Introduction

Asherman's syndrome is a condition where scar tissue forms inside the uterus, which can lead to changes in menstrual flow and difficulty getting pregnant. This can sometimes develop after procedures that scrape the uterine lining, such as an abortion. Early detection and proper care are key to protecting your reproductive health.

PRC GR believes in informed consent, which means that we believe in having full knowledge of a procedure’s risks and side effects before you decide if the procedure is right for you. If you are thinking about getting an abortion, you need to know about Asherman’s syndrome and how it could affect your health.

What is Asherman's Syndrome

Asherman's syndrome happens when adhesions, or bands of scar tissue, grow inside the uterus. These adhesions can partially or completely stick the uterine walls together. The result may be lighter periods, irregular cycles, or even no bleeding at all. This condition can affect fertility by blocking the uterus or preventing a fertilized egg from implanting properly. If left untreated, some women may face challenges with future pregnancies or experience repeated miscarriages.

Causes and risk factors

While any uterine surgery can cause Asherman's syndrome, it is more common after procedures that scrape the lining, known as dilation and curettage (D&C). In fact, researchers believe that 90% of cases are pregnancy related, as the endometrium of a pregnant woman is far more sensitive to one that is not or has not been pregnant. This technique is most common when taking uterine samples, miscarriage care, removal of uterine polyps, treating a retained placenta after childbirth, and most commonly abortion. Asherman’s syndrome is so common that it affects up to 13% of women who complete a first trimester abortion, and 23.4% of women who receive an abortion later in pregnancy. The risk factor only goes up for women who have repeating abortions.

Recognizing symptoms

Asherman’s syndrome is believed to be underdiagnosed, as most women don’t notice anything wrong until they try to get pregnant, and diagnosing it can be difficult. There are no markers that show up on an ultrasound or routine exam. However, there are still some cases where symptoms show up. These can include:

• No menstrual period or very light flow
• Absent period but significant menstrual cramps during time of expected period
• Infertility and trouble conceiving
• Recurring miscarriages

Again, Asherman’s syndrome most often does not present itself through symptoms other than struggle with conceiving and carrying a pregnancy to term. Many times it is also misdiagnosed as other issues such as hashimotos, thyroid issues, polycystic ovarian syndrome, or pelvic inflammatory disease. If you believe that you may have Asherman’s syndrome, it is imperative that you start seeking answers now, as diagnosing and treating it can be a lengthy process.

Treatment and prevention

The main treatment for Asherman's syndrome is hysteroscopic surgery. This minimally invasive procedure uses a thin camera and small instruments to cut and remove adhesions. After surgery, doctors often insert a balloon or prescribe estrogen therapy to keep the uterine walls from sticking back together. Prevention focuses on reducing risk during any uterine procedure. Recommendations include:

• Choosing providers who use gentle techniques
• Waiting for the uterus to heal naturally before having another procedure
• Monitoring for signs of infection after surgery
• Choosing alternative options to any sort of procedure that scrapes your uterus

Support at PRC GR

Knowing your body and options can help you feel confident about next steps.

If you’re worried about Asherman's syndrome or any other abortion risk, it’s important you advocate for yourself and find the answers you need. PRC GR is happy to walk you through any questions you may have.