Uterus didelphys is a rare congenital condition in which a person has two uteruses. Each uterus may have its own opening, or both may share the same cervix.
In most cases, uterus didelphys does not cause signs or symptoms and is only found during gynecological exams. However, some people with this type of uterus may have pain during sexual intercourse, severe cramps before or during menstruation, and heavier menstrual bleeding.
People with uterus didelphys may also have more difficulty getting pregnant and a higher risk of recurrent miscarriage. Because of this, follow-up with a gynecologist is important to determine whether treatment is needed, especially when planning a pregnancy.
Main symptoms
In most cases, uterus didelphys does not cause noticeable signs or symptoms and is usually only discovered during a gynecological exam or related tests.
However, some people may experience symptoms such as:
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Pain during sexual intercourse (dyspareunia)
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Severe cramps that may happen before and/or during menstruation
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Heavier menstrual flow
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Abdominal pressure, especially during menstruation
Tampon use can also be more challenging, because a tampon placed in only one vaginal canal may not fully absorb menstrual flow, leading to frequent leakage. In some cases, uterus didelphys occurs along with two vaginal openings, which can make the condition easier to notice during a gynecological (pelvic) exam.
Can uterus didelphys affect pregnancy?
Uterus didelphys does not always prevent pregnancy, but it may be linked to a higher risk of complications during pregnancy. Compared with people who have a typical uterus, there may be a higher risk of miscarriage and preterm birth.
Confirming a diagnosis
Uterus didelphys is usually diagnosed by a gynecologist using imaging tests, such as ultrasound or magnetic resonance imaging (MRI).
In addition, the American College of Obstetricians and Gynecologists (ACOG) notes that hysterosalpingography is an X-ray exam that shows the inside of the uterus and fallopian tubes, which can also help identify abnormalities like uterus didelphys.
Possible causes
Uterus didelphys is a congenital condition that happens when the ducts that form the uterus, called the Müllerian ducts, do not fuse properly during development of the reproductive organs.
According to ACOG, obstructive uterovaginal anomalies can result from a failure of the Müllerian ducts to fuse, and the American Society for Reproductive Medicine (ASRM) classifies uterus didelphys among Müllerian anomalies of the female reproductive tract. This results in the formation of two uteruses.
Treatment options
If a person has uterus didelphys but does not have signs or symptoms or fertility problems, treatment is usually not needed.
However, in rare cases, a gynecologist may consider surgery when there are significant symptoms or repeated pregnancy loss associated with the uterine anomaly. This may be considered mainly when the person also has two vaginas.