Asherman's syndrome: scarring inside the womb and its treatment, with a consultation in Panjim
Medically reviewed by our consultant obstetrician & gynaecologist (MBBS, MS OBG). Last reviewed: 11 November 2026.
Asherman's syndrome is scar tissue inside the womb, often after a scraping (D&C) for a miscarriage or for bleeding after a delivery, or after an infection. Periods become scanty or stop, and conceiving may be harder. Treatment is a hysteroscopy that cuts the scar bands under direct view, done at Pai Hospital, Vasco, after a consultation in Panjim.
Some women notice that their periods changed after a procedure on the womb: much lighter, shorter, or gone, even though hormone tests are normal. Others hear the word only when a pregnancy does not come. This guide by the Pai Hospital Team explains what Asherman's syndrome is, how it is found, how the scar bands are released through a hysteroscope, and what the months after treatment involve. For a thin lining from other causes, such as low hormones, see our page on thin endometrium.
What is Asherman's syndrome?
The inside of the womb is a flat space lined by the endometrium, the soft lining that grows and sheds each month. The lining has a deep base layer that regrows the surface after every period. If that base layer is injured, the raw surfaces of the front and back walls can heal stuck together. These bands of scar are called intrauterine adhesions, and when they cause symptoms the condition is called Asherman's syndrome.
The scarring can be thin and filmy, like a cobweb across part of the cavity, or thick and firm, closing much of it. Some women have only a band or two near the top of the womb; others have scarring at the opening of the cervix that traps blood inside.
What causes scarring inside the womb?
- A scraping of the womb (D&C), most often after a miscarriage, for retained placenta, or for heavy bleeding in the days after a delivery, when the lining is soft and easy to injure.
- Infection of the lining, for example tuberculosis of the genital organs, a cause doctors here still look for, as it can scar the womb and the tubes at once.
- Earlier operations on the womb, such as removal of a fibroid that reached into the cavity, or a caesarean section.
- Repeat procedures: the risk rises with each scraping.
Not every D&C leads to scarring; most heal normally. When scarring does happen, it is not anyone's fault.
What are the symptoms?
- Periods that become much lighter or shorter, or stop, after a procedure on the womb.
- Cramping pain at the time a period is due with little or no bleeding, because blood is trapped behind the scars.
- Difficulty conceiving.
- Repeated miscarriage, as an embryo may not settle well on a scarred lining. See our page on recurrent miscarriage and implantation failure.
Scanty periods have other causes too, such as thyroid problems, PCOS or early menopause, so blood tests are part of the work-up.
How is Asherman's syndrome found?
- Ultrasound: a vaginal scan in the middle of the cycle may show a thin lining, a broken line, or fluid collected behind a block.
- HSG: the X-ray tube test fills the cavity with dye; scarring shows as gaps or an irregular outline. Read about the HSG tube test in Goa.
- Hysteroscopy: a thin telescope passed through the cervix shows the scar bands directly, how much of the cavity is involved, and how healthy the remaining lining looks. It confirms the diagnosis and can usually treat it in the same sitting.
- A lining sample may be sent for tuberculosis testing if infection is suspected.
How are the adhesions released by hysteroscopy?
This is called hysteroscopic adhesiolysis. Under anaesthesia, the hysteroscope is passed in through the cervix, so there is no cut on the abdomen. The womb is gently filled with fluid so that the walls separate, and the scar bands are cut one by one with fine scissors or an energy instrument, working from the centre outwards while protecting the healthy lining. In dense scarring, an ultrasound scan of the abdomen may guide the surgeon, or a laparoscopy may be added so that the outside of the womb is watched at the same time. Our page on hysteroscopy in Goa explains the procedure day itself.
Filmy bands often clear in one sitting. Thick scarring may need more than one operation, done in stages, because cutting too much at once can harm the womb wall.
How is the scarring stopped from coming back?
The raw surfaces want to stick together again as they heal. Depending on the findings, the surgeon may use one or more of these measures, which are explained before the operation:
- A soft balloon or a device left in the cavity for a short time to keep the walls apart.
- Hormone tablets for a few cycles to help the lining regrow over the treated areas.
- A second look with the hysteroscope, usually a month or two later, to release any new thin bands before they firm up.
The tablets and their length are decided for each woman; please do not start any hormone without your doctor.
What happens after the operation?
Most women go home the same day or the next morning. Mild cramps and light bleeding for a few days are common. Your first periods afterwards are watched closely: heavier, longer periods are a good sign that the lining is regrowing. Please contact the hospital the same day if you have fever, a foul-smelling discharge, heavy bleeding or pain that keeps getting worse.
Trying to conceive usually waits until a follow-up check shows an open cavity and a lining of reasonable thickness, often a few months after the first operation. A pregnancy after Asherman's syndrome is looked after with extra care, because the placenta can attach more firmly where the lining was scarred, so tell your obstetrician about the treatment. No treatment can promise a pregnancy; the chance depends on how much healthy lining remains. If other fertility treatment is needed later, your doctor will discuss it once the cavity has healed.
How can women in Panjim be seen?
If you live in Panjim or nearby in North Goa, you can start with a planned consultation at our consultation point in Panjim. Bring your scans, any HSG report, and the notes of earlier procedures on the womb, so that nothing is repeated without need. If a hysteroscopy is advised, it is done only at Pai Hospital, Vaddem, Vasco-da-Gama, in our own operation theatre, and follow-up talks can be held back in Panjim. Our page for women looking for a gynaecologist in Panjim explains how the visit and travel to Vasco are arranged. Use this page for general understanding; your own plan is made with your doctor.
Your questions
What is Asherman's syndrome?
It is scar tissue inside the womb. The front and back walls of the cavity stick together with bands of scar, usually after a scraping (D&C) for a miscarriage or for heavy bleeding after a delivery, or after an infection such as genital tuberculosis. Periods may become scanty or stop, and conceiving can be harder.
How is Asherman's syndrome treated?
The scar bands are cut and released through a hysteroscope, a thin telescope passed in through the cervix, so there is no cut on the abdomen. It is done under anaesthesia in the operation theatre at Pai Hospital, Vasco. Steps to stop the walls sticking again and to help the lining regrow are planned with you.
Can Asherman's syndrome come back after treatment?
Yes, scar bands can form again, especially when the scarring was dense. That is why a check of the cavity is usually planned a month or two after the first operation, and any new thin bands found then are released in the same sitting.
Can I get pregnant after Asherman's syndrome treatment?
Pregnancy is possible once the cavity is open and the lining grows back, but no doctor can promise it, and it depends on how much of the lining was damaged. Your doctor will tell you when it is reasonable to start trying, usually after a follow-up check shows a clear cavity.
Will an HSG or an ultrasound show Asherman's syndrome?
They can raise the suspicion. An HSG may show gaps or an odd shape in the dye-filled cavity, and a scan may show a thin or patchy lining. A hysteroscopy is what confirms the scarring, because the doctor sees it directly, and it can usually be treated in the same sitting.
Where can I be seen from Panjim, and where is the hysteroscopy done?
You can start with a planned consultation at our consultation point in Panjim, bringing your earlier scans, HSG and operation notes. The hysteroscopy itself is done only at Pai Hospital, Vaddem, Vasco-da-Gama, in our own operation theatre.
Or call +91 95459 20817 · +91 75582 52088 · 0832 251 3641
This page is for general education and is not personal medical advice. Treatment depends on your own examination and reports, so please speak to a doctor about your situation. We do not carry out or offer sex determination of any kind.