About Asherman’s Syndrome
Asherman’s syndrome, also known by the name intrauterine adhesions, is an acquired condition where there is formation of scar tissue (adhesions) in the uterus or in the cervix (opening to uterus). Intrauterine adhesions are scars that result from trauma to the uterus. Endometrium is lining of uterus that composed of two layers: the functional layer, which is the superficial and is shed every month during menstruation, and the underlying basal layer from which regenerates the functional layer. Myometrium is the layer below Endometrium.
In Asherman’s syndrome, flat scar tissue replaces the functional endometrium which does not respond to hormones and causes changes in the menstrual cycle involving decrease in menstrual flow, cramping and abdominal pain increases, ultimately cessation of menstrual cycles (amenorrhea), and in some cases, it may results in infertility. Sometimes even parts of the myometrium are mistakably removed during surgery. Scarring may also develop without the formation of adhesions and is known as fibrosis.
Causes of Asherman’s Syndrome
- Asherman syndrome is a rare condition in women where most cases are due to several dilatation and curettage (D&C) procedures.
- A recently pregnant uterus is more susceptible of developing Asherman’s after D&C compared to a non-pregnant uterus
- A severe pelvic infection unrelated to surgery may also lead to Asherman’s syndrome.
- Retained placenta requiring manual removal.
- Sometimes scarring may be after uterine surgeries such as Cesarean section or myomectomy for fibroids or tumors.
- Intrauterine adhesions is also caused by infection, as genital tuberculosis.
- Even in some cases cause is unknown, patients in that case have never had any D & C or other surgery.
Risk Factors
- Women who have undergone any intra uterine surgery/procedures
- Women having increased risk for miscarriages.
- Over the age of 35 women.
- Recurrent miscarriage can also be a symptom of Asherman’s syndrome if they are of unknown cause.
- Women who suffered from complications during delivery period such as retained placenta or post-partum hemorrhaging (PPH).
Ayurvedic View
As explained by Ayurveda if Vata get vitiated, that causes irregular and painful menstruation, disturbing “Pitta-the thermal energy”. Increased “Pitta” can lead to heavy bleeding, hot flushes and irritable condition.
Symptoms of Asherman’s Syndrome
Women suffering from this condition may not have an obvious symptom, but certain problems includes:
- Menstrual irregularities such as very light periods (hypo menorrhea) or absence of periods (amenorrhea).
- May lead to Infertility due to adhesions including the uterus and fallopian tubes.
- Recurrent pregnancy loss (miscarriage).
- Pelvic pain, if scar tissue blocks the outflow of the menstrual blood, causing uterine cramping and pelvic discomfort or pain.