Double uterus

Overview

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.

Symptoms

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.

Causes

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.

Complications

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:

Infertility
Miscarriage
Premature birth
Kidney abnormalities

Diagnosis

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.

Treatment

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?

Conditions Glossary