Inflammation is a biological response involving immune cells and chemicals that can occur in any organ, including the uterus. The uterus is particularly susceptible to inflammatory processes due to its cyclical changes and connection to the outside environment through the cervix. Uterine inflammation often indicates an infection requiring prompt medical attention. This condition can range from a localized issue to one that affects the entire reproductive system, potentially leading to long-term health consequences if not addressed.
Medical Terminology and Types
Uterine inflammation is medically categorized based on which layer of the organ is affected. The inner lining of the uterus, known as the endometrium, is most frequently involved, a condition termed endometritis. When the inflammatory process extends deeper into the thick, muscular wall of the uterus, called the myometrium, the condition is known as myometritis. Clinicians may use the term endomyometritis when both the inner lining and the muscle layer are simultaneously inflamed.
This inflammation can present in two distinct forms: acute or chronic. Acute inflammation is characterized by a rapid onset, often accompanied by pronounced symptoms like a sudden fever. Acute cases show an infiltration of neutrophils, which are the immune system’s immediate responders to bacterial invasion. Chronic inflammation is a more persistent, long-standing condition that may involve subtle or non-specific symptoms. Histologically, chronic inflammation is distinguished by the presence of plasma cells, indicating a continuous, low-grade inflammatory state.
Primary Causes and Common Risk Factors
The most common causes of uterine inflammation are microbial, typically stemming from an ascending infection where bacteria travel upward from the vagina and cervix. Infectious agents include organisms associated with sexually transmitted infections, such as Chlamydia trachomatis and Neisseria gonorrhoeae. A shift in the normal balance of vaginal bacteria can also allow other microbes to overgrow and invade the uterine cavity. This polymicrobial infection often involves a mix of bacteria that normally reside in the lower genital tract.
A significant number of cases are linked to events that temporarily breach the protective barrier of the cervix. Childbirth is a major risk factor, especially following a Cesarean section, prolonged labor, or a miscarriage. These events can introduce bacteria into the sterile environment of the uterus or leave behind small amounts of tissue, such as retained products of conception, which serve as a breeding ground for infection. Invasive gynecological procedures can also increase the risk by providing a pathway for bacteria to enter the uterus.
Procedures like dilation and curettage (D&C), hysteroscopy, and even the insertion of an intrauterine device (IUD) carry a small but measurable risk of introducing bacteria. The timing of antibiotic administration, such as prophylactic use before a C-section, is one measure taken to mitigate this risk. The presence of foreign material, such as an IUD, can also sometimes be a contributing factor by altering the environment inside the uterus.
Recognizable Symptoms and Warning Signs
The signs of uterine inflammation can vary widely, from entirely asymptomatic in chronic cases to a severe, acute presentation. One of the most common signs is pain in the lower abdomen or pelvic region, which can range from a mild, persistent ache to severe, acute discomfort and tenderness upon palpation. This pain often signals that the inflammatory process is active and potentially spreading beyond the uterine lining.
Abnormal vaginal discharge is another frequent warning sign, often described as having an unusual color, consistency, or odor. Patients may also notice abnormal uterine bleeding, which can manifest as bleeding between menstrual periods or heavier-than-usual menstrual flow. Systemic signs of infection, such as fever and chills, are particularly common in acute inflammation, signaling the body’s generalized response to the presence of pathogens.
A general feeling of malaise or fatigue can also be present. Less common symptoms relate to the digestive tract, such as constipation or discomfort during bowel movements, due to the proximity of the inflamed uterus to the colon. These signs, especially when they appear suddenly or worsen rapidly, are urgent indicators that the infection may be progressing and require immediate medical evaluation.
Diagnosis and Treatment Pathways
A healthcare provider typically begins the diagnostic process with a thorough physical and pelvic examination. During the pelvic exam, the provider checks for tenderness or pain when the cervix and uterus are moved, which is a classic sign of inflammation. Laboratory tests are also performed, including blood work to check for elevated markers of inflammation, such as a high white blood cell count or an increased erythrocyte sedimentation rate.
To identify the specific microbe causing the infection, samples of fluid from the cervix are collected for culture and testing. For cases where the diagnosis is less clear, imaging like a transvaginal ultrasound may be used to visualize the uterus and check for retained tissue or abscess formation. The most definitive method for confirming chronic inflammation involves an endometrial biopsy, where a small tissue sample is taken from the uterine lining and examined under a microscope for the characteristic presence of plasma cells.
Treatment is primarily centered on eliminating the underlying infection, which typically involves antibiotic therapy. The specific medication regimen depends on the suspected source and severity of the inflammation. For severe or acute cases, especially those following childbirth, intravenous antibiotics in a hospital setting may be required to quickly control the infection. Outpatient treatment with oral antibiotics is generally sufficient for milder cases. If the inflammation is associated with retained tissue from a miscarriage or delivery, a minor surgical procedure to remove that material may also be necessary to fully resolve the infection.