SAN FRANCISCO -- Asherman's syndrome is a straightforward diagnosis in patients with secondary amenorrhea.
"It's uncommon in women who haven't had an abortion or uterine surgery," Dr. George F. Sawaya said at a meeting on women's health sponsored by the University of California, San Francisco.
Patient history is key "If you have a patient who had a recent D&C and hasn't had a period since, you should have a high suspicion of Asherman's," he said. "The specificity and sensitivity of [the patient's history] are really quite high."
Standard tests to diagnose the etiology of secondary amenorrhea in these patients, such as measuring TSH or prolactin levels, will probably not be as helpful, said Dr. Sawaya of the department of obstetrics, gynecology and reproductive sciences at the university.
Unlike all other patients with amenorrhea, patients with Asherman's syndrome do not suffer from anovulation. "They ovulate. They just don't have enough endometrial tissue to have a hormonal response," he said.
Although the diagnosis can be straightforward, treatment may be a challenge. "If you suspect Asherman's, the patient should probably have a hysteroscopy with lysis of adhesions and adjuvant therapy as needed," Dr. Sawaya advised.
COPYRIGHT 2000 International Medical News Group
COPYRIGHT 2001 Gale Group