Although endometritis and endometriosis are two separate conditions, it’s common for people to confuse them for one another. Moreover, some people even experience both. “I was diagnosed with endometriosis,” one MyEndometriosisTeam member wrote. “Then, after my first surgery, I actually got endometritis as well.”
Endometritis is characterized by persistent inflammation of the lining of the uterus (the endometrium). Endometriosis, on the other hand, is a chronic disease in which endometrial-like tissue abnormally grows in areas beyond the uterus.
Despite their similarities, endometritis and endometriosis have quite a few key differences. In this article, we’ll take a closer look at the conditions, including their symptoms, causes, and treatments.
Both endometritis and endometriosis affect the endometrial tissue. As a result, both are characterized by discomfort in the abdominal area.
In cases of endometriosis, discomfort is very common, though pain severity or discomfort generally aren’t reliable indicators of how severe the condition is.
Those with endometritis, on the other hand, may be asymptomatic (show no symptoms) or present only subtle symptoms, such as bleeding, chronic pelvic pain, dyspareunia (pain during intercourse), and leucorrhea (abnormal white, yellow, or greenish vaginal discharge).
Endometriosis occurs when endometrial-like tissue grows outside the uterus into the ovaries, fallopian tubes, and surrounding pelvic tissues. In some cases, this tissue acts like endometrial tissue would, thickening and breaking down with each menstrual period.
When this abnormal tissue breaks down, however, it has no exit and becomes trapped. This irritates surrounding tissues and causes scarring and adhesions (strands of fibrous tissue that can cause pelvic tissues and organs to stick to one another). When this tissue reaches the ovaries, blood may become embedded in ovarian tissues and form blood blisters or fibrous cysts known as endometriomas.
People living with endometriosis often experience symptoms of pelvic pain, especially during menstruation. Common symptoms of endometriosis can include:
Endometritis typically results from infections occurring in the uterus. Common symptoms of endometritis include:
Endometriosis and endometritis also differ in their causes. The endometrial inflammation characteristic of endometritis is usually caused by infection. The cause of endometriosis, however, is less clear. Researchers believe the condition results from several factors.
Recent research has suggested a strong association between the two conditions and a likelihood of comorbidity (existing side by side). In a small 2014 study, researchers identified chronic endometritis in around 53 percent of 34 participants who were also living with endometriosis.
Though the exact cause of endometriosis is uncertain, medical experts have determined a few possible explanations.
One theory relates to retrograde menstruation. This is when menstrual blood that contains endometrial cells flows back through the fallopian tubes and into the pelvic walls. Retrograde menstruation can lead to endometrial cells sticking, growing, and thickening over the course of the menstrual cycle.
Another possibility is that hormones or immune factors may transform peritoneal cells (cells that line the inner abdomen) into endometrial-like cells. Some of these hormones, like estrogen, may transform embryonic cells during puberty.
Some researchers believe certain surgeries, such as a hysterectomy, hysteroscopy, or cesarean section (C-section), may cause endometrial cells to attach to surgical incisions.
Another potential cause of endometriosis: The lymphatic system — which collects and circulates fluids in the body — may malfunction and move endometrial cells to parts of the body other than the uterine lining. Immune system disorders can make the body unable to recognize and fight this abnormal tissue growth.
According to Mayo Clinic, risk factors for endometriosis include:
Additionally, high estrogen levels, low body mass index (BMI), reproductive tract disorders, or medical conditions that affect menstrual excretion are also considered risk factors.
The causes of endometritis are somewhat less complex than those of endometriosis. In most cases, the condition results from some sort of infection in the uterus. This may include sexually transmitted infections (STIs) — such as chlamydia or gonorrhea — or other infections, including tuberculosis, urinary tract infections (UTIs), or the presence of bacteria in the vaginal canal.
Endometritis is also common after miscarriages or childbirth (most often after a C-section or extended labor). Studies from the past couple of decades suggest that endometritis may also be associated with infertility and miscarriages.
The risk for endometritis is higher for those who’ve undergone a procedure requiring a surgeon to pass through the cervix, as well as other practices that may result in infection. Some examples of these procedures include dilation and curettage (removal of lining or contents of the uterus), endometrial biopsies, hysterectomies, and intrauterine device (IUD) insertions.
Childbirth may also increase the risk of endometritis (more so in a cesarean delivery than vaginal delivery). Individuals who practice unprotected sex also have a higher risk of contracting infections that may lead to endometritis.
One of the biggest differences between endometriosis and endometritis involves their treatments. As endometriosis may be caused by hormonal abnormalities, its treatments commonly involve interventions like hormonal birth control. Because endometritis is more likely to be caused by infection, it is best treated by tackling said infections.
There is no cure for endometriosis, but there are effective treatments for the pain and other symptoms it may cause. Hormone therapy — via pill or injection — is commonly used to stop the ovaries from producing the hormones that cause endometriosis. Oral contraceptives (birth control) may also relieve pain, as they are often prescribed to lighten, shorten, or regularize your period. Progesterone and progestin — taken as a pill, by injection, or via an IUD — may improve symptoms by reducing menstruation or halting it completely.
Pain medications and surgical treatments can also provide significant short-term relief from the pain associated with endometriosis. Over-the-counter pain relievers, like nonsteroidal anti-inflammatory drugs (NSAIDs), may work well in reducing mild symptoms. Surgical treatments can allow health care providers to locate and/or remove the existing endometriosis lesions, but cannot prevent new ones from growing.
Treating endometritis is often less complex than treating endometriosis. In most cases, it involves preventing or treating the responsible infections. Antibiotics and intravenous fluids can typically eliminate the infection that caused endometritis.
To reduce symptoms, you should consider improving your sleep quality, staying hydrated, and practicing safe sexual health and hygiene. If you have the condition and discover it was caused by an STI, you should notify any sexual partners so they can seek treatment.
Treating sexually transmitted diseases early, making sure sexual partners have been treated for STIs, and following safe-sex practices all reduce the risk of endometritis. Additionally, ask your doctor about the possibility of taking antibiotics before a C-section if you are worried about inflammation or irritation.
Although people often confuse endometriosis and endometritis, they’re two distinct conditions. Both, if left untreated, can lead to infertility and permanent reproductive damage. But if they’re detected early and managed properly, people living with endometritis, endometriosis, or both can lead productive, fulfilling lives.
It can be helpful to remember that you are not alone in living with endometriosis. MyEndometriosisTeam, the social network and online support group for those living with the disorder, is a safe space for discussing common experiences and finding support.
How much do you know about the differences and similarities between endometriosis and endometritis? Have you experienced them together? Share your experiences or thoughts in the comments below or by posting on MyEndometriosisTeam.