Endometriosis vs Endometritis
Endometriosis
Presence of endometrial glands & stroma outside the uterine cavity (e.g., ovaries, peritoneum, fallopian tubes) - ectopic endometrial tissue outside the uterus. This is likely due to retrograde menstruation, metaplasia, or lymphatic spread.
- Reproductive-age women
- Often nulliparous or infertile
EndometriOsis - O stands for outside
Symptoms:
- Cyclic pelvic pain (worsens before/during menses)
- Dysmenorrhea
- Dyspareunia
- Infertility
- Pain with defecation or urination (if rectovaginal septum or bladder involved)
Diagnosis:
- Definitive diagnosis: Laparoscopy with biopsy
- Classic finding: "Chocolate cyst" (endometrioma)
Treatment:
- NSAIDs, OCPs, GnRH agonists/antagonists (e.g., leuprolide)
- Surgery if refractory or infertility is a concern
Endometritis
Infection/inflammation of the uterine endometrium. Typically caused by polymicrobial infection (often after delivery, abortion, instrumentation).
- Postpartum (especially post-C-section)
- Post-abortion
- Following IUD insertion or uterine instrumentation
- Risk factors: C-section, prolonged labor, retained products
Symptoms:
- Fever
- Uterine tenderness
- Foul-smelling lochia
- Tachycardia, sometimes leukocytosis
Diagnosis:
- May confirm with labs (WBCs), but no imaging or biopsy needed
Treatment:
- Broad-spectrum IV antibiotics
- Example: Clindamycin + gentamicin
- Remove retained products if suspected