What Is Asherman’s Syndrome?
Asherman’s syndrome is a rare condition that occurs when scar tissue (also called adhesions) forms on the lining of the uterus (endometrium) and/or the cervix. In severe cases, more than two-thirds of the endometrium and cervix can be covered with scar tissue. Heavily scarred uterine surfaces may stick together, restricting menstrual flow and causing pain.
Extensive scar tissue can also prevent the endometrium from responding normally to the influence of estrogen. This can disrupt or halt the menstrual cycle, making it difficult to conceive.
There is no single cause of Asherman’s syndrome. The condition is primarily associated with risk factors including:
- Pelvic infection caused by disease or surgical complications.
- Previous uterine surgery, such as dilation and curettage, caesarean section delivery, or uterine fibroid removal.
Symptoms vary depending on the amount and location of scar tissue that has formed and include:
- Infertility — Scar tissue accumulation can prevent a fertilized egg from implanting in the endometrium.
- Light, infrequent or absent periods — The development of scar tissue can cause menstruation to slow and eventually cease.
- Miscarriage — During pregnancy, scar tissue distorts the shape of the uterus and makes it harder for the placenta to develop normally, causing repeated miscarriages.
- Pain — Blockages caused by scar tissue can cause painful cramps when menstruation is expected, even when no bleeding occurs.
Treatment for Asherman’s syndrome helps relieve pain, regenerate normal menstrual cycles and may improve the chances of conceiving. Options include:
- Devices — A small, inflatable device may be surgically placed to support the uterus as it heals and minimize further scarring.
- Hormonal therapy — Oral contraceptive pills, birth control patches or other medications containing estrogen may be prescribed before and after surgery to prevent scar tissue formation and promote healing of the endometrium.
- Surgery — Procedures, such as hysteroscopy, are used to remove scar tissue and restore the shape of the uterine cavity.
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