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Chronic Endometritis

What is Chronic Endometriosis?


Chronic endometritis is a persistent, low-grade inflammation of the endometrial lining (the inner layer of the uterus), typically caused by bacterial infection. Unlike acute endometritis, which presents with more dramatic symptoms like fever and pelvic pain, chronic endometritis may be asymptomatic or subtle, yet it can significantly impact fertility, implantation, and menstrual health.

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What are the common causes of chronic endometriosis?


Common causes include:

  • Sexually transmitted infections (e.g., chlamydia, gonorrhea)

  • Bacterial vaginosis or mixed vaginal flora

  • Tuberculosis (rare but possible in endemic regions)

  • Retained products of conception

  • Intrauterine devices (IUDs) or prior uterine surgery


What are the symptoms of chronic endometriosis?


Symptoms include:

  • Irregular or prolonged menstrual bleeding

  • Pelvic discomfort or mild cramping

  • Vaginal discharge (often subtle)

  • Infertility or recurrent implantation failure

  • Recurrent miscarriage

  • Occasionally asymptomatic

How do you diagnose chronic endometriosis?


Diagnosis is often made through:

  • Endometrial biopsy: Gold standard for detecting plasma cells and chronic inflammation

  • Hysteroscopy: May reveal micropolyps, stromal edema, or hyperemia

  • Microbial cultures or PCR: To identify causative organisms

  • Blood tests: Elevated inflammatory markers (e.g., ESR, WBC)

Treatment typically includes:

  • Antibiotic therapy: Typically, broad-spectrum or targeted based on culture results

  • Follow-up biopsy or hysteroscopy: To confirm resolution

  • Fertility support: Especially in IVF or recurrent miscarriage cases

References:

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