One Woman, Two Reproductive Systems

The headlines come once in a blue moon, but they jump out at you. "Woman in Wisconsin Gives Birth to Twins from Two Different Wombs." "Sixteen-year-old with Two Menstrual Cycles Told She Has Double Vaginas."

Did they bring back the Weekly World News? No, we could never be that blessed.

But it is, in fact, biologically possible for a woman to have two functioning reproductive systems, thus two periods and a bun in each oven. The condition is called uterine didelphys. While many cases of uterine didelphys involve a woman having two uteruses, some cases involve two cervixes and two vaginas.

"It's very rare," said Miriam Cremer, M.D., M.P.H., an OB-GYN at the Cleveland Clinic. "The prevalence is 0.1 to 0.5 percent. If you do thousands of procedures, as I have in my career, it comes up."

Cremer noted that unless there is pain from a blockage in one of the vaginal canals, women typically don't know they have this condition. Many times it is discovered during a prenatal exam. "It doesn't present with a ton of pathologies," she said. "We'll notice it when we do the ultrasound and the stenographer tells you that [there are] two uteri."

The cause for this malformation is not known, and women are born with the condition, according to Anne-Marie Amies Oelschlager, M.D., chief of adolescent and pediatric gynecology at Seattle Children's Hospital, and a board member of the American College of Obstetricians and Gynecologists (ACOG).

"During embryological development, the uterus, cervix and upper vagina develop together," Amies Oelschlager said. "Most of the time, fetal development starts with two uterine structures that, over the course of development in the womb, join together in the midline. The wall between the two sides of the uteri and the two sides of the vagina typically open as the two sides join. Approximately 1 in 30 females will be born with a complete or partial wall between the two sides of the uterus or the two sides of the vagina."

The problem with two vaginas

We know what you're thinking: Hmmm…two vaginas, kind of a good thing, is it not? But despite dubious claims on social media platforms, the condition doesn't guarantee a woman will double her pleasure. In fact, although uterine didelphys is not classified as a sexual disorder, it can make intercourse difficult or painful.

Structurally, the two vaginas are actually one vagina divided, with only one side big enough for penetration. In some women, like Brittany Jacobs, a popular TikTok creator from New Zealand, the second hole opens a few inches into the vagina, causing confusion and discomfort for her and her partner. In Jacobs' case, she didn't know she had uterine didelphys until she was in labor.

How do I know if I have uterine didelphys?

Experience varies per woman, but you should make an appointment with your gynecologist if you consistently have two periods a month, leak through tampons, regularly experience dyspareunia (pain during intercourse), or suffer from dysmenorrhea (abnormally painful menstrual cramps).

Beyond you noticing symptoms of uterine didelphys, your doctor may choose to examine you if they observe a double cervix or an abnormally shaped uterus. According to the Mayo Clinic, diagnosis involves a regular pelvic exam, confirmed by four methods:

• Ultrasound: A transducer is placed against your stomach skin or inserted into the vagina. A 3D ultrasound could be used as well.
• Sonohysterogram: Fluid is injected through the cervix and vagina and into your uterus. An ultrasound scan is then conducted to better see the shape of your uterus.
• MRI: Radio waves and a magnetic field are used to create images of the inside of your body.
• Hysterosalpingography: A special dye is injected into your uterus. As the dye moves throughout your body, X-rays are taken to capture the makeup of your reproductive system.

Living with uterine didelphys

Most women with this condition are able to have normal pregnancies and sex lives. There is, however, an increased risk of miscarriages, cesarean births, infertility, kidney problems and premature labor. If you have symptoms and want children, it is important to plan ahead.

Having a Pap smear for each cervix is also recommended, although only a few cases of uterine didelphys complicating cancer have been documented.

In cases with extreme pain, surgery may be necessary. "Most people with uterine didelphys will have a longitudinal vaginal septum, where both sides of the vagina will be open, and menstrual blood can come out through both sides. Some people will have a blockage of one side of the vagina," Amies Oelschlager said.

If there is a blockage of one side of the vagina, blood can back up in the vagina and uterus, leading to pain, and in some instances infection. Surgery to remove the vaginal wall that is blocking the menstrual blood from coming out is essential. Many women with a longitudinal vaginal septum, where both sides are open, experience pain with sexual intercourse or difficulty with using tampons. The vaginal septum can be removed in an outpatient procedure and both sides of the vagina are combined to make one vagina.

Removing the vaginal septum can also improve fertility outcomes. One small study published in the Archives of Gynecology and Obstetrics found that removal of the vaginal septum successfully treated uterine-didelphys-related infertility in 13 of 21 women.

While incredibly rare, having two cervixes, two vaginas and two uteri is totally possible. If you experience any symptoms of uterine didelphys, talk to your doctor about scheduling a diagnostic exam.