Now, we fully understand that the words Membranous Dysmenorrhea seem more than a little scary. That’s because they totally are, and when you learn what they describe, you’ll understand why. Full disclosure here, gang, this condition, also known as Decidual cast, or even Endometrial cast, could be considered a bit on the graphic side. So what are we talking about? Let’s dive in…
What are we talking about?
The name Membranous dysmenorrhea, until very recently, was something many of us at Hormona Towers had never heard of. And thanks to our amazing community it was brought to our attention — shout out the Hormona app and the incredible conversations that take place there.
One of our users had recently experienced this phenomenon and contacted our medical experts for advice and reassurance. Which they got — our medical team is seriously freaking out. But that’s when us non-medical types realized it was time to shine a light on this extremely rare, albeit extremely worrisome, condition, in case you ever need that knowledge.
Well, let’s start from the beginning.
Membranous dysmenorrhea: What and when
If you are someone who has, or has ever had, periods, you probably know that they involve the shedding and shedding of your endometrium, or uterine lining. This generally occurs over the course of 2 to 7 days each month and may be accompanied by cramping, clots, and varying degrees of bloody discharge.
The vulture among you may well have spotted—no pun intended—the use of dysmenorrhea here. And there’s a good chance you already know that dysmenorrhea means painful periods, as many of us experience this pain during our reproductive lives.
And yes, pain is definitely a feature of membrane dysmenorrhea as it can be excruciatingly painful. Fortunately, this pain is generally temporary and often goes away completely once the event is over. The fact? Well, that’s it, sip, passing your endometriumCOMPLETE, through an undilated cervix, no pain relief, and possibly no idea what’s really going on with you.
It’s been compared to giving birth from the placenta after giving birth, and to be honest, that’s a pretty good description. Because the result of this event is tissue around the size and shape of the inside of your uterus leaving your body. In essence, if you are ever unlucky enough to experience this event, you will see what most of us never see – your actual endometrium. As a whole. As opposed to small pieces each time.
But, and this piece is an extremely important gang, this event is incredibly rare. We’re not talking about heavy periods, big clots, or painful cramps, no matter how bad they are. If this has happened to you, you will surely know. And if so, please let your healthcare team know as soon as possible.
Membranous dysmenorrhea: The how and the why
Since this is a rare condition that only affects those of us with periods and wombs, there is almost no research or real explanation as to how or why. Although medicine has known this since the 18th century…
Here’s what we know. Membranous dysmenorrhea, revealing cast or endometrial cast — however you feel comfortable describing it — generally occurs between the ages of 20 and 40. And we say generally because we’ve seen a case study where that’s exactly what happened a 10-year-old girl. Who must have been terrified.
Now, the good news: For most, it’s a one-time phenomenon. Except, that is, for our user, who experiences it every month, at least for a year.
And as far as medicine can tell, membranous dysmenorrhea can have a few causes, although no one is sure which is the correct one. Chances are they’re all a little bit right, depending on the case:
- Ectopic pregnancy, where a fertilized egg develops outside the uterus
- Endometrial infection or dead tissue
- Hormonal contraceptives containing synthetic progesterone
If you’re a hormonal regular, you’ll be well aware that when it comes to anything even remotely hormonal, chances are the causes will be individual to the patient. So there may well be other things at play here that we just don’t know about. But because the event is so rare, we’re unlikely to get a definitive answer anytime soon.
Our medical team answers your questions
Now, this is a bit of an unusual situation for us, as it’s rare that we haven’t heard of womb-related events and conditions. So we thought we’d bring our medical team into this piece. Ladies, meet Dr Anna Targonsyaka, one of our most talented and active doctors. He is here to answer the most popular questions around this topic and educate us all.
But if we haven’t covered something you want to know, get in touch and let us know. Likewise, if this is something you are living with right now — we need to get this knowledge out to as many women as possible.
Dr. Anna, it’s over for you…
Hello Anna! Thank you so much for talking to us! So, are painful periods or large clots signs of membranous dysmenorrhea?
My super short answer is yes and no. The reason for this is that although painful periods and large clots are signs of membranous dysmenorrhoea, they are not specific signs. The single most noticeable sign of this condition is the passage of whole or almost whole pieces of the inner lining of the uterus on the first or second day of the period, which looks like an upside-down triangle and can be extremely painful. Therefore, the presence of large clots alone does not indicate this condition.
How common is membranous dysmenorrhea?
No one knows the true prevalence of this condition. Thus, at present, it is considered rare. But we believe it was first described by Giovanni Battista Morgagni in the 18th centurywhich means we’ve known it for a while.
Cases are reported from various parts of the world, which amount to less than 1% if converted into numbers. However, due to underreporting, the true prevalence may actually be higher.
How can hormonal birth control help?
Thus, there is no evidence that hormonal contraceptives cause membranous dysmenorrhea, and there is no need to label this condition as a rare side effect of their use. So don’t stop using your medicine after reading this!
Based on the medical history in the reported cases of this condition, its development may be associated with synthetic progesterone, regardless of the form of hormonal contraception used — whether it is oral contraceptives, injectable progesterone, or an implantable progesterone delivery system.
As most cases are related to puberty, there is a possibility that the uterus will respond unexpectedly to the high doses of synthetic progesterone administered for some reason, leading to abnormal growth and subsequent shedding of her inner lining.
Does it affect fertility in any way?
No, membranous dysmenorrhea does not affect fertility. Or, at least, there have been no reported cases of this happening.
What should I do if it happens to me?
First of all, don’t panic. Schedule an appointment with your health care provider, such as a gynecologist or primary care doctor, to discuss your symptoms and concerns. And be prepared to provide detailed information about your menstrual cycle, symptoms, and any treatments you’ve tried. This information can help your healthcare provider make an accurate diagnosis.
Then, based on your evaluation, your healthcare provider may recommend specific treatments or management strategies to address your symptoms. Usually, this will include pain relief measures.
Finally, monitor your symptoms. This information can help you and your healthcare provider evaluate the effectiveness of any treatments and make adjustments as needed. And, I just want to reiterate that membranous dysmenorrhea is extremely rare, so chances are you’ll never experience it. That said, knowledge is power, so be sure to tell all the women you know what you’ve learned!
Membranous dysmenorrhea: TLDR
More than period pains and clots, membranous dysmenorrhea involves the passage of your entire endometrium in one go. It’s painful and, let’s be honest, a bit of a shock. But it is also, in many cases, an isolated event related to synthetic progesterone, an infection or an ectopic pregnancy.
Once you pass the endometrium, the pain should go away and your period should resume as usual during your next cycle. And aside from the traumatic memories, your physical well-being will hopefully not be affected. Wombs are amazing and can take care of themselves in ways we are still learning.
That said, if you experience membrane dysmenorrhea, let someone know. Because the more women come forward, the more we will know and the more women we can educate and help when it happens to them. We have to take care of each other, gang, at least until medicine arrives with our wombs.
