Vaginal septum disorders at a glance
- A vaginal septum occurs when the female reproductive tract does not develop and merge properly, creating a dividing wall of tissue within the vagina.
- The condition may block normal menstrual flow and cause pain during intercourse, although some women have no symptoms.
- An MRI can diagnose the condition, which generally can be corrected with surgery.
Causes & symptoms
Development of the female reproductive tract is a complicated process during which cellular development must occur in a specific order. When it doesn’t, a condition known as vaginal septum can occur. It is a congenital partition within the vagina, and may be either transverse (across) or longitudinal (top to bottom).
Transverse vaginal septum
A transverse vaginal septum is a wall of tissue created when the uteral-genital sinus and mullerian ducts inside the vagina do not develop correctly. The external genitalia appears normal, but the vagina is shortened and blocked.
A complete transverse vaginal septum – where the tissue spans an entire area of the vagina – will block menstrual flow and results in cryptomenorrhea, meaning menstruation occurs but is blocked by an obstruction in the vaginal outflow tract. Women with this condition may suffer pain during intercourse (dyspareunia).
Longitudinal vaginal septum
A longitudinal vaginal septum develops when there is an incomplete fusion of the lower parts of the two mullerian ducts, which means that the two ducts did not come together to create one space. As a result, there is a wall of tissue running down the length of the vaginal canal, partitioning the space into two vaginal passageways.
A woman may realize she has a vertical septum, or two vaginas, when she inserts a tampon during her period and blood still leaks. It is possible that one vaginal area will be too narrow for tampon insertion.
Some women with a vertical vaginal spetum will have no symptoms. During sexual activity, the septum may tear and create one vagina, or one side may be favored because it is larger.
It is not always necessary to remove a longitudinal vaginal septum unless the condition causes pain during intercourse.
A women born with a vertical or complete vaginal septum may also have duplications in the upper reproductive tract, meaning that she may have a double cervix or double uterus.
Treatment of vaginal septum
Ultrasonography or magnetic resonance imaging (MRI) can be used to diagnose the condition. Surgery is generally recommended for health reasons and to relieve pain during intercourse.