A vaginal septum is when a wall of tissue blocks your vagina, dividing it into two parts. Your vagina is a muscular canal that leads to the entrance of your uterus (called your cervix). Your vaginal canal is where a tampon goes during menstruation and where penetration occurs during sex. A vaginal septum is a vaginal anomaly that happens during fetal development when this canal doesn’t form properly. A vaginal septum isn’t visible from the outside, so you may not realize you have one until menstruation begins or when you become sexually active.
A vaginal septum can be either transverse or longitudinal. The type is based on the direction of the septum.
In a transverse vaginal septum, your vagina is divided into top and bottom parts. The tissue runs horizontally across the vaginal canal. A transverse septum can be complete or perforated (also called partial).
A complete transverse septum means the tissue blocks the entire vagina. The blockage prevents blood from flowing out of the vagina during your menstrual period. This can cause blood to back up into the upper vagina or uterus and cause pain or swelling.
A perforated transverse septum has a small hole or opening that allows menstrual blood to pass through. The tissue only partially blocks the vagina. You may have a menstrual period, but it lasts longer due to blood flowing slowly out of the small opening.
In longitudinal vaginal septum, your vagina is split into two separate cavities. It’s sometimes called a double vagina because it creates two distinct canals with a band of tissue running down the middle (from top to bottom). Menstrual blood can exit your vagina, but it may be difficult to use a tampon because you have two canals. For example, you may insert a tampon but still be leaking blood (because it’s only in one cavity). A longitudinal vaginal septum is also called a vertical vaginal septum. Most people with this type of vaginal septum also have a congenital disorder of their uterus and cervix such as a didelphic uterus (having two uteruses and cervixes).
Yes, you can still have a baby, but it’s safer to fix the septum first. Surgery involves removing the tissue that’s causing the separation. This significantly reduces complications associated with conception, pregnancy and delivery.
What are the symptoms of a vaginal septum? Some people don’t realize they have a vaginal septum until their healthcare provider finds it during a pelvic exam. Most symptoms don’t begin until a person gets their period or becomes sexually active.
Some of the most common symptoms are:
A vaginal septum is a congenital disorder, which means it’s something you’re born with. Your vagina begins to form around six weeks in to fetal development. Two tubes (called Müllerian ducts) come together (or fuse) to create one vaginal canal. In the case of a vaginal septum, the two tubes don’t fuse. It’s unknown why this happens, and there aren’t any risk factors.
There are a few conditions associated with a vaginal septum. You’re more likely to have:
Your healthcare provider typically diagnoses a vaginal septum during a pelvic exam. They may order additional imaging tests like a magnetic resonance imaging (MRI) or ultrasound to get a closer look at the tissue causing the blockage. Imaging tests can also confirm the type of septum you have and help identify other duplications in your reproductive tract (such as two uteruses).
You may not need treatment for a vaginal septum if it’s not causing any symptoms or affecting fertility. Dr. Guerette can discuss treatment with you, but in most cases, getting the septum surgically removed is the best option. This prevents complications during pregnancy and childbirth if you wish to have children in the future. There are instances when the septum tears naturally during sexual activity, and then, surgery isn’t needed.
Surgical treatment for a septum involves removing the wall of tissue that’s causing the blockage. This creates one vaginal canal. During the surgery, Dr. Guerette will drain any blood trapped inside your vagina. This is usually an outpatient vaginal surgery with no visible incisions. You’re given general anesthesia, so you don’t feel any pain.
Dr. Guerette will usually recommend vaginal dilation and pelvic floor therapy to maximize the chances the surgery heals well.
Surgery to correct a vaginal septum:
No, a vaginal septum can’t grow back because it’s a process that occurs during fetal development. You can’t regrow a vaginal septum.
Some people with a vaginal septum don’t have symptoms or health concerns. They may live their entire life with a septum and not seek treatment. However, some people with a vaginal septum have painful symptoms, issues with menstruation or difficulty getting pregnant. In this case, treatment is necessary.
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