From the Research
Asherman syndrome can cause pain, but it is not the primary symptom, and the condition is more commonly associated with menstrual abnormalities, infertility, and recurrent pregnancy loss. According to the most recent and highest quality study, Asherman syndrome is characterized by a triad of symptoms including pain, menstrual abnormalities, and infertility, and is a result of intrauterine scar tissue after instrumentation of a gravid uterus 1. The study published in 2023 in the journal Obstetrics and Gynecology, found that pain is one of the symptoms of Asherman syndrome, although it is not the most common presentation.
Some women may experience cyclical pelvic pain or cramping during their menstrual period when blood becomes trapped behind adhesions. The lack of pain as a primary symptom often contributes to delayed diagnosis, as many women don't realize they have the condition until they experience difficulty conceiving. Asherman syndrome typically develops after uterine procedures like dilation and curettage (D&C), particularly following pregnancy complications, uterine surgeries, or infections.
Treatment usually involves hysteroscopic surgery to remove adhesions, followed by hormonal therapy with estrogen to promote endometrial regrowth, and sometimes placement of a balloon catheter or IUD to prevent the recurrence of adhesions during healing. The use of stem cells and platelet-rich plasma is being explored as a means of regenerative therapy for the endometrium, but data remain limited 1.
Key points to consider:
- Asherman syndrome is a condition characterized by adhesions or scar tissue in the uterine cavity
- The condition can cause pain, but it is not the primary symptom
- Menstrual abnormalities, infertility, and recurrent pregnancy loss are more common symptoms
- Hysteroscopic surgery is the gold standard for diagnosis and treatment
- Hormonal therapy with estrogen and placement of a balloon catheter or IUD may be used to promote endometrial regrowth and prevent recurrence of adhesions.