Overview Causes Symptoms Treatment
What is Asherman’s Syndrome?
Asherman’s Syndrome is a condition in which scar tissue (adhesions) forms inside the uterus, causing the uterine walls to narrow and stick together. This scarring can partially or completely block the uterine cavity, interfering with normal menstrual flow and reproductive function.
Common Related Conditions
Causes of Asherman’s syndrome
Asherman’s syndrome can be caused by trauma to the uterine lining, inflammation, or infection after bacteria or a disease enter the vagina. In either case, the body creates scar tissue inside the uterus as the first step in healing. Once adhesions form in the uterus, they can remain in place or grow, binding the uterine walls to each other with glue-like bonds.
Asherman’s often occurs after dilation and curettage (D&C) procedures, particularly when performed after miscarriage, abortion, retained placenta, or postpartum bleeding. Uterine surgeries such as myomectomy or cesarean section can also contribute, especially if healing is complicated by infection or inflammation. In some cases, uterine infections like endometritis or pelvic inflammatory disease damage the endometrium and promote adhesion formation. Pelvic radiation therapy or repeated uterine procedures can injure the uterine lining, increasing the risk of developing these intrauterine adhesions.
Symptoms of Asherman’s syndrome
- Light or absent menstrual periods (hypomenorrhea or amenorrhea)
- Increased menstrual cramping with little or no bleeding
- Infertility or difficulty becoming pregnant
- Recurrent miscarriage
- Pelvic pain or chronic lower abdominal discomfort
- Pain during menstruation
- Pain during intercourse
- Cyclical pelvic pain without normal menstrual flow
Treatment for Asherman’s syndrome
There are two approaches to treating Asherman’s Syndrome: surgical and non-surgical. Surgical treatment involves surgically removing uterine scar tissue (adhesions) using hysteroscopy (cutting with micro-scissors or lasers) to restore the normal uterine cavity, followed by hormonal therapy (estrogen) and sometimes placement of devices or repeated procedures to prevent scar tissue from reforming, aiming to restore menstruation and fertility. While often successful, patients run the risks of repeat adhesions and the risk of general anesthesia.
Repeat adhesions can form in the uterus as the body forms post-surgical adhesions. A five-decade study in Digestive Surgery showed that 55% to 100% of women develop adhesions following pelvic surgery. (Liakakos et al, 2001) Even laparoscopy, one of the least invasive surgical procedures, was shown to cause new adhesions in 97% of cases at the exact site surgery was performed (Journal of Laparoscopy, 2020).
Non-surgical treatment: Clear Passage® Therapy is a non-surgical, manual physical therapy approach specifically designed to decrease adhesions such as those associated with Asherman’s Syndrome. It has the distinct advantage of being non-surgical. As such, it avoids subjecting the patient to surgery, a primary cause of Asherman’s Syndrome. Clear Passage® uses hands-on techniques developed over several decades of research to gently mobilize and soften scar tissue in and around the pelvic region. Besides decreasing adhesions, its primary goals include improving uterine and pelvic organ mobility, circulation, and function. Treatment programs are individualized and typically provided over an intensive period of consecutive days by trained therapists.
Condition Specific Disclaimer:
While Clear Passage® clinics use highly trained physical therapists, clinical results have generally been excellent; outcomes can vary from person to person. We suggest you fill out a medical intake form to determine if Clear Passage® Therapy may be an appropriate complementary approach for you.
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