Written by Dr.M.D.Mazumdar, MD
Asherman's Syndrome is a condition in which there is formation of scar tissue (called 'adhesions' or 'synechia') inside the uterus, obliterating the endometrial cavity partially or completely and preventing the occurance of normal menstrual periods.
The normal anatomy of the uterus consists of two thick muscular walls (the anterior uterine wall and the posterior uterine wall) enclosing a cavity called the endometrial cavity. The tissue lining of this cavity is called the 'endometrium'.
The main function of the endometrium is to proliferate and change in structure during each menstrual cycle so that a fertilized ovum can implant in it, should pregnancy occur in that cycle. If pregnancy does not occur, the endometrium degenerates and sloughs off during the menstrual period.
Adhesions inside the uterus can damage the endometrium to a greater or lesser degree. It thus fails to develop in each menstrual cycle leading to secondary amenorrhea.
Asherman's syndrome can occur in any women of any age who have undergone an intra-uterine procedure like an abortion, D&C or a childbirth. But it is most common after a D&C is performed on a recently pregnant uterus.
Grades of Asherman's Syndrome
Depending on the extent and thickness of the adhesions, Asherman's Syndrome can be graded into mild, moderate or severe.
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Causes of Asherman's Syndrome
The basic cause of Asherman's syndrome is injury to the endometrium, causing formation of scar tissue between the two uterine walls.
Treatment of Asherman's Syndrome
Treatment of Asherman's syndrome is very difficult. The main aims of treatment are:
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