Friday, January 21, 2011

Passing Your Uterine Lining, Menstrual Period Norms

Decidual Cast
Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods  Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you can find one. Women are on average bleeding about 40 ml per period: 1.36 liquid oz for us Americans...hum, that doesn't sound like much, what the heck, but up to double that is normal. And yes, blood is mostly water, our circulating blood is about 90% water, our menstrual blood, it's probably more dehydrated than that, and depending on the pace of our bleeding it could be much more dehydrated than that, and it is mixed with the tissue you see above although mostly passed in fragments. And yes, that is menstrual tissue in our picture, the "decidua" is a type of lining, really a word given to the lining that is very progestegenic due to a pregnancy, but the cast picked up that name. This gal, brought me her menstrual cycle, all of it, as she passed it all at once. Gynos will see this fairly regularly. Well, this patient tends to do this commonly (often, unfortunately, she doesn't like seeing this), passes the whole uterine at once during her periods, although for most, if it ever happens to you it won't happen again.  So yes, we pass tissue. And if we have a fair amount, we do need to pass that tissue. So in some cases we need that period to pass that tissue. In other cases, we won't have tissue to pass: maybe we are very young, very stressed, very low in estrogen (breastfeeding or training for a marathon), very old. Just a few cases where there won't be tissue to pass.

196 comments:

  1. Is there any link between Endometrial ablations and reoccuring bladder infections?

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  2. A reader has asked if there is a link between endometrial ablation and bladder infections. The initial procedure may be accompanied by a slight risk of bladder infection in the immediate treatment period of time. In the rare case where a pelvic infection develops over time or in the healing phase there is a slight increased risk of bladder infection. Over time with the decreased menstrual bleeding if anything there should be a decreased risk. But there are no specific studies I have seen that have focused on bladder infections and endometrial ablations to give us statistics to quote more specifically. Thank you for the question.

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  3. Thank you for sharing your endometrial ablation story. It is very important to get balance. Taking care of heavy menstrual bleeding does contribute to better overall sexuality so glad to hear of that as well!

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  4. I have had serious issues with endometriosis all of my life. I had a child almost 2 years ago via c-section and my doctor found tumors from the endometriosis. Since then I have had Lupron injections, surgeries and now lybrel to help with the pain. I recently passed a decidual cast. Is there a connection between this? Great blog!

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  5. There has not been a study linking endometriosis to passing decidual casts, nor has it been directly linked with Lupron Therapy. For women who have had no period for awhile their first menses may be heavy enough to trigger it. I would want to check with my patients when it occurs, thanks for your comments and hope you follow!

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    1. Plan on following. I just love the topics. Thanks for the info. I went to my dr this morning.

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  6. Thanks for posting!!keep it up!!
    Main Problems Faced by Women Trying to Conceive…………….
    Are you ovulating........?
    It is necessary to know the RIGHT Day, RIGHT Time and RIGHT Way for conception……
    Now it has become very easy to identify the right …. Day, Time, WAY…………………
    First you must determine the length of your menstrual cycle, which
    commences on the first day of bleeding or spotting and ends on the day
    before your next period starts (known as your cycle length).

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  7. So, I've been bleeding since June 2nd. It's been heavy at times but normally light bleeding. I passed my uterine lining, I think, tonight. I also was pretty sure that I had a bladder infection all day today, Is there anything you can tell me that might be wrong with me? I went to my gyno and he took all the necessary tests and blood work, He called to tell me he had no further instructions!I wish I knew what was going and also if I should just start the birth control samples he gave me? Please help! -Hannah

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  8. Vaginal bleeding is most often from the uterus. It is possible the blood is coming from the cervix or the vaginal walls, but it is usually from the uterus. It may be that the uterus itself is defective, the lining defective, the hormonal cycles of the ovaries are off, or the higher brain centers that control the cycles are off. Rarer causes have to do with medication effects or bleeding disorders. All these things can be tested for and the reader says "all necessary tests were done," but there may be other tests if no diagnosis was arrived at. Although getting that accurate diagnosis is a goal for some patients, often a reasonable approach is to get the bleeding to stop by a hormonal method, and that is how it is approached by many gynecologists. To that end, birth control pills, for those who can take them, are a great strategy for many. Others will need other methods of control of your bleeding (see posts on NovaSure, Mirena, and surgery). At Women's Health Practice we advise women with prolonged bleeding, only a tissue sample can accurately make a diagnosis of the lining abnormalities, and sometimes a biopsy is enough for others a D and C and hysteroscopy may help to plan a better treatment.

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  9. I thought that a D and C should've been done but he said nothing was to be done. I think I should just go for a second opinion, maybe they will check my lining and such for the problem.

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  10. I have had this happen to me twice, both with the doctor's looking concerned and not really having an answer for me as to what it is or why it's happening. It happened a few years ago after my first month on Yaz (now known as a terrible birth control), and now it's happened after my first month on Levora. It did not happen while I was on Lo-Ogestrol. It doesn't come out as a complete cast, but rather as a two or three long strips. Is this normal and should I switch birth control or stay on Levora? I'm going in for a follow-up check tomorrow but I'm having bad anxiety so I went to look it up on my own. I'm very scared that I will lose fertility or have some other negative side effect due to this. Any help would be appreciated. Thanks!

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  11. Women who pass decidual casts during a menstrual cycle usually have a healthy lining of the uterus in the next cycle. At Women's Health Practice we use ultrasound testing or endometrial biopsies can determine the health of the uterine lining, and your gynecologist can help you decide if these tests are in order. Most of the time we will tell patients to try for pregnancy before having additional testing.

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  12. This blog has been very helpful, i also just recently passed what i believe to have been a decidual cast larger then my palm. I am on the pill and have fibroids but this is the first occurance of something like this and it seems to be continuing. I have always had awful cycles, but within the past 8 days I have passed 2 larger ones and many smaller ones all with the same consistency and colour and I am in a lot of pain that seems to never end along with constant bleeding Is there any connection between fibroids and these clots?

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  13. There is no specfic connection between fibroids and passing a decidual cast. Most women will stop bleeding relatively promptly after their cast is past. At Women's Health Practice we would recommend an exam and pelvic ultrasound to figure out why a woman is having pain and bleeding.

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  14. I believe what I had pass was a decidual cast. I started the Nuva Ring late August and I didn't get a period until 9/22 and it was mostly that dark spotting that lasted for about a week then I started bleeding. I had really bad cramping and I use tampons. They would last almost 2 hours before they started to leak through. After several hours I passed these clots that looked like tissue. At first I thought is was a miscarriage but I also used condoms regularly so that was not an option for me. I passed several bloods clots and this tissue. The pain went away almost immediately but this watery type of bleeding has continued on and I am on day 8 of bleeding a total of 15 days so far. I always had an irregular period hence the ring and I have a septum/bicornate uterus. I still have the ring inside of me and I'm still bleeding. I just wonder how long do people bleed after passing the cast? What is a normal amount of time to bleed?

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  15. By definition a normal period is up to 7 days and up to 10 days of bleeding is not unreasonable. Bleeding for more than ten days, you need to contact your gynecologist.

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  16. By definition a normal period is up to 7 days and up to 10 days of bleeding is not unreasonable. Bleeding for more than ten days, you need to contact your gynecologist.

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  17. Is it possible to shed a decidual cast outside of your period? Or to shed endometrial tissue when you are not menstruating? I passed what looks like a decidual cast, but I'm not sure if it is actually discharge from Monsel's paste. I had an ECC done last week and the doctor said I had some bleeding, but he didn't mentions using Monsel's to stop bleeding, nor did he mention I should be on the lookout for strange tissue like discharge the size of a silver dollar, flat and rubbery like a condom or chicken skin, golden brown with black specks, and tissue-like on the other side with some grey-white, fatty lumpy discharge. I have a pic and would be happy to show - if it would help you and others. Very confused about what is going on.

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  18. Women tend to call all vaginal bleeding menstrual bleeding. Actually bleeding at other times of the month would be more accurately called "uterine bleeding." Or for birh control pill users if the bleeding is at the correct "period" time we call the bleeding withdrawal bleeding. There are other terms gynecologists use as well. Any heavy bleeding can be accompanied by decidual cassts, we do enourage our patients to bring in tissue or substances they think is tissue, into us to be evaluated. If a patient has had a recent procedure from her gynecologist, a simple phone call to discuss any medications or packing tissue that were used would answer that question.

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    1. I and my wife have been having issues of pregnancy. My sperm test was confirmed OK which means I am fertile. My is also OK but we'be been dating before marriage yet no pregnancy. Of recent she had some slimy fatty white substance in her mensuration and the menses was also smelly.what could this mean.

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  19. I know I'm a bit late on the topic, but I do hope you see this. I passed a bit of my lining (not as a whole, instead in very small grey-brown pieces) but didn't bleed more than a small spot of blood following that. This has happened two months back as well, and last month nothing happened at all. I didn't get my period until I was 17, I'm 22 now, not on birth control or any type of contraceptive, and I am a virgin. Any ideas?

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  20. I am a lot late on this topic too. I was just wondering what was the tissue blood clot looking thing that always comes about during my periods (near the end). After the thing comes out my severe cramps leave. I started having this tissue pass through my period at the age of 17 or 18 and still get one each period. I have tried to concieve and have no luck. I looked up the decidual cast and the tissue passing through during my period looks just like a decidual cast and nothing like a blood clot. I do not know what to do. Does shedding the decidual effect chances of conceiving?

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  21. There is no evidence that women who pass desidual lining with menstrual period will not be fertile. But if you have dysmenorrhea, or pain with menses then it is important to be evaluated for endometriosis.

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  22. I've seen several OB/GYNs and so far no one has given me an answer or insight to what is causing my issue or how to resolve it. About 11 days after the start of my period (around ovulation), my uterus is full of thick clumps of white and sometimes yellow tissue. Several doctors have said it's yeast, but it does not itch or smell or respond to yeast medications. If I spread out the clumps between my fingers, there are lots of small pieces of what I assume is uterine tissue. They are about the size of a quarter of a fingernail, whitish, and rubbery (like chicken skin. After a couple of days of this, I am having brown spotting until I begin menstruating. Do you have any suggestions for tests I should have done to determine what is wrong? Thank you so much for your time.

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  23. A reader asks about a uterus full of thick clumps of white and sometimes yellow tissue. It is difficult to communicate via blog, but I'm presuming that she is asking about a vaginal discharge. I encourage the readers to check anatomy diagrams with their gynecologists and get an understanding of the difference between the vulva, the vagina, the cervix and the uterus. They are all connected, but being different structures, they differ in the medical conditions they can have. Diagnosis of abnormal vaginal discharge is exactly what your gynecologist should be able to discuss with you or it may be time for a second opinion this once.

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  24. Hi I am 19 years of age and and sexually active. Recently during my period I passed a piece of grey/white piece of something which looked like flesh. I am experiencing pain below my stomach and lower back. My period ened on the sixth day but the pain is still there. I also have ovarian cysts. Please help

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  25. Women who pass decidual casts can report fairly intense cramping when the cast is passing, but it is not a common cause of persistent pain; nor would passing a decimal cast be directly related to having ovarian cyst. Painful cramps that began during a cycle and still persist may be related to other gynecologic conditions such as endometriosis, pelvic inflammatory disease, or the presence of an ovarian cyst. We would be happy to see you in consultation, call for an appointment at 217-356-3736.

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  26. Hi,
    I am 35 years old have a 28moth old baby (I conceived for the first try,delivered with C-section). I always had regular, normal periods, 27-30days apart, lasting around 7days first day usually painful, first two days very heavy, then lighter. Since having my baby the pain got better, I can manage it /o medication. Today I am about halfway, just passed ovulation on Friday I believe, can't say exactly because I am not really keeping track... This morning I noticed some red on the tissue in the bath soon I passed a huge piece of bloody tissue (that looked like chicken live and about the same size as well) that was followed by three other about the same size and a whole lot of blood (no, or very slight pain I felt). I thought I started my period early ( sometimes I passed tissue in the past during my period before) but as of now the bleeding stopped. Should I be concerned?

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  27. Heavy Menstrual bleeding (HMB) and menstrual cramping can occur with ovulatory, or even cycles that are not ovulatory. When a reader writes that she had bleeding right after ovulation, the first question is why you had your bleeding so quickly after ovulation? Did you really ovulate, and what tests did you do to confirm that. Normal menstrual periods occur about 2 weeks after ovulation, not immediately. So that heavy bleeding, with or without passing a decidual cast, that close to mid cycle is a reason to contact your gynecologist with questions.

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  28. Hi,
    Today I got my period but after intense cramping I passed a large piece of tissue.It was about 1.5 inches across. It was white/gray with veins and a few dark red clots on. My bleeding has continued normally and the cramps have now eased since. My period was a week late and we have been trying to conceive. Is this normal, could it just be some of my uterus lining?

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  29. By passing this type of tissue well it affect me from getting pregnant? Will it mess up anything with my inside organs

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  30. For the woman who wonders if passing a decidual cast can affect pregnancy, the answer depends upon what else is going on in your case. If you otherwise have a normal uterus, a normal menstrual cycle, no infection and if that is what the tissue was then it should not affect pregnancy. Tissue that is passed when the menses is late could actually be an early miscarriage, and a urine or blood pregnancy test can help figure out if that was what happened. A quick trip to the gynecologist can answer these questions.Women's Health Practice, 217-356-3736.

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  31. I have a question about uterine lining. I got a ultra sound and my uterine lining was at 4mm. I had to take the plan B pill this month and was told because my lining was at 4mm I most likely was not pregnant and that I would start my period soon. Typically how long after you find your uterine lining at 4mm do you have your period? I cant find any charts anywhere online.

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  32. We tell women to come in for blood pregnancy hormone testing to determine if they are pregnant. We do not recommend measuring the uterine lining with ultrasound to determine a pregnancy (as an isolated measurement). Menstrual lining tissue thins to about 0.5 mm during the menstrual cycle, then grows to about 3.5-5.0 mm during the estrogen, first part of the cycle, and then then usually is the thickest: 5.0-6.0 mm in the progesterone phase of the cycle. Implantation of pregnancy is usually in an endometrium that is 5-6 mm. Pregnancy implantation can occur on any day of the cycle, although in the luteal or progesterone phase is the most common time for pregnancy. It is not reliable to predict a pregnancy (or lack of pregnancy) from the look of the ultrasound appearance of the tissue or measurement of the tissue. We hope this answers your question, and that you will become a regular follower.

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    1. Thank you for response. I wish you were here in AZ. I would love to be your patient. Your medical response was well written and I appreciate you not talking to me like I'm medically stupid and giving me the facts. Thanks again.

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  33. Great article! I found something that seemed a bit too 'tussue-y' to be a little clot that I get in my menstrual blood, and had a bit of a panic whether it was normal or not! But I think it was just some of my uterine lining! But to be safe, it seemed somewhat different to the image above and it seemed a tad stringy... Also, clots are normal, right? Just want to check... It's not like they cause me any problems... Just don't want it all getting stuck, as gross as it sounds!

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  34. Gynecologists regard menstrual clotting and passing clots as 'common' but not "normal." Clots eventually thin into blood, so unless the cervix is closed completely it's not really possible for a clot to get stuck. It is a reason to be seen by your gynecologist to make sure there are no abnormalities like infection, fibroids, endometrial polyps, or medical consequences such as anemia. If you have strong pain that is unrelieved by medication, it's a reason to get in to your physician sooner rather than to wait. We suggest considering treatments for heavy menstrual clotting. The treatments will vary depending up whether you want future children or are done having children.

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  35. This just happened to me today! I have been having intense cramps since Friday. My cramps have caused me to throw up, have diarheea, be nauseous, and have a loss of appetite. Since the start of my cycle on Friday, it has smelled horrible and come out like tomato sauce. I normally have cycles with no strong smells and clots. However, this morning when I went to the restroom, it smelled so horrible that I was embarrassed someone would smell it as well and then when I wiped myself, I had this long rubber blob sort of like the pic but extremely dark purple/red to come out of me. I had no idea what it was until I came across this blog! Thank you!

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  36. Thank you for your comments, we hope you continue to follow our blog and that you recommend us to others.

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  37. I have been having some light spotting in between periods where i also pass some tissue... I also have been experiencing upper abdominal pain. im not sure if they are being caused by the same issue or not but my mother and sister have both had their gallbladders removed. Cancer of all sorts run through my family. I'm scared that i may have one of the two issues and my appt to see a docor is still two weeks away. I just wanted to know what you thought about it and if anyone else might have had similar issues. Thank you

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  38. Hi! Just got over a hell uti. Had a baby girl 6 mos ago. Just got my first period. Teeny tiny little pieces of clear rubber-like tissue are coming out. I am on jolivette. Just wondering if you've ever heard of this and what is causing it. Thanks :)

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  39. On birth control pills there is a thinning of the lining of the uterus, and the tissue under the microscope can look different. In natural cycles the tissue shows estrogen effect in the early part of the cycle, and progesterone effect in the late part of the cycle. In pill cycles, there are normally estrogen and progesterone hormones, so the tissue effect shows a "mixed" pattern.This occurs with all pills, including the jolivette the reader is on. These changes are microscopic and cannot be seen with the naked eye. Women will shed some lining fragments with each menstrual cycle, whether you are on pills or not. If a woman belives the tissue is abnormal she should consult her gynecologist, but you wouldn't be able to determine this on your own.

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  40. I am so glad that I found this blog! I had this happen to me last night; after I used the restroom I noticed that there was a glob of tissue that was heart shaped and about 1" big in the toilet bowl. I had no pain in passing it, though I had some cramping a few hours before. I was completely freaked out about it and ended it up flushing it. Immediately after flushing it, I wished I would have collected it so I could take it to a doctor with me. My period has since nearly stopped (which is actually a day or two earlier than normal) and I've had no other pain or abnormalities. Do you think that I need to see my doctor?

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  41. For women who pass a decidual cast, but otherwise have a normal period, no further pain, discharge or bleeding standard advice would be to contact your physician's office. Most likely they will ask you to be sure you are not pregnant by urine pregnancy testing, and then tell you to monitor your symptoms. If you have further concerns, you would need to be checked by your physician.

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  42. after a few minutes of doing some research on this topic, I finally found the right site! Got to say it was hard searching for what you cant even explain. I am also very late on this topic but I am kinda worried about what is happening during my periods because I have had these several times. I was shaken at first but I eventually got used to it and convinced myself it was normal. I am 22 years of age, am not using any contraceptives, I am sexually active but make use of condoms every time I engage in sexual activities, my periods are always heavy, lasting about six or seven days, I suffer from bad cramps during my period but have been using ibuprofen pills to treat them and they work, I have never been pregnant, I believe and I do pass a lot of cloths during my periods. Do you think that I could be a special case in any way?? #worried

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  43. Very heavy bleeding can lead to adverse health effects. Some of the conditions heavy menstrual periods can cause include anemia and other nutritional deficiencies, fatigue, depression, and menstrual pains. So it's important to be evaluated and treated for heavy menstrual periods whether or not you pass a decidual cast. We are accepting new patients at Women's Health Practice 217-356-3736.

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  44. Thank you so much for the info! I had the paragard iud in for 4 years and had it removed immediately after menstrual flow ended on March 6th. I went on to have a long 35 day cycle (usually closer to 30 avg). When I finally did start I passed a lot of blood and tissue (pretty sure uterine lining thanks to your info). Due to the long cycle I had taken 4 hpt all negative ~ had sore breasts that I only get when pg, veiny chest and Montgomery's tubercles. Obviously not pregnant imbwondering if removal of the copper IUD can have this effect on my uterine lining and hormones? I've never seen tissue in my flow and I'm concerned.....

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  45. The ParaGard IUD has a relatively minimal effect on the uterine lining. While a woman has the IUD thre can be what has been called a "sterile inflammatory" reaction. This inflammatory reaction women have when they have the IUD shows some white blood cells and other signs of the effects of the device on the lining. When the device is removed this resoves quickly and typically wouldn't affect more than one menstrual cycle. Hormonal symptoms experienced when on teh ParaGard really should not be due to the IUD but to other causes, and thus you can speak to your gynecologist about the reasons.

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  46. Hi there today I am on day 3 of my period and I went pee and got up and noticed a tiny white tissue that was in the shape of like a tiny baby figure but it wasn't big at all...I didn't feel it when I passed it and I have never had this before...is it just like the uterus lining like has been talked about in this forum? I didn't think about it until I flushed it to take it out and go to the doctors but it kind of freaked me out...Im not on BC but my husband and I are sexually active and trying for a baby and I was afraid it was a miscarriage but Im not sure...please I need some advice! Thanks.

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  47. For a woman to be sure she didn't pass tissue that was a miscarriage she needs to run a pregnancy test. If both urine and blood testing are negative, it is unlikely it was a pregnancy rather than a sec usual cast.

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  48. Thanks for all the info, I'm afraid my case may be a little different. About 2 months ago I started taking levora skipping the pills to have your regular period. I only did this with the first pack and now I am on the second pack and decided to have my period. About an hour ago I woke up with severe cramping so I went to the restroom to change my tampon and a large piece of tissue came with it, almost covering the whole side of the tampon (TMI) sorry but this freaked me out completely. I also have had severe pressure and lower back pain that I've suffered with. Can you please give me any suggestions or anything to put my mind at ease?

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  49. Each woman with an episode of unusual bleeding or unusual passage of tissue needs to call her own gynecologist for advice. We take our patient calls at 217-356-3736.

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  50. Hello, I'm 18 years old and I recently got the depo shot on April 18 instead of birth control pills since I knew i would have a problem trying to remember when to take them. But since the beginning of May I've had my period non-stop with cramping and I've been passing this little tissue-flesh type things. Can it be parts of a decidual cast? And is it normal to still have my period? I use super absorbent tampons and I have to change them after only 4hrs when they used to last me way more. At night I use the big bulky almost pamper-like pads. My obgyn never told me that any of this would happen and I'm scared that my period will never end. Is there any advice you can give me? Will my period ever get back to normal?

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  51. Decidual cases are passed in essentially one piece. Patients reporting passing tissue in various pieces, or over days or weeks have something else going on. This is then a reason to see your gynecologist.

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  52. Dear Doctor

    I found your article very informative. I was wondering if you could shed some light on what I think may be an early miscarriage.

    I understand it was probably a chemical pregnancy, but the way that it happened makes me wonder if I lost the embryo because my body spontaneously decided to have a period as opposed to there being something wrong with the embryo/implantation issues... this is what happened:

    I got progressively darker positive lines on home pregnancy tests, culminating in a very dark positive line 19 days past ovulation. A couple days earlier (17 days past ovulation) I had started to experience extremely light brown spotting.

    On the same day I got my darkest positive (19 days past ovulation), I was very surprised indeed that I started bleeding heavily - no clots, just blood.

    This was 3 days past the day I was due for a period. I passed a 3cm by 1cm or so strip of uterine lining which seemed thicker and larger than any tissue I've ever noticed during a period.. like chicken skin.

    I am sure this was a chemical pregnancy, but it seems odd that my HCG levels peaked the day the bleeding commenced??

    I really appreciate any feedback as I am worried I may have lost the embryo due to hormones being out of whack?? I just don't want it to happen again. Thanks so much

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  53. Home pregnancy testing cannot be used to determine exact levels of hormones and thus cannot be used to say when an HCG level peaked in a pregnancy. Only serial blood testing at your gynecologist's office can determine actual HCG levels. If you had tissue passage and a positive HCG (pregnancy) test you may have had a miscarriage, but many other things could be going on, including a tubal pregnancy. At www.womenshealthpractice.com we would advice contacting your provider's office and being evaluated promptly. When it is established what happened in this pregnancy, your provider can give you options for your next pregnancy.

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  54. Thanks for the post Dr. I've always noticed this pink fleshy chunk of "meat" that's about nearly 2 inches long and in the shape of an elongated triangle being passed out around day 3 of my periods. Reminds me a little of a liver or a piece of placenta. And yes normally, once it's out, my periods quickly dwindle over the next day until it is finished by day 5.

    I can always feel it when it is passed out. It feels like a little thing slipping out effortlessly. It's not painful, and there are no noticeable cramps accompanying it (though I seem to recall when I was in my late teens/early twenties, there was sometimes a slight cramping before it came out). I always had regular periods (except when I was exclusively breastfeeding my babies for a year from when they were newborns). They always last about 5 days, heaviest is in day 1 and 2 and by day 3 dwindling down slowly to nothing. I don't tend to suffer from period cramps. Maybe a slight feeling of pressure on the first or second day of period when the period is heaviest.

    And yes because I'm so used to seeing this fleshy blob, I just don't think it's a baby or a piece of placenta or anything (I got the all-clear from my postnatal exams each time - no retained placental issues). I've also had an ultrasound done on my pelvic area once (when my period came 3 months late once, during the time I was still breastfeeding my 1 year old and periods were dead irregular at that time because of the breastfeeding)... They found no polyps, cysts, or abnormalities with the scan. And all PAP smears done every 3 years came back fine.

    I've always had this since I was a teenager although back then it wasn't every period that I'd pass it out. It was the odd period when it happened. Nowadays though, I would say, since I became a mother, I would pass a blob of this out every other period or so. I'm not on the pill or any form of contraception.

    I have 3 children, am not sexually active now though I'm 34.

    Do you think it's a desidual cast? Or something else? Either way, it's fascinating. I passed one out today (day 3 of my period) and took a photo. If you don't mind taking a look at it here and letting me know what you think. I've uploaded the pic to my Flickr account here : http://www.flickr.com/photos/13428931@N02/8955344264/

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  55. I am 33 years old, and through my entire life I have never had regular periods without the help of birth controls. Just 3 days ago, I began to wipe pink when I would go to the restroom, it then started to turn into a full period by the end of the day, but then stopped the very next day, then came back heavily all of a sudden through that next night, (last night) and I woke up in a sheet soaked with blood. I have now stopped bleeding again and just wiping pink again, but have passed a chunk of meat, kinda reminds me of a red sperm, but about 1.5 inches long and about .5 inch wide. I've never had this happen to me before.

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  56. Passing decidual casts is not as typical on oral contraceptive pills, as pills taken correctly think the lining tissue so there is less tissue to pass. It is also not typical for a woman to pass decidual casts monthly. Heavy clotting is a form of heavy menstrual bleeding that can be treated in many ways, you may want to read our posts on office endometrial ablation.

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  57. So glad I found this site. My body expelled what I believe to be a decidual cast. Unlike the photo above, mine was a very dark red/purple. One side was triangular but the othe side had what looked like long strands of bubble wrap attached. This occurred one week before my regular period. I had bad cramping for three days and then only minor spotting after expulsion. Freaked me out!

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  58. Hi there,
    I've never done this before but figured maybe it would be wise to ask.
    2 years ago I had a Novasure ablation. Best thing ever till several months ago, I've started spotting again and have lately had horrible pain for about a week when I ovulate. Today is Friday and on Monday of this week I had a endometrial biopsy. I've had 3 vaginal births, and that was the worst pain ever. She wasn't sure she could even get any lining but thankfully did. Last night I noticed what I described to my sister as "used condom" slightly bloody came out when I went potty. Followed by a dime size dark dark blood clot. I am still cramping today and have noticed throughout the day more "pieces" of something still coming out. Could this have been caused by the biopsy? I'm actually having to take 800mg of ibuprofen with a Percocet because I've been so uncomfortable. I've emailed my dr but have not heard back and probably won't now since its Friday evening. My biopsy came back fine but I am wanting to have a hysterectomy because I'm tired of dealing with pain while ovulating as well as bleeding. I've had horrible periods since 13 and Im a month shy of 40. Tubes are tied as well. Dr wants to try Lupron therapy but Im thinking that is just a bandaide. Plus the side affects sound yuck! Any info you can provide would be wonderful. The original picture posted here is how I found the site. Via google. Thanks so much.

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  59. Hi, I need answers. Maybe u can help me. I was spotting on and off from being stressed. Then my period came im bleeding a lil bit heavy and passing alot of clots also cramping. I recently lost 15lbs. This first time happening to me. Is this normal? This is the 2nd day on period. Shall i wait it out til day 3. Can this be from weightloss? Worried.

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  60. Lupron therapy is a treatment for uterine fibroids, and for endometriosis. Lupron therapy has also had some success with the treatment of severe PMS or PMDD. Lupron has not been studied extensively or approved for the treatment of heavy menstrual bleeding, and it would not be considered a first line treatment for that condition or for post endometrial ablation syndrome.

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  61. Weight loss can cause irregular menstrual cycles, particularly if it has been rapid and you haven't watched the nutritional balance well. It is not a known side effect of weight loss to specifically pass a decidual cast, and weight loss is not really correlated with heavy sudden bleeding. For women who have heavy sudden bleeding, we remind them to contact a gynecologist.

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  62. Yesterday morning I used the restroom and noticed pieces of tissue. The night before I had spotted but it was very little. I shouldn't start my period for 9 days and had no pain when it happened. Any ideas?

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  63. Bleeding, with passing tissue, or no tissue, that occurs "mid cycle" or "between menstrual periods" is not normal bleeding and this is a reason that you should contact your gynecologist. Vaginal discharge, that is not bloody, with the passage of tissue, is not normal and you need to contact your gynecologist. Getting a home pregnancy test can always be helpful in getting at an accurate diagnosis, but professional medical care is necessary to get an accurate diagnosis.

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  64. Last month I expelled a decidual cast. The tissue measured about three inches total...the cast of the triangular uterus on one side and on the other side was attached what looked like long strands of bubble wrap. The tissue was very lush, pillowy, and deep red/purplish in color, very different from the photo.

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  65. Decidual cast colors can vary, as can the amount of tissue. The photo was in fairly bright light, and the patient brought it in, so it had been sitting in fluid for a few hours. Mucus and blood can change the appearance of the tissue. But do contact your own gynecologist to confirm what any tissue actually is.

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  66. I have a question. I was 6 days late today. I went to the bathroom a little while ago and found I passed a little light pink blood and a gray worm looking piece about the size from the tip of my pinky to my first knuckle joint and half as wide as the nail. it had a string from it to a small red clot. That was all i passed. I have never passed anything like this and have had miscarriages before - dncs done - but was always told to watch for gray tissue before the dncs. I'm usually never this late and am very concerned I was pregnant. I had severe cramps wake me several times in the night 2 nights ago. My husband was recently 'fixed' and we are now wondering if something may not be right. Is there any other reason to pass a gray piece like that?

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  67. HELP

    Glad I found this website,
    Am a 20 year old female. Here's my problem.
    Last week sunday I had sex with my boyfriend, straight after I took my usual daily contraception pill, Tuesday I started bleeding, wednesday I passed a "flat greyish tissue" followed by cramps.
    I took my usual pills till friday but the Bleeding hasn't stoped. I've been bleeding since tuesday 4th june (11 days) for me that's unsual because my periods are usually 5 days. Is thr greyish tissue the cause of the long lasting bleeding which doesn't seem to be stopping. Should I go to my GP to get checked out or should I start my new pack of contraception pills in a few days in hopes to stop the bleeding??

    Please help

    Jenny

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  68. Remember gals, this is blogging, not actually your gyno office! Of course the first thing to do is to call your gynecologist/GP office if you have prolonged bleeding, or passing tissue! As for birth control pills, it's again, your gyno's call but, in our office we usually remind women that stopping effective contraception leads to pregnancy and we would prefer women continue their contraception and call us for further advice. 217-356-3736 for women who would like to come to our practice.

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  69. For couples using vasectomy for contraception: it is very effective once you have been cleared by your physician. It's important to have men have that final check up after the procedure to make sure it is really working. Women with heavy menstrual bleeding can misinterpret large clots for decidual casts, and if you do obtain any tissue that you have passed place it in a clean jar and take it to your gyno's office!

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  70. Hi,
    I'm glad I found this blog while searching for answers.
    For several years now, I've been passing "tissue" during my first day of the period. I had always assumed it was part of the endometrial lining. Its size ranges from 0.5-2" and it happens nearly every month. Once it passes, the cramps lessen but bleeding continues. My periods are regular and I have never had any kind of hormonal therapy.
    Is this normal or should I be concerned?
    Thank you

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  71. I'm having brown discharge instead of a period. My period is a week late. I have had all the symptoms of a normal period just no blood. I'm not sexually active, I'm not pregnant (obviously) and I do have ovarian cysts. What could this be?

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  72. Women differ in the overall all structure of their menstrual periods. Your age, the medications you are on, the amount of exercise and stress can all affect your monthly bleeding. So just a difference from the average woman might not mean it's a medically important difference. That is for your and your gynecologist to work out. Light amounts of menstrual bleeding are often brown in color not red. The period can be light because of contraceptives or because of hormonal changes that in fact could be related to an ovarian cyst. You would have to see your own physician to establish whether this a medical problem that needs to be corrected.

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  73. Umm soo i got out of the bathtub and i was getting ready to clean it out and i see this weird thing its small but anyways i get a wash cloth and pick it up and it was green and sorta pointy and had a small circle of dry clearish blood on it and then later on in the day i used the bathroom and flushed but before it went down i hirried to look to see of it was just a weird thing and to see if i was actually on my period because i bled very little on my pad and i usually bleed a lot but anyways there was like a globbish red.thing in there and well im freakn out i dont want to tell my mom because well its weird and i was wondering if it could be because i started loosing weight recently and walking every night...help please..

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    Replies
    1. Im the same girl that posted this but umm it is also sorta hurting not much just like a little sting and im a virgin is its like not possible that i have an std right cause thatd be screwed up....

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  74. I am wondering if I could get a little light shed on to what I may be experiencing right now, I attended my doctor about this same problem last year, I was informed that it sounded like stress had in fact triggered it. But I've noticed it has started up again, since Saturday morning I have been experiencing what I can only describe it as is skin clumps being passed after I've urinated, it doesn't appear like discharge, its too thick & very dark brown. Like I said I had the same thing last year but far worse, it lasted for 5 days like a period but without actual bleeding. I went on to miss an actual period that month, until things returned to normal 30 days later. Around this time though I was under a great deal of stress, right now I am again & it returns. Is this solely down to stress or could there be an underlying problem? I sometimes get 'mid month' discomfort occasionally which is like a hot dull ache just above my crotch bone, sometimes 2 weeks before I have a period. Should I return to my doctor?
    Thanks.

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  75. Most women do not realize that much of the discharge with minor vaginal infections is actually skin cells of the lining of the vaginal walls. These cells, known as epithelial cells, is what the white clumps of a yeast infection are made of. If there is old blood, light bleeding, or other discharge, there can be some very odd discharges that aren't serious although they shouldn't be labeled as "normal." For anyone with thick dark brown discharge and irregular periods, they should see their gynecologist. Women's Health Practice 217-356-3736

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  76. Hi, So three weeks ago I was in a car accident (May 30th) & went in for an ultrasound to check my left ovary (my only one) two weeks ago...they said my lining was thick because my period usually comes on the 9th...however, I have not had my period still. Could this be because of the stress/shock of the accident? I also bled twice in May ...the 9-14 & also like the 24-26. I don't know what is going on =( I've asked to have Provera but was told I need to not have a period for 3 months in order for them to give me some. I know I cannot possibly be pregnant. So please help me ? ) : I feel so bloated, unlike myself and overall weird without my period.
    What should I do??

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  77. Gynecologists and ultrasonographers measure many features of the lining of a woman's uterus when evaluating periods. One feature is the thickness, other features might be the presence of a pregnancy, the presence of polyps, or the presence of fluid within the cavity. When women are menopausal they have very quiet thin uterine lining. When women are not menopausal, the thickness of the linin tissue when measured by ultrasound will vary depending on your age, hormone use, where you are in the cycle as well as other factors. "Thick" is a relative term and may not be abnormal what so ever. How frequently the lining should shed, whether thick or thin, is commonly debated by gynecologists. Using progesterone to bring on periods can be helpful, but it can also induce irregular bleeding if timed poorly. Stress can be a factor that affects the hormonal cycles, and thus stress can affect the uterine lining indirectly. We advise on going examination to see the evolution of the lining changes.

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  78. I have regular periods. Each month I shed a decidual cast which I always thought was normal because that's how my periods have always been. My husband and I have had difficulty conceiving over the past two years. I had a lab test that showed I was ovulating however I am wondering if passing a decidual cast each month could be indicative of a hormonal imbalance or is this normal?

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  79. Menstrual periods in the woman are triggered by progesterone drop. The progesterone drop triggers the blood vessels in the lining (spiral arteries they are called) to spasm simultaneously, and essentially the lining tissue is thus strangled of oxygen. This triggers a release of enzymes and prostaglandins which together with this lack of oxygen breakdown the lining and causes it to shed. This shedding process is typically accomplished in fragments, what we know as our normal periods. There really are not case series of women who shed decidual casts monthly. A woman who has regular periods, in whom temperature shifts are showing ovulation, and in whom ovulation predictor kits say you are ovulating; then you probably don't have an actual hormone imbalance, but there still could be a change in the local sequence of events that triggers your period since it is something occurring monthly. At Women's Health Practice we can perform more sophisticated testing to see if in fact you are having hormone imbalances. 217-356-3736.

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  80. I have been on the Nuva Ring off and on for a few years now. Last year I started back on the ring in June and I would replace it every 3 weeks to avoid having a period. In August I didn't replace it in time and I experienced severe cramping and passed a big piece of tissue. I thought it was a miscarriage. I had not put a ring back in until April of this year. I got back on my ring and would replace every 3 weeks again to avoid my period. Well, I took my ring out about 5 days ago and did not put another back in so I was expecting my period any day.
    Today I experienced severe cramping and was doubled over in pain. It also felt like I had to take a bowel movement, so I went to the restroom and I expelled a large piece of tissue With quite a bit of blood . Since then, i am barely bleeding. There is no way I could have been pregnant, we have only had sex a couple times in the last couple of months. I have never had severe cramping with my periods. I have always had normal periods.
    Do you think this is happening because I am replacing my ring and not having periods monthly?
    My cramps have subsided a litte bit, but I'm still getting sharp ones here and there. This is just weird to me, first thing I thought was miscarriage again, but there is no way. I didn't know about shedding uterine lining all at once like I've read about today. Please help and tell me what you think.

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  81. Women who use their NuvaRing continuously (without a break) and women who take their birth control pills continuously should have a thinned uterine lining over time. Thin linings won't typically shed much, or if at all. This is why women can take long cycle pills and not have regular menstrual periods by design. It is assumed that over time, thin linings will need to shed, so by reason, occasionally this will trigger a decidual cast. This cannot be confirmed, however, without seeing your gynecologist, so for women with new symptoms, of pain, bleeding, tissue; you do need to bring these symptoms to the attention of your (a)gynecologist, and following her advice. Women's Health Practice 217-356-3736.

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  82. I'm a midwife & I had never heard of a uterine cast, that is until I passed one (I was also a virgin at the time). I was having what I can only describe as contractions, pelvic pain that was coming & going for about an hour. I was vomiting. I was not feeling good at all. My boyfriend was rubbing my lower back. Then I had a strong urge to go to the toilet (what I thought was bowels). I put toilet paper in the bowel & whammo - this thing was coming out of me, out of my vagina. I thought my whole uterus was coming out. It was painful at vaginal introitus also due to being a virgin. It fell into toilet - but wow, the pain was now completely gone. I pulled it out & put into specimen bag & took myself to local (London) hospital. I had a African male Gynae tell me that I had just passed a cast. How amazing. To describe it physically - it looked like a little handbag or an upside down pear with a 2 inch hole at the bottom It was complete, a hollow bag about the size of my fist. It was tough, about 4mm thick, cute looking. It was basically the whole inside of my uterus. I now realise in hindsight that I was having contractions to pass this mass & that when the cervix has something to pass through it (no matter what size), it is painful. I have always had regular periods before this & now continue to have regular periods. (that was 9 yrs ago).

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  83. This is a little off topic, but this is an active blog so I'm hoping this could answer a question of mine. I have no pain, no burning, no itching etc, all i have is a discharge that smells horrible and it makes me EXTREMELY self conscious. What are the chances that i have a lost tampon? I have tried "investigating" myself but I don't know if it may just be deeper than what i can reach. I really don't want to have to go to a Gynie, I want to faint just thinking about it.

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  84. I am 24 years old, never had sexual intercourse however my periods have been extremely abnormal, the worst experience I had was last year whereby my period lasted from 3 September 2012 to the 6 January non-stop everyday. Doctors didn't know what was wrong with me, was not referred to a gynaecologist, was given tranexamic acid to reduce bleeding but didn't work. I was in a lot of pain, terrible cramps, affected my bowels. Had numerous blood tests but nothing came back out of the ordinary accept that I was anaemic, doctor finally arranged a pelvic scan and that came back as normal also. It seems that I am a mystery.
    During that horrendous period of time of having vaginal bleeding, I was passing very large dicidual casts, sometimes as large as my palm, I couldn't use tampons or sanitary towels but had to use baby nappies to catch the amount of blood that felt like gushing out of me, my mum got very concerned at one point when I was constantly bleeding that I just had to stay on the toilet till it slowed down. Since January I have had 2 periods lasting 6-7 days, very heavy as normal for me with excruciating pains in lower back and tummy. In between the two periods this year I have been passing dark brown discharge, sometimes very thick and smelly and occasionally white thick discharge. This has been an issue that has been affecting me for quite sometime and this is the first time writing about it and hope that you can shed some light on the situation because I have given up all hope on my doctor. Thank you for reading and would appreciate any replies.

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  85. Very heavy menstrual bleeding that has not been found to be due to anything specific is by definition "dysfunctional." However, it's important to have had all the tests necessary to determine there is actually nothing wrong. Bleeding over several months may be due to anovulation, meaning not ovulating. I would suspect that tests of ovulation were not 'normal' if they were in fact done. Ultrasounds can determine many things, but they are not the same as an actual sample of the tissue of the uterus, that too can determine the cause. Sampling can be done with endometrial biopsy, or a D and C (dilatation and curettage). I also prefer hysteroscopy (check those posts). It is never a bad idea to get a second opinion if you have gynecologic issues that have not been successfully treated by your physician. Once a diagnosis is made you can be offered rational treatment alternatives.
    Readers who would like to know more about retained tampons, review the post
    http://www.gynogab.com/2011/03/retained-tampon.html

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  86. Okay well I just went and wiped and it looks like the lining of my vaginal wall just without. The blood

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  87. I am 36yrs old. I got married last year & immediately contracted uterine infection which became progressively severe. Before my marriage i had a 28day cycle with 4days of menses,in which first 2days were heavy flow and the remaining 2days light/spotting. After marriage the cycle length has remained the same but now i have started passing parts of my uterine lining. The blood flow has decreased considerably. I have had my FSH,LH,Prolactin,estrogen,progesterone & thyroid hormones checked. I have also got ultrasound & sonosalpingograph done. All my results have come out normal. Is passing of uterine lining in parts for every menses normal? Will passing less blood affect my ability to have a baby? We have been trying since marriage to conceive & so far have been unsuccessful. Please help.

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  88. Women who have sudden and worse back pain always need repeat evaluation to make sure there is not a treatable condition. Patients who have had a few blood tests, but are trying for pregnancy need additional testing for ovulation monitoring and ovarian reserve (there are posts on both) and it may be beneficial to get actual evaluation of the endometrium for the treatment which usually means (at Women's Health Practice) office diagnostic hysteroscopy or an endometrial biopsy. Women who are over 35 and have been trying for pregnancy for over 6 months without conceiving need to be seen for infertility evaluation.

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    1. Thnx a lot for the input. I will take up these issues with my doc.

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  89. I passed a decidual cast at the end of June. My doc said it was likely not,though it was exactly like the picture,the size of a plum and other than the cast,my menstrual bleeding was light. This was approximately 5 days after my period was supposed to start. A blood test was negative for pregnancy. While generally very heavy, my periods are normally regular. This is bizarre. I am still lightly bleeding 3 weeks later. Small bits of white tissue. A swab said nothing but yeast present. COULD the cast be due to yeast? I am still bleeding and my doc has dismissed it.Hormonal changes? I am 39 so could it be perimenopause? Very upset.

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    1. I might also add that bleeding had tapered to barely there brown. Now it is abit heavier and red again. Still light by normal standards.

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  90. Yeast infections can cause thick discharges that have layers of vaginal wall cells, but the discharge never appears to have the same characteristics as a decidual cast. Ultimately, unless the tissue was analyzed which typically means sent to a lab or viewed under a microscope, it's a judgement call as to what the substance was, some patients have misinterpreted blood clots as tissue. Bleeding between normal periods is not normal and has a cause, of which there are many. Normal menopause is around ages 49-51, but it can be earlier and would need evaluation to determine if any symptoms are due to menopause. For most women, decidual cast are not recurrent and not in need of treatment, but for all the conditions not decidual casts we would like to see our patients and determine if treatment is available.

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    1. the small amounts are the same texture as the cast. Just tiny. The bleeding for 3 weeks concerns me. I did a 3 day yeast treatment. No change. The cast was a cast. Chicken skin, rubbery, like a pouch. Thankyou

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    2. I think I may have figured out the WHY to the decidual cast. I had a cortisone shot last month and have read that this can cause all sorts of problems with the follicular stage/progesterone surge. As I am still spotting a month later, I am hoping this will right itself. Taking vitex and trying to eat super healthy. Have you noticed problems with women who have taken cortisone shots???

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  91. I was about a week late on my period this month. Im very regular. On Levora for my iral contraceptive. A few days prior to my period starting, i was having a lot of lower back pain. No abdominal cramping. And when i finally started, A LOT of cramping (not as bad as labor contractions, but intense enough to double me over) and A LOT if back pain. Im having a lot of frank blood and grey tissue discharge. My partner and i have a 3 year old. Had a miscarriage a year and a half ago. But i had to have a DandC because my body wouldnt expel. Does it sound like i have another miscarriage, or do i need to go see a gyn? Can something else be going on. Not sure of its relevance, but i have been an emotional WRECK the past week or two. Right around the time the back pain started, and my "crazy" peaked right before i started passing grey stuff!

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  92. Women who have abnormal bleeding and pelvic pain need to be seen by their gynecologist. As we have side before, passing a decidual cast can be 'normal' or at least need 'no treatment' in most cases, but you have to have an examination to determin this. It's important for women who suspect a spontanteous abortion (miscarriage) to have a pregnancy test, and only women with a positive pregnancy test could be possibly having a miscarriage. womenshealthpractice.com

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  93. I got the depo provera needle in mid may and three weeks ago started bleeding lightly in the morning then not at all by lunch time, that went on for a week and the second week was quite heavy but not quite as heavy as my usual period, the Third week had been lighter and tonight i pulled out a tampon that had a big chunk of thick fleshy fat looking stuff with blood as well, it doesn't look like the picture so i'm not sure what it is? I saw the doctor last week and i'm not pregnant, and she had a look to see if there was a tear on my cervix or a cyst but couldn't see anything so she said to just 'wait it out' i'm concerned

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  94. DepoProvera as an injectable contraceptive is an extremely effective form of birth control with failure rates as low as 2/100 women. It is administered as a shot every three months, and the side effect profile is normally very favorable. The method is effective for contraception within the first day, and over time most women will stop having their menstrual period when given the shot for contraception. However about 1/3 women will have irregular bleeding after getting their first few shots. For most women this bleeding is light, and normally most women would not pass a significant amount of tissue with this bleeding. If you are passing a significant amount of tissue make sure you are not pregnant, make sure you do not have any lining abnormalities, and know that over time it is not likely to re-occur. It is possible to pass a decidual cast with a heavy period after first getting on DepoProvera without having any thing else wrong.

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  95. Cortisone (steroid) injections are used for a variety of medical conditions. If a cortisone injection was given in a very small dose, such as for an acne eruption, it would be very unlikely to have systemic effects. If the dosage is large enough, or frequent enough then many systemic effects are possible, including some irregular bleeding. If the irregular bleeding is heavy enough, a woman might pass a decidual cast with her bleeding. Check with your physician to make sure you are not having any other side effects from your cortisone treatments.

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  96. I have been bleeding for 8 weeks, I have had a paragard iud since 2010, everyone keeps telling me its normal but its ruining my life, I have had some clots but not many, I'm tired all the time and uncomfortable, I had some small grey clots about a week ago, I have also had a mirena iud previously and never had any issues with it. I feel like death, have recently switched ob/gyns so nobody really cares what's wrong it seems....

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  97. i have the mirena IuD... I Pass a thick white FLESH LOOKING tissue through my vagina and is that normal?? It looks like skin...

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  98. Mirena IUDs are known as a treatment for heavy menstrual bleeding and thins the lining tissue. It would be possible, but very uncommon to pass a decidual cast if you have a properly placed Mirena IUD. We suggest our patients bring in the tissue in a clean jar and get physically checked. Women's Health Practice: 217-356-3736.

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  99. ParaGard IUDs are copper wire wound around plastic and in the early use can cause heavy menses, and right after insertion can cause some irregular spotting. Bleeding for 8 weeks is never considered "normal" but may not need treatment. This can only be assessed by seeing your physician and making sure the IUD is properly placed, that you are not pregnant, that you do not have an infection or there is another reason for irregular bleeding. physcianquestions@womenshealthpractice.com

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  100. This month I have the most weird period ever. I was 2 days late. On the 2nd late day i began spotting dark brown, which then turned to Dark red blood, somewhat heavy. As the day went by i passed a flat semi-long clot, resembling the picture above. The weird thing is later on that day the blood was bright red but still not heavy, barely filling a pad. By the end of the nigh there was nothing. The next morning somewhat bright red blood enough to fit a panty liner and by the end of day light brown only when wiping. Today on my (3/4 day of weird period) NOTHING. After throwing up at 12:20am I decided once i am fully awake i'll take a pregnancy test...It was negative. My question is was this an actual period? or is there a chance that i am pregnant?

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  101. Women can rely on pregnancy tests to be very accurate. If the test is negative, it is a reasonable idea to run another in a couple of days if the bleeding is not like your normal period. And after that, if signs and symptoms of pregnancy exist then seeing your gynecologist so that you can have a blood pregnancy test is the most accurate determination. Those that have passed tissue and have a positive test could be in the process of a miscarriage, and contacting your gynecologist is the right strategy.

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  102. Hi, my 16 years old daughter was on hormone therapy for over a month to stop her periods since she was very anemic (due to heavy bleeding) after stopping the hormones she passed decidual cast on her first period, very painful. She is a virgin and not sexually active. I was just wondering could you lose your virginity with passing of the decidual cast?

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  103. The reader asks if passing a decidual cast means she's not a virgin. In gynecologic circles 'sexual debut' means starting to have sex. Penetrative sex usually produces tears in the hymen, and they usually have specific configuration but not always. Tampons produce some stretching and or tearing of the hymen and reportedly so can some physical activity. Bleeding or clotting shouldn't be able to tear the hymen. Passing a decidual cast in a young woman could cause some stretching or tearing, but it's not likely.

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  104. Hi. I'm 26. Always had normal 7-day periods. About a year ago things became weird. Didnt get my period for 4 months. Now its been nonstop for almost 2 months (some days barely there and others its heavy and i've had chunks fall out (the size of a dime but yesterday a chunk the size of a lemon fell out with my tampon. No pain though. Sometimes it's sore around the lower parts of my stomach. The blood is sometimes pink and more often dark red. I haven't had sex in several years, never been on the pill or anything. I keep blaming stress but my mom is worried. (I've had an ear infection for a while but doubt it spread down there).

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  105. Young women who miss menstrual cycles for more than 90 days need to see a gynecologist or health care provider to be evaluated. There are a number of possible reasons, but simply not ovulating is the most common cause. Not all cases of irregular periods need to be treated. But you have to determine the reason before deciding on treatment. We accept new patients at 217-356-3736. Thanks.

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  106. Hi i am 19 years of age and for as long as i can remember i have had problems with my cycle. I tend to bleed all the time without any brakes in between or just one or two brakes. I had all the swabs done and a biopcy too and i was told it was all normal hadnt been on any birth control for over a year so i really thought something was wrong. The doctors have told me i cannot use hormonal birth control as it makes my bleeding worse. So they fit the copper coil and i had two regular cycles my bleeding lasting 11 days but i have now been bleeding for 16 days. The doctors say nothing is wrong but surely this can't be normal?

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  107. A reader asked: About pain she felt 2-3 days after her last period a felt a slight pinch in her lower right abdomen which I thought was ovulation. However, about an hour later she say a bunch of grey tissue
    matter in the toilet. I wiped and found it was coming from my vagina
    vs coming from the pee. She was told after a vaginal ultrasound she has many cysts on both ovaries, and that some fluid seen represented rupture of the cysts.She then talked to another obgyn who thought consuming a large
    amount of soy was contributing to her gynecologic problems. It is unlikely since the estrogens in soy are so weak, but eating less soy has made her feel better. After her next menstrual period she was still passing tissue that she thought perhaps came from the cysts, but again, this is unlikely as there has never been a link between decidual casts and ovarian cysts. Aw always, women need to actually consult in person for a more firm diagnosis.

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  108. Great questions on this blog, and appreciate the time to answer. I'm 42 and have been on my period now for 4 wks. The cycle rotates from heavy for 2-3 days where I pass clots/tissue, then lightens for 4-5 days, then back to heavy, etc. Is this normal as I become pre-menopausal? No pain at all, but it is inconvenient. I have had normal paps for 20+ yrs every year, most recently in June. Feel great, but am wondering if this is expected. Thanks.

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  109. A reader asks about a prolonged bleeding episode. Bleeding that occurs for many more days than a normal menstrual cycle, exceeding 10 days is not normal, and you need to see your gynecologist for any prolonged bleeding episodes. The causes of prolonged as well as heavy bleeding do overlap, and the testing to determine the reasons may remain the same. For women who begin to have long bleeding, stop your aspirin, begin a vitamin with iron, get plenty of water and rest and get into see your gynecologist. We are accepting new patients at womenshealthpractice.com

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    1. Hi Thankyou for the response. I am the same reader who asked about the prolonged bleeding with the copper coil. My bleeding eventually stopped on the 19th day. My period is suppose to come on the 9th of every month, this month however i have not started my period. Could this be because of how long i bled last time? I know its only 4days but i am just a bit worried. I would really appreciate a response. Thankyou

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  110. Women who have irregular bleeding most often have disordered menstrual cycle. You cannot assume that the periods will resume on their former schedule once bleeding has stopped and it's important to seek consultation after a prolonged bleeding episode. 217-356-3736 for appointments.

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  111. I'm 6 weeks pregnant and two days ago I had sex with my husband and I started having greyish discharge with a bit of blood and no pain. I'm also taking progesterone suppository vaginally once a day...whats going on if you can please help me!!

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  112. Bleeding in a pregnancy requires a trip to your Gyno to determine the cause, infection, ectopic pregnancy or miscarriage all could be the reason trod the blood.

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  113. Hello!

    I had whay appeared to be a yeast or bacterial infection...itching, burning, light discharge no real odor. The burning and itching has almost become unbearable. I went to use the restroom and a big flesh-pale thing came out. Now with this blog i am assuming it is the tissue lining. I am scheduling an apt with my gyno. My question is...is that normal to NOT bleed but pass tissue? Besides pregnancy what else could this be?.

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  114. Many women will have extremely light bleeding with their menstrual period, and some will feel the amount of tissue they are passing is greater in volume than the amount of blood they are passing. What is important is whether you have had a change, where you are in your life cycle (menstrual periods in perimenopause are shorter and lighter), whether you are taking hormones, and if you are in fact pregnant. For the most part your gynecologist has to sort this for you.

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  115. Hello my question is i was on my light days coming into my heavy i am 40 and i just recently had surgery done nd i wss under anitshia nd then after surgery i did not get until 2days after nd my surgery was on October 30th. I also had told my wife about it so we can scratch out me being pregnant my question is can is can anistshia effect my period nd cause its now november 16th i mean someone did tell that it csn but i wanna make sure of it.. Thank You

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  116. I was diagnosed with 3*4 cm follicle cysts in both rt n lt ovaries a week before my period (15th)was expected. TTC this cycle, I expelled what resembles to decidual cast on 15th n since thn only brown discharge. Ystdy I had a severe upper to mid abdomen pain which lasted for several minutes. Tdy 17th evn though I am discharging I did preg urine test tht came -ve. CN it b ectopic preg. I am very scared

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    1. I am 35+. and had no previous pregnancy.

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  117. The stress of surgery, and the medical condition(s) that lead to surgery can alter menstrual cycle. There is no proof that specifically the anesthetics themselves can alter a cycle.Planning for surgery and getting post operative care from your gynecologist is important.

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  118. Ovarian cysts can cause pain for a variety of reasons. Ovarian cysts can burst, they can bleed, they can leak, or they can twist. Only medical examination can determine what is happening. Often no actual intervention is needed. Pain of ectopic pregnancy can mimic the symptoms of ovarian cysts. It is not possible to have an ectopic pregnancy without a positive pregnancy test, but gynecologists rely on blood testing not just home pregnancy tests. Just passing a decidual cast can cause pain, but since it's not a typical experience you need to be seen by your gynecologist. At Women's Health Practice.com we recommend that patients get seen promptly for cysts and suspected tubal pregnancies.

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    Replies
    1. Tdy 18th got beta- hcg test done and it is neg (1.2). I ve been very regular with periods in past. Never had an instance of missed one. Since I TTC evry alterate days we were together during my feertile window. Does presence of ovarian cysts cn lead to anovulatory cycle. SINCE I want to conceive, I was very positive for this cycle. Also, if I conclude this as an anovulatory cycle does tht mean I shudn't try in next cycle. Many regards Dr.

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  119. I'm hoping you can help clear up what is happening with me. I'm going crazy thinking it's something bad. I am 23 years old and just had a baby in September. I thought everything was progressing normally with the lochia/bleeding. The flow was starting to slow down and was pretty much gone in about 4 weeks and then I had to have my gallbladder removed. The bright bleeding returned and again it started to slow down and was completely gone by my 6 week check up. I had sex with my husband later that week and everything was fine. Then we had sex a couple days later and I started to bleed again. I saw my doctor at 8 weeks again for the inserting of my Mirena iud. He told me I would not be able to tell the difference between the end of postpartum bleeding and the iud bleeding. My concern...I thought postpartum bleeding stopped by 6 weeks? The bleeding that I have is still bright red and looks really slimy. It is clear in some areas and red in others. I also pass tiny really dark blood clots and when I urinate I see a stringy dark looking discharge in the toilet. I wiped the other day and it was very stringy like. I'm scared because I think I should have stopped postpartum bleeding sooner. Is this normal? I'm also obese and I'm not sure if that contributes? I would appreciate your feedback so I can stop freaking out. Thank you.

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  120. The reader is asking several different questions: when does the uterus return to normal size and health after a delivery, when does the bleeding stop after having a baby, and when can an IUD be inserted. In fact an IUD can be inserted immediately after birth in the birthing room, however the expulsion rate is just slightly higher. Some gynecologists therefore recommend waiting until after the 6 weeks to insert, to give you the best possible chance of not having it expelled. It is also a contraindication to insert the IUD if there is infection of the uterus, so it's possible a gynecologist would wait for insertion. It is typical for the uterus to return to normal size at about 6 weeks, but it can take longer. For most women when the uterus shrinks back to normal size the bleeding will stop, but other causes of irregular bleeding can be occurring. I suggest that you ask your gynecologist a few more questions about what they think, before concluding there is actually something wrong.

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  121. Women will have anovulatory cycles, and just having one won't necessarily predict having another in the very next cycle. However medication can produce ovulation, and for those who want to conceive more rapidly it may be time for treatment.

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    Replies
    1. Tdy my Dr. Prescribed Novelon for 21 days. I already got periods few days back. But she says it will treat cysts. Will ill be able to conceive after this course is over or does it takes much longer than a month.

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  122. I have missed a couple of my pills and was also on anti biotics I have come on my period a week earlier than expected..this is the second day of my period ive had more painful than normal cramps and on my tampon there was just bigger than a nut sized lump which was grey in colour and hard..what is it please?

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  123. Women on birth control pills are not as likely to pass decidual casts as women who have spontaneous cycles. For accurate diagnosis your gynecologist can get a patholgy ananlysis on any tissue you have passed.

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  124. Hello, my periods usually last 6 days but my last period only lasted 2 days then two days later I had very little old dark blood. I am 36 yrs old and currently started trying to have a baby.

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  125. Oh and I hadnt started trying to have a baby yet when i had my period for only two days. Why did I get my period for only two days instead of regular 6 days?

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  126. Menstrual cycle bleeding can last longer or shorter for a variety of reasons. Most often we can theorize but not pinpoint the exact reason for this. In general whether a woman has a 2 day or a 6 day menses is not clinically significant. But any change may mean something so we would see the patient and do a pregnancy test.

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  127. I'm 20 years old and have had lots of problems with my menstral periods. I was on deppo verra shot for 8 years n have been off it for almost 2yrs. While on deppo, I had a constant period for most the time, then never got one the last few years. Always had horrible periods with extreme pain. I ve been off it for quite some time,now and I was bleeding fir 30 days straight , then not bleeding for a month or two. Ive been trying concieve for a year with no luc. My bodie will act asthough its pregnant, sore achey brests, colostrum coming from the, tired all day n ect.. But oi d still get negative tests. My periods are fibally becomming regular, but i've passed these cast things your talking about on here, every since it became regular. ( about 5months. ) I also have also always had issus with infections. Constantly on medication to fix an infecton. Uti's, bv , yest n the medications only seem to stop it for a week or two n my infection re occurs. I'm very worried n confused on whats going on with my body n why I've failed to concieve this long. N also, I pass this every month ( the cast) for the oast 5 months, n most the time its in peices, , first a larger one the size of a 50 cent peice n the smaller ones fallowing with in a day or two. Once they pass, my servere crams n my bleeding subside. My perionds only last 3-5 days now, since they became regular. I 'd go to a gynecologist, but don't gave insurance. any advice or suggestions would be very much appreciated ! Thank you!

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  128. Sorry for all the misspellings n typos, my phone is hard to type on. :/

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  129. Hi, firstly great blog! Thank you for your time and valuable information. The answer to the question I wish to ask has been partially answered, but I'd really appreciate if you could fill in some of the gaps.

    I'm 28 years old and have always had regular 29 day cycles, period length 7 days. Every month, consistently, on day 3, I shed , what I believe is the decidual cast. Since I've had it for such a long time, I don't pay much attention to it but I'd still like to know if this monthly occurrence is normal? I have never been on birth control and apart from some cramping , don't think I feel very uncomfortable during my period.

    I haven't tried for conception so far, so I have no clue about my fertility status and whether the decidual cast will have any impact on it in future.

    Essentially, is it a cause for concern if I shed the cast monthly, but feel no other unusual symptoms?

    Thank you.

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  130. Although there are isolated cases of women who have monthly decidual casts and not 'normal' periods, there really are no case series of these cases. I always say that you have to bring the tissue to your physician for analysis to really figure out what is wrong. And if someone had pathologic (tissue analysis) confirmation on a monthly basis, we could write it up for the medical journals.

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  131. So its not very normal n I should get checked out. . I was told once I faied to cocieve for a year, to go to a specialist, but aloso was told they dobt take medicare.. I'm a little confused on how to get started with a ob/gyn and weather any of it is actually covered. Any info or advice on this topic could help alot. Thank you for this very helpful and insightful blog! Also im in michigan, if tht matters with the coverage n stuff. _

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  132. Once again, sorry for all the typos.

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  133. There have been no studies to link infertility to specifically passing menses with decidual casts. It is unlikely that the decidual cast itself would cause patients to not have a fertile uterine lining. However, heavy menstrual bleeding, recurrent miscarriages, damage to the cervix, or uterine lining infections could all lead to potential fertility compromise. Having medical problems evaluated is most typically a covered benefit of all plans, but it is true the specific fertility treatments may not be covered. Each state, and each medical plan has a defined set of benefits and your plan administrator and your physician can help you best navigate specific questions.

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  134. I have had a miscarriage before, and it is nothing like what I just had happen. I have no pain that is any different than any other period, but i passed two skinny strips of grayish white tissue when i took out my tampon. I recently started back up on a different brand of birth control after almost being off it for an entire year. When i miscarried in the past, it was beyond painful and the bleeding was very different. I am hoping that i just passed the uterine lining and that everything will be okay?? ahh.

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  135. When women begin on birth control pills they are going to thin the lining of the uterus over time and menstrual periods will become light. For some women, with thicker, or relatively thicker, uterine linings it will be a process over time to thin the lining. The new start pill user may experience a heavier bleeding episode with the first or first few periods. Pregnancies can be confirmed by a pregnancy test, and any abnormal bleeding is a reason to run one. Only examination of the tissue passed and a visit to the gynecologist can confirm that you passed a decidual cast.

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  136. I ve been diagnosed with 30mm*33mm ovarian cysts in both left and right (eccentric nodule) ovary in Nov. Before my period was due. My periods started with brown discharge for 2 days n thn like routine flow. Both hcg n urine test came -ve tht overruled any ectopic preg. Dr. Prescribed me Novelon for 21 days followed by TVS. In TVS left cyst didnt appear while right was intact. Now she has precribed me Novelon for another two months (21+21 days) antibiotic (brakke for 5 days BD) and multi vitamin (A to z for 15 days OD.). With antibiotic added I feel very uneasy dizzy and confused. Dr says she cant remove the cust as its small. I ve cervical with pinched nerve. Cn this combination of tablets cause a concern with my history of cervical pain? Plz suggest if I shud continue with abv mentioned therey. Regards.

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    Replies
    1. In addition, during 2nd TVS a fibroid of size 10* 9 mm was observed. I am continuing next 2 nd course of novilon and antibiotics. I am 35+.

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  137. For appropriate second opinion you would have to actually visit a gynecologist and have them review your records and make an independent evaluation. It is true that women on birth control pills will form fewer cysts in the future. Birth control pills will not dissolve cysts that are already present, but most small cysts will resolve. Pain that is not responding to any therapy, where ever the pain originates, needs to be re-evaluated by your physician as well.

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  138. I have been on birth control for 17 years. I came off them this past October, I had a normal 28 day period. My last one this December was on the 28 day count also. Both were only 5 days long with brown color at the end and very beginning of the cycle. Having some tissue coming out towards the end of these periods. No pain, is this normal coming off birth control? Endometrium measured 0.53 on birth control, last week measured at 0.63 off birth control.

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    1. That was in cm those measurements

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  139. Typical menstrual cycles last 4 days +/- 2 days, so 2-6 days is a normal cycle length, and a 17 year old with 5 day menstrual periods would be, based on days of bleeding alone, considered normal. Cycles are most consistent from ages 20-40, and the 2-3 years just after starting periods, and just before menopause are the most irregular. The actual look and thickness of the endometrium on ultrasound (lining tissue) varies depending on the cycle day. There are various layers that cover the whole lining of the uterus, and some layers do not shed, and some should shed relatively completely. Then as estrogen rises early in a cycle, the lining will thicken, as progesterone rises later in the cycle, the tissue changes and the appearance may change. Although we can use the ultrasound to determine whether there are abnormalities like polyps in the lining, there are no actual 'normal' thickness measurements for women prior to menopause. Most studies show that about the thickest the lining gets is 0.8 cm during a cycle. Measurements of less than that are considered normal, based on thickness alone. Other characteristics might make the gynecologist want to evaluate further.

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    1. Could the lining tissue thats coming out at the end of the last menstrual cycles post birth control be normal? Didn't have tissue like this being on the pill.

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  140. hi..i am 5 day heavy flow with some tissues along with the flow. i was suppose to get my periods on 28 dec but i got it on 31 dec that too it was dark brown thing till 6 th jan then from 6th jan i got my period that to they r heavy...
    plz reply as im tensed abt the tissues its like live chicken fat. what are reason behind theses tissues...plz help...

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  141. If a woman passes tissue with her menstrual period, the tissue is usually red in color and spongy in consistency. It is not possible for most women to differentiate the 'look' of this tissue from the 'look' of miscarriage tissue. Women with double uterus, or enlarged uterus due to fibroids or adenomyosis may have more lining to pass, and may in fact see larger pieces of tissue. Tissue that is thought to be other colors might either be a case of mistaken identity or perhaps indicate something else, like infection, is going on. It's not possible to know from blog reading, it's more likely you will get a firm diagnosis by seeing your gynecologist.

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  142. Hello.
    I have been on my period for 2 months now. The blood has not been normal red blood except for the week im actually supposed to be on my period. Bc I am taking birth control. I bleed everyday. But its always the black tar blood or purple flesh blood during the weeks im NOT supposed to be on my period. What could this be a symptom of. Lately ive been experiencing sharp pains in the cervix area and its very normal to have normal pains on what appears to be poking my vagina wall from the inside pushing in. Its very deep. I just recently had nasal surgery and they said im anemic which I assume is from all this. Thanks in advance.

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  143. Break through bleeding when on birth control pills is common, although not a common cause of anemia. Heavy periods, and a diet poor in iron is actually more commonly a cause of anemia. Pelvic pain, cervical pain, or vaginal pain, is also more commonly due to endometriosis, infections, or causes other than simple break through bleeding on oral contraceptive pills, and your gynecologist can help you sort out the diagnosis and plan a treatment. We welcome new patients at 217-356-3736.

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  144. I have read up on all of this grey tissue being passed during periods and constantly hear that its normal or can be a miscarriage which lead me to believe from Feb 2013-Oct 2013 that everything was normal. In Oct at the age of 30 i was taken in to have a hystorectomy. I found out after the surgery that my uterus had broken apart and the grey tissue was my uterus falling apart and coming out of me. My advice is if it doesn't seem normal to you see a ob if what he says you don't agree with get a second and/or third opinion.

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  145. I am an 18 year old virgin and yesterday and last year,I believe,4 months ago I started the pill (rigevidon) due to extremely painful periods which the doctors believe could be due to endometriosis. I took them at the same time every night without breaks and everything was fine,until around 8 days ago when I tarted getting brown/red discharge,I went to the doctors yesterday because of extreme abdominal pains and they told me it was a breakthrough bleed and to take a break for a week from the pills. I got home and went up to the toilet because the cramping was getting worse, I felt an sensation which I can only describe to be passing a massive clot and I looked down to see a fleshy/bloody sort of tissue clot about the size of the palm of my hand. I panicked and went straight back to the doctors and they said it looked like I had a miscarriage which is completely impossible as I have never done anything sexual in my life. They have sent it off to the lab to check as well as a blood test. I know I can't get a definite answer but does this sound like a decidual cast to you?

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  146. I do not believe what I had was a cast but thought I would ask...I have a 3 day period and 23 days window in between periods. I was on the 11-13 of Feb. Based on info I have read I should be within my ovulation window. Last night I felt kind of weird down there so I took a pad to the restroom just to be sure everything was fine. I sat down to urinate and a big blackish glob came out. I had no cramping at all. 2hr later I went back to the restroom to check the pad because I didn't feel nothing else coming and only a couple a spots appeared like old blood. Nothing else since then. I did feel nauseated last night also but I figured it was because I was hungry. After I ate a little nauaeated and a little hungry. Very tired. Haven't had sex since January 26. Since my cycle was normal for me I didn't think anything until now.....

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  147. When women pass more than just a very tiny fragment of tissue or unclotted blood during their menstrual period it is unlikely to be painful. Larger pieces of tissue, as with a miscarriage or a decidual cast or large blood clots through the cervix are likely to cause more significant cramping.If clotting goes on long enough, the duration of the pain and the loss of fluid and any component of anemia can produce symptoms as some of the readers describe. If one is pregnant, even with a miscarriage, the pregnancy test should be positive. Tissue analysis can determine the type of tissue. For most physicians tissue analysis means sending the tissue to a pathology lab to be inspected. Clots dissolve when under running water and this most gynecologists can determine if there is tissue verses a clot when you have a specimen for them to evaluate.

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  148. Hi, I don't know if you still continue to check your blog....but I had a tubal done in June 2012. I have 2 sons, and just recently I had light cramping (I rarely get cramping with or before periods fortunately), nothing that stopped my day at all and then a few days later went to the bathroom and FELT that something had passed while peeing and when I looked in the toilet there was a greyish wrinkly clump a little smaller than my thumb in the toilet with a string of blood attached. The next day I started my period (which was on schedule...) but I'm very busy in my job and with 2 kids and I don't know if I missed my period in March or just forgot to mark it on my calendar...but I instantly thought I possible mis carried (and didn't know I was pregnant) or just learned about this decidual cast possibility while googling my situation....What would be your professional opinion?

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  149. To add to my above comment/question....it seemed like a rubbery firm texture, not like a "clot" or "gooey" at all...

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  150. Now and then we do like to remind readers that this blog is informational, not practicing medicine. We are accepting new patients at Women's Health Practice. Basic advice is that the following symptoms the last commenter revealed: bleeding, pain, pressure and passing tissue are all symptoms that should trigger a visit to your provider.

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  151. Dr. Is it advisable to get cryocautery done for cervical erosion. I ve never being pregnant and ttc. And learnt tht the procedure may cause stenosis making pregnancy impossible to achieve. Sry for posting my query here as i didn't find any relevant thread on this site. I appreciate your kind reply. Thnx

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  152. Your blog is awesome. I must say a good jib well done.

    However, I have a query or two which I think you might be able to help with.

    - When I have my period, most times I have unbelievable pain for some days and I put this down to my Fibroid which was diagnosed a couple of years ago but I believe it started growing in 2008 because that was the first time I experienced such pain . After my period which has red flow for 5 days, I get another flow of CM which is looks like it's turning from pink to cream but can be very smelly. I guess because the smell is registered in my brain, I can't help smelling it. What do you think can be the cause of this? Because my CM just goes back to what is expected after that.

    Second question, I am on day 14 of my cycle and I normally have an average of 27 days cycle but I cannot see an EWCM despite checking. Progesterone Day 21 came back fine in March but does it mean that I don't actually ovulate half way through my period?

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  153. My wife and I are considered fertile but i have been trying to impregnate my wife nothing seems to be working.we have used ovulating kits all to no avail. Of recent she started mensuration with smells and whitish slimey substance in the menses. What does this mean.

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  154. Only an exam can determine the nature of the vaginal discharge that accompanies menstrual flow and whether that has any bearing on fertility.

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  155. On March 10th, 2014 I had a missed miscarriage. I decided to have a natural miscarriage. 12 weeks later, I had my first period, and 35 days after that I had my second period - just last thursday. My period was light, brown, and started and stopped often until tuesday of this week. I had been experiencing cramps that intensified everyday until they started to feel like contractions. I went home from work, and when I got home passed a large peice of tissue that was half the size of my fist and was hollow like a pod. I assume I had a decidual cast, but my doctor would like to follow up with blood work to make sure it was not leftover tissue from my miscarriage. However, with that large size of tissue, wouldn't I have an infection if it was indeed from my 4 month old miscarriage? I have had no signs, no pain, no odd discharge, or smell. If this was a cast, could it have been related to the miscarriage, and could I expect this to happen again? Thank you!

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  156. The nature of any uterine tissue passed can only, ultimately, be determined by appropriate microscopic analysis by a pathologist.The tissue is most likely to be for the lining of the uterus or a placenta, but other tissue can be passed as well, such as a uterine fibroid. If the tissue was not saved, most all gynocologists will want to evaluate their patient for a miscarriage. Missed abortion tissue that is retained for weeks can cause infection or other serious complication, but often does not. www.womenshealthpractice.com

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  157. On July 7th i had the iud mirena inserted and my period started on the 17th. Id been having severe super painful cramps that i havnt had for about two years (i am 17) and after passing some tissue yesterday have been fine. And after reading your post i think it was a cast. Ive never had something like this before so i was wondering if the iud had caused it to happen or if its my body getting used to the iud still. Thanks so much!

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  158. I started my period last night and noticed a white piece of , I dont even know how to explain it, but um maybe almost like cottage cheese, but not so chunky . I have a history of cysts and menestration problems. I also have a kidney and uti infection at the moment, but i was just wondering if if someone might have an idea of what it may be. I also found more white looking stuff today when i wiped but not so umm the texture was thick or i dont know how to explian this. just white oh Have you had sick tonsils and that stuff that comes out of your throat, thats what it looks like but white.

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  159. I have had the same sexual partner for 3 years, and had never had any issues during intercourse. We broke up several months ago and recently I started dating someone else that I have known for years . We had sex and the first two times there were no issues, everything was normal,except where we had sex at, we had it in my car so we weren't able to fully engage I guess is the way to put it.The third time we had sex we were at home and well he is larger than my ex and what I am used to well I bled. I actually thought maybe I started my period for how much blood there was. I bathed and put a tampon on and when I went to change , there was nothing there, so it was just during intercourse. Well we have been together for a few months now and sometimes I don't bleed at all and sometimes it is very little and there are times that , my goodness, there is a lot. Now the weird part is we dob't do anything out of the norm, and like I said it's sometimes none, little or very much, and sometimes painful but not like inside, inside of me. It is more like the entry way that is most painful. But I had him look to see where the blood was coming from, thinking maybe he was just rubbing me the wring way but the blood is coming from within. I have only ever bled the first time I had sex with my ex husband because he was extremely large but even then it only happened once.My other ex was a bit large but I never had an issue with him like this. I don't know if im changing or if something is wrong with me.

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  160. Bleeding with sexual intercourse, with or without other gynecologic symptoms has many causes. Examination and testing will probably be able to give you answers, but a discussion on a blog unfortunately cannot provide enough of an answer to be safe without a gynecologic evaluation. Many causes are son serious, but some would have long term consequences if ignored and it's important to be seen. www.womenshealthpractice.com

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  161. The nature of vaginal discharges based on their look is possibly predictive of the cause, but ultimately testing is necessary to determine the actual cause. Simple cells sloughing from the walls of the vagina can cause a fairly heavy and odd looking discharge that is not significant, however there are quite serious cases, such as toxic shock that have similar discharge reported. Since the outcome is so variable you must consult your own gynecologist to be safe. www.womenshealthpractice.com

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  162. Hi Dr., How are you? I just wanna ask you about my period.
    Ive started experiencing a very long days of my period which always last for more than 12days (1st 3 days was just like spotting and the rest was a very heavy period with blood clots. ) It was happened since March 2014. I went to the doctor and just prescribed me Mefenamic Acid.

    But nothings happened, it'was still the same so last July 2014 I started to take OCP (Oral Contraceptive Pills)
    which I think can help me for my menorrhagia with blood clots.
    On the 1st day of my period I started to take OCP, then the following day, my period was stopped but I still continued my OCP. Until this August 4, 2014 my peroid was started around 7:00 in the morning. At this time my period was not yet heavy but around 7:00 in the evening I started experiencing dysmenorrhea (it'was very painful, and it'was my first time to experience that).

    When I went home, I always wants to go toilet and do squatting. The 3rd time I went to toilet and do squatting, there are two (2) tissues came out which I believed they are decidual cast/ uterine lining.

    After that I felt relieved and more comfortable.

    Thank you for your time reading my query Dr.
    Have a nice day!

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  163. In addition to my above query (12:07 AM). Im 26 years old, virgin and have 32 days average cycle.

    Thank you Dr.

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  164. No matter what a woman's cycle is like, if the birth control pills (oral contraception, OCs) are working correctly they will typically give you a 28 day cycle. This is not the case if you are on longer cycle pills, and the cycles refer to the menstrual period, not to any (if any) breakthrough bleeding. It may take a few cycles for you to be regulated, but whether your cycle used to be 22 days or 32 days, a typical pill will give you 28 day cycles. For most women OCs cure menstrual , and yet there are still other medications that may be required depending upon the cause of the menstrual cramps, which your gynecologist will have to help you determine.

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  165. Hi Dr., I will just ask..
    In the situation below, is there any possibility that the patient has FIBROIDS?

    Thank you.

    --->Hi Dr., How are you? I just wanna ask you about my period.
    Ive started experiencing a very long days of my period which always last for more than 12days (1st 3 days was just like spotting and the rest was a very heavy period with blood clots. ) It was happened since March 2014. I went to the doctor and just prescribed me Mefenamic Acid.

    But nothings happened, it'was still the same so last July 2014 I started to take OCP (Oral Contraceptive Pills)
    which I think can help me for my menorrhagia with blood clots.
    On the 1st day of my period I started to take OCP, then the following day, my period was stopped but I still continued my OCP. Until this August 4, 2014 my peroid was started around 7:00 in the morning. At this time my period was not yet heavy but around 7:00 in the evening I started experiencing dysmenorrhea (it'was very painful, and it'was my first time to experience that).

    When I went home, I always wants to go toilet and do squatting. The 3rd time I went to toilet and do squatting, there are two (2) tissues came out which I believed they are decidual cast/ uterine lining.

    After that I felt relieved and more comfortable.

    Thank you for your time reading my query Dr.
    Have a nice day!

    ReplyDelete
  166. Birth Control pills will probably not cause nor prevent uterine fibroids. In general menstrual periods are lighter when on the pill and wouldn't have as much tissue to pass a uterine cast from. It would be important to consult your won gynecologist if you have symptoms that persist over several days as you are describing.

    ReplyDelete
  167. I was reading most of the comments and your response to find an answer and I didn't really see one for my problem so Im commenting. I am 24 now and this has happened to me about 5 times since I was 19 years old. (I started my period when I was 15). Ive done research and saw that it could be associated with progesterone BC but I don't take progesterone only. I was taking ortho tri cyc when it first happened and the last time it happened a few months ago I was on Yaz. I have decided to forgo BC all together the past 4 months. I am curious if these were all more signs. How common is it to happen more than once? I have a 21-27 day cycle. It varies each month and I keep track. Some periods last 4 days some 10days. Im worried that the combination of having a decidual cast and a very irregular period could be correlated and eventually mean trouble TTC. I don't know if I would have a pregnacy scare because of the irregularity and I feel like I would have already been pregnant by now. My gyno has left me all crazy since my last visit because he was doing a coloscopy to follow up on pap (i had tumors from HPV and had the electric loop surgery done a year prior). He asked " has anyone told you that you have two cervixes?" I replied no and he goes "oh this must be moving on me to the side" SINCE then I have always been confused. I had a decidual cast a month after that visit. Could a biopsy with the iodine and clotting chemical they use cause a decidual cast?

    ReplyDelete
  168. one last thing I forgot to add. It happened once when i was taking ortho tri cyc, 2 times when I was on the patch, and 1 time when i was on yaz..... I want to say it clearly is hormone related - and that it may not effect me and pregnancy in the future when i dont take any birth control.

    ReplyDelete
  169. For women with two cervix (if that was the case) some will and some will not have two uteri as well. The two uteri usually function together, and have their periods together as those a controlled by the ovarian hormones. But anyone with an enlarged or double uterus will likely have more uterine lining to shed and the possibility of forming a decidual cast slightly greater. It is less likely to have a decidual cast if you are on hormonal birth controll pills. If you can capture the tissue that you pass you can bring it to your physician for evaluation and that is the best way to confirm what is going on. Once you have a diagnosis your physician can determine if this would have an effect on your fertility, but most women will not have a negative fertility affect just from passing a decidual cast.

    ReplyDelete
  170. I have always had irregular cycles this year however it has been much better than in my late teens. But last month cycle and this month cycle i realised a passed the lining/fleshy stuff, which really, wasn't much, on the first or second day of the cycle and then the cycle would slow down or stop. Im not pregnant that I know for sure so it isnt due to miscarriage. My cycles are usually 4-5 days not that much activity, nothing heavy, not much pain if any at all (prob only on first day for a few hrs). Im on day 2 now and passed the "cast" last night.

    ReplyDelete
  171. i forgot to add to the abovee comment!,,,i am not on birth control. Is this normal passing of uterine lining?

    ReplyDelete
  172. Although not discussed much with patients the readers can see from this comment stream many women report passing these decidual casts, whether they are very young, or middle aged, or on contraception or off contraception. If you have a gynecologic concern get in for a routine gynecologic evaluation.

    ReplyDelete
  173. GYNO GAB
    I NEED HELP.
    im currently on lupron for the past 3 mothns ,and yesterday condom fail. can i take plan b in order to avoid a pregnancy.

    any help really appreciated

    ReplyDelete
  174. Lupron treatment for uterine fibroids or endometriosis is likely to suppress ovulation, but is not considered contraception. Plan B is a progesterone post coital treatment to prevent conception by preventing ovulation in women who have had unprotected sex and it is not contraindicated by Lupron therapy. Always read instructions on Plan B and contact your physician if you have unanticipated side effects.

    ReplyDelete
  175. Good day!

    Last September 15 2014, transabdominal ultrasound was done to me and that was my 12 day cycle.

    Ultrasound revealed the following:

    uterus 1.2 cm intramural fibroid seen in the posterior wall

    right ovary 1.7 cm clear cystic area seen

    left ovary is enlarged with a cyst with low level echoes of 3.3 x 2.7 x 2.8 cm. No obvious vascularity seen.

    no fluid in POD. No obvious adnexal mass seen.

    May I hear an opinion or idea from you about my ultrasound result.

    Thanks a lot.

    ReplyDelete
  176. Correction on my previous message:
    It was August 15 2014 not September 15.
    Thank you.

    ReplyDelete
  177. An ultrasound examination is only one piece in the evaluation of gynecologic issues. The context of the case, the pelvic examination, your pap smear, and other testing would have to be evaluated for a gynecologist to give a woman an opinion about the finding. So a woman really needs to rely on her gynecologist's consultation, or see another consultant for an actual opinion. www.womenshealthpractice.com

    ReplyDelete
  178. It was d 9th day of my periods and everything was normal after 7 day. Then suddenly on the 9th day a hard tissue about a inch, covered with red and black blood came with my urine. Is it because the periods was not totally cleaned or something else?

    ReplyDelete
  179. I think I just had one of these, but I had a lot of pain and cramping and heavy bleeding with it, this happened Saturday morning and I am still in pain and bleeding, should I be worried? Iv never seen anything like it aside from clots I passed after I had my daughter, 19 months ago. and it was the size of a strawberry and more purple in color.
    Im very scared of going to the hospital.

    ReplyDelete
  180. Women with symptoms of pain, bleeding, urinary changes, fevers, bowel changes, or discomfort after any gynecologic procedures should contact their gynecologic surgeon for advice.Some of these symptoms are an expected part of postoperative management, but they may not be normal. This blog is not for active care.

    ReplyDelete

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