Asherman Syndrome and Changes to Your Periods

Adhesions can join areas of the uterine lining together or obstruct the route through which menstrual blood leaves the uterus. The resulting pattern depends on where the scars are and how much of the cavity they involve: bleeding may become scant, less regular or stop. Some people also develop cyclical pelvic pain when blood cannot drain freely. Fertility difficulties or repeated pregnancy loss can be part of the presentation, but not everyone has these concerns.

Pregnancy, hormonal contraception, breastfeeding, menopause-related changes, thyroid problems and other conditions can also alter periods. A clinician therefore considers the timing of the change, pregnancy possibility, medicines and any previous uterine surgery, infection, birth or miscarriage care before deciding which tests are appropriate.

Arrange a gynaecology appointment if your periods became unexpectedly light or stopped, especially after treatment inside the uterus. Note the dates and flow of recent periods, episodes of cramping, pregnancy tests and relevant procedures. The initial assessment may include a pregnancy test and pelvic ultrasound. A hysteroscopy allows the clinician to view the uterine cavity directly; if adhesions are found, specialist operative hysteroscopy can divide them. Follow-up is individual because scar tissue can form again and pregnancy plans may affect the care offered.

Seek urgent medical help for severe or rapidly worsening pelvic pain, fainting, very heavy vaginal bleeding, fever, or foul-smelling discharge. These symptoms need assessment for acute bleeding, infection or another urgent cause; they should not be assumed to come from adhesions. If a period is late and pregnancy is possible, take a pregnancy test. Obtain urgent assessment for significant pain or bleeding with a positive test because pregnancy-related complications must be excluded.

You may want to ask which other causes of absent or light periods need checking, whether imaging or hysteroscopy would be most informative, and how any proposed procedure could affect future periods or pregnancy plans. If treatment is recommended, ask how the adhesions will be divided, what aftercare is planned and how the uterine cavity will be reassessed.