Symptoms and Causes of Asherman's Syndrome

Symptoms

Do you experience or have a history of any of the following?

  • Menstrual changes: sudden reduction in menstrual flow or absence of menstruation, a lot more brown blood/less red blood. Note: a few sufferers don't notice menstrual changes.
  • Pain or cramping at the time of menstruation with little or no blood (pain resulting from outflow obstruction)
  • Endometriosis: this could result from backflow of blood caused by AS.
  • Unexplained infertility (primary or secondary)
  • Repeated miscarriage which is unexplained.
  • Invasive placenta (eg. Placenta accreta, placenta percreta, placenta increta) in a past pregnancy could possibly indicate AS.

Causes

Do you have a past history of uterine surgery?

Examples:

  • D&C (in the presence or absence of infection) for any reason including:
    • miscarriage (missed or incomplete)
    • retained postpartum placenta
    • postpartum hemorrhaging
    • elective abortion/termination of pregnancy
    • endometrial biopsy
    • fibroid removal
    • treatment of excessive uterine bleeding
  • Hysteroscopic myomectomy
  • C-section
  • Uterine artery embolization
  • Endometrial ablation (This is the intentional creation of Asherman's Syndrome to treat excessive uterine bleeding.)

Other Non-surgical Causes

Have you ever had the following?

  • Manual removal of placenta
  • Uterine packing (filling the uterus with gauze; sometimes used to control postpartum hemorrhaging)
  • Pelvic irradiation (cancer treatment)
  • Caustic abortifacients (douching with a corrosive chemical to induce an abortion)
  • Endometrial tuberculosis

Diagnostic Tests and Procedures

Have you tested the following?

  • Blood tests: Estrogen, LH, progesterone, FSH, thyroid, prolactin to rule out hormonal problems affecting ovulation. Some women may not want to jump into hysteroscopy or HSG, which are not without some risks.
  • Imaging:
    • Ultrasound to measure endometrial thickness at ovulation and to check normal follicle development
    • Sonohysterography (SHG) or hysterosalpingogram (HSG (these procedures are not as accurate as hysteroscopy, but will confirm patency of tubes if infertility is a problem)
  • Other: Some doctors suggest a hormone challenge test but this can be a waste of time if blood tests are normal. It just gives pain for women whose periods are blocked by Asherman’s Syndrome.
  • Gold standard for diagnosis: diagnostic hysteroscopy

To top

International Ashermans Association

This book is dedicated to telling stories of women who were given no hope by their doctors but ended up with babies. 

Click here to order your copy of the silent syndrome @$14.99.

Conditions of third party use

Contents from this website may be reprinted only under the condition that the content is credited to International Ashermans Association and a URL link i.e.  http://www.ashermans.org/ 
is included.