Chronic Endometritis – Diagnosis, Symptoms and Treatment
What is Chronic Endometritis?
What is chronic endometritis? It is a long-term inflammation of the inner lining of your uterus called the endometrium. It is often linked to infections that remain untreated. This condition can impair endometrial receptivity. That means the ability of the endometrium to accept the implantation of an embryo. It reduces the chances of embryo implantation. Unlike sudden, “acute” endometritis, chronic endometritis has very few noticeable symptoms. That makes it essential to know how to accurately diagnose chronic endometritis.
What Are the Symptoms of Chronic Endometritis?
Chronic endometritis symptoms are often subtle and go unnoticed. However, some signs that may indicate the condition are:
- You may observe abnormal uterine bleeding. This means spotting between periods or having periods that are much heavier than usual.
- Some feel a persistent pelvic pain.
- Watch out for unusual vaginal discharge that has a bad smell.
- Recurrent miscarriage in early pregnancy is also common in this condition.
- Some patients undergo repeated implantation failure during assisted reproduction cycles.
- You might experience abdominal pain that does not improve with usual treatments.
- Pain during or after intercourse is also reported as a symptom of this condition.
- You may experience symptoms similar to those of a UTI. This may include a burning sensation when urinating or a frequent need to urinate.
- Some people may experience a low-grade fever or simply feel unwell. However, this is less common.
How to Diagnose Chronic Endometritis?
For diagnosing chronic endometritis, doctors do some specific tests. These tests help them check for inflammation in the lining of the uterus. Here are the common ways they do it:
- Endometrialbiopsy:
In this method, a small tissue sample is taken from the lining of the uterus. It is examined under a microscope to check for plasma cells. A plasma cell is a type of white blood cell. The presence of these cells in an endometrial biopsy indicates the presence of chronic inflammation.
- Hysteroscopy:
This diagnosis requires a thin tube with a camera that is inserted into the uterus. The gynaecologist visually inspects for signs of chronic endometritis. These could be inflammation, polyps, or scarring.
- Immunohistochemistry (IHC):
This is used to improve the detection of plasma cells in biopsy samples. It is performed when standard microscopy does not give clear results. IHC is a staining technique that facilitates the identification of plasma cells more easily in tissue samples.
- Microbial culture or PCR testing:
Chronic endometritis is often caused by an infection. Therefore, doctors may conduct tests to identify the specific bacteria or pathogens responsible for the infection. This includes checking for conditions like sexually transmitted infections (STIs) or pelvic inflammatory disease (PID).
- Timing of testing:
The biopsy is ideally performed within 14 days after menstruation (period). This helps make sure the tissue sample is of good quality.
Who Should OPT for Chronic Endometritis Panel?
A Chronic Endometritis Panel is a specialised group of diagnostic tests. It is used to detect the presence of chronic inflammation in the endometrium. Women dealing with unexplained infertility should opt for it. If you face any of the above-mentioned symptoms, you should consider taking these tests. Finding it early can improve the success rate of fertility treatments. It will help avoid serious complications such as septic shock. Septic shock is a life-threatening drop in blood pressure due to severe infection.
What is the Chronic Endometritis Treatment?
The primary goal of chronic endometritis treatment is to eliminate the tract infections. This usually means taking antibiotics. This is a simple breakdown of how treatment typically works:
- Oral antibiotics: Typically, doctors prescribe a combination of two antibiotics. These are doxycycline and metronidazole. It is usually advised to take these pills for about two weeks.
- Antibiotic therapy adjustment: If the infection does not clear, the course of antibiotics may be changed. Alternatively, when specific bacteria are identified through the culture, the doctor adjusts the treatment accordingly.
- Follow-up endometrial biopsy: After you finish your antibiotics, your doctor might do another small biopsy. This is to make sure the signs of the infection are completely gone.
Treating chronic endometritis can actually help your uterus be better prepared for a pregnancy. This means that treatments like IVF (in-vitro fertilization) have a better chance of working.