Asherman’s Syndrome: Heal and Prevent Uterine Adhesions Naturally

Asherman’s Syndrome: Heal and Prevent Uterine Adhesions Naturally

Asherman’s syndrome is caused by damage to the uterus that causes the formation of adhesions (scar tissue). The extent of damage can vary, and there are different grades of Asherman’s syndrome severity. The adhesion formation can affect the cervix, uterine lining, the deeper layers of the uterus, or in some cases the opening of the fallopian tubes. The scar tissue may be thin or thick. In some cases the front and back of the uterus may be adhered together, the opening to the fallopian tubes scarred shut, or the cervix covered over with scar tissue. Severe Asherman’s may lead to complete blockage of menstrual blood (endometrial lining) from being shed naturally each menses. This may lead to the formation of endometriosis, another painful and debilitating fertility issue.

Causes of Asherman’s Syndrome

The number one cause of Asherman’s syndrome is D&C (dilation and curettage) procedure. According to the International Asherman’s Association, 90% of Asherman’s cases are due to pregnancy related D&C. Women who have had a D&C 2-4 weeks post-delivery, due to retained placental reminants have up to a 25% risk of developing Asherman’s. D&C performed for missed miscarriage have a 30.9% chance of developing Asherman’s, where as women who have had a D&C due to an incomplete miscarriage only have a 6.4% chance of developing Asherman’s. Women who have had more than 2 D&C’s have an increased chance of developing Asherman’s by 32%.

Study Shows Repeated D&C Increases Risk of Developing Asherman’s Syndrome

A study, published in Human Reproduction, evaluated 50 women ages 19-44, through hysteroscopy, to determine the presence of uterine adhesions after a required second D&C due to either remaining placental remnants following delivery, missed miscarriage or medical abortion. Of the 50 women, 20 (40%) had developed intrauterine adhesions. Of that 40%, 75% had developed grade II-IV, grade IV being the most severe.

Surgical procedures that may lead to Asherman’s Syndrome:

  • D&C for miscarriage, incomplete or missed
  • D&C for retained placenta
  • Suction method D&C
  • Hysteroscopic myomectomy (removal of submucosal uterine fibroids bulging into uterine cavity)
  • Cesarean section
  • Uterine artery embolization (procedure to block blood flow to uterine fibroids, with the intent to shrink them)
  • Vacuum procedure performed for abortion, this rarely happens
  • IUD (intrauterine device birth control), this rarely happens

Non-surgical procedures that may cause Asherman’s Syndrome:

  • Retained placenta requiring manual removal
  • Uterine packing with gauze to prevent postpartum hemorrhage
  • Douching with a caustic chemical to induce abortion
  • Endometrial tuberculosis
  • Pelvic irradiation for cancer treatment

Thoughtful Preparation Prior to Choosing D&C

Asherman's ResearchPlan ahead for the possibility of miscarriage. If you are trying to conceive, consider the fact that early miscarriage is quite common. This does not mean go overboard and worry, or have it on your mind constantly. This means educate yourself now on ways to help prevent scar tissue and adhesion formation. If you were to experience a miscarriage, would you want a D&C, or a natural miscarriage? It may be best to let your body do the work of naturally cleansing the pregnancy loss, rather than have a D&C. Most women’s bodies are perfectly capable of miscarrying naturally on their own. D&C runs the risk of causing Asherman’s syndrome and should only be performed when medically necessary. Some studies suggest that the use of the drug Misoprostil for missed or incomplete miscarriage, or retained placenta after childbirth, lowers the risk of developing Asherman’s. This is because Misoprostil is a medication that causes the uterus to slough off the endometrium on its own.

If your doctor suggests D&C procedure for a missed miscarriage, or incomplete miscarriage, consider natural therapies that will greatly help to prevent scar tissue and adhesion formation.

Medical Procedures for Asherman’s Syndrome

Depending on the extent of adhesion formation within the uterus, a doctor may recommend surgery to remove the scar tissue. This may potentially lead to more adhesion formation, but for women who have severe damage to their reproductive organs, it may be an effective option. Doctor’s cut, or use resectoscopes or lasers to remove scar tissue patches and adhesions from inside of the uterine cavity. Some doctor’s prescribe estrogen hormone replacement to prevent new adhesion formation. This is meant to regrow the endometrium. A ballon is placed in the uterine cavity as a splint to help the uterus retain its shape. This splint is often used in combination with estrogen therapy. Many patients are asked to come in weekly for hysteroscopy to remove new adhesion growth. All of this is very invasive and while it may remove scar tissue that is present, it may also be causing more damage. There is also an increased risk of infection with these types of procedures.

If it is determined a surgical procedure is needed to remove adhesion formation from the uterus, natural therapies may be a complimentary approach to healing. Below are some wonderful complimentary healing methods, not only for prevention, but healing of Asherman’s as well.

Natural Prevention and Healing of Asherman’s Syndrome

Systemic Enzyme Therapy for Scar Tissue Prevention

Systemic Enzyme Therapy using systemic enzymes helps the body to break-down and prevent scar tissue formation. If you know that you are going for a D&C procedure, consider having a systemic enzyme blend on hand for post-procedure healing. Beginning systemic enzymes after bleeding has stopped, after D&C, may help to prevent scar tissue from forming. This may help prevent Asherman’s syndrome.

How systemic enzyme blends eliminate and prevent scar tissue:

  • The systemic enzyme blend works as a biological response modifier; working with the bodies own immune defense system to moderate inflammatory response.
  • They support cleansing of the tissues, promote better circulation.
  • They break down and remove “fibrin”, the make-up of prolonged inflammation and scar tissue/adhesion formation.
  • They break down the proteins in the blood that cause inflammation, this facilitates their removal via the lymphatic and circulatory system.
  • Reduction in inflammation , increase in proper blood formation, increase in proper circulation hinders scar tissue and adhesion formation, while reducing pain.

Systemic Enzyme Therapy using systemic enzymes are most effective when used for 2 months after D&C to help prevent Asherman’s. The sooner they are begun after the procedure the more effective they will be. Systemic enzyme blends must be take on an empty stomach 45 minutes to 1 hour, prior to eating, or 1-2 hours after consuming a meal to be effective. Drink with at least 8oz of water. It is better to take your dosage spread out in the day rather than all at once. Do not use during heavy bleeding times. Discontinue use 2 weeks prior to any type of surgical procedure.

Consider Shatavari

In one study the herb Shatavari (Aspargus racemosus) was shown to increase phagocytic activity of macrophages in turn reducing intraperitoneal adheshions. These are adhesions within the abdomen specifically. Macrophages have been shown to play a role in adhesion development. But this is just one study, if Shatavari can increase phagocytic activity of the macrophages there is hope for it in reducing adhesions in the entire body. This may be great news for women suffering from adhesion damage causing fertility issues.

Support a Healthy Uterus

Ensuring that you have a strong, healthy uterus prior to any surgical procedure involving the uterus, may help to prevent Asherman’s!

Self Fertility Massage

Self Fertility Massage is one of the easiest and most cost effective ways to improve uterine health, break-up and prevent adhesion formation, and promote healing of the uterus. Plus it can be done from the comfort and privacy of your own home. Not only can you do both Self Fertility Massage and Castor Oil packs prior to any surgical procedure to improve uterine health, you can do it after those procedures to prevent adhesion formation. If you have already been diagnosed with Asherman’s, I highly suggest this non-invasive healing therapy!

How does Self Fertility Massage Prevent and Heal Asherman’s Syndrome?

  • Massage helps to break up scar tissue/adhesion formation
  • Helps the uterus to rid itself of old stagnant blood and tissues
  • Brings fresh oxygenated blood to the uterus
  • Helps to strengthen the uterine muscles
  • Reduces inflammation
  • Helps the body to loosen tight or twisted tissues

Do not do Self Fertility Massage for at least 2-3 weeks after D&C or other abdominal procedure. Do not do this massage during bleeding after miscarriage or menses. The uterus may be sensitive and sore after any kind of surgical procedure, start off slowly and gently with this type of massage. Listen to your body, do not press too hard; you should not press so hard it is painful.

Castor Oil Pack

Castor Oil PackA Castor Oil Pack is a cloth soaked in castor oil, which is placed on the skin to enhance circulation, and promote healing of the tissues and organs underneath the skin. This therapy is complementary to Self Fertility Massage.

  • Increases breakdown and removal of scar tissue build-up via the lymphatic system
  • Increases circulation, brings in fresh healthy blood
  • Promote new healthy tissue growth
  • Aids the body of cleansing out old, dead, toxic, or damaged tissues

Castor oil packs are best used 2-3 times a week. A good healing plan with these packs are 3 days on, 3 days off, for several months. If you have had a surgical procedure, do not begin this until you feel your uterus is healed. Do not use on a C-section incision that is not fully healed.

Consider the Risk of Infection

Talk to your doctor about the risk of infection due to surgical procedures performed after miscarriage. If you develop an infection you risk more scar tissue and adhesion formation, as well as increased risk of infertility due to blocked fallopian tubes. Some herbs that help to aid the body in fighting infection and boosting immunity for proper immune response to the D&C would be Echinacea and Goldenseal. An Echinacea/Goldenseal liquid extract taken every 3 hours for the first two days after surgery may greatly help to reduce infection. This extract blend may be continued on 3 times a day, for a week as continued infection prevention.

Women’s Best Friend combines herbs shown to help fight infection and balance hormones after miscarriage loss. This herbal blend is extremely antibiotic, antimicrobial and anti-inflammatory. It works to heal any infection in the reproductive system, while also reducing pain and inflammation from foreign tissue growth. Reduction in inflammation may help to prevent scar tissue and adhesion. Some herbs in this blend are tonifying for the uterus, aiding in strengthening the uterine muscles and tissues. We do not recommend combining this herbal blend with medications prescribed by your doctor.


References:
1. mayoclinic.com/health/uterine-artery-embolization/MY00502
2. www.ashermans.org/home/
3. wikipedia.org/wiki/Asherman%27s_syndrome
4. Hum. Reprod. (1998) 13 (12): 3347-3350.
doi: 10.1093/humrep/13.12.3347
5. Reproductive BioMedicine Online, (2011) Volume 23, Issue 1: 63-76.
doi:10.1016/j.rbmo.2010.11.018

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[-] 8 Comments
  1. Thank you, Dalene, for your quick response. I’ve been battling my fibroid for over two years, and the best thing about it is that it has helped me appreciate eating raw, which I am currently at about 50% raw. I am hoping that my diet and exercise will help to keep my hormones in check so that it does not regrow, and that the tips that you gave me to strengthen my uterus both before and after surgery will hopefully help me to conceive. Fingers crossed, anyway. Thanks again~

  2. I have severe Asherman’s and cervical stenosis, which endometriosis on the way. I’m having a my furst of possibly two hysteroscopies in two weeks with a balloon and inserted tube in the cervix afterwards. I’ll be put on IV antibiotics during surgery and estrogen for three weeks. I’d like to know if echinacea or the woman’s best friend would be effective for me. Are there off side effects from these? Any suggestions for reductions infection and future scar tissue growth are welcome. Thank you!

    • Hi Gail,

      I am sorry to hear of your challenging and painful situation. Echinacea purpurea and Goldenseal (Hydrastis canadensis) are fine to combine with medications prescribed by your doctor. The guidelines are outlined in this article. Women’s Best Friend should not be combined with prescription estrogen. Because you will be on antibiotics, be sure to support healthy internal bacteria by supplementing with a good probiotic as well. I know in the hospital nutrition is not a priority, so have your family help to bring in healthy, nutrient dense meals. Miso soup is a really good one! I have a recipe for it here:
      Bok Choy Miso Soup
      2 tablespoons oil
      4 leaves of Bok Choy, rinsed, sliced in 1 inch ribbons including stems
      4 cups vegetable broth
      1 carrot, thinly sliced
      1/2 cup bamboo shoots
      2 green onions sliced
      1/4 cup sliced mushrooms
      1 teaspoon tamari
      1 garlic clove crushed
      2 tablespoons miso paste
      black pepper to taste

      1. In a heavy soup pot place oil, turn to medium heat, put in carrots and garlic, saute until almost tender.
      2. Add broth, tamari, and mushrooms, bring to a boil, once boiling reduce heat to low so that soup is simmering, simmer until mushrooms are almost done.
      3. Add green onion, Bok Choy, black pepper and bamboo shoots, cook for a few minutes, add miso. Stir until miso is well blended. Add additional sliced shallot for garnish if desired.

      Serves 2

      Two weeks post surgery consider Systemic Enzyme Therapy, Self Fertility Massage and Castor Oil Packs and possibly Women’s Best Friend to help deter new formation of excessive tissue build-up.

      May your surgery be successful!

  3. Update 2014 – We are back! We have been away for a while and we sure have missed all of your wonderful questions and thoughts on our articles. Moving forward, one of our staff herbalists will be here to respond to comments! We look forward to connecting with our readers once again!

    • Hi Dalene,
      I am considering having a robotic assisted myomectomy, and I am hearing two different things regarding conception after myomectomy. More than half the women that have a myomectomy fail to conceive afterwards. I was wondering if scar tissue could be one of the main reasons, and also, if I do the enzyme therapy immediately after I have the procedure, will it increase my chances of having a successful pregnancy? I have a bottle of neprinol in my medicine cabinet, but I also do castor oil packs a couple of nights a week. Would the combination of these two be beneficial and create a healthy uterine environment for pregnancy?

      Thank you

    • Hi MusicMaven,

      To tell you the truth, I just don’t know about the statistics on conception after myomectomy removal. I do think scar tissue is a main culprit, including the receptivity of the uterine tissues. The uterine muscles are all very different, layer after layer of different muscle patterns/structure, and any growths within the muscles and then surgical removal is a set-up for scar tissue formation. If you decide to go for the myomectomy: To prepare for surgery, yes the Neprinol and Castor Oil Packs would be a start. Include Self Fertility Massage daily, if you can, that will keep the muscles and uterine tissues healthy, flexible and strong. Discontinue enzyme therapy 2 weeks prior to surgery, castor oil packs and Self Fertility Massage the day before surgery. Do not begin enzyme therapy until at least a week and a half to two weeks after surgery, as this has a slight blood thinning effect. Do not begin Castor Oil packs or Self Fertility Massage until around 3 weeks to a month post surgery, or until you feel ready. Go slow!

      May your decision come with confidence and clarity!

  4. Hi Heithir, thanks for this very educative article. is it possible that i have Asherman’s Syndrome?. I had a laparoscopy 2 yrs ago to remove broad adhesions in my appendical area, and it was confirmed following procedures that my tubes were blocked with hydrosalpingx, and ovary burried behind uterus. really sad result! can i benefit from the fertility massage & Womens’ best friend. Trying TTC for 10 yrs. please advise. Thanks.

    • Hi Taiyelollu,

      I am sorry to hear of your difficult diagnosis! The Fertility Massage may be very beneficial for you. I am not sure Women’s Best Friend is the best choice for healing the scar tissues, but rather aiding the health of the reproductive organs, mainly the uterus. Wobenzym N, Castor Oil packs and Fertility Massage may all be good choices as well.

      May you go on to heal!

      Dalene