Ozone in the Treatment of Endometritis

Background: treating inflammation of the uterine lining

Endometritis is inflammation of the endometrium, the lining of the uterus. It often develops after childbirth or after a termination of pregnancy, when bacteria enter the uterine cavity and trigger an acute infection. Left untreated, the inflammation can spread and become harder to resolve. Standard care combines antibacterial, anti-inflammatory and supportive medicines. Researchers in Russia set out to test whether irrigating the uterine cavity with ozonated water could add to this conventional approach by acting directly on bacteria at the site of infection.

Study design: 60 women treated with ozonated-water irrigation

This was a single-arm observational study of 60 women aged 18 to 34 with acute endometritis that had followed either an abortion or childbirth. There was no separate control or comparison group. Each woman received intrauterine irrigation, sometimes described as intrauterine dialysis, using distilled water that had been ozonated to a concentration of 5,000 micrograms per litre. Between 400 and 1,200 millilitres was passed through the uterine cavity via a two-way catheter, once a day for one to three days, alongside the standard anti-inflammatory therapy. The team tracked clinical symptoms such as pain, temperature and discharge, together with a panel of laboratory markers including erythrocyte sedimentation rate (ESR), white blood cell (leukocyte) count, circulating immune complexes, immunoglobulins, C-reactive protein and measures of oxidative and antioxidant activity in the blood.

Findings: inflammatory markers fell over the treatment period

Across the group, the inflammatory and immune markers improved over the short course of treatment. ESR fell by roughly half, and the white blood cell count returned to normal in about 95 per cent of the women. Circulating immune complexes dropped by around 60 per cent and immunoglobulin M by about 35 per cent. C-reactive protein, a marker of acute inflammation, became negative in about 95 per cent of patients, and so-called medium molecules normalised across the group. Antioxidant activity in the plasma rose by about 39 per cent. The authors reported that the irrigation was well tolerated, with no adverse effects noted.

What the authors concluded

The authors concluded that ozonated water applied directly to the uterine cavity produced a local bactericidal effect that helped clear infection, shortened the treatment period and was well tolerated, which in their view makes it a promising addition to the management of endometritis. They were careful to state that it should be used alongside, not instead of, the standard antibacterial, anti-inflammatory and supportive medicines, rather than as a stand-alone therapy.

Limitations of this study

This was a small, single-arm study of 60 women with no control or comparison group, so the improvements cannot be attributed to ozone alone. Because the irrigation was given on top of conventional anti-inflammatory treatment, the two effects cannot be separated, and much of the recovery may reflect the standard therapy and the natural course of the illness. The study was carried out at a single centre with a narrow age range and short follow-up, and the numerical results are reported without full statistical detail for every marker. It was published in Revista Española de Ozonoterapia, a specialist ozone-therapy journal, and carries no DOI, so it has not been subject to the wider indexing and scrutiny of a general medical journal. The findings are best read as preliminary and would need confirmation in larger, controlled trials.