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.