Thedidelphic uterus is a rare congenital malformation affecting 0.3% of women. When asymptomatic, this uterine anomaly often goes unnoticed. In fact, it is difficult to detect during a follow-up gynecological examination. But what is a didelphic uterus? And what risks can it pose to health and pregnancy? Let's find out.
What is a didelphic uterus?
Before focusing on the case of the didelphicuterus, let's recall a few general notions about theuterus. The uterus is a hollow muscular organ of the female reproductive system. Located between the rectum and the bladder, it receives the fertilized egg, protects it throughout gestation and expels it when it reaches maturity.
The womb is made up of several parts : the cervix, body and fundus . Its walls are lined with three distinct layers: theendometrium (uterine mucosa), the myometrium (inner muscular layer) and the perimetrium (outer serous layer).
Each woman' s uterine morphology is unique. Health professionals distinguish between different uterine shapes (straight, anteverted or retroverted), all of which are completely normal.
However, some patients suffer from a matrix malformation. In 5% of cases, this is a didelphys uterus. This congenital anomaly, also known as "double uterus" or "uterine didelphia",results in the presence of two independent uterine cavities in affected women.
Frequently confused withbicornuate uterusthedidelphic uterus is divided into two subtypes:
- Didelphe bicervical (two vaginas, two cervixes and two uterine cavities) ;
- Didelphe unicervical(one vagina, one cervix and two uterine cavities).
What causes didelphe uterus malformation?
Theuterus is formed duringorganogenesis, from the 7th week of pregnancy. The womb of a female baby normally develops in three stages:
- Between weeks 6 and 9, the Müllerian ducts migrate towards the urogenital sinus;
- From the 9th to the 13th week, the lower part of these ducts fuse. This phase creates the upper two-thirds of the vagina and the cavity of the uterus, which is divided by an inter-Müllerian septum;
- Between the 13th and 17th weeks, this septum dissolves and uterine formation is complete.
A double uterus results from an anomaly in embryonic development during the second stage of differentiation of thefemale reproductive system. The Müller ducts do not join, resulting in the formation of two separate cavities .
What impact does a didelphic uterus have on health?
Women with a didelphic uterus do not always experience symptoms. However, some may experience severe pain during menstruation and intercourse, bleeding periods and difficulty using tampons. Others experience various complications during pregnancy.
Menstrual pain or heavy bleeding
Sometimes, a double uterus can cause menstrual problems. This matrix anomaly can lead to :
- Severe pelvic pain during men struation(dysmenorrhea or painful periods);
- Very heavy bleeding(heavy periods or menorrhagia);
- Two periods per month.
Difficulty using internal sanitary protection
Using internal sanitary also remains difficult in the case of a didelphic uterus. Indeed, if you have a bicervical didelphic uterus and two vaginas, inserting a tampon or a menstrual cup will be complicated, and the risk of leakage will be high.
We therefore advise you to use sanitary towels or menstrual menstrual pants. These are ideal for absorbing the blood draining from the uterine cavity during menstruation.
Pain during intercourse
Having a didelphic uterus can sometimes cause more or less intense pain during interc ourse (dyspareunia). Some women may experience localized pain at the entrance to their vagina( s) when the penis is inserted, or deeper pain throughout the pelvic area during penetration.
Complications during pregnancy
While this uterine malformation does not generally affect fertility, it can be the cause of a number of complications during pregnancy. complications during pregnancy. A double uterus increases the risk of fetal growth retardation, miscarriage, premature birth and malpositioning of the baby during delivery.
In very rare cases, gestation in a didelphic uterus may be characterized by the presence of two fetuses developing independently in each uterine cavity. Monitoring of this pregnancy will therefore need to be very rigorous in order to bring it to term.
How is a didelphe uterus diagnosed?
As we've seen, a double uterus does not systematically give rise to symptoms. Identifying it during a gynaecological check-up is therefore not always easy. A woman experiencing repeated miscarriages or severe pain during menstruation, for example, will be prescribed a medical imaging examination to detect a possible malformation.
In the first instance, a conventional or 3D pelvic ultrasound scan will provide an overall view of the uterus and help diagnose a didelphic uterus. Secondly, the gynaecologist may perform a hysteroscopy toexplore the interior of the cavities using a small probe equipped with a camera.
In an emergency, an MRI (Magnetic Resonance Imaging) will also be able toquickly identify a didelphic uterus.
Is there a treatment for a didelphic uterus?
Today, there is a surgical procedure for reconstructing a double uterus. If this is not an option, patients can turn to natural methods to alleviate their symptoms.
Strassman metroplasty, a surgical treatment to reconstruct a double uterus
Strassman metroplasty is a medical procedure designed to repair a didelphic uterus. This surgical procedure involves reuniting the patient's two uteruses into a single one. It is not always possible, however, as the two matrices are not necessarily the same size. What's more, it is usually reserved for very specific cases.
Natural methods to relieve symptoms of uterine didelphia
To alleviate some of the symptoms associated with uterine didelphia, you can turn to natural remedies. Here are a few tips to reduce your flow and ease uterine spasms:
- Drink herbal teas made fromyarrow (renowned for its antispasmodic properties) or coriander seeds;
- Apply a cold compress to your lower abdomen to constrict blood vessels and reduce bleeding;
- Usenettle in soup, decoction or mixed in a drink to reduce blood flow.
To prevent iron-deficiency anemia caused by bleeding periods, eat iron-rich foods such as legumes, green leafy vegetables, egg yolks and red meat.
Finally, to relieve menstrual pain, we recommend placing a hot water bottle on your stomach and lower back. You can also massage yourself with a vegetable oil in which you have diluted three drops of tropical basil essential oil.
