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So I want to know - Does this happen to anyone else?
I tried to tell a gynecologist about it once, and he laughed at me and told me it was just a blood clot. Um, definitely not a blood clot, buddy.
From what I can tell, no one really cares about the condition, and they can't really do anything about it, but it sure as heck makes my life painful every month (and I wonder if it will impact my future fertility at all...).
Anyway, I'm just wondering if anyone else out there has experienced the same thing, or if I'm really as much of an anomaly as the research says.
VERY rarely a woman will pass a "uterine cast" also known as "decidual cast" (like decidual tissue of the uterine lining). This is when the lining is passed as a triangular shaped bit of tissue similar to the shape of the inside of the uterus. The predisposing condition for passing a uterine cast is abrupt cessation of high dose progesterone therapy. I have also seen a cast associated with an ectopic/tubal pregnancy. Here are two citations on this from the National Library of Medicine site:
J Pediatr Adolesc Gynecol. 2007 Jun;20(3):191-4. Links Decidual cast in a girl receiving depot medroxyprogesterone acetate--a case report.Singh V, Talib N, Strickland J. Departments of Pathology, Pediatrics, and Gynecological Surgery, Children's Mercy Hospital, Kansas City, Missouri 64108, USA. [email protected]
BACKGROUND: The passage of tissue per vaginam in a young girl raises several diagnostic considerations that include aborted pregnancy, benign polyp, rhabdomyosarcoma, and rarely decidual cast. CASE: A 9-yr-old girl who was receiving depot medroxy-progesterone acetate to suppress menstruation passed tissue per vaginam. Pathological examination of the tissue showed a decidual cast with no chorionic villi, while a serum hCG test was also negative. CONCLUSIONS: Decidual cast formation is a rare side effect of progestogen use and should be considered in the differential diagnosis of passage of tissue per vaginam.
Obstet Gynecol. 2010 Aug;116 Suppl 2:488-90.
Membranous dysmenorrhea: a complication of treatment for endometriosis.
Appelbaum H.
Department of Obstetrics and Gynecology, Division of Pediatric and Adolescent Gynecology, Long Island Jewish Medical Center/Steven and Alexandra Cohen Children's Medical Center of New York, USA. [email protected]
Abstract
BACKGROUND: Progesterones are frequently used to treat endometriosis. Exaggerated response of the endometrium to high levels of progesterone can result in a decidualization reaction. Decidualization may cause an exacerbation of symptoms of dysmenorrhea associated with endometriosis.
CASE: A 16-year-old girl with uterine didelphys and obstructed hemivagina presented with irregular bleeding and severe abdominal cramping after resection of the vaginal septum. Persistent endometriosis treated with norethindrone acetate resulted in severe colicky abdominal pain and expulsion of a decidual cast.
CONCLUSION: Membranous dysmenorrhea can occur in response to excess progesterones. An understanding of the physiologic response of the endometrium to treatment will guide us to a high clinical suspicion of this rare entity when symptoms worsen in response to progesteronal treatment for endometriosis.
Bottom line, I would wonder if you had endometriosis or adenomyosis as a part of the severe cramps.
Yours,
Jane
Although I am not on hormonal therapy, I am quite certain these are casts I am passing. They are triangular, purplish-gray, thin, and absolutely nothing like blood clots. Trust me... I've seen plenty of those, too.
My periods are really quite short and light. I only pass one "cast" per period. I'll spot lightly for a few hours or a day, then get really bad cramps for several hours, then pass one of these things, then bleed moderately (and painlessly) for a day or two, then I'm done. It makes perfect sense to me.
Funny that you don't believe me either...
Yours,
Jane
-Lauren
My periods have always been regular, but ever since they started when I was 12, a few hours after the period started, I would have 3-6 hours of horrible pain that no painkiller could touch. It's true that you have to lie down just to get through it. It's the kind of pain that causes a cold sweat over your whole body. After a few hours I would have an especially excruciating cramp and feel something pass, and the pain would subside. What I pass every month is not a clot - it's a blob of membrane. If I tease it out with my fingers (not squeamish!) it's probably about 2 inches across. It usually comes out whole, but sometimes in pieces.
I realize that clots can seem solid and liver-ish. I have those too - everyone does I guess. But I also pass this blob of membrane, which is something quite different.
The only time this didn't happen was during my 20s for a while when I was on the Pill.
I've always wondered if this unusual menstruation was related to the fact I've never conceived. Anyone have any insight into this?
Thanks!
~Wendy
To answer your questions, I have perfectly normal periods most months, but 2-4 times per year, I have HORRID cramps (like, dry-heaving over the toilet because of the pain)... and those are the periods where I pass a sheet of tissue.
I am single and have never attempted to become pregnant, but I'm fairly certain that this should not affect a woman's fertility.
It happened to me agian today. This is my first period in 2 1/2 years. Or at least my first period since getting pregnant with my youngest. I breast fed so didnt get my period, then I went on 3 months of birth control so that explains why no periods for so long.
Since this first started happening my periods are very light. Now that I passed the cast I have a super heavy flow. My cramps when getting ready to pass the cast were similar to the start of labor. Definitly not painful to the point they used to be, but still no picnic. Guessing having kids has something to do with the lessening of pain.
Interesting part... this isnt 1 single triangular piece. Its a full cast, meaning its more like a pouch and there are 2 triangular pieces connected together. Obviously the entire uterine lining came off at once in one piece. I am also throwing lots of clots now. The weird thing though is what is on/attatched to the inside of the cast. There are white chunks of tissue, different from the cast. I had some major infections after my daughter was born, so I wonder if those are left over pieces of placenta. The only problem with that is I would think they would cause infection. But.. I have been on antibiotics several times in the last 10 months so maybe that prevented further infection?
Question for anyone who has had these issues... did anyone else end up with pain during sex after it started happening? I did for all the time it was happening before, and since my last child was born, and obviously things were started and leading up to the cast today.....
Any professionals with ideas on this too?
Anyways, I hope to be pregnant agian soon so hopefully this issue will go away for another few years, and I swear when we feel we are done having kids, I might go with a partial histerectomy to prevent any other further issues.

Thank you for your answer. There was hysteroscopi and laparoscopi on the last Thursday. My doctor wrote:
The whole uterine cavine is covered with thin adhesions in all directions. Doctors tried to inject methylene blue through the cervix. No fluid passes out to the tubes or the cavity. Conclude that the tubes are blocked in the medial ends on both side. Uterine adhesions is known to be part of the Plasminogen deficiency syndrom. Infertility is also an issue. I cannot be pregnant naturally method, we can try with in vitro fertilisation, but doctors said that isn t much hope because of the whole uterni cavity is covered with adhesions.
Thank you for your answer.
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