Disclaimer: Please note that this blog is for educational purposes only, it includes general information on health-related topics. Women’s Healthcare of Boca Raton is giving medical advice to Patients Only. Follow this link to request an appointment with Dr. Ellman.
A vaginal septum is a condition that is considered a congenital anomaly as it is a developmental issue that forms in embryos. It occurs when the female’s reproductive system does not fully develop and leaves a dividing tissue wall in the woman’s vagina.
Vaginal septums can run horizontally or vertically, and they divide the vagina into two sections. Some women don’t know that they have this condition as they don’t experience any symptoms. Others may notice that they have abdominal cramping during menstruation, sexual discomfort, or a change in vaginal discharge, among others.
In this article, we’ll explore what a vaginal septum is in more detail and how we can provide a diagnosis and a treatment plan. We’ll also describe how it can affect pregnant women and the signs of pregnancy that you can experience when you have this condition.
Types of Vaginal Septums
There are two types of vaginal septums, which depend on how they are positioned in the woman’s vagina:
Longitudinal Vaginal Septum
We may refer to longitudinal vaginal septum as a “double vagina,” as it runs vertically and divides the vagina into two separate canals. These include two vaginal openings that both lead to the cervix. As a result, patients with this condition may also have a double cervix, a septate uterus, or two uteruses.
It occurs during fetal development when two vaginal cavities or tubes, known as Mullerian ducts, which are supposed to form one vaginal canal, fail to merge completely.
In addition, many women don’t know that they have this condition if it doesn’t cause any problems. As a result, we can’t estimate how many patients a longitudinal vaginal septum affects.
That said, people who have any of the following symptoms should see a doctor to determine whether they have a longitudinal vaginal septum:
- Painful menstruation.
- Abnormal uterine bleeding.
- Period leaking out of the tampon.
- Pain during intercourse
Transverse Vaginal Septum
Patients may discover this vaginal abnormality when they start menstruating, as the septum blocks the menstrual flow. That said, this can cause abdominal pain if blood accumulates in the reproductive tract.
A transverse vaginal septum occurs when the ducts inside the vagina don’t fully develop or don’t merge.
Furthermore, women with a transverse vaginal septum have a small hole in their septum, allowing menstrual blood to flow through. However, if the gap isn’t large enough, the patient may have periods that last more than seven days.
A transverse vaginal septum runs horizontally, and it divides the vagina into a top-half and a bottom-half. This division can either be partial or complete.
This condition is not common and only affects one out of every 3,000-80,000 female infants.
However, if the menstrual blood is trapped inside the vagina, this can lead to retrograde menstruation. The blood flows inward and causes endometriosis, increasing your chance of having painful periods and fertility problems.
Sexual activity can also cause discomfort or pain, as the septum can block the vagina.
Other symptoms associated with a transverse vaginal septum are:
- Back pain.
- Abdominal swelling in newborns.
- Difficulty using tampons.
- Pelvic pain.
How Do We Diagnose a Vaginal Septum?
We recommend seeing a doctor if you have any symptoms associated with a vaginal septum. The medical professional can provide a diagnosis, as symptoms can be similar to those of endometriosis.
When you visit our women’s health clinic, we ask about your medical history and talk about the symptoms that you are experiencing. Then, we also perform a pelvic exam and check whether there is something unusual, such as, in this case, a septum.
Afterward, we can also use an MRI scan or an ultrasound to help us determine whether you have a longitudinal or a transverse vaginal septum.
These imaging tests also help us if you have any other organs in your upper reproductive tract. These include a double cervix or a double uterus.
In the next section, we’ll describe how Dr. David Ellman, women’s clinic’s obstetrician in Boca Raton, treats vaginal septums.
How Do We Treat a Vaginal Septum?
When you have a vaginal septum, you may not require treatment if it isn’t causing any symptoms affecting your fertility. However, if the doctor thinks it could lead to pregnancy complications, they may advise that you undergo surgery for vaginal septum removal.
During this procedure, the surgeon removes this extra tissue and drains any blood accumulated from previous menstrual cycles.
It is important to note that vaginal removal septum surgery requires minimal recovery time. You may also notice that sexual intercourse is no longer painful or uncomfortable after surgery. Menstrual flow can increase as well.
Now that we have discussed how we perform a vaginal septum removal surgery, we can move on to the next section.
How Does It Affect Pregnancy?
Healthy pregnancies are common in women who have a vaginal septum, but problems that the patient may experience include:
- Difficulty conceiving naturally due to the vaginal blockage
- Miscarriage.
- Premature birth or preterm labor
- Congenital anomalies develop in the fetus
- Difficulty during labor.
That said, if your water breaks before the 37th week of your pregnancy, call your healthcare provider as they can advise on what you can do.
Even if you are experiencing water breaking but don’t have any contractions, seek immediate medical help.
Other Vaginal Conditions
Other vaginal conditions that people may develop:
Vaginal Agenesis
This refers to the absence of the vagina and affects about one in every 5,000 female infants. We don’t know its cause; the condition is known as Mayer-Rokitansky-Küster-Hauser syndrome, as the vagina did not grow during embryologic development.
Doctors may recommend that the patient undergo surgery to create a vagina using vaginal dilators or a skin graft.
Lower Vaginal Atresia
Lower vaginal atresia is when the woman’s lower portion of the vagina doesn’t fully develop, and we may have to replace it with fibrous tissue. It can cause abdominal pain, vaginal obstruction, pelvic mass, and a dimple replacing the vaginal opening.
In most cases, we diagnose this condition when the patient doesn’t get their first period, and we perform blood tests, an ultrasound, and an MRI.
Vaginal dilators can help us treat lower vaginal atresia, and we may also recommend the patient undergo reconstructive surgery.
Book Your Appointment Today
It’s hard to tell whether you have a vaginal septum, as some women don’t experience any symptoms, and only a doctor can provide a diagnosis.
Sometimes, this congenital anomaly can cause complications during pregnancy, and it can also affect your fertility.
That said, if you have any symptoms that could indicate that you have extra tissue in your vagina, call us today. These include abdominal bleeding, pelvic pain, and painful menstruation, among others.
Our team at Women’s Healthcare of Boca Raton looks forward to meeting you.
Dr. Ellman is a Board Certified OBGYN who established his medical practice in South Florida over 25 years ago. His office, Women’s Healthcare of Boca Raton, is located in Boca Raton, Florida at West Boca Medical Center. Dr. Ellman attended Albert Einstein College of Medicine of Yeshiva University, where he received his medical degree. He went on to intern at Beth Israel Hospital in Boston- an affiliate of Harvard Medical School- and continued his residency at North Shore University Hospital in Manhasset, New York- an affiliate of Cornell Medical School.
Dr. Ellman has practiced Obstetrics and Gynecology in the Boca Raton area since 1995. In addition to treating patients at West Boca Hospital, Dr. Ellman also treats patients through his own private practice, Women’s Healthcare of Boca Raton, located on the West Boca Medical Campus.