Children's Hospital Colorado

Vaginal Septum

What is a vaginal septum?

A vaginal septum is an anomaly of the vagina that is congenital, meaning that it exists at birth. This anomaly forms in the reproductive tract during fetal development, while the baby is being formed in the mother's womb.

A septum is a partition that divides two chambers. Having a vaginal septum means that a partition of tissue has formed during fetal development that divides the vagina into two parts. This partition can interfere with menstruation, sexual function and childbirth.

Vaginal septa are categorized based on the way the septum has formed and how it is positioned. We use the following terms to describe different formations of vaginal septa: transverse or longitudinal (whether the septum runs across the vagina or lengthwise), obstructive or non-obstructive (whether the septum blocks menstrual flow), high or low (the septum's positioning in the vagina), and thin or thick (the thickness of the septal tissue).

  • Longitudinal vaginal septum – The septum runs along the length of the vagina and essentially divides the vagina into two canals. This type of septum does not block menstrual outflow.
  • Obstructed hemi vagina – The septum partially divides and blocks half of the vagina. This is almost always associated with a didelphys (double) uterus and a renal (kidney-related) anomaly on the same side of the block. Girls with this type of vaginal anomaly will have normal menstruation on one side and menstrual obstruction on the other side.

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  • Transverse vaginal septum – The septum runs across the width of the vagina and can be located at low, middle or high positions.
    • A complete transverse vaginal septum blocks the vagina, which obstructs the menstrual outflow.
    • A perforated transverse vaginal septum only partially blocks the vagina and contains an opening that allows passage of menses.

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What causes a vaginal septum?

Doctors don't completely understand the cause of vaginal anomalies. They are considered multifactorial, which means they are likely caused by defects in multiple genes, with some influence from factors in our environment.

The reproductive organs of a female begin developing around six weeks gestation (six weeks after conception) inside the mother's womb, or uterus. This occurs when two Müllerian ducts slowly migrate toward each other in the fetus and then fuse together in the middle. Some of the tissue migrates upwards to form the uterus and fallopian tubes and the remaining tissue migrates downwards to form part of the vagina. The Müllerian ducts fuse with the vaginal plate, which then forms a vaginal canal. Any disruption to this process may result in a malformation of the uterus or vagina. These types of malformations are known as Müllerian anomalies.

Who gets a vaginal septum?

A vaginal septum is a congenital anomaly that can happen to any woman. Doctors have not identified any specific risk factors that cause this condition. Vaginal anomalies can be isolated or can occur in association with other anomalies including renal anomalies, skeletal anomalies or anorectal malformations, which are anomalies that relate to the anus or rectum.