In some cases, after surgical procedures in the uterine cavity, such as curettage, abortion, diagnostic curettage, etc., the menstrual flow is inexplicably reduced or even disappears. It turns out that a disease called “uterine adhesions” is to blame. What is uterine adhesions? A normal uterine cavity has a certain amount of space and can be filled with about 5ml of fluid. The uterine cavity is covered with the endometrium. If the endometrium is damaged by a disease (e.g. endometrial tuberculosis, endometritis), or by surgery on the uterine cavity (e.g., curettage, abortion, etc.), adhesions can occur in the uterine cavity where space would otherwise exist. Mild adhesions will form some membranous or wispy material in the uterine cavity and will have little or no detectable effect on menstruation. Heavy adhesions can cause complete destruction of the lining of the uterine cavity, resulting in extremely reduced or even amenorrheic menstruation. Why do uterine adhesions affect menstruation? Menstruation is essentially the regular shedding of the endometrium. Therefore, a normal endometrium is a prerequisite for normal menstruation. When uterine adhesions occur, the endometrium is destroyed and replaced by some scar tissue or inactive fibrous tissue. The normal endometrial tissue is reduced or even destroyed, and the natural menstrual flow changes. How are uterine adhesions diagnosed and treated? If decreased menstruation or even amenorrhea occurs and problems with sex hormone production have been ruled out, then it is important to consider the problem of uterine adhesions. Patients who have a history of endometrial tuberculosis or a history of uterine surgery should be considered first for uterine adhesions. Hysteroscopy is the best and most accurate means of diagnosing hysteroscopic adhesions. Hysteroscopy can both diagnose and treat uterine adhesions. Under direct hysteroscopic view, the surgeon can use instruments to separate and open the adhesions and restore as much normal uterine structure as possible. After surgery, to prevent the adhesions from reoccurring, a birth control ring may need to be placed in the uterine cavity or high doses of estrogen may be used to promote the repair and growth of the endometrium. How can uterine adhesions be prevented? Once adhesions occur, especially if they are extensive and severe, they are more difficult to treat and have the potential to recur. Besides affecting menstruation, adhesions may also cause infertility. This is why it is especially important to prevent the occurrence of uterine adhesions. Diseases such as endometrial tuberculosis are relatively rare, but if the patient develops tuberculosis from other sites such as pulmonary tuberculosis it is important to treat it aggressively to prevent it from spreading to the endometrium. More importantly and more frequently, it is important to minimize the chance of uterine cavity surgery. For example, careful use of contraception, minimizing the possibility of surgical abortion, and going to a regular hospital for surgery by an experienced surgeon are all effective means of preventing uterine cavity adhesions.