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Endometrial cast

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I am 17 year old girl and I got my period yesterday so today when I went to the bathroom (please excuse the gross details) and was peeing something fell out into the toilet. It looked like a round piece of skin with a little pink tone to it. Then when I wiped there was another little piece of "skin" on the toilet paper. This has never happened before and i dont know what it is. Please help
Thank you

Category: OBGYN

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Category: Infertility Specialist
 31 Doctors Online

Thanks for writing to with your health concern.

If you are sexually active, please take a pregnancy test to rule out an ongoing miscarriage.
Otherwise the possibility is that it is a endometrial decidual cast.

Sometimes, the endometrial lining ( lining of the uterus ) gets thickened, and then when it gets shed off, it resembles a fleshy piece of tissue.

It can happen when you have irregular cycles or history of delayed periods.

This could be a small vaginal skin tag also that is getting shed off.
Stress, tensions, weight gain, hypothyroidism, late nights, erratic eating habits, change of climate or altitude - all these can sometimes lead to a brownish discharge, that might resemble fleshy skin tags.
A small polyp in the uterus or cervix might be dropping off .

If you are sexually active, an STD screening, considering possibility of genital warts, should be done.

If this recurs, please have an internal exam ( gynecological check up - per vaginum and per speculum ) to confirm the diagnosis.

All the best.
Please feel free to discuss this further.

Patient replied :

No I am not sexually active. What is an endometrial decidual cast exactly? And is this something to worry about or is it normal? I usually have regular periods but in the summer when I traveled to another country it was delayed about a month. Also, I usually get cramps but this time around I got none. Could it be because of the tissue that fell out?

When the lining of the uterus ( endometrium ) grows quite thick, then when it gets shed off, it resembles a fleshy piece of tissue, that is an endometrial cast, because it is cast in the shape of the uterine cavity.
It is nothing to worry about if this is an isolated event, and does not recur with each cycle.
If you are not sexually active do not worry.
If you experience a recurrence of this symptom, please have the evaluation for a polyp / skin tags / endometrial decidual casts.
Take care.

Dr. Aarti Vazirani
Category: Infertility Specialist
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
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