Case report
Spontaneous Endometrial Cast Expulsion in Membranous Dysmenorrhoea: A Case Report
Correspondence Address :
Dr. Aneesha Nallapati,
C1-803, Mahindra Antheia, Nehru Nagar Road, Pimpri, Pune-412303, Maharashtra, India.
E-mail: anishakrishna13@gmail.com
Membranous dysmenorrhoea is a rare gynaecological condition characterised by the expulsion of the endometrium as a single intact cast that retains the shape of the uterine cavity. The authors report the case of a 36-year-old multiparous female who presented with a history of heavy and prolonged menstrual bleeding associated with the passage of tissue per vaginum for 7-8 months. She had a preceding history of amenorrhoea for six months and pregnancy was excluded. Clinical examination revealed expulsion of a membranous structure through the cervix; it was removed, resulting in immediate symptomatic relief. Ultrasonography (USG) demonstrated a thickened endometrium with no focal uterine or adnexal pathology. Histopathological examination confirmed the diagnosis, showing pre-decidualised endometrial tissue with dilated, congested vessels. The patient remained asymptomatic on follow-up over three menstrual cycles. Membranous dysmenorrhoea remains a poorly understood entity with limited reported cases, often associated with hormonal influences, though spontaneous occurrences, as seen in the present case, are uncommon. Recognition of this condition is important to differentiate it from other causes of abnormal uterine bleeding and to avoid unnecessary interventions.
Abnormal uterine bleeding, Decidual cast, Exogenous hormones, Menstrual disorders
DOI: 10.7860/JCDR/2026/87402.24407
Date of Submission: Jan 12, 2026
Date of Peer Review: Mar 27, 2026
Date of Acceptance: Jun 24, 2026
Date of Publishing: Sep 01, 2026
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 28, 2026
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ETYMOLOGY: Author Origin
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