"A" Is For Asherman's Syndrome And Adenomyosis

It is probably quite safe to say that most women know their body's signals and can tell when something isn't right. Pelvic pain, abnormal bleeding or irregular periods can be an indication that there is a problem with the reproductive organs and may require medical treatment. Uterine abnormalities are an example of this kind of problem as they can be a factor in a woman's inability to conceive or to carry a pregnancy.

Asherman's Syndrome-The Scarring Of The Uterus

Asherman's syndrome, as defined by The National Infertility Association, is the presence of scar tissue in the uterine cavity, called intrauterine adhesions. If the condition is severe and the entire uterine cavity is scarred, the woman will not menstruate. When scarring is not as serious, then menses is generally very light.

Dr. Ricki Pollycove of San Francisco, California, says, "Asherman's syndrome is basically a loss of the normal lush lining of the uterine cavity. Most often this is after an endometrial curettage (a scraping procedure to empty the cavity of pregnancy tissue; post-spontaneous, incomplete or elective abortion). Scar tissue can form and cause the inhospitable environment of the uterine cavity."

Diagnosis And Treatment Of Asherman's Syndrome

The symptom which presents most frequently in Asherman's syndrome is the lack of menstruation after an instrumented curettage. In order to detect a partial Asherman's syndrome, an HSG (hysterosalpingogram) is performed. This uterine X-ray procedure is used to check out the uterine cavity and to rule out Asherman's.

"Treatment is usually very successful," Dr. Pollycove says. "A hysteroscopic surgical procedure is done to remove the scar tissue bands and also replenish the endometrial surface tissue with estrogenic hormone support. Sometimes an IUD is also placed to help prevent reforming of scar tissue between the walls of the cavity."

Adenomyosis-Tissue Growing Where Is Shouldn't Grow

Adenomyosis, a condition which is similar to endometriosis, is described by experts as a benign disease of the uterus in which tissues and components that are normally found in the endometrium (the innermost part of the uterus) are discovered in the middle layer of the uterus, called the myometrium. In both endometriosis and adenomyosis, which are considered progressive diseases, the uterine lining is growing where it should not be growing. They differ in the fact that adenomyosis is found specifically in the uterine wall.

Links With Other Reproductive Organ Disorders

According to the Center for Uterine Fibroids in Boston, Mass., symptoms of adenomyosis include pelvic pain and abnormal uterine bleeding-either prolonged bleeding from the uterus or irregular bleeding. This condition can also be linked to other uterine disorders, such a fibroids, found in 50 percent of patients; endometriosis, found in 11 percent of women and endometrial polyps, present in seven percent of the women with adenomyosis. It is usually the symptoms of the accompanying disorders that obscure the preliminary finding of adenomyosis in women.

The only treatment to deal with this condition permanently is a total hysterectomy. Hormone supplementation of GnRH (gonadotropin releasing hormone) has been used to help with conception but has proven to be short term and re-growth of adenomyosis happens within six months after therapy has ended.


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