When everything is not about Perimenopause

Caesarean scar defects (CSD), also referred to as isthmoceles or uterine niches, are a recognised complication of caesarean delivery and have been described in the medical literature since 1959. Despite this, they remain under-recognised in clinical practice. Symptoms commonly associated with CSD include abnormal uterine bleeding, post-menstrual spotting, pelvic pain, dysmenorrhoea, and fertility challenges, many of which may be attributed to perimenopause in women in their forties, potentially delaying accurate diagnosis.