A case of unusual course of adolescent menorrhagia: decidual cast as a side effect of treatment.

OBJECTIVE

To present an unusual side effect of therapy for adolescent menorrhagia, with commentary on management options.

DESIGN

Case report.

SETTING

Tertiary gynecologic center.

PATIENT(S): A 13-year-old girl presenting with profuse uterine bleeding.

INTERVENTION(S): Dysfunctional uterine bleeding was diagnosed, and pharmacologic therapy with a monophasic oral contraceptive (OC) pill was introduced.

MAIN OUTCOME MEASURE(S): A large decidual cast occurred during treatment.

RESULT(S): After finishing therapy with OC followed by three cycles of cyclic progestogen, the patient experienced regular menses.

CONCLUSION(S): A large decidual cast may occur during treatment of adolescent menorrhagia with OCs; patients should be informed about this possibility, to reduce stress connected with the appearance of this side effect.