Patient's question:
Patient Gender: Doctor, I would like to ask: I had a painless abortion on November 12th because a previous examination revealed severe cervical erosion. Therefore, two weeks after the abortion, I started using "Zhimoling Effervescent Tablets." For the first four days of use, there were small amounts of medication discharge. However, on the fifth day, December 3rd, there was a significant amount of medication mixed with some blood. What could be the reason for this? Also, I was told that menstruation should not occur until one month after the abortion, but my previous cycle was only 22 days. I am anxiously waiting...First Follow-up Question: After one week post-abortion, there was no bleeding because of abdominal pain. A follow-up examination by the doctor revealed mild endometritis and adnexitis.
Doctor's answer:
Endometritis is divided into acute and chronic types. The main cause of acute endometritis is miscarriage, puerperal infection, insertion of an intrauterine device, radium needles, cervical dilation, diagnostic or physical treatments such as cervical electrocautery, laser, or microwave. Ascending infections from pathogens such as sexually transmitted diseases can also cause it. Additionally, endometrial polyps, submucosal uterine fibroids, and other conditions often lead to endometritis. The etiology of chronic endometritis is largely similar to that of acute endometritis.The main symptoms of acute endometritis include fever, lower abdominal pain, increased vaginal discharge, which may be 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.
Treatment primarily involves the use of antibiotics, along with addressing obvious triggers, such as removing an intrauterine device, clearing residual placental tissue or endometrial polyps from the uterine cavity. If submucosal uterine fibroids or endometrial cancer are present, appropriate management should be taken based on the situation. In cases of uterine cavity abscess, cervical dilation may be necessary to promote pus drainage. After the inflammation subsides, a diagnostic should be performed to rule out the presence of cancer. In some chronic cases, physical therapy may also be considered.