Asherman's Syndrome Likely Cause of Frida Kahlo’s Infertility

Painting by Frida Kahlo
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For many people who have viewed the works of Frida Kahlo, they are a stark reminder of the artist’s lifelong battle with pain and infertility. Until now, little research has focused on the condition that caused her infertility, which a surgical pathologist has identified as likely being Asherman’s syndrome.

What is Asherman’s syndrome?

Asherman’s syndrome is a condition characterized by the formation of scar tissue (adhesions) inside the uterus. In many cases, the front and back walls of the uterus stick together following some form of trauma to the endometrial lining, which triggers the healing process that causes damaged tissue to adhere.

Most women with Asherman’s syndrome develop the problem because they have undergone a D&C (dilation and curettage), which is typically performed after a miscarriage, retained placenta after giving birth, or an elected abortion. About 90% of Asherman’s syndrome cases are associated with a pregnancy-related D&C, according to the International Asherman’s Association.

Most women with Asherman’s syndrome have scanty or no menstrual periods (amenorrhea), although some do experience normal periods. Infertility and recurrent miscarriages are also symptoms, and Kahlo experienced numerous miscarriages and several abortions.

The International Asherman’s Association reports that the condition is believed to be underdiagnosed and estimates that between 5% and 39% of women who experience recurrent miscarriage and up to 40% of those who have had a D&C following childbirth or incomplete abortion are affected by the syndrome.

Now, according to Dr. Fernando Antelo at the Harbor UCLA Medical Center, it is likely Kahlo was affected by Asherman’s syndrome. Antelo presented his findings at the American Association of Anatomists Annual Meeting.

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Kahlo and Asherman’s syndrome
Kahlo experienced a streetcar accident as an adolescent, in which a piece of metal penetrated her abdomen, severely damaging her internal organs. Antelo explained that “the scar formation in her uterine cavity is theorized to have played a role in the continual miscarriages and pregnancy failures that Kahlo experienced.”

Kahlo’s history of trauma to the uterus and her subsequent history of pain, infertility, abortions, and miscarriages not only support a diagnosis of Asherman’s syndrome but also were the impetus behind many of her most famous works. The artist painted many images of related to fertility, female reproductive organs, birthing, and hemorrhaging, including a 1932 painting entitled “Henry Ford Hospital” in which she portrayed her bleeding body, surrounded by a male fetus and female pelvic bones, while lying in a hospital bed.

Today, the treatment for Asherman’s syndrome includes removal of adhesions in the uterus. Sometimes surgeons implant a balloon or splint to prevent the walls of the uterus from adhering during the healing phase.

Because adhesions have a tendency to reform, it is common for women to take hormones (estrogen) after surgery to help prevent additional scarring and to promote healthy tissue growth. It is often necessary to remove newly formed adhesions.

Kahlo’s paintings are a lasting reminder to everyone, and especially women, of the pain and suffering that can accompany living with infertility and, it appears, Asherman’s syndrome. Perhaps Antelo’s research into Kahlo’s work and history will prompt more women to be aware of Asherman’s syndrome and to communicate with their healthcare providers about their symptoms.

SOURCES:
American Association of Anatomists Annual Meeting
International Asherman’s Association

Image: Wikimedia Commons

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Comments

I glad to see attention focused on asherman's syndrome as a cause of infertility. The cause of my Asherman's syndrome was a fibroid removal surgery. The doctor never mentioned that I might develope Ashermans so not untiil years later when I was seeking infertility treatment was it diagnosed. It took several Reproductive Endocrinologist to figure out that it was Asherman's, even with my fibroid surgery history, it never crossed their mind that I might have Asherman's. Not even the specialist that diagnosed me with Asherman's suspected that it was the cause of my infertility, the sonohysterogram that she performed she believed that she was looking at a fibroid, she proposed surgery to remove it and during the hysteroscopy surgery all she could see was a white wall of scar tissue and adhesions. Sadly her inexperience with Asherman's in her attempt to remove the ridged scar tissue she performed a D&C which which may have done more harm then good. More doctors need to be educated on the causes of Asherman's Syndrome so they can diagnose it faster and treat it correctly.
I acquired Asherman's from just one poorly performed D&C by a board-certified ob/gyn at an "award-winning" clinic at a major metropolitan university where medical students and residents are trained. I would think that a pole being traumatically jammed across Kahlo's uterus would definitely cause scarring as well!! I've suffered two years of unexplained infertility and may have lost my opportunity to have a 2nd child due to this so-called "rare" condition. Asherman's needs to be highlighted as a real risk by medical practitioners whenever they perform any gynecological surgery but they would prefer not even to bring it up to their patients as mine did not. Thank you to this doctor for shedding light on this condition. I can imagine that Kahlo would have given anything to at least have had a clear diagnosis of a specific condition - I am thankful for that even if my treatment is in vain.