Vaginal Septum: Symptoms, Causes, and Treatment

The vaginal septum occurs due to the partition of vaginal tissues causing a separation of the vagina into two parts. This partition runs horizontally or vertically, making its effects noticeable during menstruation. The surgical treatment is necessary, but sometimes, it doesn't cause any symptoms and is benign.

It is a congenital condition in which the reproductive system of the female fails to develop correctly, forming division in the wall of the uterus. It is not externally visible and is often challenging to realise. Many people do not know they have it until they reach puberty.

By this time, the symptoms, e.g., pain, unusual menstrual flow and discomfort, start to develop. Many people still miss this condition at this stage and notice the symptoms only as they experience pain during sexual intercourse in sexually active years. In a minority of people, the vaginal septum doesn't cause any symptoms. 

This article discusses various types of vaginal septum, diagnosis and treatment options. Continue reading to delve into more details. 

What is the vaginal septum? 

The vaginal septum is a birth defect (congenital anomaly) that causes poor development of the septum while the foetus is still developing in the womb. In this gynaecological condition, a wall of fibrous tissues develops in the vagina that divides it into two parts. 

Depending upon the location of the septum and how it forms, the irregularities in the periods develop, and sexual intercourse and tampon insertion become difficult. For better information, we have summed up the common questions about vaginal health in another article. Visit our page to read it.

Types of vaginal septum 

There are three main types of vaginal septum, e.g., longitudinal vaginal septum, transverse vaginal septum and obstructed hemi-vagina. Each type has its clinical picture and symptoms. Let's have an overview of these types.

Longitudinal vaginal septum 

The longitudinal vaginal septum is also known as a complete or vertical vaginal septum. In this condition, a fibrous wall develops in the vagina that runs along its length and divides it into two channels. This vaginal septum is non-obstructed, meaning that it doesn't cause the blockage of menstrual blood flow. 

Nevertheless, pain during sexual intercourse and tampon insertion is often noticeable. It is the most common type of vaginal septum.

Transverse vaginal septum

In the transverse vaginal septum, the wall of the fibrous tissue runs across the whole width of the vagina. The position of the septum in the vagina can be high, middle or lower, but most commonly, it occurs in the lower vagina. Such a septum impedes the menstrual flow and causes a complete block of the vagina and is known as a complete transverse vaginal septum. 

Sometimes, an opening is present in the septum that causes the passage of menstrual blood, and this type of septa is known as transverse vaginal septum. Nevertheless, It is rare and develops in just one woman out of 30,000 to 80,000 women. 

Obstructed hemi-vagina

The obstructed hemi-vagina occurs when the septum that divides the vagina develops partially and blocks the half of the vagina. The woman having this type of obstruction experiences various other complications, e.g.,  a missing kidney, a double vagina and a double uterus. The people having an obstructed vagina experience that they have an obstructed menstrual flow on one side of the vagina and a normal menstrual flow on the other side. 

How to identify the vaginal septum? 

In very few cases, it is tough to identify the presence of the vaginal septum as these septums are not visible from the outside and are associated with very few symptoms. Nevertheless, some symptoms indicate the presence of the vaginal septum. 

Longitudinal vaginal septum

A woman having longitudinal vaginal septum experiences difficulty while inserting a tampon, pain during menstruation and persistent bleeding in the vagina.

Transverse vaginal septum

Likewise, a person having transverse vaginal septum experiences severe abdominal pain, a considerably more extended period that lasts for 4-7 days longer than usual and a collection of menstrual blood in the vagina, a condition known as hematocolpos, and a total absence of periods or amenorrhea. 

Obstructed hemi-vagina

The symptoms in people with obstructed hemi-vagina are pain in the lower vagina and pelvis, irregular bleeding, painful periods, vomiting, unusual discharge from the vagina, constipation, vomiting, fever and having a mass in the pelvis and vagina.

Discomfort and pain during sexual intercourse is a common symptom of all types of vaginal septum. Our collection about vaginal health has numerous medications & products related to vaginal health. Visit it today for better vaginal health tomorrow.

Causes of Vaginal Septum

It is due to unknown genetic factors. Current research has found that it is a multifactorial issue resulting from changes in multiple genes, and environmental factors also influence it. It develops during foetal development as a part of Mullerian anomalies, which cause improper growth of the female reproductive tract.

The Mullerian ducts are vital components of the female reproductive system and have a critical role in the development of the female reproductive system. These tubes develop all of the organs in the female reproductive system, e.g., fallopian tubes, cervix, uterus, and the upper part of the vagina. Sometimes, these mullerian ducts fuse, and these fused parts resorb together to develop a cavity. 

Due to any disruption, these tubes do not fuse properly and cause vaginal septum, which causes severe pain. 

Diagnosis of vaginal septum 

To diagnose the vaginal septum and other related issues of the female reproductive system, it is advised to consult the healthcare professionals. For this purpose, a gynaecologist is specialised and focused on the reproductive health of the females. 

The diagnostic session with the gynaecologist usually starts with questioning about the symptoms, e.g., if there is any difficulty with the passage of menstrual flow or any other symptoms of the female reproductive system. The physical examination, mainly the pelvic exam, is done to confirm the presence of septum in the vagina. 

If doctors still find it challenging to identify it, additional tests for confirmation are recommended. These tests include imaging tests, such as an MRI scan and ultrasound. Vaginal discharge is an important indicator of various health conditions related to the vagina. Let's talk about vaginal discharge with our health professionals.

Treatment 

Treatment is not necessary if there are no other symptoms, e.g., severe pain and obstruction of menstrual flow. However, if there is an obstruction in the menstrual flow and other symptoms, treatment is recommended. The most common treatment options on the table of contents doctors are; surgical resection 

It is a surgical procedure in which the fibrous tissue is permanently removed from the uterus. This procedure requires general anaesthesia and takes just 1-3 hours. The other treatment options are; 

Reconstructive surgery

In very complex cases, the vaginal septum is linked to various structural anomalies and reconstructive surgery is recommended to ensure normal vaginal health and reduce the risk of complications. It is performed to reduce the risk of potential complications.

Hormonal therapies 

If the vaginal septum interferes with menstruation, hormonal therapy is used to manage the symptoms. It suppresses or regulates the symptoms as soon as the surgery is done to restore it. Thus, It is not a permanent solution but a temporary option to alleviate the symptoms. 

Laser ablation 

The laser removes the septum, mainly if it is fragile. This option is minimally invasive and reduces healing time and scarring. However, it is not suitable for all locations and thickens the septum. For better results, it must be performed by a trained laser expert.

Dilation 

Vagina dilation is very helpful if the vaginal septum is fragile or the surgery is not necessary immediately. In this process, the large dilators are used to stretch the vaginal tissues gently. It is often used in combination with other treatments and in more advanced cases.

Compilations of vaginal septum  

There are many potential complications of vaginal septum as well as surgical resectioning, which is done to treat it. If the condition is not treated properly, the vaginal septum causes interference with childbirth, menstruation and sexual intercourse. 

Soreness in the vagina and light bleeding are among the significant side effects associated with the incorrect resectioning of the vaginal septum during vaginal resectioning. The other complications of vaginal resectioning are bleeding, injuries to the rectum and bladder, stenosis or narrowing of the vagina and scarring. 

To avoid these complications, doctors often use a vaginal dilator to expand the vagina, prevent its narrowing and restore the flexibility of the vaginal tissues and vaginal capacity. A vaginal stunt is an alternate choice to prevent vaginal narrowing. 

When to see a doctor? 

Consultation with the doctor is necessary and advised if a person experiences pain, problems with the menstrual period, and discomfort in the pelvic region and abdomen. It is recommended to contact the doctor if the period is irregular or absent and there is pooling of blood in the vagina. Once diagnosed, it is strictly advised to consult the doctor for treatment.

Although the clinical symptoms do not always indicate the vaginal septum, they do indicate other vaginal conditions that need diagnosis and treatment. The different situations that necessitate consultation are difficult menstrual hygiene, e.g., improper fitting or insertion of tampons, prolonged periods, choice of pregnancy, pelvic and urinary tract issues, unexplained or persistent pelvic pain, diagnosis of associated conditions of the urinary system, emotional and psychological concerns and when the condition is doubtful. 

Frequently Asked Questions  

What is the cervical septum? 

It is a partition of fibrous tissues that develops during foetal development and divides the cervix into two halves. A tissue membrane runs in the middle of the cervix and divides it into two equal parts. It is also a congenital anomaly, just like the vaginal septum.

Is it possible to get pregnant while having a vaginal septum? 

Yes, it is possible, and many women with vaginal septum do become pregnant, although it is sometimes challenging to carry the pregnancy to term. As the tissues in the vaginal septum have poor blood supply, infertility is mainly associated with issues with implantation. 

Is a septate uterus associated with PCOS? 

A higher risk and percentage of PCOS was reported in people with a uterine septum, and a study noted that 31% of people with PCOS have uterine anomalies in the form of septate uterus or arcuate uterus. 

Is it possible to have a normal delivery with a septate uterus? 

Yes, it is possible to have a normal birth and delivery while having a septum in the vagina, although the risks are too high and occasionally, interventions are necessary. 

Does ultrasound detect the septate uterus? 

Yes, a skilled ultrasonographer can quickly diagnose a septate uterus by sweeping the probe on the uterus using just a two-dimensional ultrasound. However, a 3-D ultrasound is better for this job.

Bottom-line  

The vagina septum is a wall of fibrous tissues that separates the vagina into various parts and canals. It is a congenital anomaly and has been primarily present since birth. Also known as Mullerian anomaly, it occurs during pregnancy as the foetus develops in the uterus. 

It occurs in three different forms, obstructed hemi-vagina, a transverse vaginal septum and a longitudinal vaginal septum. It causes a variety of symptoms, e.g., pooling of menstrual blood in the vagina, difficulty while inserting tampons and a total absence of menstruation. 

The most common test to diagnose it is the pelvic exam; imaging tests are occasionally used for this purpose. As soon as it is asymptomatic, it doesn't require treatment. However, sometimes, it causes painful symptoms and needs surgical resectioning to remove and treat it. Visit our page about Women's Health to explore various products, blogs, and tests related to women's health.