Asherman Syndrome: Intrauterine Adhesions, Causes and Treatment

Asherman syndrome is scar tissue, called adhesions, that forms inside the uterine cavity. It most often develops after uterine surgery, especially repeated dilation and curettage (D&C) procedures. The scar tissue can partially or fully block the space inside the uterus, which can affect periods and fertility.

Medical Disclaimer: This page is for general education only. It is not medical advice, diagnosis, or treatment, and reading it does not create a provider-patient relationship. Talk with a licensed healthcare provider about your specific situation. If you are having a medical emergency, call 911 or go to the nearest emergency room. See our full Medical Disclaimer.

Seek Care Right Away If You Notice These Signs

Call your doctor or seek urgent care if you have had a recent uterine procedure, such as a D&C, hysteroscopy, or cesarean section, and develop any of the following:

Fever or chills
Heavy vaginal bleeding that soaks through a pad every hour or two
Severe or worsening pelvic pain
Foul-smelling vaginal discharge

These can be signs of infection or other complications that need prompt medical attention, separate from the longer-term concerns discussed below.

What Causes Intrauterine Adhesions

Asherman syndrome is a rare condition. It occurs most often in women who have had several D&C procedures. A severe pelvic infection that is not related to surgery can also lead to it. Adhesions can also form after infection with tuberculosis or schistosomiasis, though these infections are rare in the United States, and uterine complications from them are rarer still.

Symptoms That Suggest Asherman Syndrome

The adhesions may cause:

Amenorrhea (missed or absent menstrual periods)
Repeated miscarriages
Infertility

These symptoms can also come from several other conditions. They are more likely to point to Asherman syndrome if they start suddenly after a D&C or other uterine surgery. Only a qualified clinician can tell the difference through testing.

How Doctors Diagnose It

A routine pelvic exam usually does not find anything unusual in Asherman syndrome, since the adhesions are inside the uterine cavity. To look inside the uterus, a doctor may use imaging tests or hysteroscopy, a procedure that uses a thin, lighted scope passed through the cervix to see directly into the uterine cavity. Hysteroscopy is generally considered the most direct way to both view and diagnose adhesions.

How Hysteroscopic Treatment Works

Treatment usually involves surgery to cut and remove the adhesions or scar tissue. This is most often done through hysteroscopy, using small instruments and a camera guided into the uterus through the cervix, without external incisions.

After the scar tissue is removed, the uterine cavity needs to stay open while it heals so adhesions do not re-form. A healthcare provider may place a small balloon inside the uterus for several days to help hold the space open. Estrogen may also be prescribed while the uterine lining heals. If an infection is present, antibiotics may be needed. Any decision about these treatments, including medication, should be made with a qualified clinician who has examined you.

What to check before acting on Asherman Syndrome

Have my periods changed suddenly, especially after a uterine procedure?
Have I had repeated miscarriages or trouble becoming pregnant?
Have I had more than one D&C, or a severe pelvic infection?
Would imaging or hysteroscopy help find out what’s going on?
If adhesions are found, what would treatment and recovery involve for me?

Putting Asherman Syndrome information into practice

If your periods stop or change suddenly after a uterine procedure, tell your doctor rather than waiting to see if it resolves on its own.
Ask whether imaging or hysteroscopy is appropriate to check for adhesions.
If Asherman syndrome is diagnosed, ask your doctor to explain the treatment options and what recovery and follow-up typically involve.
If fertility is a concern, ask about a referral to a reproductive endocrinologist or fertility specialist.
Ask what monitoring or follow-up testing is recommended after treatment.

Fertility Outcomes After Adhesion Removal

Research on Asherman syndrome shows that removing adhesions can improve menstrual symptoms and, for some patients, the chance of pregnancy. However, outcomes vary widely depending on how much scarring was present before treatment, whether adhesions return after surgery, and individual health factors. No treatment can guarantee a specific outcome, and this page does not predict what will happen for any individual. A fertility specialist can review your personal history and test results to discuss what is realistic in your situation.

Where current knowledge about Asherman Syndrome stops

People who have had multiple D&C procedures, a severe pelvic infection, or certain uterine surgeries have a higher chance of developing adhesions and may want to discuss monitoring with their provider. This page does not cover every possible cause of Asherman syndrome, every diagnostic test available, or the full range of treatment techniques, since these decisions depend on individual history and what a clinician finds. It also does not cover cost, insurance coverage, or recovery timelines, which vary by provider, treatment, and location. This is a general educational overview, not a personalized diagnosis or treatment plan.

Coping With a New Diagnosis

Learning you have a condition that affects fertility can be stressful. Support groups, whether in person or online, can help some people process a diagnosis like this alongside medical care. Ask your care team if they can recommend a reputable support resource.

Questions readers ask about Asherman Syndrome

Is Asherman syndrome common?

No. It is considered a rare condition. It occurs most often in women who have had several D&C procedures, though it can also follow a severe pelvic infection unrelated to surgery.

Can Asherman syndrome cause missed periods even if I’m not pregnant?

Yes. Amenorrhea, or the absence of menstrual periods, is one of the main symptoms linked to this condition. However, missed periods have many possible causes, so testing is needed to find the actual reason.

Does a normal pelvic exam rule out Asherman syndrome?

Not necessarily. A pelvic exam does not reveal problems in most cases, because the adhesions are inside the uterine cavity itself. Imaging or hysteroscopy is generally needed to see them.

Will treatment guarantee I can get pregnant afterward?

No treatment can guarantee a pregnancy. Removing adhesions can improve symptoms and, for some patients, improve the chances of pregnancy, but outcomes depend on the severity of adhesions and other individual factors. A fertility specialist can give you a clearer picture based on your own history.

Educational Disclaimer

This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. It does not diagnose any individual, recommend a specific treatment, or predict outcomes for any person. Always consult a qualified healthcare provider about your specific symptoms, diagnosis, and treatment options.