What is Uterus Didelphys?
When a female foetus develops, the uterus starts as two small tubes called Mullerian ducts. Normally, these tubes fuse together to form a single, hollow organ shaped like an upside-down pear. In uterus didelphys, these ducts don’t join properly and result in two separate uteruses. Each uterus is narrower than a typical uterus and has its own fallopian tube and ovary. Some individuals with this condition also have two cervixes or even two vaginal canals separated by a thin tissue wall, resembling the shape of bananas rather than a pear. This condition is rare and affects only about 0.3 per cent of the total population, making it one of the least common uterine abnormalities.Unlike a bicornuate uterus, which is a single, heart-shaped uterus, uterus didelphys involves two distinct uteruses. Both are congenital, but a bicornuate uterus is more common.
Causes of Uterus Didelphys
The exact reason why some people develop uterus didelphys isn’t fully understood. It happens when the Mullerian ducts fail to fuse during foetal development, leading to the formation of two separate uteruses. In some cases, this can also result in two cervixes or a vagina divided by a thin membrane. Researchers suspect genetics might play a role, as the condition sometimes runs in families. But no specific cause has been pinpointed. More research is needed to understand the underlying factors.Symptoms of Uterus Didelphys
Many individuals with uterus didelphys don’t experience any symptoms, so the condition often goes undetected unless discovered during a routine exam or while investigating other issues. When symptoms do occur, they’re usually related to menstruation or sexual activity and can vary in intensity.- Painful periods: You might feel severe cramping or pelvic pressure before or during your period due to the smaller size of the uterus.
- Heavy menstrual bleeding: The condition can cause abnormally heavy periods.
- Pain during sex: Some people experience discomfort or pain during intercourse, especially if there’s a vaginal septum dividing the vagina.
- Tampon issues: A tampon may not be fully effective during menstruation if there are two vaginal canals. It typically absorbs blood from only one canal, so the other may continue to bleed.
Diagnosis of Uterus Didelphys
Doctors often discover uterus didelphys during a routine pelvic exam or when investigating issues like severe menstrual pain or repeated pregnancy loss. If your doctor suspects you have a double uterus, they’ll likely recommend imaging tests to confirm the diagnosis and examine the size and shape of your uteruses.Pelvic exam: Your doctor may feel two cervixes or an unusually shaped uterus during a routine check-up.
- Ultrasound: This test uses high-frequency sound waves to create images of your uterus. An abdominal ultrasound involves applying a device to your stomach, while a transvaginal ultrasound uses a wand inserted into your vagina for clearer images.
- Sonohysterogram: A thin tube is inserted into each uterus to inject saline, followed by a transvaginal ultrasound to visualise the uterine cavities as the fluid moves through.
- Magnetic Resonance Imaging (MRI): This uses magnetic fields and radio waves to produce detailed images of your uterus. It requires you to lie still in a tunnel-like machine.
- Hysterosalpingography (HSG): A dye is injected into each uterus through the cervix, and X-rays track the dye’s movement to reveal the uterus’s shape and size.
- Vaginoscopy: A small instrument examines the vaginal vault and cervix to check for a double cervix or vaginal septum.
- Hysteroscopy: A tiny telescope is inserted into the vagina to directly view the uterus and confirm the presence of two uterine cavities.
Associated Conditions
Uterus didelphys can sometimes be linked to other health issues, particularly affecting the kidneys, as the Mullerian ducts develop alongside the Wolffian ducts, which form parts of the kidney system. Some individuals with a double uterus may have a mispositioned or missing kidney due to developmental issues with the Wolffian duct.Questions to Ask Your Doctor
You might want to ask your doctor some key questions to better understand your condition if you’re diagnosed with uterus didelphys:- What caused my double uterus?
- Are there any health concerns I should be aware of?
- How will this affect my periods or overall health?
Uterus didelphys is a rare but manageable condition that many people may not even realise they have. While it can affect menstruation, sexual health, and fertility in some cases, others may experience few or no symptoms at all. If you’ve been diagnosed, being aware of how your body functions can help you make better decisions and ask the right questions.
FAQs on Can a Woman Have Two Uteruses? Causes, Signs, and How It's Found
- How is a uterus didelphys different from a bicornuate uterus?
A bicornuate uterus is heart-shaped with a partial divide, while a uterus didelphys involves two completely separate uteruses, often with two cervixes. - How is uterus didelphys diagnosed?
Diagnosis often happens during a pelvic exam or through imaging tests like ultrasound, MRI, or hysterosalpingography.
