Vaginal Atresia and Agenesis
Vaginal Atresia
Vaginal atresia is a rare congenital vaginal condition, meaning it’s present at birth. In this condition, the vaginal canal is either partly or completely closed. It happens when the vagina doesn’t fully form during development before birth. Some people may not notice symptoms until puberty, when periods don’t start as expected or when the buildup of menstrual blood builds up and causes pain in the abdomen.
Vaginal Agenesis
Vaginal agenesis is another rare condition that is also present at birth. In this case, the vaginal canal is completely missing and never developed. Sometimes, the uterus may also be small or absent. Like vaginal atresia, this condition is often discovered during the teen years, especially if periods haven’t started.
What’s the Difference Between Vaginal Atresia and Vaginal Agenesis?
Vaginal atresia and vaginal agenesis are both congenital vaginal conditions, which means they are present at birth. They affect how the vaginal canal develops. The key difference is that vaginal atresia means the canal is there but blocked or closed, while vaginal agenesis means the canal never formed at all.
If you think your child may have a congenital vaginal condition, it’s normal to have questions and to feel overwhelmed. At CHRISTUS Health, our team of experts is here to help you understand your child’s treatment options. Your health care team will work closely with you to create a personalized treatment plan focused on your child’s long-term health, comfort, and confidence.
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Causes of Congenital Vaginal Conditions
Congenital vaginal conditions, such as vaginal atresia and vaginal agenesis, occur during early development in the womb. This happens when the reproductive system does not form as expected. In most cases, the exact cause is unknown—and nothing a parent did or didn’t do caused it.
Vaginal atresia or agenesis may occur on their own or as part of a genetic syndrome such as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, Bardet-Biedl syndrome, or Fraser syndrome, which can also affect other parts of the body like the kidneys, eyes, or limbs.
Symptoms and Signs of Vaginal Conditions
The symptoms of vaginal atresia and vaginal agenesis vary depending on how the condition affects the body. These conditions are often noticed when the child is young if there is no visible vaginal opening. But in many cases, it isn’t diagnosed until adolescence—often when a young woman doesn’t begin having periods by around age 15, even though other signs of puberty have started.
Common signs include:
- No visible vaginal opening
- No menstrual periods, known as amenorrhea
- Pain or pressure in the lower abdomen
- A pelvic mass caused by menstrual blood that cannot leave the body if the uterus is present
If you think your child may be showing these symptoms, talk to your doctor. With the right care and expertise, these conditions can be treated, and your child can lead a healthy, confident life.
Treatment for Vaginal Conditions
Usually, the first recommendation for treatment for vaginal atresia or vaginal agenesis is to use vaginal dilators to safely create or enlarge the vaginal opening and canal. Many women don’t need to start treatment until their late teens or early 20s, depending on their condition and personal choice. Your doctor can help you decide when to start treatment and the best method for dilation.
If your child’s condition requires more medical intervention, your doctor may recommend constructive surgery, called vaginoplasty. They will use a tissue graft to construct a vaginal opening and canal. Recovery may include self-dilation to maintain the vaginal canal after surgery.
Recovery from Surgery
After surgery, you will have several follow-up appointments with your doctor to make sure your recovery is going well. Your doctor may also prescribe dilation therapy after surgery to ensure your vaginal canal is maintained.
If needed, your doctor may recommend talking to a psychiatrist or therapist to support your mental health related to your reproductive health and body image.