What is a vaginal septum?

A vaginal septum is a condition that happens when the female reproductive system doesn’t fully develop. It leaves a dividing wall of tissue in the vagina that’s not visible externally.

The wall of tissue can run vertically or horizontally, dividing the vagina into two sections. Many girls don’t realize they have a vaginal septum until they reach puberty, when pain, discomfort, or an unusual menstrual flow sometimes signal the condition. Others don’t find out until they become sexually active and experience pain during intercourse. However, some women with a vaginal septum never have any symptoms.

There are two types of vaginal septum. The type is based on the position of the septum.

Longitudinal vaginal septum

A longitudinal vaginal septum (LVS) is sometimes called a double vagina because it creates two vaginal cavities separated by a vertical wall of tissue. One vaginal opening may be smaller than the other.

During development, the vagina begins as two canals. They usually merge to create one vaginal cavity during the last trimester of pregnancy. But sometimes this doesn’t happen.

Some girls find out they have an LVS when they start menstruating and use a tampon. Despite inserting a tampon, they might still see blood leaking. Having an LVS can also make intercourse difficult or painful due to the extra wall of tissue.

Transverse vaginal septum

A transverse vaginal septum (TVS) runs horizontally, dividing the vagina into a top and bottom cavity. It can occur anywhere in the vagina. In some cases, it can partially or fully cut off the vagina from the rest of the reproductive system.

Girls usually discover they have a TVS when they start menstruating because the extra tissue can block the flow of menstrual blood. This can also lead to abdominal pain if the blood collects in the reproductive tract.

Some women with a TVS have a small hole in the septum that allows menstrual blood to flow out of the body. However, the hole might not be large enough to let all the blood through, causing periods that are longer than the average of two to seven days.

Some women also discover it when they become sexually active. The septum can block the vagina or make it very short, which often makes intercourse painful or uncomfortable.

A fetus follows a strict sequence of events as it develops. Sometimes the sequence falls out of order, which is what causes both LVS and TVS.

An LVS occurs when the two vaginal cavities that initially form the vagina don’t merge into one before birth. A TVS is the result of ducts inside the vagina not merging or developing correctly during development.

Experts aren’t sure what causes this unusual development.

Vaginal septums usually require a doctor’s diagnosis since you can’t see them externally. If you have symptoms of a vaginal septum, such as pain or discomfort during intercourse, it’s important to follow up with your doctor. Many things can cause symptoms similar to those of a vaginal septum, such as endometriosis.

During your appointment, your doctor will start by looking at your medical history. Next, they’ll give you a pelvic exam to check for anything unusual, including a septum. Depending on what they find during the exam, they may use an MRI scan or ultrasound to get a better look at your vagina. If you do have a vaginal septum, this can also help to confirm whether it’s an LVS or TVS.

These imaging tests will also help your doctor check for reproductive duplications that sometimes occur in women with this condition. For example, some women with a vaginal septum have additional organs in their upper reproductive tract, such as a double cervix or double uterus.

Vaginal septums don’t always require treatment, especially if they aren’t causing any symptoms or impacting fertility. If you do have symptoms or your doctor thinks your vaginal septum could lead to pregnancy complications, you can have it surgically removed.

Removing a vaginal septum is a very straightforward process involving minimal recovery time. During the procedure, your doctor will remove the extra tissue and drain any blood from previous menstrual cycles. Following the procedure, you’ll likely notice that intercourse is no longer uncomfortable. You might also see an increase in your menstrual flow.

For some women, having a vaginal septum never causes any symptoms or health concerns. For others, however, it can lead to pain, menstrual issues, and even infertility. If you have a vaginal septum or think you might, make an appointment with your doctor. Using some basic imaging and a pelvic exam, they can determine whether your vaginal septum could lead to future complications. If so, they can easily remove the septum with surgery.