Although quite uncommon, some women are born with abnormalities of the vagina that may go undiscovered for years, and may cause difficulties throughout the lifespan. Vaginal abnormalities may lead to problems having sex and using tampons, or may interfere with menstruation and childbirth.
Vaginal abnormalities typically involve the development of a septum – this is a fleshy piece of tissue that separates an anatomical cavity. The tissue separating your nasal cavity into two nostrils is one example of a septum. However, septums can also grow abnormally inside the vagina. There are two types of vaginal septum abnormalities: transverse and longitudinal.
These abnormalities are difficult to spot because they typically do not affect the appearance of the external genitals. To identify the precise nature of your vaginal abnormality, your doctor use an MRI.
Transverse Vaginal Septums
When a septum develops “horizontally” across the vaginal canal, this is called a transverse vaginal septum. It divides the vagina into a top-half and a bottom-half; sometimes the division is complete, and sometimes it is partial.
This type of vaginal abnormality is very rare, occurring in only one out of every 3,000-80,000 female infants. Doctors are not entirely certain how many patients this condition affects, because it often goes unnoticed unless it’s causing problems.
A complete or nearly-complete division could cause blockages, trapping menstrual blood inside the vagina at the onset of puberty.
In the case of a complete blockage, there is an increased chance that menstrual blood will flow inward instead of outward, which may cause endometriosis. Endometriosis is a painful condition in which the endometrium (uterine lining normally shed during menstruation) attaches itself to tissue outside of the uterus. Endometriosis can cause painful periods and fertility problems, but there are treatments available.
Symptoms of Transverse Vaginal Septums
Many women go their whole lives without experiencing any problems caused by a septum. However, symptoms typically arise at puberty, due to accumulated menstrual blood that cannot escape, such as:
- Pelvic pain in monthly cycles
- Urinary problems
- Back pain
- Painful or impossible vaginal intercourse
- Difficulty using tampons
- Abdominal swelling (in newborns)
Longitudinal Vaginal Septum
Also known as a “double vagina,” in this condition a septum divides the vagina “vertically” into two separate canals, both leading from the vulva to the cervix. Many women with a longitudinal septum also have a double cervix and an abnormality of the uterus, such as a uterine septum or two uteruses.
This type of abnormality occurs during fetal development. Normally, the vaginal canal is formed from the fusion of two adjacent tubes called the Mullerian ducts. If these ducts fail to merge completely, the infant will be born with a “double vagina.”
This is another condition which many women may not discover until later in life, or never if it doesn’t cause any problems. For this reason, it is difficult to estimate how many women are affected, although it does seem to be more common than transverse septums.
Symptoms of Longitudinal Vaginal Septum
Some symptoms include:
- Painful menstruation (dysmenorrhea)
- Menstrual blood that “leaks out” despite using a tampon
- Abnormal uterine bleeding
- Pain during sex
Pregnancy with Vaginal Abnormalities
Vaginal septums can cause some problems getting pregnant and during pregnancy, but most women with vaginal septums are able to carry healthy pregnancies. Some areas where you may run into problems include:
- Conceiving naturally with a complete vaginal blockage may be difficult.
- Miscarriage and early pregnancy loss. Incidence is slightly higher for women with vaginal septums.
- Risk of premature birth and preterm labor
- Possible congenital abnormalities in the fetus
- Difficulty during labor, especially if the mother has a previously undiscovered septum
Talk to your doctor about your concerns. A vaginal septum can be surgically removed if it causes you discomfort, or if your gynecologist suspects it will cause complications to your fertility. This type of procedure is known as a septoplasty.