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Had painful period and discharged a large piece of flesh coloured tissue. Trying to conceive. On progesterone. Suggest?

Mar 2013
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Hi, My period this month came on very painfully and I discharged a large piece of flesh colored tissue and since then I haven't had further pain but my period is very light and all brown. I am trying to concieve, is this a cause for concern. Nb I was definitely not pregnant so it couldn't have been related to a miscarriage and I am on additional luteals phase support. - progesterone. Any thoughts?
Posted Wed, 22 May 2013 in Menstruation and Miscarriage
Answered by Dr. Aarti Abraham 43 minutes later
Thanks for your query.
If you are sure you were not pregnant, then we can rule out a miscarriage.
There could be other possibilities -

1. You are on luteal phase support - progesterone is responsible for thickening the lining of the uterus and making it favourable in case fertilization occurs and a fertilized egg or embryo implants on the uterine lining. Hence, if you did not conceive this month, then the thickened lining of the uterus would be shed off, and a decidual " cast " or a mould of the lining of the uterus would be passed out, which often looks like a fleshy piece of tissue, and can be commonly mistaken for aborted tissue.

2. Conditions like polycystic ovaries or endometrial hyperplasia - where periods are delayed due to hormonal imbalance, and then when it does occur, it is painful , heavy and lots of uterine lining is shed off in the form of fleshy casts.

It is not a cause for concern as long as your periods are otherwise regular and this is an isolated event. If it recurs, then you need to consult a gynecologist. ideally, if the tissue had been preserved, you could send it for biopsy to know the cause .
Next cycle if the same thing recurs, you could have an ultrasound around day 21 of your cycle, to know the lining of the uterus and you could request a D and C or endometrial biopsy to confirm the diagnosis.

Take care, and feel free to ask further questions.
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