Can an intrauterine device be removed if there is endometritis?

Written by Zhang Lu
Obstetrics
Updated on February 12, 2025
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When endometritis occurs, because there is inflammation locally, intrauterine operations cannot be performed, thus the intrauterine device (IUD) cannot be removed. The symptoms of endometritis can include the discharge of purulent secretions from the vagina and tenderness in the lower abdomen, and it can even lead to systemic infection symptoms such as fever. If one wishes to remove the IUD, it is essential to carry out standard anti-inflammatory treatment using antibiotics to treat the inflammation, and the IUD can only be removed after the symptoms have alleviated. The alleviation of symptoms primarily includes the following aspects: First, there is no longer pus discharge from the vagina. Second, there is no longer tenderness or rebound pain in the lower abdomen. Third, there are no symptoms of systemic fever or others. When removing the IUD, comprehensive disinfection should be noted to avoid causing a recurrence of endometritis or spreading the inflammation.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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What tests are done to diagnose endometritis?

Endometritis is generally definitively diagnosed by undergoing a diagnostic curettage at the hospital, where material is scraped and then sent for pathological examination to confirm the presence of endometritis. Clinically, the diagnosis of endometritis is mostly based on a combination of clinical symptoms and gynecological ultrasound examination. Patients with endometritis typically experience abdominal pain during menstruation, lower abdominal pain, and an unusual odor during their period. At such times, anti-inflammatory medication can be administered symptomatically. Most pelvic cases are considered to be anaerobic bacterial infections, thus medications targeting anaerobic bacteria can be used for symptomatic treatment. Therefore, while the definitive diagnosis of endometritis is established through diagnostic curettage, this procedure is invasive, and in most clinical cases, it is not performed. If endometritis is initially suspected, it is generally assessed through gynecological internal examination, ultrasound, and the patient's clinical manifestations and symptoms, followed by symptomatic treatment.

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Written by Du Rui Xia
Obstetrics
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Causes of endometritis

Endometritis can be divided into tuberculous endometritis and non-tuberculous endometritis, with the latter being more common in clinical settings. Non-tuberculous endometritis is often caused by various pathogenic infections. It commonly occurs during menstruation, after a miscarriage, or during childbirth due to bacterial infections. For instance, inadequate sterilization during surgery, sexual activity during menstruation, and the retention of placenta or membranes after childbirth can all facilitate ascending infections.

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Written by Du Rui Xia
Obstetrics
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Endometritis

Endometritis refers to the inflammatory changes in the uterine lining caused by various reasons. Common clinical causes include infections resulting from miscarriage or childbirth, as well as various intrauterine procedures, where bacteria opportunistically enter the uterus through the vagina. Clinically, this condition is characterized by congestion and edema of the endometrium, and in severe cases, it may lead to suppuration. Patients may experience fever, abdominal pain, and an increase in vaginal discharge, which is often purulent or hemorrhagic-purulent in nature. Clinically, antibiotics are primarily used for treatment. It is recommended that women develop good personal hygiene habits in daily life, maintain genital cleanliness, engage in moderate exercise, and enhance the body's resistance.

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Written by Shen Li Wen
Obstetrics and Gynecology
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How is endometritis diagnosed?

When suspecting endometritis in women, the first step is to inquire about the medical history. Most women exhibit abnormalities in their menstrual cycle, and some only show changes in the amount of menstruation. Ultrasound examination of the reproductive system shows no organic lesions, and the hormone panel is normal. During a gynecological examination, tenderness in the uterine body may be observed. Sometimes, ultrasound examination suggests that the endometrium is thin and uneven. Performing a hysteroscopy, localized hyperemia and edema of the endometrium can be seen, and diagnostic curettage plays a certain role in diagnosis.

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Written by Wang Jing Hua
Obstetrics and Gynecology
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Should you have sexual intercourse during endometritis?

During periods of endometritis or while treating endometritis and pelvic inflammatory disease, it is not permissible to engage in sexual activity. The stimulation from sexual activity can exacerbate the inflammation or cause it to spread, increasing the likelihood of chronic pelvic pain, worsening inflammation, causing fever, or other severe consequences. Therefore, it is crucial to not only discover and treat these conditions promptly but also to avoid fatigue and sexual activity during treatment. Generally, this is only temporary, and it is important to exercise self-control.