Asherman Syndrome: Symptoms, Causes, Treatment

Scar bands join uterine walls and may be limited or extensive. They differ from adhesions outside the uterus in the pelvis. Some intrauterine adhesions produce no obvious symptoms.

Related reading: Other causes of secondary period pain.

Periods may become light or absent, sometimes with cyclic pain, infertility or recurrent miscarriage. Other conditions can cause these symptoms and should be assessed before attributing them to adhesions.

Scarring can follow injury to the uterine lining during an intrauterine procedure, particularly after pregnancy, or follow infection or certain operations. Previous curettage does not make the syndrome inevitable.

Risk relates to endometrial injury, some repeated procedures and infection. The extent varies between individuals; a previous operation’s name alone cannot predict the outcome or guarantee pregnancy after treatment.

Clinicians review previous procedures and other causes of absent periods, including pregnancy. Contrast imaging or saline ultrasound can help; hysteroscopy directly visualizes adhesions and their extent.

A specialist may divide adhesions through hysteroscopy and select temporary barriers or hormonal treatment afterward. Repeat treatment and follow-up may be necessary. Stem-cell or platelet-rich-plasma approaches are not established routine substitutes.

Adhesions may recur, and menstrual or fertility problems can persist. Pregnancy prospects depend on damage severity. Inform the maternity team about prior adhesions and treatment during any later pregnancy.

Not every case is preventable. Discuss the indication and alternatives for intrauterine procedures and treat diagnosed infection. Fear of adhesions should not delay a necessary intervention.