What is a decidual cast? Explain menstrual experience, pain

What is a decidual cast?  Explain menstrual experience, pain

What is a decidual cast? Explain menstrual experience, pain

What is a decidual cast? Experts share what you need to know about these menstrual cramps. (Photo: Getty Images)

A TikTok of the midwife about her rare menstrual experience going viral.

Madi Swegle, who lives in Iowa, took to the video-sharing platform with a PSA on Nov. 23. She said her period had started the day before and that although it started as a normal cycle, she started having severe cramps at dinner time. Swegle sat on the toilet with a heating pad and hoped the cramps would go away. Instead, after an hour of the “most intense pain” she’s ever felt in her life – which included chills and nausea – something else happened.

“At first I thought it was a massive blood clot, but it wasn’t,” Swegle said in the video. “It was tissue the size of my palm and the perfect shape of my uterus. The best way I can describe it is if you’ve ever seen or felt a placenta, it felt like that type of tissue. It was terrifying to see that coming out of my body.”

After Swegle passed the tissue, her spasms “completely went away.” It was only after she texted a doctor a photo of the tissue that she found out what it was: a decidual cast.

dr Jessica Kingston, clinical professor of gynecology at UC San Diego Health, tells Yahoo Life that a decidual cast is “a layer of tissue that’s shed from the lining of the uterus — the lining of the uterus — all at once.” It’s not very common to shed the entire mucosa at once, she notes, since the decidual mucosa is much more likely to be shed in fragments over the course of menstruation.

Although having a decidual cast can be painful, Kingston says it’s usually not a medical emergency.

“There is no need to see a doctor unless the person is also having unusually heavy bleeding, meaning the equivalent of a maxi pad being soaked in less than an hour in two hours, or if the person has a positive pregnancy test,” says Kingston. “The presence of the decidual cast is not necessarily a sign of a serious health condition. The only exception is when it is an ectopic pregnancy or a non-uterine pregnancy that has not been diagnosed and treated.” An ectopic pregnancy is a condition where a fertilized egg implants somewhere outside the uterus, such as in the fallopian tubes.

Though it’s unclear what exactly caused Swegle in her situation, she tells Yahoo Life that her doctor suspects it was caused by the birth control she was taking before beginning her IVF journey, which was affecting her progesterone levels.

Before starting IVF, Swegle was on oral contraceptives for a month “to control and ‘reset’ your cycle,” she says. “So I was on birth control for a month, stopped it, and then came the decidual cast.”

DR Sam Rahmana gynecologist and founder of Center for gynecology and cosmetology, notes that decidual effusions “occur most frequently in pregnant women between the ages of 20 and 40 who have experienced an ectopic pregnancy.” However, she says there are also cases in non-pregnant people.

“Although there is no clear reason why someone might experience a decidual cast, possible causes include use of hormonal birth control pills, particularly those high in progesterone,” Rahman explains. “Oral contraceptives, injections and implants are possible options.”

After what Swegle had been through, she felt it was important to raise awareness about decidual casts, especially after people on TikTok reached out to her saying they had suffered a pregnancy loss.

“I was a little nervous about even putting the video online because I thought people would see it as too personal, too weird, too taboo,” she says. “But it’s gotten so much support and so many women come out and say, ‘Oh, that happened to me ten years ago — and they just told me it was a miscarriage.’ Or, “This happened to me 10 years ago, and I thought I was just a baby, and my doctor totally dismissed me.” I think it really made me realize that women need to stand up for themselves — and when something feels uncomfortable, stand up for yourself, knowing that you know your body better than anyone.”

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