When patients present with unusual bleeding and the passage of tissue, two very rare but distinct phenomena may be considered: an endometrial cast and a decidual cast. While both involve the shedding of uterine-lining tissue, their causes, appearance, clinical implications and management differ significantly. As a women’s health specialist, I’ll guide you through the subtleties…
Introduction — Why Understanding the Endometrium Matters The inner lining of the uterus, known as the endometrium, is far more than simply the “uterine lining”. It is a dynamic, hormone-responsive tissue that undergoes monthly cycles of growth, preparation for pregnancy, shedding, and regeneration. This lining is the tissue that is shed during menstruation and also…
Introduction Every month, the female body prepares for a potential pregnancy. The uterus builds a soft, nutrient-rich layer called the endometrium, or uterine lining. When pregnancy doesn’t occur, this lining breaks down and is shed — resulting in menstruation. Shedding of the uterine lining is a natural and essential process of the menstrual cycle. However,…
Overview Passing tissue or clots per vagina may be alarming. Two commonly conflated entities are the decidual cast (also described as an endometrial cast or membranous dysmenorrhea) and routine menstrual blood clots. Clinically, the distinction is based on structure, composition, etiology, and the associated diagnostic findings. This article summarizes the evidence-based approach to differentiate decidual…
Introduction Passing tissue from the vagina can be an alarming experience, especially when it’s unclear whether it’s a decidual cast or a miscarriage. Both may involve pain, cramping, and visible tissue — but their causes, risks, and medical implications are very different. Understanding how to distinguish the two can help you make informed decisions and…