How Asherman syndrome is managed

Not everyone needs the same intervention. Decisions reflect symptoms, the extent and position of adhesions, menstrual changes, pregnancy goals, and whether the uterine cavity can be restored safely.

Operative hysteroscopy uses a narrow viewing instrument passed through the cervix so the surgeon can see and carefully divide scar bands. The aim is to reopen the cavity while limiting further injury to healthy endometrium.

After surgery, the clinician may recommend medicine to encourage the lining to regrow or a temporary device intended to keep healing surfaces apart. These measures are selected individually. Follow-up imaging or repeat hysteroscopy may be used to check the cavity.

Tell the surgeon about previous pregnancies, uterine procedures, infections, medicines, allergies, bleeding changes, and fertility plans. Ask what anaesthesia is planned, how adhesions will be divided, and what symptoms are expected during recovery.

Follow instructions on pelvic rest, medicines, and review appointments. Track bleeding and periods after the procedure, but do not judge the result from the first bleed alone. If conception is a goal, wait until the treating team confirms when trying is appropriate.

Call the surgical team for increasing pelvic pain, fever, unpleasant-smelling discharge, heavy bleeding, difficulty passing urine, or vomiting that prevents fluids from staying down. Seek emergency help for collapse, severe breathlessness, chest pain, or bleeding with marked dizziness.

Outside the recovery period, arrange review if periods remain absent, become lighter again after initial improvement, or cyclical pain returns. These changes may have several explanations, but recurrence of adhesions is one reason the cavity may need reassessment.

Ask what the procedure aims to improve in your case, how the uterine lining will be protected, and what follow-up will confirm healing. Discuss how treatment findings affect menstrual expectations and pregnancy planning, including when specialist fertility input may help.