A double uterus is a rare congenital abnormality. In a female fetus, the uterus starts out as two small tubes. As the fetus develops, the tubes normally join to create one larger, hollow organ — the uterus.
Sometimes, however, the tubes don't join completely. Instead, each one develops into a separate structure. A double uterus may have one opening (cervix) into one vagina, or each uterine cavity may have a cervix. In many cases, a thin wall of tissue runs down the length of the vagina, dividing it into two separate openings.
Women who have a double uterus often have successful pregnancies. But the condition can increase the risk of miscarriage or premature birth.
A double uterus often causes no symptoms. The condition may be discovered during a regular pelvic exam or during imaging tests to determine the cause of repeated miscarriages.
Women who have a double vagina along with a double uterus may initially consult a doctor for menstrual bleeding that isn't stopped by a tampon. In these situations, the woman has placed a tampon in one vagina, but blood is still escaping from the second uterus and vagina.
When to see a doctor
Seek medical advice if you have a menstrual flow despite the insertion of a tampon, or if you have severe pain with menstruation or experience repeated miscarriages.
Doctors aren't certain why some fetuses develop a double uterus and others don't. A genetic component may be a factor because this rare condition sometimes runs in families.
Many women with a double uterus have normal sex lives, pregnancies and deliveries. But sometimes a double uterus and other abnormalities of uterine development are associated with:
- Premature birth
- Kidney abnormalities
A double uterus may be diagnosed during a routine pelvic exam when your doctor observes a double cervix or feels an abnormally shaped uterus. If your doctor suspects an abnormality, he or she may recommend any of the following tests:
- Ultrasound. This test uses high-frequency sound waves to create images of the inside of your body. To capture the images, a device called a transducer is either pressed against your abdominal skin or inserted into your vagina (transvaginal ultrasound). Both types of ultrasound may be done to get the best view. A 3-D ultrasound may be used where available.
- Sonohysterogram. The sonohysterogram (son-o-HIS-ter-o-gram), an ultrasound scan, is done after fluid is injected through a tube into your uterus by way of your vagina and cervix. This allows your doctor to look for problems in the shape of your uterus.
- Magnetic resonance imaging (MRI). The MRI machine looks like a tunnel that has both ends open. You lie down on a movable table that slides into the opening of the tunnel. This painless procedure uses a magnetic field and radio waves to create cross-sectional images of the inside of your body.
- Hysterosalpingography. During a hysterosalpingography (his-tur-o-sal-ping-GOG-ruh-fe), a special dye is injected into your uterus through your cervix. As the dye moves through your reproductive organs, X-rays are taken to determine the shape and size of your uterus and whether your fallopian tubes are open.
If you have a double uterus but you don't have signs or symptoms, treatment is rarely needed. Surgery to unite a double uterus is rarely done — although surgery may help you sustain a pregnancy if you have a partial division within your uterus and no other medical explanation for a previous pregnancy loss.
If you have a double vagina in addition to a double uterus, you might be a candidate for an operation that would remove the wall of tissue separating the two vaginas. This can make childbirth a little easier.
Preparing for an appointment
You're likely to start by seeing your primary care provider. You might be referred to a doctor who specializes in conditions affecting the female reproductive tract (gynecologist) or a doctor who specializes in reproductive hormones and optimizing fertility (reproductive endocrinologist).
What you can do
To prepare for your appointment:
- Ask if there's anything you need to do in advance to prepare for any possible tests.
- Make a list of any menstrual symptoms you've had and for how long.
- Make a list of your key medical information, including any other conditions for which you're being treated and the names of any medications, vitamins, herbs or supplements you're taking.
- Take a family member or friend along, if possible, to help you remember everything.
- Make a list of questions to ask your doctor to help you make the most of your visit.
Some basic questions to ask your doctor include:
- What is the most likely cause of my signs and symptoms?
- Are there any other possible causes?
- What treatment approach do you recommend, if any?
- Am I a candidate for surgical treatment? Why or why not?
- Am I at increased risk of problems during pregnancy?
- What options are available to improve my chances of a successful pregnancy, if necessary?
- Should I see a specialist?
- Are there any brochures or other printed materials that I can have? What websites do you recommend?
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
- What are your signs and symptoms, and when did you first notice them?
- Are your signs and symptoms continuous, or do they come and go?
- Do you menstruate regularly?
- What is a typical menstrual period like for you?
- Have you ever been pregnant?
- If you have been pregnant, what was the outcome?
- Do you hope to have biological children in the future?
- Are you currently being treated or have you recently been treated for any other medical conditions?
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