Absent periods cause
Womb scar tissue (intrauterine adhesions)
Intrauterine adhesions are scar bands inside the womb cavity. They can make periods much lighter, stop periods, cause pain, and affect fertility or pregnancy outcomes.
Quick definition
After uterine lining injury, opposite walls of the cavity can heal together and form scar bridges. This can reduce normal lining function and alter periods or fertility.
If your main concern is absent periods generally, view Absent periods for the broader pathway.
When to seek urgent care
- Positive pregnancy test with one-sided pain, shoulder-tip pain, faintness, or bleeding.
- Severe pelvic pain, fever, or heavy bleeding after a recent uterine procedure.
- New severe dizziness, collapse, or symptoms that are rapidly worsening.
If you are unsure, contact reception or your nearest emergency centre.
At a glance
- Adhesions are scar tissue bands inside the uterine cavity.
- They are most often linked to prior pregnancy-related uterine procedures.
- Common patterns include lighter periods, no periods, cyclic pain, and fertility or pregnancy-loss issues.
- Hysteroscopy is the most accurate way to confirm diagnosis and can often treat in the same procedure.
Why intrauterine adhesions can happen
Adhesions usually form after injury to the deeper endometrial lining (the basalis layer). During healing, opposite surfaces can fuse and create scar bridges.
Pregnancy-related procedures
Risk is highest after pregnancy-related uterine instrumentation, especially in the postpartum or post-loss period.
Other uterine procedures
Some non-pregnancy uterine surgeries can also lead to adhesions, depending on how much lining is affected.
Inflammation and infection
In selected cases, inflammatory or infectious pathways can contribute, and severe genital tuberculosis can cause dense disease.
Important: some people are diagnosed on fertility work-up imaging even with mild symptoms, so pattern and history both matter.
What you may notice
Periods become lighter or stop
Many people notice clear cycle change after a prior uterine event or procedure.
Cyclic pelvic pain
Pain can happen when blood flow is restricted by scarring.
Fertility or pregnancy-loss concerns
Adhesions can affect implantation and are associated with recurrent pregnancy loss in some patients.
How we assess intrauterine adhesions
Step 1
History first
We map period changes, pelvic pain, fertility history, and any prior pregnancy-related or uterine procedures.
Step 2
Examination and baseline review
Physical examination is often normal, so your history is key. Additional hormone tests may be used to check overlap causes where needed.
Step 3
Imaging for cavity clues
Ultrasound, saline sonography (SIS), or HSG can suggest adhesions, but normal imaging does not always rule them out.
Step 4
Hysteroscopy confirms diagnosis
Direct visualization with hysteroscopy is the gold standard and can often allow diagnosis and treatment in one sitting.
Treatment options
Treatment is based on symptoms, severity, and fertility goals. The main goal is to restore cavity shape and reduce recurrence risk.
Hysteroscopic adhesiolysis
Scar bands are divided under direct view to reopen the cavity while minimizing extra trauma.
Reduce scar re-formation risk
After treatment, clinicians may use cavity-separation and follow-up strategies to reduce recurrent adhesions.
Structured follow-up
Follow-up is individualized, especially if your goal is cycle recovery or pregnancy planning.
Key point: early diagnosis is helpful because untreated severe adhesions can continue to affect cycles and fertility outcomes.
Fertility and pregnancy planning
Adhesions can affect implantation and increase pregnancy-complication risk in severe cases, so preconception planning matters.
- Cycle and cavity review before trying to conceive can clarify readiness.
- Treatment timing is planned around your goals, symptom burden, and imaging/hysteroscopy findings.
- If there is a history of recurrent pregnancy loss, management is coordinated with fertility planning.
Common questions
Frequently asked questions
What are intrauterine adhesions?
They are scar bands inside the womb cavity. They can partly or completely narrow the cavity.
Do adhesions only happen after miscarriage treatment?
Pregnancy-related procedures are a common setting, but other uterine procedures and selected inflammatory causes can also contribute.
Can scans miss adhesions?
Yes. SIS or HSG can detect many cases, but normal imaging does not fully exclude adhesions.
Is hysteroscopy mainly diagnostic or also treatment?
Both. It is the gold-standard diagnostic test and can often treat adhesions during the same procedure.
Can adhesions affect fertility?
They can. Some people have trouble conceiving or recurrent pregnancy loss, which is why early assessment is useful.
Still unsure? Bring your timeline of procedures, cycle changes, and prior reports so we can decide the safest next diagnostic step.