Chronic endometritis usually occurs as a result of acute endometritis (inflammation of the endometrium, the inner lining of the uterus) that was not cured thoroughly after childbirth or abortion. Repeated intrauterine intervention with uterine bleeding, use of antibiotics in insufficient quantity, and a weakening of the body’s defenses all lead to chronic inflammation.
The clinical picture and symptoms of chronic endometritis largely reflect the depth and duration of changes in the uterine lining.
Uterine bleeding of varying degrees of severity – post-menstrual, pre-menstrual and intermenstrual – is the main symptom of chronic endometritis. These hemorrhages, which are sometimes profuse, but can also be scanty and take the form of a smearing spotting before and after a woman’s period, appear due to deficiency in the basal layer of the endometrium that is responsible for restoration of the functional layer after menstruation.
Decrease in uterine contractions and impaired platelet aggregation can also cause uterine bleeding. The regeneration process of the functional layer is slower than normal, thereby leading to protracted menstruation.
Periodic dragging and boring pains in the lower abdomen, and a small increase and contraction of the uterus, uterine tenderness during gynecologic examination are all less pronounced but quite common symptoms of chronic endometritis.
Apart from bleeding, such patients often experience a change in the secretory function, which manifests in the form of serous or sero-pussy discharge from the genital tract.
If the patient has sexually transmitted infections, chronic endometrial inflammation primarily occurs. The main symptoms of chronic endometritis are menstrual cycle disorders such as smearing spotting before and after menstruation, scanty or, on the contrary, heavy menstruation, miscarriage, and infertility.