the egg from moving to the uterus.
• Polyps of the uterine cavity. The result of endometritis is endometrial hyperplasia. When the layers of the endometrium build up, polyps appear, which feed on blood vessels.
• Adenomyosis. This is the germination of the endometrium into the layers of the myometrium. Scars form in the uterine cavity, which prevent pregnancy. In addition, constant spotting appears, as well as pain during sex.
• cysts. Due to inflammation, cysts can form on the ovaries or in the uterine cavity. This interferes with pregnancy and may cause the removal of the ovary.
• Risk of miscarriage. If, nevertheless, pregnancy has occurred, then endometritis can cause premature birth or rejection gestational sac.

PCR diagnostics. The study is used to identify various specific infections. Used to diagnose sexually transmitted diseases.

Linked immunosorbent assay. This blood test also helps in the detection of sexually transmitted diseases.

Treatment of acute endometritis

Combination of penicillins and beta-lactam antibiotics:
augment 1.2 g (intravenously) 4 times a day + unazine 1.5 g (intramuscularly) 4 times a day.

Combination of second-generation cephalosporins with nitroimidazoles and aminoglycosides
Cefazolin 1 gr. (intramuscularly) 3 times a day + netrogil 0.5 g 3 times a day (intravenously) + gentomycin 0.08 g (intramuscularly) 3 times a day.

The optimal dosage, treatment regimen and duration of antibiotic therapy is 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, washing 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 by the gynecologist individually.

Fight against intoxication
With endometritis, the volume of affected tissues is large, because the amount of toxins released by bacteria is large. Getting into the bloodstream, toxins have a damaging toxic effect on all structures of the body. Therefore, it is necessary to take all measures for the speedy removal of toxins circulating in the blood. For this, they are used various solutions used in the form of droppers (saline solution, reopoliglyukin, refortan, albumin). Together with droppers, it is possible to use antioxidant preparations (vitamin C).

Immunostimulation
The ongoing 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 fight. This requires treatment in a hospital, where conditions are created for bed rest and rational nutrition.

Also, in order to increase the protective properties of the body are used vitamin preparations(vitamin C and B vitamins), as well as drugs that stimulate non-specific immunity:

• thymalin or T activin 10 mcg daily, the course of treatment is 10 days
• viferon in the form rectal suppositories from 500 thousand units, 2 times a day, the course of treatment is 5 days.

Chronic endometritis, causes, symptoms, diagnosis and treatment

How does chronic endometritis develop?

Symptoms of chronic endometritis

• Irregular menstrual cycle
• Profuse bleeding during menstruation
• Appearance spotting during the intermenstrual period
• Soreness in the lower abdomen not associated with the phase of the menstrual cycle
• Spontaneous abortions (miscarriages) may occur early dates

Diagnosis of chronic endometritis

• Visit to the gynecologist - the gynecologist will be interested in whether you have had acute endometritis in the past, pelvic surgery, abortions, curettage, or endoscopic operations.
• Gynecological examination may reveal a moderate increase in the size of the uterus, scanty discharge from the uterine cavity (external pharynx 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 violation of the structure of the endometrium, an increase in the size of the uterus.
• Diagnostic curettage- allows you to extract for research the endometrium of the uterus. In the future, this will allow studying the structure of the endometrium, isolating the infectious agent and determining its sensitivity to antibacterial drugs.
• blood PCR will help identify venereal diseases, which can cause chronic inflammation of the uterine mucosa

Treatment of chronic endometritis

In the event that the reason was the presence of suture material in the uterine cavity, it is necessary to consider, together with your gynecologist, the possibility of its removal.

In the event that the cause was chronic vaginosis need to be restored normal microflora vagina with live cultures beneficial bacteria(hilak forte, lineks, atsilakt) and normalization of immunity.
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?

The development of postpartum endometritis is facilitated by:

• violation of the integrity of the cervical barrier;
• violation of the integrity of the endometrium;
• protracted childbirth;
• manual examination of the uterine cavity;
• maternal trauma during childbirth;
• decrease in maternal immunity.

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-perfused 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. Postpartum area inner surface uterus, to which the placenta was attached, is wound surface large diameter, in the area of ​​​​which the protective properties are practically absent. As a result, bacteria can freely multiply, leading to the development of endometritis.

The final recovery of the endometrium occurs within 4 to 6 weeks after childbirth. This entire period is potentially dangerous in terms of the development of infectious complications.

protracted labor
Protracted labor is defined as labor that lasts more than 18 hours for nulliparous 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 a long anhydrous period ( after the passage of amniotic fluid, but before the birth of the child) and an open cervical canal 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 child, the uterus re-contracts and the placenta is born ( that is, the release of the placenta and fetal membranes from the uterine cavity). If a given period is delayed or proceeds with any violations ( for example, the doctor found tears or deformation of the placenta, indicating that part of it may have remained in the uterus), the doctor performs a manual examination of the uterine cavity in order to remove the remnants of the placenta. Although this manipulation is performed with sterile gloves and in compliance with all asepsis 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.

Maternal trauma during childbirth
During childbirth, various injuries to the internal organs of a woman can occur ( cervical rupture, uterine rupture), which lead to a violation of the barrier function of the organ, and also require additional surgical interventions (wound suturing), contributing to the development of endometritis.

Reduced maternal immunity
immune suppression ( protective properties of the body) mothers during pregnancy is natural process preventing 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 caesarean section?

A caesarean 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 asepsis rules ( prevent the entry of microorganisms into the surgical wound), certain bacteria can still enter the uterine cavity ( for example from respiratory tract women in labor or medical personnel, with skin women in labor with poor treatment, and so on), which can lead to the development of endometritis.

Cesarean section can be performed in a planned manner or for emergency indications, and the course of the operation and the risk of developing postoperative endometritis in both cases is different.

Differences between planned and emergency caesarean section

Is it possible to get pregnant with endometritis?

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, the male sex cells ( spermatozoa) penetrate into the uterine cavity, and then into the fallopian tubes, where one of them merges with the female sex cell ( ovum). The resulting cell zygote) begins to divide, while gradually moving into the uterine cavity. On the 8th - 9th day after conception, the implantation of the future embryo occurs ( blastocysts) into the functional layer of the endometrium ( mucous membrane that lines the inside 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 action of the hormone progesterone until it completely surrounds the attached blastocyst.

With the development of endometritis, a violation of the above processes occurs, as a result of which the development of the fetus becomes impossible. Mechanisms of pregnancy failure differ in different forms diseases.

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) strikes as a functional layer ( usually separated 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 nature. noted pronounced infiltration endometrial leukocytes ( neutrophils, lymphocytes) - protective cells of the immune system that fight foreign microorganisms. Under these conditions, the process of fertilization is impossible, since the spermatozoa are destroyed in the uterine cavity without reaching the egg. If, nevertheless, fertilization has occurred, then 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 exudate release.

Chronic endometritis
Usually it is the result of undertreated acute endometritis and is characterized by a long, sluggish inflammatory process in the uterine mucosa. Clinical manifestations of chronic endometritis can be very poor, which is why a woman can 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 ( cicatricial) tissue in the lining of the uterus.
• Lymphoid infiltration – cluster a large number lymphocytes in the basal layer of the endometrium.
• Atrophy of the glands a decrease in the number and death of the endometrial glands, which is manifested by its thinning.
• The formation of cysts proliferation of the lining of the uterus which can be observed in chronic endometritis) leads to compression excretory ducts glands, resulting in the formation of cavities filled with the secret of these glands.
• The 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.
• Disturbance of sensitivity to hormones - occurs due to the fact that the concentration of receptors for steroid sex hormones decreases in the uterine mucosa ( 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?

Endometritis is an infectious inflammation of the mucous membrane of the uterine cavity ( endometrium), which develops as a result of the penetration of alien microflora from the outside. Despite the possibility of developing dangerous complications ( such as infertility), acute endometritis responds fairly well to antibiotic treatment.

With endometriosis, migration and growth of endometrial tissue in various areas is observed. 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 estrogen) the endometrium is prepared for implantation of the embryo ( there is an increase in the functional layer, the appearance of a large number of glands, and so on). If pregnancy does not occur, the concentration of estrogens and progesterone in the blood decreases, which leads to rejection of the functional layer of the endometrium, that is, to menstruation, after which its gradual recovery begins ( due to the basal layer).

In 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

Is it possible to cure endometritis with folk remedies?

In the treatment of endometritis is used:

• Infusion mother-and-stepmother. The tannins that make up the plant have a pronounced anti-inflammatory and antibacterial action. To prepare an infusion, 50 grams of chopped coltsfoot grass must be poured with 1 liter boiled water and insist for 4 hours. After that, carefully strain and take orally 1 tablespoon 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 chopped nettle leaves with 1 liter of boiling water and insist for 2 to 3 hours. Strain and take orally 1 tablespoon of infusion 4-5 times a day half an hour before meals and at bedtime.
• A decoction of blueberries. It has anti-inflammatory, astringent, antimicrobial and weak diuretic action. To prepare a decoction of 100 grams of dried blueberries, pour 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 body's physical endurance. To prepare the infusion, you need to take 1 tablespoon of each ingredient ( crushed) and pour 500 ml of boiling water. Infuse for 2 hours, then strain and take 50 ml ( 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 crushed plantain grass 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 not more than 1 month.
• Douching of 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 a decoction, 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. The resulting decoction is used warm for douching ( flushing) vagina. For this purpose, you can use an ordinary medical pear or a special syringe.

Is there a cure for endometritis?

Endometritis is an infectious inflammatory disease that affects the lining of the uterus ( endometrium). Under normal conditions, bacteria cannot enter the uterine cavity, as this is prevented by the narrow lumen of the cervix and the cervical mucus in it. In addition, the normal microflora of the vagina also prevents the development of foreign microorganisms.

The development of endometritis is possible only after the violation of the integrity of the described barrier, which is observed during various medical manipulations ( abortion, digital examination vagina, caesarean section), during natural childbirth or with vaginosis ( replacement of the normal microflora of the vagina with pathogenic microbial associations). In this case, foreign bacteria enter the surface of the endometrium, causing the development of an inflammatory process and clinical manifestations of the disease.

Prevention of endometritis includes:

• Compliance with personal hygiene. Regular hygiene of the external genital organs prevents the development of vaginosis and reduces the risk of penetration of pathogenic microorganisms into the uterine cavity.
• Protected sex. The use of 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 infectious diseases. Adequate treatment sexually transmitted infections begin with broad-spectrum antibiotics ( for example, ceftriaxone 1 gram 1 time per knock 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, as well as at least 3-5 days after the disappearance of the clinical manifestations of the disease.
• Study of the microflora of the vagina before medical procedures. This study should be carried out before hysteroscopy ( examination of the uterine cavity using a special apparatus), abortion, natural childbirth and other activities that increase the risk of infection of the uterine cavity. If at the same time pathogenic microflora is detected, then the study is postponed, and antibacterial drugs are prescribed. Before performing the planned manipulation, a repeated study of the vaginal microflora is shown.
• Preventive use antibiotics. After a caesarean section, complicated delivery, abortion, or other medical manipulations associated with increased risk 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 manipulation.
• Ultrasound procedure ( ultrasound) in the postpartum period. This study is conducted for women in whom childbirth proceeded with any complications. Although ultrasound does not allow diagnosing endometritis on early stages, it can be used to detect blood clots and remains of the placenta ( placenta and membranes, which are usually shed from the uterus after the baby is born) in the uterine cavity. These complications from big share probabilities can lead to the development of postpartum endometritis, therefore, if they are detected, adequate treatment is necessary ( from the appointment of drugs that increase the contractile activity of the uterus to instrumental removal of the remains of the placenta).
• Regular follow-up with a gynecologist. Women of reproductive age are advised to visit a gynecologist with preventive purpose at least 2 times a year. In this case, it is necessary to take a general blood test and a general urinalysis, an analysis of the vaginal microflora, and perform an ultrasound scan of the pelvic organs. The complex of these simple research will allow time to suspect the presence infectious disease and prescribe adequate treatment, which can prevent the development of endometritis. It should be noted 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 the gynecologist weekly for 1 month after the procedure, and then 1 time in 2-3 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 antibiotic therapy helps prevent the transition of acute endometritis to chronic, which is difficult to treat and is often accompanied by infertility.

What are the complications and consequences of endometritis?

With endometritis, the infection can spread in several ways, namely:

• By contact - with the direct transition of microorganisms from the uterine mucosa to neighboring organs.
• By the lymphogenous route – as part of the lymph that flows from the uterus to the sacral and lumbar lymph nodes and further ( through the chest lymphatic duct ) enters the systemic circulation.
• By the hematogenous route when the infection enters the blood through damaged blood vessels.

• Metroendometritis - the transition of the inflammatory process from the mucous membrane to the muscular layer of the uterus.
• Lymphadenitis - inflammation ( and often festering) regional lymph nodes, which got the infection.
• Metrothrombophlebitis - inflammation of the veins of the uterus as a result of the penetration of pathogenic microorganisms into them.
• Cervicitis - inflammation of the cervix.
• Vaginitis - inflammation of the mucous membrane of the vagina.
• Salpingitis - inflammation of the fallopian tubes.
• Oophoritis - inflammation of the ovaries.
• Peritonitis - inflammation of the peritoneum thin serous membrane that covers internal organs 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, which occurs due to a violation of the patency of the cervix.

• Chronicization of the inflammatory process. With untreated acute endometritis, it can turn into chronic, which is characterized by a less obvious clinical picture, but more serious and dangerous changes in the lining of the uterus.
• Development adhesive process. As a result of the progression of the disease, special cells appear in the focus of inflammation - fibroblasts, which begin to produce collagen fibers ( major component of scar tissue). From these fibers, adhesions are formed, which are dense strands that "glue" the tissues together. Growing, they can squeeze and pinch various organs ( bladder, intestines) or disrupt the patency of the uterus and fallopian tubes, which will lead to the corresponding clinical manifestations ( urination disorders, constipation, infertility).
• Infertility. The inability to conceive and bear a child is the most frequent consequence chronic endometritis. With this disease, changes occurring in the mucous membrane of the uterus ( inflammation, cellular infiltration by leukocytes, microcirculation disorders, and so on), make it impossible for the process of attachment of the embryo to the wall of the uterus and its further development, as a result of which any pregnancy ( if it does come) will end in miscarriage in the early stages. The development of adhesions in the uterus and fallopian tubes can also lead to infertility, since the male germ cells ( spermatozoa) will not be able to reach the female germ cell ( eggs) and conception will not occur.
• Violation of the menstrual cycle. Inflammatory changes in the uterine mucosa lead to impaired organ sensitivity to hormones ( estrogen, progesterone), which normally regulate the menstrual cycle. In this regard, there may be a delay in menstruation, polymenorrhea ( prolonged and profuse blood loss during menstruation), metrorrhagia ( bleeding from the uterus that is not related to the menstrual cycle) and so on.

Is it possible to have sex with endometritis?

Endometritis is an inflammatory disease that develops as a result of the penetration and reproduction 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 mucous plug ( mucus is secreted by numerous glands in the area), which prevents the penetration of infection from the external genital organs and the environment. During intercourse, the integrity of this barrier is broken. If you do not use mechanical means of protection ( condoms), an infection from a sick partner can penetrate the uterine cavity and cause endometritis.

Having sex with endometritis can be complicated:

• Re-infection. Treatment of endometritis consists in the use of antibacterial drugs in order to completely destroy the pathogenic microflora in the uterine cavity. If you have sex during this time, there is a high chance of re-infection. In this case, the ongoing treatment will be ineffective, and acute endometritis may become chronic. In addition, the surviving microorganisms will become resistant to the action of the antibiotics used, making further treatment of the disease even more difficult.
• The 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 pass to the external genitalia, leading to inflammation of the cervix, vagina and other external genital organs. In addition, uterine contractions during orgasm can contribute to infection in the fallopian tubes and abdominal cavity, followed by the development of salpingitis ( inflammation of the fallopian tubes), oophoritis ( inflammation of the ovaries) and pelvioperitonitis ( inflammation of the peritoneum of the small pelvis).
• partner infection. Since the cause of endometritis is pathogenic microflora, during unprotected sexual contact, infection of the partner may occur, as a result of which he may also develop an infection of the genital organs - balanitis ( inflammation of the glans penis), posts ( inflammation foreskin ), balanoposthitis, gonorrhea and so on.
• Pain during intercourse. Endometritis is characterized by plethora of the endometrium, impaired microcirculation and its cellular infiltration. Besides, infectious process often passes to the external genitalia, which is accompanied by their hypersensitivity (hyperesthesia). As a result of this, the slightest touch to the inflamed organ can be felt by a woman as a strong pain irritation.
• Bleeding. As already mentioned, the inflamed uterine mucosa is characterized by swelling and plethora. This is due to the fact that a large amount of biologically active substances is released in the focus of inflammation ( histamine and others), which cause the expansion of small blood vessels and increase the permeability of the vascular wall. Vessels become more brittle, 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 the conception and development of the fetus. However, if conception occurs ( what is possible with the treatment), pregnancy may end in spontaneous abortion ( miscarriage), since the developing fetal egg will not be able to firmly attach to the inflamed endometrium.

Is physiotherapy used for endometritis?

Physiotherapy involves the use physical energy (sound, light, heat and other) for the purpose of therapeutic effect on individual bodies or the body as a whole.

With endometritis, physiotherapy contributes to:

• normalization of microcirculation in the endometrium;
• decrease in swelling of the uterine mucosa;
• activation of the protective properties of the body;
• normalization of the menstrual cycle;
• elimination pain syndrome;
• reduce the risk of complications.

• interference therapy;
• UHF therapy ( ultra high frequencies);
• ultrasound therapy (UST);
• laser therapy;
• ultraviolet irradiation ( UFO).

One procedure takes about 10-20 minutes. General course treatment for no more than 15 days.
Interference current is contraindicated during an acute inflammatory process in the endometrium.

Magnetotherapy
The positive effects of magnetotherapy include anti-inflammatory, anti-edematous and healing effects. When exposed to a constant magnetic field, microcirculation improves and the intensity of metabolic processes in the uterine mucosa increases, which contributes to the speedy 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, as a result of which nonspecific defensive forces 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 lies in the impact on the patient's tissues with a high-frequency electromagnetic field. The resulting energy is absorbed by the liquid tissues of the body ( blood, lymph) and is released in the form of heat, that is, heating occurs certain body. Exposure to a high-frequency electromagnetic field leads to the expansion of blood vessels, facilitating the release of immune cells to the site of inflammation. Also, this method contributes to the subsidence of the acute inflammatory process, and therefore is used in 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 contributes to the formation of adhesions in the focus of inflammation ( under the action of a high-frequency magnetic field, fibroblasts are activated - cells that synthesize collagen fibers, from which scar tissue ). For the same reason, the use of UHF in chronic endometritis should be avoided.

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, one of which ( usually on the cathode side) drug is applied. The cathode and anode are placed in the required area of ​​the body in such a way that the organ to be treated is located directly between them. When applying electric current the drug begins to move from one electrode to another, while penetrating deep into the tissues that are in its path.

With endometritis, electrophoresis with copper, zinc, iodine, 10% calcium iodide solution and other drugs is used. For the treatment of pain, you can enter 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 contributes to the activation of intracellular enzymes and the acceleration of metabolism ( metabolic process). Secondly, under the action of ultrasound there is an increase in tissue temperature ( about 1ºC). All this leads to an improvement in microcirculation and tissue trophism, an acceleration of metabolism and loosening of connective tissue ( which prevents the formation of adhesions).

The duration of one UST procedure is 8-10 minutes. The 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 impact of this radiation on the tissues of the uterine mucosa improves microcirculation, increases local immunity and promotes the speedy healing of damaged tissues. Also, the laser 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 the 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 especially effective if vaginosis has become the cause of endometritis ( pathological condition, characterized by the replacement of the normal microflora of the vagina with alien microbial associations).

One UVR 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;
• on suspicion of neoplastic disease in the area of ​​influence;
• with concomitant endometriosis ( growth of endometrial tissue outside the uterine cavity).

What is the classification of endometritis?

Treatment of endometritis in women is not an easy task for the reason that it is very difficult to treat endometritis. Very difficult to treat.

Especially its chronic form. Achieve long-term remission and wellness women are good.

Treatment of endometritis in women, what is endometritis:

Endometritis is almost always combined with chronic cervicitis. Chronic endometritis does not have clear symptoms, the manifestations of the disease are erased.

Doctors generally tend to diagnose chronic endometritis in all women who have had at least one undeveloped pregnancy.

Among infertile women in 60% of cases, endometritis is found - an inflammatory process of the endometrium, which lines the inner lining of the uterus.

Forms of endometritis in women:

Spicy:

Usually these are patients with an ambulance. Treatment in a hospital.

• Strongly, it is the area on the lower abdomen.
• Rise in temperature above 38 degrees.
• Chill.
• Discharges appear (purulent or purulent - watery.
• Pain when urinating.

Chronic:

The whole picture of the above symptoms of the acute course of endometritis is blurred. Sluggish flow.

• The temperature does not rise.
• The discharge is long and bloody.
• Pain.

Causes of endometritis in women:

• The presence of endometriosis or adenomyosis of the uterus.
• Chronic form of inflammatory diseases of female organs.
• Long term wearing intrauterine device.
• Complications after your pregnancy or childbirth.
• Infections, including those transmitted sexually.
• abortion.
• HIV infection in a woman

• Irregular monthly cycles.
• In the presence of cervicitis - leucorrhoea.
• Pain in the lower abdomen, back.
• Chronic pain in the pelvic region.
• Severe bleeding or vice versa scanty.
• Shortened periods between cycles or vice versa elongated.
• Infertility.
• Pregnancy: non-carrying, non-developing pregnancy.
• Complications during pregnancy: placental insufficiency, intrauterine infections, chlorianamnionitis.

Classification of endometritis:

Non-specific.

Examination by a gynecologist, patient complaints.

• Hysteroscopy: 90% accuracy of diagnosis. Mandatory diagnostic stage of the examination.

• ultrasound ( ultrasound examination) women in the first phase of the cycle. After menstruation, no later than 10 - 12 days. The endometrium should be smooth, clear, without seals, knots.
• Colposcopy.
• Smears for flora.
• Morphological examination of the endometrium (if detected lymphocytic infiltration basal layer of the endometrium, antibiotic therapy is required in all cases). If fibrosis, deformation of the glands, focal hyperplasia of the basal layer is detected, it is worth weighing the pros and cons of antibacterial treatment.
• Immunohistochemical study of endometrial lymphocytic cells. Rarely done. Norm: the ratio of cells is less than ten. If the ratio is increased - a picture of an autoimmune disease. Still determine (CL16+, CL56+, HLA DRII).

Antibacterial treatment:

The basis of antibacterial treatment:

1. Protected penicillins (the well-known amoxicillin / clavulanic acid) with macrolides.
2. Fluoroquinolonols and nitroimidazoles.
3. Cephalosporins are already 3 generations.

Sample treatment:

• Amoxicillin / clavulanate + azithromycin or doxycycline 1 gram on the first and eighth day.
• Azithromycin or doxycillin 1 gram on the first and eighth day + metronidazole.
• Levofloxacin or ofloxacin + metronidazole 500 mg twice a day for up to 14 days + cefixime 400 mg once orally.
• Moxifloxacin.

Antibacterial therapy has a positive effect in the treatment of up to 75% of cases.

Antivirals :

required for treatment.

• Panavir: acts on the herpes virus, papilloma, cytomegavirus.
• This drug is a plant polysaccharide.
• Assign intravenously at 5.0 every other day.
• You need to do five or ten times.
• Then treatment with suppositories 1 suppository five or ten times (rectally).

Second method:

Panavir 5.0 intravenously in 1, then 3.5, then 8.11 days of treatment + Panavir gel for vaginal use for 15 days (if genital warts are detected).

Non-steroidal anti-inflammatory drugs:

Epigallat: we are treated for one month, two capsules twice a day. Treatment is carried out immediately from the first days of antibacterial use.

Enzyme preparations:

• Longidaza (candles). They have an anti-inflammatory effect, enhance the antibacterial effect of drugs.

Venotonics:

• Phlebodia: for three, four months. Drink one tablet.

Hormone therapy:

Strictly according to the doctor's prescription for weakness of the corpus luteum.

• Femoston.
• Progesterone.

May prescribe antiadhesive, antiplatelet drugs.

Vitamin preparations.

Antioxidant preparations.

Physiotherapy:

Electrophoresis:

• With zinc galvanic current up to 30 times. Treatment begins on the fifth day of the cycle.
• With diclofenac and vitamin B 12.
• Keep in mind that after the third or fourth procedure there are exacerbations, continue the treatment.

Low frequency magnetotherapy:

• Vaginal.
• Abdominal.

It would be nice to spend twice a day. Repeat up to 30 times.

• Electropulse treatment.
• EHF, TLF treatment (there are vaginal devices on sale, it is not expensive for home treatment) and ultrasound.

Laser:

• Red Spectrum Pulse Mode diode laser"Matrix" gives amazing results in the treatment of endometritis. It has a resolving, anti-inflammatory, antimicrobial effect.
• A course of 12 procedures is required.
• Treatment must be done twice a year. Mandatory: autumn, spring.

Treatment in sanatoriums is shown, mud therapy helps very well.

Treatment of endometritis in women with folk remedies:

Conducted as additional treatment between courses of primary treatment in the hospital.

The disease is very serious, dear women, and only herbs cannot cope here. Please, please understand the seriousness of the disease.

Potato juice:

• Freshly squeezed potato juice made from a whole potato with the skin on.
• Add 40 drops of pharmacy 20% propolis tincture to ¼ of the juice.
• Take once/day.
• Course up to 6 months.
• Potato juice can be replaced with beet or carrot juice.

Herbal collections:

First collection:

• Leuzea root.
• Blueberry leaf.
• Lavender herb.
• Althea root.
• Nettle leaf.
• Sweet clover grass.
• Wormwood grass.
• Pine buds.
• Weed grass.

All herbs are taken in equal amounts.

Second collection:

• Tansy flowers.
• Leuzea root.
• Mistletoe grass.
• Lingonberry leaf.
• Lavender herb.
• Elecampane root.
• Plantain leaf.
• Viburnum bark.

All components are taken equally.

Third collection:

• Badan root.
• Clover flowers.
• Eucalyptus leaf.
• Coltsfoot.
• Mint herb.
• Bearberry leaf.
• Tansy flowers.

Everything is taken in equal amounts.

Medicine preparation:

• Choose one herbal collection.
• Grind in a coffee grinder.
• At night, we cook in a thermos at a dose of 2 tablespoons of chopped collection.
• Add 500 grams of boiling water.

Drink according to the scheme:

1 day:

Dilute a tablespoon of infused and filtered medicine in 500 grams of water.

Drink a little throughout the day.

2 day:

• Take two tablespoons of medicine already.
• Dilute in 500 grams of water.
• Drink a little throughout the day.

3 day:

• If the drug is well tolerated, drink it undiluted from a thermos.
• It turns out that you drink 500 grams a little during the day.
• The medicine must be prepared fresh every day.

Improve the results of treatment of microclysters from the same infusion after the toilet once in the morning or in the evening, 30-50 ml. We make a pear in the rectum.

Treatment of endometritis in women takes a very long time. Treatment is serious and responsible.

To avoid such torment, treat all infections on time, including serious ones that are transmitted only sexually.

There is no need to be embarrassed, we are all living people. If you delay with treatment or with its incorrect action, you can cripple your life.

I wish you women's good health.

Do not get sick, if there are problems, get treated and get better.

I always look forward to the site, visit often.

Watch a video on how to treat endometritis with folk remedies:

Content:

After childbirth, complicated abortions, infertility, miscarriages and gynecological interventions, women are faced with such a diagnosis as endometritis. Fortunately for women, this disease is successfully treated.

What is endometritis

Endometritis is a disease of the lining of the uterus inflammatory nature. It can be caused by Escherichia coli, streptococci, chlamydia, staphylococci, Trichomonas, gonococci, viruses and other pathogens.

Infection of the uterus occurs in three ways:

• Ascending way from the cervical canal, vagina.
• Lymphogenically.
• Hematogenous.

Most often, this disease develops when hygiene rules are not followed and antiseptics are neglected during intrauterine manipulations, as well as after childbirth and abortion (especially after incomplete curettage).

Prolonged inflammation of the endometrium can go to muscle tissue(myometrium), then the diagnosis is called metroendometritis.

Causes of endometritis

The endometrium consists of two layers: functional and basal. The functional layer exfoliates at the end of each period, and the basal layer serves to form a new functional layer and cause new periods to begin.

The functional layer consists of a cylindrical epithelium - cells resembling cylinders in shape, between which are glandular cells (these cells produce mucus), as well as branches of small spiral arteries. Such a single-layer structure is very fragile and is very sensitive in case of any violations.

Damage to this structure (uterine lining) - main reason manifestations of endometritis. The damage itself does not have serious complications, their appearance is due to the penetration of the virus or pathogenic molecules.

Among the causes of damage to the mucous membrane are:

1. Probing of the uterine cavity.
2. Inaccurate douching.
3. Curettage of the uterine cavity (with suspicion of oncology, bleeding, medical abortion).
4. Installation of an intrauterine device.
5. Hysteroscopy.
6. Hysterosalpingography (examination of the fallopian tubes and uterus in the treatment of infertility).

Endometritis of the uterus is caused by such pathogens:

• coli.
• Chlamydia.
• Streptococcus group B.
• Klebsiella.
• tuberculosis microbacterium.
• Enterobacter.
• Diphtheria stick.
• Proteus.
• Mycoplasmas.

Also, pathogens include viruses and protozoa.

Diagnosis of endometritis

When contacting a doctor, it is worth talking about disturbing symptoms and anamnesis so that the gynecologist can make a presumptive diagnosis.

In addition, the doctor must carry out a number of actions:

1. Do gynecological examination uterus to evaluate the discharge (smell, color, quantity).
2. Take smears and send them for research to identify the pathogens of endometritis and track their reaction to a particular medication.
3. Take blood for analysis.
4. If necessary, do an ultrasound of the uterus. With the help of ultrasound, you can see thickening of the mucous membrane, blood and purulent clots, as well as affected fallopian tubes and ovaries (if the disease has affected them).

At various stages of endometritis will be involved different methods diagnostics.

Symptoms of endometritis

On the initial stages the symptoms of endometritis are expressed implicitly, which does not allow women to consult a doctor in time to prevent the transformation of the disease into metroendometritis. To avoid such a case, women need to know the signs of endometritis.

Endometritis is acute and chronic. There is also a separate subacute form of the disease. Acute endometritis occurs with mechanical damage, and chronic - with infections with sexually transmitted diseases.

Symptoms of acute endometritis

Already in the first week after diagnostic manipulations, childbirth or abortion, the following symptoms:

1. Deterioration of well-being, lack of appetite, headache.
2. Increasing the temperature to 39°C.
3. Pain in the lower abdomen - aching, pulling, weak or severe pain can be given to the sacrum and lower back.
4. Discharge from the genital tract, which has an unpleasant odor, resembles a mixture of pus with blood clots.
5. Uterine bleeding (quite rare)

When identifying such symptoms, you should not hesitate and self-medicate. Inflammatory diseases tend to spread and affect large areas of tissue.

The longer you wait, the longer and more difficult the treatment will be. Results of a belated appeal for medical care can be deplorable, therefore, at the first manifestations of acute endometritis, you need to contact a gynecologist.

Symptoms of chronic endometritis

Pathology occurs when infected with infections that are sexually transmitted. Therefore, in chronic endometritis, symptoms characteristic of the infection that caused the disease appear. There are such symptoms of chronic endometritis:

• Weak aching pain in the lower abdomen.
• The temperature rises to 37-38.5°C.
• Discharge from the genital tract: with gonorrhea - purulent (yellow-green), with trichomoniasis - frothy, abundant.
• Long heavy menstruation that last 7 days or more.
• Infertility, miscarriage are complications of chronic endometritis.

Treatment of endometritis

To understand how to treat endometritis, you should contact a gynecologist. With an uncomplicated course of the disease, treatment can take place on an outpatient basis under the strict supervision of a physician. Acute endometritis is treated in a hospital.

The treatment regimen for endometritis includes: antibacterial substances, mechanical cleaning of the uterine cavity, detoxification (blood is cleaned of harmful toxins produced by bacteria).

Treatment of acute endometritis

If the disease is diagnosed in time and treatment is started, there will be no complications and problems during further pregnancy. Stages of therapy:

1. The use of immunomodulators and vitamins.
2. Introduction of antibiotics: Metragil in combination with cephalosporins intravenously, as well as intramuscularly Gentamicin. The duration of the course of treatment is 5-10 days, depending on the complexity of the disease and the need for intravenous antibiotic therapy.
3. If the remains of the fetus (after an abortion) or the placenta (after a caesarean section and childbirth) remain in the uterine cavity, curettage of the uterine cavity is prescribed.
4. Physiotherapy treatment (physiotherapy).

Treatment of chronic endometritis

Treatment is based on the destruction of the causative agent of the disease, therefore, smears are taken for seeding and the susceptibility of the pathogen to antibiotics is checked in order to find the best therapy option. Then apply the scheme of antibacterial treatment in addition to antiviral drugs.

The most effective method of treatment is the direct injection of drugs into the uterine mucosa, which helps to concentrate the largest amount of drugs in the focus of inflammation.

In addition to all of the above, the following also applies:

1. hormone therapy. Oral contraceptives are used, especially for women who want to become pregnant in the future.
2. Separation of formed adhesions surgically.
3. Physiotherapy for chronic endometritis, when the woman's condition returned to normal. It is carried out in a hospital, it helps to increase the outflow of mucus and pus from the uterine cavity and improve local reparative functions.

Treatment of purulent endometritis

The therapy requires mechanical cleaning of dead tissue and pus from the uterine area, followed by hormonal therapy. The procedure is painful, so it takes place under general anesthesia.

Among the diseases in women, chronic endometritis is especially common, which develops as a result of untreated acute stage inflammation of the endometrium, i.e. the functional lining of the uterus. This is a very serious gynecological pathology that can lead to dangerous complications on the organs and muscles of the peritoneum. Knowing the clinical symptoms of chronic endometritis, you can suspect the disease in time.

What is chronic endometritis

Speaking in an accessible language, this is the name of a gynecological disease of a chronic nature that affects the inner layer uterus. Infections can be caused by bacteria or viruses. As a result of the activity of these microorganisms, there is a violation of the rejection and growth of the endometrium. The result is uterine bleeding, failure of the menstrual cycle, miscarriages. Endometritis is the cause of infertility. The disease can be atrophic, cystic and hypertrophic.

Symptoms

The danger of the disease lies in the fact that it can not manifest itself for a long time. If chronic inactive endometritis is manifested by symptoms, then they are not so pronounced. The main features are:

• aching pelvic pain in the lower abdomen;
• vaginal discharge yellow-green, brown or transparent, depending on the type of pathogen;
• pain during intercourse;
• violation of the phases of the menstruation cycle;
• rise in temperature to 38 degrees.

Allocations

The consistency, color, and amount of discharge may vary from woman to woman. it main feature sluggish endometritis. Patients have purulent or mucopurulent discharge. With purulent endometritis, they are accompanied bad smell. Due to the rejection of the uterine mucosa and its slow recovery, an admixture of blood may be observed in the secretions. The ichor against the background of the chronic stage of this disease persists for a long time.

Menstruation with endometritis

Another characteristic sign of the development of endometritis in a woman is a violation of the menstrual cycle. It can manifest itself in different ways:

• metrorrhagia - uterine bleeding;
• hyperpolymenorrhea - an increase or lengthening of the volume of menstrual flow;
• spotting discharge on the eve of menstruation.

echo signs

This is the name of the complex of pathological changes that are found in the uterine cavity during ultrasound(ultrasound). With this procedure, you can study the size and position reproductive organ, the state of the uterine cavity and internal surface. Ultrasound signs of chronic endometritis are as follows:

• bending the body of the uterus back - retroversion;
• enlarged or reduced size of the uterus;
• decrease or increase in the thickness of the endometrium, the formation of cavities in it;
• accumulations of gas;
• the appearance of areas of sclerosis, fibrosis or calcification;
• heterogeneous surface of the myometrium;
• adhesions in the uterine cavity, which are visualized as hyperechoic areas.

The reasons

There are many factors that can lead to endometritis flowing into a chronic form. They are divided into specific (viruses and bacteria) and non-specific, associated with endometrial injuries. In general, the reasons for the development of this inflammatory disease are:

• intrauterine manipulations in the form of scraping of the mucosa;
• improper douching;
• birth trauma membranes of the cervix;
• use of intrauterine contraceptives;
• use of vaginal tampons;
• foci of sexually transmitted infections;
• reception hormonal contraceptives;
• autoimmune pathologies, decreased local immunity;
• damage to the mucosa when probing the uterus;
• sexual intercourse during menstruation;
• remnants of the placenta, decidual tissue, blood clots or fetal egg (causes of postpartum endometritis).

Exacerbation of chronic endometritis

The disease begins with acute endometritis and only then flows into a chronic form. It is characterized by less severe symptoms, which do not cause discomfort to a woman, but the disease develops during this period and affects the genitourinary system. Sometimes there is an exacerbation of endometritis. It is characterized by an increase in all the symptoms described above. Signs appear abruptly, and against their background, severe bleeding may even open.

Is it possible to get pregnant with chronic endometritis

In the early stages of the disease reproductive functions are still in good condition. Depending on the activity of the immune system and the infectious agent, the adequacy of therapy, pregnancy at this stage is possible, but most patients experience postpartum complications and even miscarriages. With treatment, the chances increase significantly, but after conception, the expectant mother is under the constant supervision of doctors. If endometritis is not treated, then even the IVF procedure will not help to carry the pregnancy.

Diagnostics

When characteristic symptoms endometritis chronic form it is necessary to immediately contact a gynecologist to confirm the diagnosis. To this end, the following studies are being carried out:

• hysteroscopy;
• examination by palpation, ultrasound of the uterus and its appendages;
• sowing material taken during hysteroscopy to determine the infectious agent;
• smear from the vagina on the flora;
• a blood test for the concentration of hormones;
• general urine analysis.

Treatment of chronic endometritis

Therapy of chronic endometritis can be started only after confirmation of the diagnosis. The treatment regimen for the patient is prescribed by the doctor, taking into account the severity of the disease and the individual characteristics of the organism. In general, therapy is carried out in 3 stages:

1. Elimination of infection of the endometrium, for which broad-spectrum antibiotics are used.
2. Restoration of the immune system through hepatoprotective, enzymatic, metabolic, immunomodulatory and microcirculation-improving agents.
3. Regeneration of the structure of the endometrium. At this stage, the main role is played by physiotherapeutic methods - mud therapy, magnetotherapy, laser therapy, plasmaphoresis, zinc or copper iontophoresis. Additionally, the hormones estrogen and progesterone are prescribed.

Medications

In the treatment of chronic endometritis, drugs from several groups are used at once. They are prescribed only by a doctor, taking into account the causative agent of the disease and the nature of the course of the pathology. These may include the following medications:

1. Broad spectrum antibiotics. After identifying the causative agent of the infection, the doctor prescribes drugs from this group. If the disease was provoked by chlamydia, then it can be treated with Doxycycline, viruses with Acyclovir, fungi with Flucostat.
2. anti-inflammatory solutions. They provide high concentration antiseptic and antibacterial drugs in the focus of inflammation. For this purpose, solutions of Furacilin, Dimexidum, Chlorhexidine, Novocaine, Calendula, Lidaz and Longidaz are used. They are used in washing courses of 3-5 procedures.
3. metabolic drugs. In this group, aloe extract, Actovegin and the vitreous body stand out. They contribute to the regeneration of the endometrium and stimulation of local immunity.
4. Hormonal preparations. Necessary for reduced ovarian function to restore the cyclic change of the endometrium, eliminate intermenstrual bleeding and normalize the menstrual cycle.

Antibiotics

Treatment of chronic endometritis with antibiotics is often prescribed in the form of droppers, therefore it is carried out in a hospital. The drugs are administered intravenously 2 times a day. Treatment begins on the 1st day of menstruation and lasts about 5-10 days. Used for antibiotic therapy the following drugs:

1. Ceftriaxone. Based on the active ingredient of the same name, it belongs to the group of cephalosporins. Active against staphylococcus and streptococcus and a number of aerobic gram-negative bacteria. The downside is the large number adverse reactions.
2. Metronidazole. Belongs to the category of antibiotics with high anaerobic activity. The advantage is the release in all possible forms, even in the form vaginal gel. Its bioavailability is 2 times higher compared to tablets. Has few contraindications, but big list side effects.

hormone therapy

The goal of hormonal drugs is to restore the normal monthly cycle. Their therapy necessarily takes into account the age of the patient and the severity of the disease. Equally important is how severe the violations are. hormonal background. To restore it, the following drugs are prescribed:

1. Duphaston. The active ingredient is didyrogesterone, an analogue of natural progesterone. The advantage of the remedy is that it does not affect the functions of the liver and metabolic processes in the body. The downside is the long list. negative reactions.
2. Utrozhestan. Another hormonal drug based on progesterone. The medicine is very quickly absorbed already 1 hour after ingestion, stimulating the restoration of the uterine mucosa. The downside is bad reviews about taking this remedy in the form of capsules - they have many side effects.

Treatment with folk remedies

Along with drug treatment endometritis, you can use some folk remedies. The following recipes are effective:

1. In equal proportions, take cherry and nettle leaves, pine buds, wormwood grass, sweet clover, cudweed, lavender, marshmallow and leuzea roots. After grinding 2 tbsp. raw materials pour 0.5 liters of boiling water, insist in a thermos for 12 hours. Use the product 1/3 cup up to 3-5 times a day for 2 months.
2. Take 1 tbsp. chopped St. John's wort, brew a glass of boiling water and boil for 15 minutes. Cool the broth, strain and drink 1/4 tbsp. up to 3 times during the day. Treat endometritis with this remedy for 4-6 weeks.

Prevention

The main preventive measure is timely complex treatment any disease of the reproductive system. For this purpose it is necessary:

• follow the doctor's recommendations when using an intrauterine device as a contraceptive;
• adhere to the rules of intimate hygiene;
• refuse abortion;
• use barrier contraception in the form of condoms to avoid sexual infections;
• to prevent postpartum infections.

Video