Patient's question:
Expert: Hello! I have been pregnant for 9 months and am not breastfeeding. Three months ago, I experienced irregular bleeding for 3 months, and the hospital diagnosed me with endometritis. I was given ethinyl estradiol for 3 days and gentamicin for 5 days. I didn’t feel well, so I switched to oral medication. I have taken Gynecological Qianjin Tablets, Fuhukang, and others. For the past 3 months, my menstruation has been normal, but I have been experiencing persistent pain, especially at night. When I touch my abdomen, I can feel it is hard, but I don’t like being touched. I hope the expert can recommend a highly effective treatment or medication, no matter how long it takes, as I am willing to stick with it. Thank you!Doctor's answer:
Hello: In addition to the primary use of antibiotics during treatment, it is also necessary to remove obvious triggers, such as removing an intrauterine device, clearing residual placental tissue or endometrial polyps in the uterine cavity, etc. If there is an endometrial submucosal fibroid or endometrial cancer, appropriate treatment should be administered based on the situation. In cases of uterine cavity abscess, the cervical os should be dilated to promote pus drainage. After the inflammation is controlled, a diagnostic should be performed to rule out the presence of cancer. In some chronic cases, physical therapy may also be considered.During acute endometritis, sexual activity must be avoided to prevent further spread of inflammation. Due to symptoms such as increased vaginal discharge, abdominal pain, lower back pain, and a sense of heaviness, the female's interest in sex may decline and become unenjoyable. Even after the inflammation is controlled, resuming sexual activity should not be too frequent to avoid pelvic congestion and recurrent episodes due to weakened resistance. In chronic cases, due to chronic lower back pain, sexual activity may exacerbate symptoms, leading to increased vaginal discharge, abdominal pain, and worsened lower back and sacral heaviness. Sexual activity should be limited, and even if intercourse is forced, it may lack pleasure and climax. Alternatively, even if pleasure and climax are experienced, post-coital pelvic congestion may cause symptoms to recur or worsen. In such cases, antibiotic treatment for several days after intercourse is recommended. The vagina should be cleaned promptly after intercourse to remove secretions and semen, or a condom should be used to prevent bacterial ascent and further spread through friction during sexual activity.
To reduce pelvic congestion during intercourse, prevent symptom recurrence, and facilitate disease control, the sexual position should be female-on-top, allowing the female to control the intensity and level of arousal. The frequency of sexual activity should also be minimized, and normal activity can be resumed once the condition is fully controlled.