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Womens Health > Womens Conditions Forum > Treating Asherman's Syndrome
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Q: Treating Asherman's Syndrome
asked by: DoctorQuestion on March 6th, 2009
I have had 2 D&C's last year for polyps. Since my last D&C in 10/08 I have not had a period. I was regular prior to this. Since then I have noticed monthly cyclic pain with bloating and cramping. It is very painful. Now I have almost daily cramping with pressure. I went to a new GYN to see if she thought I could have Asherman's syndrome. She wants me to try provera to see if it jumps start me into having a period, if not, then she wants me to have a HSG test. I am 47 and I have been tested for menopause and I am not in menopause. My question is will the provera cause me extreme pain when my body thinks it's time to have a period? And if my HSG shows that I have scar tissue what is the next step?


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Dr. Andrijana Shterjovska , MD
replied on August 16th, 2009
Womens Conditions Answer A7052


Given the data you provided (missing period after 2 D&C, monthly cyclic pain with bloating and cramping), it seems possible that you might be experiencing Asherman’s syndrome. Asherman’s syndrome is a condition in which an excessive scar, or fibrous tissue has developed in the uterine cavity. It is usually formed after a kind of injury to the inner lining of the uterus. Dilation and Curettage is one such condition and perhaps the most frequent cause for Asherman’s syndrome.


If the woman had her menstrual period regularly prior to the D&C, then the scar tissue might more or less block the leaking of blood during the period. This might lead to hypomenorrhea, oligomenorrhea or even a complete cessation of the menstrual period (amenorrhea).


The body still produces hormones regularly, but the blood cannot be expelled and the pressure might cause pain monthly, approximately when the menstrual period is expected.


You might want to consult with a gynecologist about your condition and have hysterosalpingography to confirm or to rule out Asherman’s syndrome.
If it is confirmed, then operative dissection of the adhesions with laparascopy might be recommended. Please note, that the prognosis often includes repetitive adhesions. To prevent adhesions from forming again, different techniques might be used to keep the walls of the uterus detached while healing.




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