Asherman’s syndrome

What is Asherman’s syndrome?

Asherman’s syndrome is a condition where there is scar tissue in the uterus or cervix. This causes the walls of the uterus to stuck together and reduces the size of the cavity. It is otherwise known as intrauterine synechiae or adhesions.

What are the symptoms of Asherman’s syndrome?

• Having very light or no periods 
• Having severe cramps or pain 
• Having difficulty getting pregnant 

What causes Asherman’s syndrome?

A major risk factor for Asherman’s syndrome is surgery to the uterus. Most women who have had surgery to their uterus do not go on to have Asherman’s syndrome; however the majority of women with this condition have a history of dilation and curettage, surgical abortion, myomectomy or caesarean section. Sometimes, infection or radiation can also cause this.

How to diagnose Asherman’s syndrome?

The best way is through a hysteroscopy. This gives direct visualisation of the entire uterine cavity, and also allows for treatment if required (e.g. excising scar tissue) at the same time.

Other ways to diagnose Asherman’s syndrome include a hysterosalpingography (HSG) or saline infusion sonography (SIS).

How to treat Asherman’s syndrome?

Asherman’s syndome is treated via hysteroscopy and excision of scar tissue. Commonly, this requires more than 1 procedure as there is a significant risk of scar tissue reforming. Your gynaecologist may need to insert a copper-T IUD and/or anti-adhesion gel into the cavity of your uterus to reduce the risk of scar tissue reformation and/or prescribe hormones to encourage the uterine lining to grow back properly. You will need to have a hysteroscope at the end of your treatment to check that the cavity of your uterus is back to its normal shape and size. 

What happens after my treatment is completed?

Your periods should go back to normal, and you can resume trying for pregnancy if you wish. 

Photo credit: Floranerolia / Wikimedia Commons