If your uterus feels sore, you have fever, or you notice unusual discharge after childbirth or a procedure, you might be dealing with endometritis. It’s an infection of the uterine lining that can turn serious fast if left untreated. The good news? Most cases respond well to antibiotics and simple self‑care steps. Below we break down what triggers it, how you’ll know it’s there, and the treatment plan most doctors follow.
Endometritis usually shows up after delivery, a miscarriage, or any uterine surgery. Bacteria from the birth canal, an unsafe C‑section incision, or retained placenta fragments can slip into the uterus and cause inflammation. Common signs include a fever over 100.4°F (38°C), lower‑abdominal pain, foul‑smelling vaginal discharge, and sometimes chills. If you notice any of these symptoms within two weeks of giving birth or after a uterine procedure, call your doctor right away.
The backbone of treatment is antibiotics. Doctors often start with a broad‑spectrum combo such as clindamycin plus gentamicin, covering both aerobic and anaerobic bacteria. In many clinics, you’ll get an IV dose first, then switch to oral pills once you’re stable. Finish the entire prescription—even if you feel better after a few days—to prevent relapse.
Alongside meds, supportive care helps your body heal faster. Stay hydrated, eat protein‑rich meals, and rest as much as possible. Over‑the‑counter pain relievers like ibuprofen can tame fever and cramps, but avoid aspirin if you’re still bleeding. If the infection is linked to retained tissue, a follow‑up procedure (often a gentle suction) may be needed to clear out any leftover fragments.
When antibiotics don’t work after 48–72 hours, your doctor might change the drug based on culture results or try a different combination. Rarely, severe cases need admission to the hospital for stronger IV therapy and close monitoring of vital signs.
Prevention is just as important as treatment. If you’re planning a C‑section, discuss antibiotic timing with your surgeon—getting a dose before skin incision cuts infection risk dramatically. After birth, keep any stitches clean, change pads frequently, and report persistent foul odor or heavy bleeding immediately.
For women who’ve had endometritis before, talk to your OB‑GYN about prophylactic antibiotics for future pregnancies or surgeries. Some doctors recommend a short course of oral doxycycline after delivery if you’re at high risk (multiple previous infections, diabetes, or prolonged labor).
Recovery time varies. Most people feel back to normal within a week of finishing antibiotics, but it can take two weeks for the uterus to fully settle. If you notice new fever spikes, worsening pain, or discharge after treatment, reach out again—these could signal an unresolved infection.
In my latest blog post, I discussed the role of azithromycin in treating endometritis, which is an inflammation of the endometrium lining in the uterus. Azithromycin is a commonly prescribed antibiotic that has shown promising results in treating this condition. It works by targeting the bacteria causing the infection, reducing inflammation, and promoting healing within the uterus. This treatment is particularly beneficial for women who are trying to conceive, as endometritis can lead to infertility if left untreated. Overall, azithromycin appears to be a valuable tool in managing endometritis, providing relief and improving the chances of conception for many women.
