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  • When healing never ends

    When healing never ends

    Understanding Asherman syndrome beyond adhesions

    Asherman syndrome is often described as “scar tissue inside the uterus,” usually understood as a consequence of surgery, infection, or inflammation. The uterine lining becomes injured, adhesions form, and the uterus loses part of its natural form, function, and flexibility. Menstrual patterns may change, fertility can be affected, and for some women, infertility becomes a painful reality.

    While this explanation is accurate, it does not capture the full picture. Patients undergo repeated surgeries to remove adhesions, only to see them return—even after careful treatment in optimal conditions.

    Over time, both patients and professionals are left asking the same question:

    Why does the body keep forming scar tissue long after the original injury has passed?

    A serious need for attention

    For many women, the diagnosis arrives after an experience that was already deeply distressing—a miscarriage, an incomplete abortion, a complicated delivery, or an unexpected intervention carried out under pressure. When healing does not unfold as expected, the emotional weight grows heavier over time.

    Years of repeated procedures, unexplained pregnancy loss, and unanswered questions often give rise to fear, anger, grief, and self-blame—directed toward doctors, circumstances, or one’s own body. Feeling damaged, broken, or responsible is painfully common.

    Even early on, many patients sense something important:
    healing feels unfinished.

    This awareness matters. Emotional strain, prolonged uncertainty, and chronic stress are not separate from physical recovery. They interact with immune activity, hormone signaling, and tissue behavior—quietly shaping how the body responds.

    To better support those living with Asherman syndrome, we need a broader understanding of what limits true healing and stabilization.

    This article explores:

    • the deeper biological drivers behind recurrence
    • factors that shape uterine health beyond structure
    • the connection between physical and psychological stress
    • directions future care may take

    The insights that follow grew from years of listening, learning, and working alongside specialists—and from honoring the lived experience of women, including myself, whose bodies are still asking to be understood.

    A different starting point

    When the healing environment stays unsettled

    The uterus is a highly responsive organ. Its lining renews itself through close coordination between cells, hormones, immune signals, blood flow, nerves, and beneficial bacteria. In a healthy uterus, these systems guide healing toward completion. Once repair is finished, inflammation resolves, signals quiet down, and the tissue returns to a flexible, receptive state.

    In Asherman syndrome, this coordination is disrupted.

    Healing begins—but it does not fully settle. Inflammatory signals remain active, repair pathways stay switched on, and the tissue struggles to return to rest. The body behaves as though danger is still present, even when the original injury is long past.

    Understanding why this happens requires looking beyond adhesions and toward the systems that regulate when healing should stop.

    Cellular communication

    When stop signals are not received

    Healing depends on constant dialogue between endometrial cells, immune cells, fibroblasts, blood vessels, and nerves. Together, they continuously answer three questions:

    • Is there danger?
    • Is repair needed?
    • Is it safe to stop?

    In Asherman syndrome, danger and repair signals tend to dominate. Messages that normally quiet inflammation and slow repair are weakened or ineffective. As a result, immune cells remain alert, repair cells continue working, and the tissue stays tense and reactive.

    Even in the absence of active injury, the uterus behaves as though it is still under threat.

    Cellular balance

    When repair outweighs renewal

    In a healthy uterus, different cell types exist in carefully regulated proportions. Repair cells, immune cells, glandular cells, blood vessel cells, and nerve fibers work in balance, allowing the lining to cycle between activity and rest.

    In Asherman syndrome, this balance can shift.

    Research shows that the uterine lining may contain fewer healthy lining cells and more cells linked to inflammation, fibrosis, and vascular constriction. Repair-oriented cells can become dominant, while those responsible for softness, hormone responsiveness, and regeneration become less prevalent. Some immune cells remain overrepresented, while others that support resolution and tolerance are reduced.

    As a result, the tissue becomes organized around repair rather than renewal. Regeneration struggles, the lining becomes rigid and adhesive, and both fertility and menstrual function are affected.

    Effective care therefore requires more than clearing scar tissue—it involves guiding cellular populations back toward a healthier proportion, closer to what allows the uterus to regenerate fully each cycle.

    Hormone signaling

    When instructions fail to land

    Hormones act as messengers. For their instructions to shape tissue behavior, cells must be able to receive and respond to them. Normal hormone levels do not automatically mean effective signaling.

    When signaling is impaired—due to inflammation, nervous system activation, or reduced cellular responsiveness—hormonal messages may arrive but fail to register.

    Estrogen normally stimulates growth, blood flow, and rebuilding early in the cycle. This activity is healthy and necessary, but it is meant to be followed by stabilization. Progesterone delivers that message, guiding the tissue to slow down, organize, and rest.

    When responsiveness is disrupted, estrogen-driven activity may continue without adequate progesterone effect. The tissue remains active instead of settling. Repair processes stay engaged, even when hormone tests appear normal. This helps explain why hormone supplementation alone often falls short.

    The microbiome

    A subtle but powerful regulator

    The uterine lining also depends on a stable microscopic environment. Beneficial bacteria, immune cells, and glandular secretions support healthy cycling, implantation, and early pregnancy.

    When this environment is disrupted, low-grade inflammation can persist even when imaging suggests structural improvement. The uterus may appear restored while remaining unsettled at a deeper level—less responsive, less receptive, and slower to stabilize.

    Why adhesions return

    When cellular communication remains disrupted, hormonal calming signals are missed, the microbiome stays unsettled, and inflammation persists, the body responds exactly as it is designed to: it reinforces.

    Repair does not resolve. Fibroblast activity continues, temporary scaffolding is not broken down, and flexibility gives way to stiffness. Over time, this gradual shift leads to fibrosis and adhesions.

    This explains recurrence.

    Even after adhesions are removed and the original injury is long past, the uterus remains in repair mode. Surgery may temporarily clear the cavity, but it also introduces new micro-injuries. In a system that never fully settled, these interventions can restart the same cycle.

    This is not failure. It is biology following familiar instructions.

    Surgery alone falls short

    Surgery can remove existing adhesions, but it does not correct disrupted cellular communication, hormone responsiveness, microbiome balance, or nervous system input.

    It clears scar tissue, yet simultaneously reactivates inflammation. When the underlying environment remains unchanged, repair resumes in the same way, and adhesions re-form.

    Healing feels incomplete because, at a biological level, it is.

    What is missing is not effort—it is an environment that allows repair to come to rest.

    Reframing Asherman syndrome

    Asherman syndrome extends beyond adhesions. It can be better understood as a condition of incomplete resolution within the uterine lining.

    Immune balance, hormone responsiveness, cellular dialogue, nervous system signaling, and microbial stability all influence whether healing settles—or continues indefinitely.

    Why this perspective matters

    When focus shifts from scar removal to the healing environment:

    • surgery becomes one step, not the entire plan
    • recurrence becomes understandable rather than discouraging
    • care can center on restoring balance instead of repeatedly triggering repair

    The goal is not to force healing or aggressively suppress inflammation. The goal is to help the uterus recognize that it is safe to stop. When that message finally lands, healing can come to rest.

    Looking forward

    Regeneration instead of repeated correction

    If Asherman syndrome is understood as unresolved healing, future approaches naturally turn toward regeneration rather than repeated removal.

    Stem-cell therapy as a developing path

    Stem-cell therapy is an emerging area of research in Asherman syndrome. Rather than focusing solely on scar tissue, these approaches aim to influence the uterine lining at a deeper level.

    Stem cells may support regeneration, calm inflammation, and help reestablish healthier cellular balance. In theory, this could improve communication between cells, enhance hormone responsiveness, and guide the uterus out of constant repair mode.

    This field is still evolving and not yet widely accessible. Still, it reflects an important shift: lasting recovery may come not from repeated correction, but from supporting the tissue’s inherent capacity to renew, soften, and regain balance.

    Psychological support

    Why safety matters for healing

    Healing does not settle unless the body feels safe enough to do so. That sense of safety is shaped by the nervous system, which responds to both physical and emotional signals.

    Persistent inflammation, pain, or disrupted cycles tell the body something is wrong. Experiences such as fear, loss, uncertainty, and repeated disappointment send the same message. The nervous system does not distinguish between emotional threat and physical danger—both sustain a high-alert state.

    When this continues, immune activity remains elevated, repair signals persist, and tissues struggle to soften. The uterus stays tense not because it cannot recover, but because it has not received a clear signal that it is safe to let go.

    This creates a reinforcing loop: physical symptoms increase stress, and stress keeps physical healing from settling. For this reason, emotional support, psychological care, and nervous system regulation are not optional additions. They are integral to biological recovery.

  • The best treatments for intrauterine adhesions

    The best treatments for intrauterine adhesions

    About Asherman Syndrome

    The formation of intrauterine adhesions (also referred to as Asherman Syndrome) occurs when scar tissue forms inside the uterus. This can narrow or partially block the space, making it harder for normal menstruation or pregnancy to occur. It often follows surgical procedures such as dilation and curettage (D&C), cesarean section, fibroid removal, or, less commonly, infections or radiation. 

    Symptoms to pay attention to

    • Very light periods or no periods at all
    • Pelvic discomfort or cramping
    • Difficulty conceiving or repeated pregnancy loss

    Because the symptoms can be subtle or mistaken for other issues, it’s important to bring them up alongside your medical history with your healthcare provider.

    Key diagnostic tools

    Hysteroscopy:
    This is considered the most accurate test. A thin camera is gently inserted through the cervix to view and assess any scar tissue directly 

    Imaging tests, such as:

    • Hysterosalpingogram (HSG)—an X-ray with dye that outlines the uterine cavity
    • Saline infusion sonohysterogram (SHG)—ultrasound with fluid for clearer views
    • Transvaginal ultrasound, which can measure the endometrial lining and hint at adhesions 

    These tools help your clinician understand whether adhesive bands are present and how extensive they might be.

    Treatments

    To successfully restore the uterus to its normal function, your specialist might suggest a mix of different treatments. This will depend on the severity of your adhesions and your medical history. Treatments may therefore vary, and there is no one-size-fits-all. However, here’s a breakdown of the most common ones, so you can go into the conversation prepared.

    Removing the adhesions

    Hysteroscopic Adhesiolysis
    This is the most widely used, effective first step. A special scope is used to gently remove scar tissue while preserving healthy uterine lining In more complex cases, laparoscopy may assist to protect against uterine perforation 

    Preventing adhesions from returning

    To avoid the adhesions from reforming, several supportive measures might be used after removal to support the uterus’ healing process.

    Mechanical barriers
    such as balloons, stents, or bioresorbable gels (like hyaluronic acid-based barriers: Hyalobarrier®, Seprafilm®) help keep the uterine walls apart during healing 

    Hormone therapy
    typically estrogen (sometimes followed by progesterone), encourages the growth of healthy endometrium and reduces adhesion risk 

    Follow-up hysteroscopy
    or imaging about 1–2 months later ensures that any new adhesions are detected early, so they can be addressed promptly 

    Regenerative therapies 

    Research is into restoring the uterus microbiome and cells balance on a deeper level is still ongoing. For patients who’ve had multiple unsuccessful treatments with recurring adhesions, the following regenerative therapies might bring hope:

    Stem cell therapy, using regenerative cells to rebuild endometrial tissue 
    Platelet-rich plasma (PRP), another potential regenerative tool, though data are still evolving 

    While hopeful, these approaches aren’t yet considered standard care due to limited evidence — but they may become part of future treatment options. If you’re interested in participating in a clinical trial, do not hesitate to contact Asherman Therapy, part of Carlos Simon Foundation. 

    Recovery

    Symptom Relief

    Many women notice their periods become more regular and that cramping or pain improves after treatment. Recovery looks a little different for everyone — it depends on how extensive the adhesions were and which treatments were used.

    Some women may feel mild cramping or pressure in the uterus in the days after surgery. If hormone therapy is part of your care, you may notice temporary side effects, and if an intrauterine device (IUD) or small balloon was placed to protect healing, it can feel a bit uncomfortable. These are usually removed at your follow-up hysteroscopy. Most women are able to return to daily routines quite quickly.

    Fertility Outlook

    When adhesions are mild to moderate, many women are able to conceive successfully after treatment. In more severe cases, additional procedures may be needed. Doctors generally recommend waiting a few months before trying for pregnancy, giving the uterus time to heal and the lining a chance to restore itself. This waiting period is an important step in supporting both fertility and a healthy pregnancy.

    Because pregnancies after treatment carry some risks — like placenta abnormalities or preterm labor — thoughtful prenatal care and monitoring are essential 

    Steps to take from diagnosis to recovery

    1. Symptom awareness
    Notice changes in your cycle or comfort, and trust your observations.

    2. Specialist referral
    Seek a gynecologist with experience in uterine adhesions or reproductive concerns.

    3. Accurate diagnosis
    Ask about a hysteroscopy, possibly preceded or supplemented by imaging like SHG or HSG.

    4. Surgical and supportive care
    If adhesions are found, talk about adhesiolysis followed by estrogen and barrier measures.

    5. Follow-up
    Schedule imaging or evaluation a few weeks later to monitor healing.

    6. Planning ahead
    If fertility is your goal, discuss timing, monitoring, and potential next steps — including IVF if needed.

    To summarize

    With thoughtful care, Asherman’s syndrome can be managed effectively. Hysteroscopic removal of adhesions, supported by hormone therapy and barriers, offers real hope. If you feel uncertain or overwhelmed, you’re not alone — compassionate, expert help is available, and with the right team, clarity and healing are within reach.

  • Supporting a Loved One with Asherman’s Syndrome

    Supporting a Loved One with Asherman’s Syndrome

    A guide for partners walking alongside

    Introduction

    When someone you love is diagnosed with Asherman’s Syndrome, it can be difficult to know what to say, how to act, or even how to begin helping. You may feel helpless, worried, or unsure of how to best support them. These feelings are natural.

    What matters most is not having all the answers—it’s being present. Your steady care and understanding can make a world of difference to your partner as they navigate the physical, emotional, and mental weight of this condition.

    This guide was created to help you better understand what your loved one may be going through, and to give you gentle tools to walk alongside them with empathy and strength.

    Understanding the Journey

    Living with Asherman’s can feel overwhelming and isolating. Your partner may be grieving, facing repeated medical procedures, or struggling with uncertainty about fertility or long-term health. These challenges are not their fault—and reminding them of this truth can offer comfort.

    Listening Without Fixing

    One of the greatest gifts you can give is to listen—fully, without rushing to solve or minimize. Sometimes your partner may not need answers, but simply a safe space to share fears, sadness, or frustration. Phrases like “I hear you” or “I’m here with you” can mean more than advice.

    Respecting Grief and Emotions

    Your partner may grieve lost possibilities, time, or dreams that now feel uncertain. They may cycle through sadness, anger, or even guilt. Remind them gently that none of this is their fault. Validate their feelings, even if you don’t fully understand them.

    Being Present in Practical Ways

    Support doesn’t have to be grand—it’s often found in the small things. Accompany them to appointments, take notes during consultations, prepare a comforting meal, or handle everyday tasks when they feel drained. These gestures say, “You’re not alone in this.”

    Intimacy and Connection

    Asherman’s may affect your physical relationship, especially during or after treatment. Intimacy may look different for a while—and that’s okay. Talk openly, move gently, and find ways to connect emotionally and physically that feel safe for both of you. Patience and reassurance go a long way.

    Encouraging Self-Care and Professional Support

    Encourage your partner to care for their mental and physical well-being—whether through counseling, gentle movement, journaling, or simply resting. Offer to join them in these activities if it helps. Professional help, like a therapist or support group, can also provide an important layer of care.

    Caring for Yourself, Too

    Supporting someone with Asherman’s can feel heavy at times. To truly be there for your partner, you also need to look after yourself. Make space for your own feelings, find someone you can talk to, and remember that your well-being matters, too.

    Do’s and donts

    Do’s

    • Listen fully. Let your partner share their feelings without rushing to give solutions.
    • Validate their emotions. Say things like, “It’s okay to feel this way” or “I understand this is hard.”
    • Remind them it’s not their fault. Gently reinforce that Asherman’s is something that happened to them—not because of them.
    • Be present at appointments. Offer to go along, take notes, or just sit by their side.
    • Help with daily tasks. Small gestures—cooking a meal, tidying up, or handling errands—can ease their load.
    • Encourage rest and self-care. Support them in taking time for themselves, whether it’s through rest, therapy, or small joys.
    • Communicate openly. Share how you feel, too—it helps keep the relationship honest and balanced.

    Don’ts

    • Don’t minimize their pain. Avoid phrases like “At least it’s not worse” or “It could be worse.” These may feel dismissive.
    • Don’t rush their healing. There is no timeline for grief or recovery—allow them to move at their own pace.
    • Don’t make it about you. Your feelings matter, but avoid centering the conversation on your own worries when they’re sharing theirs.
    • Don’t push intimacy. Respect when they need space; intimacy should feel safe, not pressured.
    • Don’t assume you understand. Even if you’ve read about Asherman’s, their personal experience is unique. Ask instead of assuming.
    • Don’t give empty reassurances. Instead of saying “Everything will be fine”, try “Whatever happens, I’ll be here with you.”

    A Closing Note for Partners

    Walking alongside someone with Asherman’s Syndrome isn’t easy—but your presence is powerful. You don’t need to fix everything or carry all the answers. What your partner needs most is your patience, empathy, and willingness to stay by their side.

    Remind them gently that Asherman’s is not their fault. Remind yourself that your role isn’t to make everything perfect, but to share the journey. Together, step by step, you can find strength, closeness, and even new ways of seeing life.

    Learn more about Asherman Syndrome

    When healing never ends

    Understanding Asherman syndrome beyond adhesions Asherman syndrome is often described as “scar tissue inside the uterus,” usually understood as a consequence of surgery, infection, or inflammation. The uterine lining becomes injured, adhesions form, and the uterus loses part of its natural form, function, and flexibility. Menstrual patterns may change, fertility can be affected, and for…

    Isa's avatar by Isa

    The best treatments for intrauterine adhesions

    About Asherman Syndrome The formation of intrauterine adhesions (also referred to as Asherman Syndrome) occurs when scar tissue forms inside the uterus. This can narrow or partially block the space, making it harder for normal menstruation or pregnancy to occur. It often follows surgical procedures such as dilation and curettage (D&C), cesarean section, fibroid removal,…

    Isa's avatar by Isa

    Supporting a Loved One with Asherman’s Syndrome

    A guide for partners walking alongside Introduction When someone you love is diagnosed with Asherman’s Syndrome, it can be difficult to know what to say, how to act, or even how to begin helping. You may feel helpless, worried, or unsure of how to best support them. These feelings are natural. What matters most is…

    Isa's avatar by Isa
  • Living with Asherman syndrome

    Living with Asherman syndrome

    A journey of mental strength and resilience

    Discovering you have adhesions, searching for answers, facing treatments, and dealing with the impact is often very different from the life you once imagined. Living with Asherman’s—no matter its cause or severity—is undeniably challenging. It can feel isolating, filled with uncertainty, and leave you with questions that don’t always have simple answers.

    Yes—it’s hard. But it’s not beyond you. Many people facing Asherman’s discover a strength they didn’t know they had. With each step, even the small ones, you are proving your resilience. Your journey won’t look exactly like anyone else’s, and that’s okay—healing is deeply personal.

    In the next part of this guide, you’ll find ideas and steps that might help you move forward. Some will speak to you, others may not—and that’s part of the process. Take what feels right, leave the rest, and remind yourself that every choice you make in caring for yourself is already a step in the right direction.

    Accept

    Acceptance doesn’t mean you have to like what’s happening to you—it means acknowledging where you are right now. Living with Asherman’s is not something you chose, and it is not your fault. Allowing yourself to accept the reality of your diagnosis can be the first step in finding the right way to live with it and find peace without resistance.

    Grieve

    It’s okay to be sad when life doesn’t unfold the way you expected. Whether it’s mourning lost time, missed opportunities, or dreams that feel uncertain, grief has its place in healing. It’s simply unspent love you had for others and yourself—it makes you human. Let yourself feel it, and trust that those emotions will find their place over time.

    Connect

    Since it’s a rare syndrome, Asherman’s can sometimes feel isolating, so social connection is one of the most powerful antidotes. Sharing your story will make your loved ones understand, joining support groups will boost your sense of belonging in this world, and remind you that you don’t have to carry this alone.

    Heal and collapse

    Healing is not a straight line. Some days you may feel strong, other days fragile—and both are part of the process. Healing is physical, yes, but it’s also emotional and mental. Enjoy the days you are okay, and soothe yourself on the day’s you’re not. Preparing grounding techniques and tools to calm yourself down on hard times will generally make you feel more stable among this journey.

    Rest and routine

    Take time off when you need to. You don’t need to ‘work yourself’ through it all. To ensure the best quality of resting, do maintain a healthy sleeping routine with a fixed schedule. Go outside for 15 minutes each morning and evening, light a candle before going to bed and allow yourself to disconnect.

    Take care of your body

    The best way to get your energy back, or to maintain healthy energy is to eat well. Take care of your body, be gentle to it, connect with it. It’s done some incredibly hard work for you we have to appreciate. Move, take a massage, cuddle yourself, take a bath, eat healthy and don’t be too hard on yourself.

    Focus on something new

    Opening the space in your brain for something new might have surprising benefits in your healing journey.This process can drain you, so a very refreshing thing to do could be to focus on something new, something that gives you energy. A forgotten hobby, completing something that’s on your bucket list, helping others, reconnecting with old friends or going on that trip you’ve always wanted.

    Redirect and find your purpose

    A diagnosis doesn’t take away your worth or your future. If anything, it can push you to discover parts of yourself you hadn’t seen before. Your purpose is not defined by Asherman’s—it’s defined by who you are, what you love, and how you choose to live, even in the face of difficulty. Take a deep look into your talents, into things that give you energy and follow this path to build something great. 

    Manage Relationships

    Asherman’s can affect your relationships, whether with a partner, family, or friends. Some people may not fully understand what you’re going through. Being open about your needs and boundaries can help, but it’s also okay to step back when you need space. Relationships can grow stronger through honesty and compassion—both from others and from yourself.

    Be proud of yourself

    One of the hardest but most important steps is to recognize your own strength. Living with Asherman’s requires courage every single day. Remind yourself that none of this is your fault, and yet you continue to face it with resilience. Internal recognition is about giving yourself credit for surviving, for coping, and for showing up, even when it’s hard.

    Know you’re not alone

    If you take one thing from this guide, let it be this: having Asherman’s syndrome is not your fault. You did not cause this, and you are not defined by it.

    The journey is not simple—it is layered with moments of grief, strength, setbacks, and courage. Yet within all of that, there is also hope. Every step you take, no matter how small, is a step toward healing.

    You are stronger than you think, and you do not have to walk this path alone. Whether it’s through the support of loved ones, connecting with others who understand, or finding comfort in small daily rituals, you can create light along the way.

    Life with Asherman’s may not look like the life you once imagined—but it can still hold beauty, purpose, and joy. And as you move forward, remember: your story is still yours to write, and you are already showing remarkable courage in writing it.

    Learn more about Asherman Syndrome

    Living with Asherman syndrome

    A journey of mental strength and resilience Discovering you have adhesions, searching for answers, facing treatments, and dealing with the impact is often very different from the life you once imagined. Living with Asherman’s—no matter its cause or severity—is undeniably challenging. It can feel isolating, filled with uncertainty, and leave you with questions that don’t…

    Isa's avatar by Isa

    Understanding Asherman Syndrome

    In the ever-evolving world, the art of forging genuine connections remains timeless. Whether it’s with colleagues, clients, or partners, establishing a genuine rapport paves the way for collaborative success.

    Isa's avatar by Isa
  • Understanding Asherman Syndrome

    Understanding Asherman Syndrome

    Ever heard of intrauterine adhesions? Probably not the first go-to topic for a chit-chat, but they’re very real—and if you’re dealing with them, you’re definitely not alone. Lots of women suffer from adhesions, but since they´re not always diagnosed, we´re not always aware of having them.

    So whether you’re here wondering if adhesions are causing some of your symptoms, are looking for help or just want to learn more about this medical condition, here’s everything you should know about Asherman Syndrome.

    What is Asherman Syndrome?

    Having Asherman Syndrome means you´re overdeveloping scar tissue (the so-called adhesions) inside your uterus. Depending on where and how severe they are, they can limit the uterus space and block your cervix. This can lead to abnormal menstruation, pelvic pain and can sometimes makes it hard to conceive.

    Causes

    Asherman Syndrome is usually diagnosed as a consequence of uterine trauma. However, some people simply seem to be more prone to developing adhesions. Research shows that a different balance in cell types and how they interact can lead to a pro-inflammatory environment in the endometrium, affecting how your body responds.

    That said, the most common and direct causes of the initial uterine trauma leading to adhesions include:

    • Curettage or dilation: often done after a miscarriage, abortion, or delivery. Mostly when the procedure was incomplete and the uterus wasn’t entirely cleared.
    • Surgical interventions: surgeries like a myomectomy or cesarean section
    • Infections: Severe uterine infections, such as endometritis
    • Certain cancer treatments

    While these are the most common causes, only a few percentage of people who undergo these procedures actually develop Asherman Syndrome. As mentioned above, individual health, genetic factors and surgical techniques also influence the appearance.

    Besides the above, uterine adhesions have occasionally been found in individuals who´ve had treatments in closely located organs such as the bladder or intestine.

    How common is Asherman Syndrome?

    It’s hard to know exactly how common Asherman Syndrome is because mild cases often go undiagnosed. It´s currently considered a rare syndrome since it´s only been diagnosed in 1 out of 10.000 women—meaning it might not be the first thing your doctor thinks of when assessing your symptoms. Adhesions are still being studied, and unfortunately, many healthcare professionals don’t have a deep understanding of them yet.

    Even though adhesions are considered rare, we want to help you get the answers you deserve. By sharing everything we know, you’ll be able to bring this possibility up with your doctor and get diagnosed.

    Main symptoms of intrauterine adhesions

    Symptoms of Asherman Syndrome can vary depending on how severe and where the adhesions are. Common signs include:

    • Changes in menstrual flow: your periods might become lighter, irregular, or stop altogether (amenorrhea). Sometimes your menstruation will stop and continue a few days later. Your blood flow might have a different consistency than before. It can include spotting, blood clotting or thick scar tissue.
    • Pelvic pain or discomfort: chronic pelvic pain or cramping can occur, mostly prior to- or during your period. You might feel symptoms of inflammation and feel like your menstruation should have come out for days already but it´s not actually appearing.
    • Difficulty getting pregnant: adhesions can interfere with the uterine lining or entrance, making it harder to conceive.
    • Recurrent miscarriages: some people suffer from repeated pregnancy losses.

    Diagnosis

    A good first step to diagnose the existence of adhesions is to talk to your gynaecologist about your medical history—especially any past uterine procedures, infections, or surgeries as these can be key indicators. If your doctor suspects adhesions to be the cause, they will most likely recommend the following diagnostic steps:

    Hysteroscopy: a thin, flexible camera is inserted into your uterus through the cervix, allowing your doctor to directly see (and potentially remove) any scar tissue. It’s not always mentioned, but you have a choice—you can stay awake or opt for sedation, whatever feels right and most comfortable for you.
    Sonohysterogram: a specialized ultrasound in which a saline solution is injected into the uterus to create a clearer image of its shape and any possible adhesions.
    Ultrasound: uses sound waves to create images of the uterus, might sometimes suggest the presence of adhesions but is generally less reliable. A routine uterus scan typically won’t detect them.

    Treatments

    Asherman treatments usually focus on removing scar tissue, restoring the uterus to normal and preventing adhesions from growing back. Here are some of the options that specialists tend to apply. Keep in mind that your treatment will depend on your personal situation, severity of the adhesions and medical background.

    • Removing the scar tissue: this can be done in the same procedure as your diagnostic hysteroscopy. Through a thin, flexible camera, a specialist can both see and remove any scar tissue.
    • Preventing returning adhesions: your specialist might place an IUD, balloon or apply gel to prevent adhesions from forming again after the above mentioned surgical hysteroscopy. These usually get removed after a couple of weeks, during your final evaluation hysteroscopy, where your specialist can see if the treatment has worked and adhesions have not grown back
    • Hormonal therapy: additionally, estrogen hormone therapy can help strengthen the uterine lining after the adhesions are removed. Your healthcare provider might advise you to take hormone supplements for a couple of months, depending on your personal situation.
    • Stem cell therapy: this new, upcoming treatment can be applied to patients that suffer from recurring adhesions. By implanting specific cell types obtained from your own blood, stem cell therapy helps you strengthen your uterus health on a deeper level. The improved harmony and communication between cells can avoid formation of new adhesions and boost fertility. Since this is a very new treatment yet to be rolled out, not many clinics in 2025 will offer this just yet.
    • Follow-up hysteroscopy: Finally, your doctor will schedule a hysteroscopy to see if the treatment has worked and the adhesions haven’t grown back.

    Recovery

    Asherman Syndrome recovery varies a lot. After removing adhesions, there´s usually a 50% chance you´ll stay clean. In case they do return, you´ll need a follow up treatment. For some women, dealing with Asherman can be a hopeless and stressful experience. For others, it´s a one off.

    Asherman recovery can be tough, not just physically but emotionally too. The mix of hormonal changes, physical exhaustion and uncertainty can feel overwhelming. Will the adhesions come back? Am I healing the way I should? Can I still get pregnant—and when? These are real concerns that many go through. It’s not easy, but please remember—you’re not alone in this.

    How to get help

    Treating Asherman syndrome requires expertise, precision and personal attention. Especially since the adhesions could return, you want to make sure you get treated by the best specialists only. Therefore it’s important to find a clinic that understands the syndrome, has the latest technology in place and carefully listens to your needs and past treatments. 

    • Gynecologists: For diagnosing and managing the condition.
    • Reproductive endocrinologists: Especially for those trying to conceive.
    • Hysteroscopy specialists: Experts in the procedure to remove adhesions.
    • Psychologists:
    • Support communities

    Some hospitals, like Spaarne Hospital, offer comprehensive care with a range of experts to address both the physical and emotional aspects of the condition.