Abstract

A CLASSIC CASE REPORT OF MEMBRANOUS DYSMENORRHEA

Kaushik Richa*, Kumar Ashwani, Bhaskar Aastha, Bansal Priyanka and Singh Vineeta

ABSTRACT

Introduction: Membranous dysmenorrhea is a rare condition in which entire uterine endometrial cast is expelled spontaneously with menses with considerable cramping pain. Exact etiology is unknown, but seems to be related to estrogen-progesterone imbalance. Case Description: A 16 years old girl, who was recently prescribed diane-35 (2mg cyproterone acetate + ethinyl estradiol 0.035mg) pills since one month for poly cystic ovarian disease (PCOD), presented to our hospital emergency with severe cramping abdominal pain associated with the onset of menses since two days followed by vaginal passage of membranous material and after that her pain got relieved. Her trans abdominal pelvic ultrasound showed multicystic bilaterally enlarged ovaries only. Quantitative serum βhCG was also negative. Grossly membranous material was of uterine shape and on histopathological examination showed endometrial cast with large decidualized areas. This helped us to reach the diagnosis of membranous dysmenorrhea. Discussion: An understanding of physiologic response of endometrium to hormonal treatment will help us to diagnose rare clinical conditions.

Keywords: Membranous dysmenorrhea, Endometrial cast, Estrogen-progesterone imbalance.