Asherman Syndrome

Asherman Syndrome is a condition where scar tissue (adhesions) forms inside the uterus. This tissue build-up can cause parts of the uterine walls to stick together, reducing or even blocking the space in the uterus. This condition can lead to menstrual problems, pain, and infertility, as the adhesions interfere with the uterine lining’s ability to function normally.

What Happens in Asherman’s Syndrome?

In Asherman's Syndrome, scar tissue forms within the uterus, often as a result of trauma. When this happens, the walls of the uterus may stick together in places where there is scar tissue. This can block menstrual blood flow or prevent the embryo from implanting, leading to infertility or recurrent miscarriages.

Who Is at Risk?

Asherman’s Syndrome is often linked to women who have undergone uterine surgery, especially a procedure called dilation and curettage (D&C). This procedure is sometimes done after a miscarriage, delivery, or abortion to clear the uterus. Other risk factors include:

• Having multiple D&C procedures
• Uterine infections, especially if untreated
• Uterine surgeries, like a myomectomy to remove fibroids or Cesarean section
• History of tuberculosis

Symptoms of Asherman’s Syndrome

Symptoms can vary, but they commonly include

• Very light periods or no periods at all (amenorrhea)
• Pain during menstruation due to blocked blood flow
• Difficulty getting pregnant or recurrent miscarriages
• Pelvic pain in some cases
• Some women with mild adhesions might not have symptoms but still experience infertility.

Causes of Asherman’s Syndrome

The main cause is trauma to the uterus, especially following a D&C. The trauma can trigger an abnormal healing response, leading to scar tissue. Other causes include:

• Uterine infections (e.g., endometritis)
• Radiation treatment to the pelvic area
• Some untreated chronic infections (e.g., tuberculosis) which may damage the uterine lining.

Ayurvedic interpretation

In Ayurveda, Asherman's syndrome may not be specifically named, but it can be interpreted based on Ayurvedic principles of reproductive health. According to Ayurveda, any reproductive issue involves an imbalance in the body’s doshas (Vata, Pitta, and Kapha) and dhatus (tissues), particularly Artava dhatu (reproductive tissue). Asherman's syndrome could be viewed as a disturbance in the Artava vaha srotas (channels carrying reproductive tissue) due to scar formation, which disrupts the normal flow of menstruation and fertility.

Conventional treatment of Asherman’s syndrome

Treatment generally involves surgery to remove the scar tissue and restore the uterine cavity. This can be done through a procedure called hysteroscopy, where a thin, flexible tube with a camera is used to locate and remove adhesions inside the uterus.

After treatment, women may need to be monitored to ensure the uterus heals properly, and sometimes additional therapy is recommended to improve fertility outcomes.

Ayurvedic treatment useful in Asherman’s syndrome

Panchakarma Therapy:

Procedures like Basti (medicated enema) help regulate Vata and improve reproductive organ health.

Virechana (therapeutic purgation) may help in detoxifying and balancing Pitta to reduce inflammation.

Uttarbasti: Is a specialised treatment in which herbal medicinal oils or ghritham can be administered inside the uterine cavity under strict aseptic precautions.

Diet and lifestyle recommendations

A Vata-Pitta balancing diet, with warm, nourishing, easily digestible foods, is recommended.

Practices like yoga, meditation, and avoiding excessive physical and mental stress are also helpful.

It’s A pinch of turmeric powder mixed with warm milk or water can be taken daily to approach Ayurveda under the supervision of a qualified Ayurvedic practitioner who can tailor treatments based on individual dosha constitution and symptoms, especially when dealing with a complex condition like Asherman’s syndrome.

Herbs useful in Asherman’s syndrome

In Ayurveda, certain herbs are considered beneficial for improving uterine health, reducing scar tissue, and balancing the doshas that may be involved in Asherman's syndrome. These herbs, used in various forms, can support tissue regeneration, reduce inflammation, and improve blood flow to the uterus.

Shatavari (Asparagus racemosus):

Shatavari is a nourishing and rejuvenating herb useful to support tissue growth (especially the damaged uterine lining. Shatavari powder or capsules can be taken daily, often with warm milk, which enhances its nourishing effect. A typical dose may be 1–2 teaspoons daily, but it’s best to consult an Ayurvedic practitioner for personalized dosage.

Ashoka (Saraca indica):

Ashoka has anti-inflammatory and pain-relieving properties. It is traditionally used to treat menstrual disorders and improve uterine health.

Ashoka can be consumed as a powder or decoction. Typically, 1–2 teaspoons of Ashoka powder or an Ayurvedic-formulated Ashoka syrup can be taken under guidance.

Guduchi (Tinospora cordifolia):

Guduchi is considered a powerful anti-inflammatory and immune-boosting herb. It supports tissue repair. It promotes cellular regeneration and helps reduce scar tissue. Its immune-supportive properties also reduce the risk of recurrent infections that might worsen adhesions.

Haridra (Turmeric)(Curcuma longa):

Turmeric is anti-inflammatory and aids in reducing scar tissue formation. It also supports circulation and has antimicrobial properties. A pinch of turmeric powder mixed with warm milk or water can be taken daily.