Nurse raises awareness for decidual cast after experiencing the 'traumatic' menstrual condition

A labor and delivery nurse is raising awareness for a rare and 'extremely painful' menstrual condition that led her to shed her entire uterine lining all at once, saying she had 'never heard of this before.'

Madi Swegle, 24, from Iowa, opened up about having a decidual cast — a large piece of tissue that passes through the vaginal canal — in a now-viral TikTok video that has been viewed more than 6.5 million times. 

'So something extremely scary and honestly a little traumatic happened to me last night. If you are a woman, this is important,' she said. 'I've never heard of this before in my life. I'm a nurse. Never heard of it. I wish I had, which is why I'm posting this video.'

Madi Swegle, 24, from Iowa, opened up about passing a decidual cast in a now-viral TikTok video, saying she is a labor and delivery nurse and had 'never heard of this before' 

A decidual cast is a large piece of tissues that passes through the vaginal canal. It occurs when the uterine lining is shed all at once instead of over a series of days

Swegle, who posted the educational clip on November 23, explained that she had started menstruating the day before. 

'It started out as a normal cycle, normal cramping, normal flow. Everything was very normal. Around 7 p.m. last night, my cramps suddenly got very, very intense,' she recalled. 

The nurse said she went to sit on the toilet because she knew 'something was not right,' but she just assumed she was experiencing a painful period. 

'This pain is the worst pain I've honestly felt my entire life. I was on the toilet for about an hour. I had a heating pad,' she continued. 'I had a bucket in front of me because I felt nauseous from the pain. I had goosebumps all over, and it wasn't like normal cramps where they kind of like ebb and flow. It was a consistent severe pain.'

'The amount of pain I was in, [my husband] Jake was like, 'Do we need to take you to the ER? This is not normal.' And I was like, "No," I thought it was just an awful period.'

Swegle explained that her menstrual cycle started normally, but then she started experiencing 'very intense' cramps. She said it was the 'worst pain' she had ever felt in her life

After about an hour 'something came out' and the pain immediately subsided. She later learned the tissue she had passed was a decidual cast

Swegle admitted that she thought she was 'just being a big baby about the pain' and opted not to go to the hospital to get checked out. 

'An hour later, after this consistent, like, never-ending extremely painful cramp, something came out of me,' she said. 'At first, I thought it was a massive blood clot. But it wasn't. It was tissue about the size of my palm and it was in the perfect shape of my uterus. The best way I can think to describe it is if you've ever seen or felt a placenta, it felt like that kind of tissue.'

'It was terrifying to see come out of my body,' she added, but as soon as it passed, her cramps went away and she 'felt a hundred times better.' 

After turning to Google and texting a picture to her obstetrician, she learned that she had passed a decidual cast, which occurs when the uterine lining is shed all at once during menstruation instead of over a series of days. 

'The cramps I was feeling were really like contractions, and my cervix dilated a little bit to pass this,' she explained. 'I'm not going to show you my picture. If you're curious you can Google it, but beware it's pretty gross and nasty.'

'Honestly debated if I should share this or not, but I wish I had known about this before it happened to me,' she wrote in the caption. 'It was so painful and scary.'

More than 20,000 viewers have commented on her video, and many opened up about their own experiences passing a decidual cast. 

'I am literally in tears because this happened to me last month and I had no idea what it was,' one woman wrote. 

'This happened to me when I was 17 and home alone and I called the emergency line crying on my bathroom floor,' someone else shared. 

A number of people recalled how they thought they were 'dying' or 'having a miscarriage' when this happened to them. 

'Honestly debated if I should share this or not, but I wish I had known about this before it happened to me. It was so painful and scary,' she wrote in the caption of her video 

Swegle's video has received more than 6.5 million times and 20,000 comments. A number of women shared their own experiences with the frightening condition 

'You just answered a mystery [that] all of my [doctors] have never been able to answer for me!' another added. 

Swegle filmed a follow-up video to answer a few questions about what happened after she passed the decidual cast.  

'First of all, I just want to say I am shocked by the amount of comments that I have gotten [about this],' she said. 'So many women that have experienced this that weren't taken seriously. They didn't know what it was. They were gaslit into thinking they had a pregnancy loss. It's truly astounding, and, honestly, very traumatic.'

Some commenters had asked if she continued to bleed, and she explained that she did 'but only for a day after.' 

'It was extremely light,' she noted. 'I just had to wear a liner and I was covered.'

'So many women that have experienced this that weren't taken seriously. They didn't know what it was. They were gaslit into thinking they had a pregnancy loss. It's truly astounding, and, honestly, very traumatic,' she said in a follow-up video 

Swegle shared that her doctor thinks the high levels of progesterone in her birth control is what caused the decidual cast

A decidual cast could be a sign of an ectopic pregnancy, which occurs when a fertilized egg grows outside of the uterus. However, she assured concerned viewers that this wasn't the case. 

'My husband and I are actually going through IVF right now to try to get pregnant, but I was on birth control prior to my cycle starting and passing the cast,' she said. 

Swegle added that her doctor thinks the high levels of progesterone in her birth control is what caused the decidual cast. 

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