Reduced or absent periods is the most common symptom. Pelvic pain may also occur due to areas of trapped menstrual fluid being squeezed by the surrounding muscular walls of the uterus. If the cervix is completely blocked by scar tissue then the fluid that builds up behind the obstruction cannot flow out and the pressure can cause pain that is sometimes so great that it requires admission to hospital and strong pain killers.
It is presumed that adhesions can affect fertility, however the degree that these adhesions cause difficulties in becoming pregnant is unknown, since there may be women who have adhesions and become pregnant easily.
The best way to treat Asherman’s Syndrome is by a surgical procedure to remove scar tissue from the uterine cavity and restore it to normal function. Dr Budden will admit you to hospital and perform the procedure under general anaesthetic. A thin hysteroscope is used to look through the cervix and identify the areas of scar tissue. In difficult cases, Dr Budden may need to pass a small needle through the scar tissue and then inject a special dye while using an X-ray machine to help find the normal passage. The same dye and X-ray machine can also be used to check that the tubes are open and that it would be possible for a spontaneous pregnancy to occur after treatment.
After the procedure you will be prescribed oestrogen to be taken for three weeks following your treatment to ensure that your body has every opportunity to repair the endometrium (lining of the uterus) naturally and reduce the risk of the scar tissue reforming. A repeat hysteroscopy is then performed 4, 8 or 12 weeks later to check whether the uterine cavity and cervix are normal and would allow both normal menstruation and the possibility of pregnancy. The average number of surgeries required to reconstruct the cavity is 2, though this may vary from 1 – 6.