A vaginal septum happens when a partition of tissue separates the vagina into two parts. It may run either vertically or horizontally. The effects may become noticeable when menstruation starts. Some people may need surgery.

A vaginal septum refers to a congenital condition where the female reproductive system does not fully develop. A septum describes a partition, meaning that a vaginal septum denotes a dividing wall of tissue in the vagina that is not visible externally.

Many individuals may not realize they have a vaginal septum until they reach puberty. At this point, symptoms such as pain, discomfort, or an unusual menstrual flow may indicate the condition. Others may not be aware of the septum until they become sexually active and experience pain during intercourse. In other cases, some people with a vaginal septum may not experience any symptoms.

This article explores the different types of vaginal septa, how a person can tell if a vaginal septum is present, and what treatment they may require.

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A vaginal septum is a congenital condition, meaning that it is present from birth. This is because the septum normally forms while the fetus is still developing in the womb.

It is a gynecological condition that results in a wall of fibrous tissue that divides the vagina into two parts. The septum can run across the vagina either vertically or horizontally. Depending on how and where the septum forms, a person may notice irregularities with their period, or difficulty with tampon insertion or vaginal intercourse

There are three types of vaginal septa. These include:

  • longitudinal vaginal septum
  • transverse vaginal septum
  • obstructed hemi-vagina

Longitudinal vaginal septum

A longitudinal vaginal septum, also known as a vertical or complete vaginal septum, describes a wall of fibrous tissue that runs along the vagina’s length. It divides the vagina into two channels.

A longitudinal vaginal septum is normally nonobstructive, meaning it does not block menstrual blood flow. However, a person may notice difficulty with tampons or pain during sexual activity.

Transverse vaginal septum

A transverse vaginal septum refers to when the wall of tissue is present across the width of the vagina. The septum may have a low, middle, or high position in the vagina, but more commonly occurs in the lower part of the vagina.

A transverse vaginal septum can completely block the vagina and impede menstrual flow, known as a complete transverse. A perforated transverse vaginal septum describes when the tissue only partially blocks the vagina and contains an opening that allows for the passage of menstrual blood. Transverse vaginal septa are relatively rare, with an incidence of 1 in 30,000 women.

Obstructed hemi-vagina

An obstructed hemi-vagina occurs where the septum partially divides and blocks half of the vagina. A person with an obstructed hemi-vagina may also experience other complications, such as:

  • a double uterus
  • a double vagina
  • a missing kidney

A person with an obstructed hemi-vagina may also notice that they have normal menstrual flow on one side of the vagina and an obstruction on the other.

In some cases, it may be difficult to identify if a person has a vaginal septum, as they are not visible externally and may not present with any symptoms to indicate the condition. However, certain symptoms may suggest the presence of a vaginal septa.

A person with a longitudinal vaginal septum may experience:

  • difficulty inserting a tampon
  • persistent vaginal bleeding
  • painful menstrual periods

A person with a transverse vaginal septum may experience:

  • abdominal pain
  • periods that last longer than 4–7 days
  • the absence of a period, known as amenorrhea
  • pooling of menstrual blood in the vagina, known as a hematocolpos

A person with an obstructed hemi-vagina may experience:

In addition, a person with a vaginal septum may experience discomfort or pain during sexual intercourse.

The genetic cause of vaginal septa is currently unknown. Researchers believe that the condition is multifactorial, meaning it likely results from changes in multiple genes, with some influence from environmental factors.

Vaginal septa occur during fetal development and are known as Müllerian anomalies. The Müllerian ducts are a critical component of the female reproductive system. They are tubes present in the female reproductive tract that play a key role in the development of the entire reproductive system, including the fallopian tubes, the uterus, the cervix, and the upper portion of the vagina.

Typically, the Müllerian ducts fuse, and the fused sections resorb to form a cavity. However, sometimes a disruption occurs and the ducts do not fuse properly, which can lead to a vaginal septum.

A person will need to consult a doctor to receive a diagnosis of a vaginal septum. This may be a gynecologist, which is a doctor specializing in female health, with a particular focus on the the female reproductive system.

The doctor may ask the person if they are experiencing any symptoms and additional questions, such as if they are having difficulty with menstruation.

The doctor will normally then complete a physical examination, known as a pelvic exam, of the vagina to confirm that a septum is present. If the doctor cannot identify a septum, they may order additional tests to confirm the presence of a septum. These will normally consist of imaging scans and may include an ultrasound or an MRI scan.

A vaginal septum may not require treatment if the person is not experiencing symptoms such as pain, and the septum is not causing obstructions to menstrual flow.

However, if the vaginal septum is causing symptoms and obstructing menstrual flow, a person may require treatment. The most common treatment option that a doctor may use to treat a vaginal septum is surgical resection.

Surgical resection is a procedure that involves the removal of the fibrous septal tissue. A person will normally be under general anesthesia during the operation, meaning that they will not be awake during the procedure. Surgical resection takes between 1–3 hours.

There are potential complications, both with a vaginal septum as well as surgical resection to treat vaginal septa. If a person does not receive treatment, a vaginal septum may interfere with sexual intercourse, menstruation, and childbirth.

Side effects of a vaginal septum resection can include light bleeding and soreness. Potential complications that may occur after a vaginal septum resection may include:

  • scarring
  • narrowing of the vagina, known as stenosis
  • injury to the bladder or rectum
  • bleeding

To prevent these complications, a doctor may give a person a vaginal dilator. This is a device that expands the vagina to prevent it from narrowing and to restore vaginal capacity and flexibility. Alternatively, the surgeon may place a vaginal stent to prevent narrowing.

A person should consult a doctor if they are experiencing problems with menstruation or pain and discomfort in the abdomen or pelvic region. A person should also contact their doctor if their period is irregular or absent or if they experience pooling of blood in the vagina.

While these symptoms may not necessarily indicate a vaginal septum, they may indicate a different condition that may still require a doctor’s diagnosis.

A vaginal septum refers to a wall of tissue that separates the vagina into two canals, which is present from birth. It is known as a Müllerian anomaly and occurs when the fetus is developing in the womb. There are three different types of vaginal septa: a longitudinal vaginal septum, a transverse vaginal septum, and an obstructed hemi-vagina.

A person may experience symptoms such as painful periods, difficulty inserting a tampon, pooling of menstrual blood, or the absence of a period. A doctor can normally diagnose a vaginal septum after performing a pelvic exam. A person may not require treatment if they are not experiencing symptoms. However, some individuals may require a surgical resection to remove the septum.