Can you menstruate without a vagina?

Many people think that everyone has a reproductive system, both men and women. However, some women over 18 years old still do not have menstruation, and do not have normal secretions. They also feel abdominal distension and pain from time to time. In this case, it should be considered that there is no vagina. Vaginal closure is medically called a stone woman. This kind of woman will not have menstruation, and even if she does, the amount of menstruation will only be a little.

Diagnosis

1. Early adolescence is often neglected. If you examine carefully, you may or may not have a hymen, a shallow depression at the opening of the hymen, or a short and shallow lower vagina.

2. With or without uterine dysplasia. If the uterus develops abnormally and manifests as primary amenorrhea after puberty, the uterus will be small or deformed. If the uterus develops normally, primary amenorrhea will occur with cyclical abdominal pain, intrauterine blood, and enlarged uterus.

3. Sexual dysfunction. 4. Those with ovarian hypoplasia have incomplete development of secondary sexual characteristics, short stature, webbed neck, cubitus valgus and other deformities.

Long-term absence of menstruation

Girls over 18 years old have not yet had their periods, a phenomenon called "primary amenorrhea". There are many reasons for delayed menstruation during adolescence, including physiological, psychological factors and certain diseases. What people commonly call "stone women" actually refers to women who do not have menstruation due to some congenital developmental defects of their genitals. The clinical manifestations of stone women include hymen atresia, congenital absence of vagina or vaginal atresia, complete transverse vaginal septum, etc. This type of congenital defect does not attract people's attention when they are born. Some people only pay attention to it when they see delayed menstruation during puberty, while others are not discovered until they cannot have sex on their wedding night.

A normal woman has a vaginal opening below the urethra and above the anus, and is covered with a layer of circular thin membrane tissue, which is the hymen. A normal person's hymen has a small hole through which menstrual blood flows out. If there is no hole in the hymen, it is called hymen atresia. The uterus and vagina of this type of patient can develop normally, but menstrual blood accumulates in the vagina and cannot be discharged, forming hematoma. The hematoma can extend to the uterine cavity, fallopian tubes and flow back into the abdominal cavity. Due to the accumulation of blood, the patient had abdominal pain once a month, and the pain gradually became worse. The method for treating hymen occlusion is relatively simple. Just cut the hymen and release the blood. "Stone women" have no menstruation at all and cannot have sexual intercourse after marriage. Then we need to check whether it is "congenital absence of vagina". Because such people often do not have a uterus, they do not menstruate. Even though a few people have a uterus, menstrual blood cannot be discharged because they do not have a vagina. The treatment method is to recreate an artificial vagina through surgery, and then you can have sexual intercourse after the surgery.

No uterus and no vagina

Congenitally without uterus and vagina, that is, "double absence". It means that the hypothalamus, pituitary gland, ovaries and chromosomes are all normal, but the vagina is closed, there is no uterus in the pelvic cavity, only the corner uterus or the primordial uterus. Manifestations include primary amenorrhea and sexual intercourse disorders. In fact, she is just like male cryptorchidism, not truly without a uterus. Oral mucosa transplantation for vaginal reconstruction is universally recognized as the best surgical procedure, because the oral mucosa and vaginal mucosa are homologous tissues, there are no scars on the abdominal wall, and in fact oral sex is also a form of sexual intercourse. Compared with other surgical procedures (sigmoid colon replacement for vagina, corner vaginal reduction surgery), its advantages are no odor after surgery, less bleeding, less adhesion, and it is indistinguishable from the real thing. Before the operation, you should understand that this procedure only solves the problem of sexual life. To solve the problems of menstruation and fertility, you must first do oral mucosal vaginoplasty, and then do uterine-uterine fusion and endometrial transplantation half a year later to solve the problems of menstruation and fertility.

Clinical manifestations and diagnosis

The vast majority of patients with congenital anterior vaginal angulation only have completely closed vaginal vestibule mucosa at the normal vaginal opening, with no vaginal marks. Some patients also have a shallow depression in the vaginal vestibule, and some have a blind vagina shorter than 3 cm. In the position of the normal uterus, only a slightly thickened strip of tissue (congenital vaginal angulation) is seen, located in the middle of the broad ligament. About 1/10 of patients may have partial uterine development and functional endometrium. After puberty, due to menstrual blood retention, they experience periodic abdominal pain and amenorrhea, or are not diagnosed until they seek medical attention after marriage due to sexual intercourse difficulties.

It is often accompanied by other malformations. When the mesonephric duct is severely malformed, there is often incomplete renal rotation, low migration of the kidney, or migration to the pelvis, forming urinary tract malformations such as pelvic kidney, horseshoe kidney, transboundary renal ectopia (two kidneys located on the same side of the body), renal agenesis, and renal insufficiency. Literature reports that renal malformations account for more than 30% of RKH syndrome. Therefore, when vaginoplasty is performed in cases of congenital absence of vagina, intravenous pyelography should be performed before the operation to alert the presence of the above-mentioned malformations and avoid surgical injuries. In addition, patients with this disease also have skeletal deformities, accounting for about 10%, including spina bifida, sacral occult fracture, intervertebral fusion and non-segmental spinal cord.