How to distinguish endometritis and functional uterine bleeding

Patient's question:

I am 26 years old and have had skin breakdown for 3 years. I previously had pelvic effusion, and after it was drained, my menstruation has been irregular. A few days after it ended, the skin still broke down, first turning brown and then bright red. It's hard to stop without medication, and I also experience lower back pain, general weakness, and excessive sleepiness.
Medical tests and results: The report said my endometrium was slightly thickened (12.5 mm) and that there was some vaginal inflammation.
Previous treatment history and outcomes: I visited some local hospitals, some of which diagnosed me with functional uterine bleeding, while others said it was endometritis. Generally, I was overcharged at hospitals. One visit cost thousands of dollars, yet no clear diagnosis was made.
What kind of help I need: I want to understand what exactly is wrong with me and don't want to be prescribed unnecessary medications.

Doctor's answer:

Endometritis is the inflammation of the endometrium. Based on the duration of the course, it can be divided into acute endometritis and chronic endometritis. The main symptoms of acute endometritis include fever, lower abdominal pain, increased vaginal discharge, sometimes bloody or foul-smelling, and sometimes a slightly enlarged uterus with tenderness. Chronic cases also present similarly, but may also include excessive menstrual bleeding, lower abdominal pain, and pronounced lumbosacral discomfort. Generally, treating endometritis and pelvic inflammatory disease with medication alone is not very effective. A combination of traditional Chinese and Western medicine, as well as physical therapy, can be considered for treatment. In fact, having a gynecological disease is not something to be afraid of. Patients should believe in their ability to overcome the illness as long as they recognize the symptoms in time.

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