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Myometritis - Causes, Symptoms, Diagnosis, and Treatment

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Myometritis is a medical condition characterized by inflammation of the myometrium, the muscular layer of the uterus.

Medically reviewed by

Dr. Monica Mathur

Published At May 22, 2023
Reviewed AtNovember 23, 2023

Introduction

Myometritis, also referred to as metritis, is a form of pelvic inflammatory disease (PID) that specifically affects the myometrium - the muscular layer that lines the uterus. The condition is commonly caused by an infection called endometritis, which can lead to inflammation of the endometrial lining. The primary pathogens responsible for myometritis include bacteria such as Arcanobacterium pyogenes, Fusobacterium necrophorum, and Escherichia coli, among others, and may occur in combination.

What Causes Myometritis?

Myometritis is primarily caused by an infection in the uterus. The uterus can become infected when microorganisms such as bacteria or viruses enter it through either the cervix or the bloodstream. The most common cause of myometritis is an infection called endometritis, which is an inflammation of the endometrial lining of the uterus. Myometritis can also occur after childbirth or miscarriage, as the cervix may be open and susceptible to infection. Myometritis may be a result of a sexually transmitted infection, such as chlamydia or gonorrhea, in certain instances. Rarely, myometritis can also be caused by invasive medical procedures or surgeries involving the uterus.

What Are the Symptoms?

Myometritis is a condition that can cause a range of symptoms, which may vary in severity and duration from person to person. Some common symptoms of myometritis include:

  • Abdominal Pain or Discomfort: This is one of the most common symptoms of myometritis, and it can range from mild to severe. The pain may be crampy in nature and can occur in the lower abdomen or pelvic area. It may worsen during sexual intercourse, bowel movements, or urination.

  • Fever and Chills: A fever is a common sign of infection and is often accompanied by chills. A high temperature, usually above 38 degrees Celsius, may be a sign of myometritis.

  • Heavy Vaginal Bleeding or Discharge: Myometritis can cause heavy or prolonged vaginal bleeding, which may be accompanied by clots. The discharge may also have a foul smell or unusual color.

  • Painful Urination or Difficulty Urinating: Myometritis can cause inflammation in the bladder, leading to painful or difficult urination. One may also feel the urge to urinate more frequently than usual.

  • Enlarged Uterus: An enlarged uterus is another symptom of myometritis. The uterus may feel swollen or tender to the touch.

  • Foul-Smelling Vaginal Discharge: Myometritis can cause a foul-smelling vaginal discharge, which may be a sign of an infection.

In some cases, myometritis may not cause any noticeable symptoms, especially in the early stages of the infection. However, if left untreated, myometritis can lead to serious complications, such as sepsis, infertility, and chronic pelvic pain.

How Is Myometritis Diagnosed?

A combination of a physical exam, a medical history, and diagnostic tests to diagnose myometritis. A medical professional will assess the symptoms and conduct a physical examination to look for any indications of infection or inflammation. They may also take a sample of the vaginal discharge or blood to test for infection. Some common diagnostic tests used to diagnose myometritis include:

  • Blood Tests: An infection in the body can be detected through blood tests, which can also measure the severity of the infection. An increase in white blood cell counts and levels of C-reactive protein (CRP) may suggest the presence of an infection.

  • Urine Tests: A urine test to rule out a urinary tract infection, as it can cause similar symptoms to myometritis.

  • Imaging Tests: Imaging tests, such as ultrasound or MRI (magnetic resonance imaging), may be used to evaluate the size and shape of the uterus, as well as to look for any signs of inflammation or infection.

  • Endometrial Biopsy: In some cases, an endometrial biopsy may be performed to collect a sample of the tissue from the lining of the uterus. The specimen is examined using a microscope to detect any indications of inflammation or infection.

  • Culture Tests: If an infection is suspected, the healthcare provider may take a sample of the vaginal discharge or blood and send it to a laboratory to identify the specific type of bacteria causing the infection. This helps to determine the appropriate treatment for the infection.

How to Treat Myometritis?

The treatment of myometritis depends on the severity of the infection and the underlying cause. The primary goal of treatment is to eliminate the infection, relieve symptoms, and prevent complications. In most cases, myometritis is treated with a combination of antibiotics and supportive care.

  • Antibiotics: Myometritis caused by bacterial infections is treated using antibiotics. The type and duration of antibiotics depend on the severity of the infection and the specific bacteria causing the infection. A course of antibiotics typically lasts between seven and 14 days. In cases where the infection is severe, hospitalization may be necessary to administer antibiotics via an intravenous (IV) line.

  • Pain Relief: Myometritis can cause abdominal pain, which can be relieved with over-the-counter pain relievers such as Ibuprofen or Acetaminophen. In severe cases, stronger pain medication may be prescribed.

  • Rest and Hydration: Getting adequate rest and staying hydrated can assist the body in fighting the infection and alleviating symptoms. Adequate fluid intake, sufficient rest, and avoiding intense activities are crucial during treatment.

  • Surgery: In rare cases, surgery may be required to remove infected tissue or drain an abscess. This is typically only done if the infection is severe or has spread to other organs.

It is important to complete the full course of antibiotics prescribed by the healthcare provider, even if one starts feeling better. This helps to ensure that the infection is completely eliminated and reduces the risk of complications. It is also important to avoid sexual activity until the infection has cleared to prevent the spread of the infection. In addition to medical treatment, it is important to practice good hygiene and safe sexual practices to prevent future infections. This includes washing one’s hands regularly, using condoms during sexual activity, and avoiding douches or other vaginal products that can disrupt the natural balance of bacteria in the vagina.

Conclusion

Myometritis is a condition that primarily affects the myometrium, which is the muscular layer that lines the uterus. It is commonly caused by an infection called endometritis, which can lead to inflammation of the endometrial lining. Myometritis can cause a range of symptoms, such as abdominal pain or discomfort, fever, heavy vaginal bleeding or discharge, painful or difficult urination, and an enlarged uterus, among others. The diagnosis involves a physical exam, a medical history, and diagnostic tests such as blood tests, urine tests, imaging tests, endometrial biopsies, and culture tests. Treatment includes antibiotics, pain relief, rest, hydration, and, in rare cases, surgery. Finishing the entire prescribed course of antibiotics is crucial to completely eliminate the infection and reduce the risk of complications, such as infertility, chronic pelvic pain, and sepsis.

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Dr. Monica Mathur
Dr. Monica Mathur

Obstetrics and Gynecology

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