Discovery Fit & Health has had approximately five commercials in rotation today it seems. One such commercial highlighted the new season of their popular show Strange Sex. The commercial starts with a confused man saying, “Francis told me she was born without a vagina. I’d never heard of that before.” Around the eighth time this commercial played over a two hour period, additional research on my behalf finally ensued, because well, frankly I hadn’t heard of that either.
Me to TV, “What do you mean she has no vagina?! How does she go to the bathroom? What is down there then…?”
Vaginal atresia is a birth defect or congenital abnormality of the female reproductive system that manifests itself in the absence of a vagina. This birth defect is actually a well known occurrence. The anomaly is estimated to occur in about 5 percent of the female population. In 1983 it was estimated that about one in 4,000 females are affected, today the numbers are more like one in 5,000 affected. Visually speaking it’s not something that is necessarily obvious (Incase you thought these women looked like real life incorrect Barbie dolls. No, not the case.); the nature of the problem is that the vagina in fact resembles that of any virgin whose hymen is intact. Externally, the genital area is perfectly normal, with clitoris, labia, and urethra all in place. But where the vagina should be there is only a small dimple or indentation.
There are various causes for vaginal atresia, the most common being Rokitnasky-Mayer-Kuster-Hauser (RMKH) Syndrome. At around nine weeks, the duct elongates in females, and reaches the urogenital sinus, forming the uterovaginal canal”. Meaning I basically that male and female babies start out the same, but then depending upon the gender and genetics, the development differs slightly. Sometimes, due to genetics and pregnancy complications, there are misfires. Genetic testing in many cases has revealed that some birth defects revolving around openings and closings are a result of an unpreventable brief (could happen for less that 3minutes) oxygen supply cut off occurring between the 6th and 9th week of pregnancy. (Maybe like an umbilical cord was twisted) It’s not something that is passed down from mother to child.
Treatment for an absent vagina varies depending upon the distinctive situation of the patient, but generally its between two options. (Both treatment options lead to the ability to have an active sex life.) For example, some women only have their lower 1/3 missing, and surgery is required. Corrective surgery is rather simple.
Option two is that a self made vagina creation through what is known as a‘dilatation’ technique. That procedure is much slower and requires a certain degree of high motivation. The process begins with a ‘number one’ dilator, a tiny glass tube, like the smallest size of test tube, and requires the task of applying pressure for half an hour, morning and night, on where the vagina should be. The soft tissue slowly gives way to pressure, and definite indentation can appear, therefore leading to use of larger dilators. It can take up to two years to get up to a number four. (Which is over an inch in diameter and about five inches long.) And discontinuing use can cause the vagina to contract and begin to close up again. The concept behind the technique is that dilators will be used until regular sexual intercourse occurs, and the need for constant dilatation will dissipate. Intercourse is possible about two or three weeks after surgery, but it takes the better part of a year of applying dilators before intercourse can be attempted.
More presently it’s recommended that newborns be evaluated for vaginal absence because delayed detection can cause significant emotional and physical risks. Some women only become aware of the absence when they become of menstrual age, and they experience severe pain due to their abdomen becoming filled with menstrual fluid that cannot escape.
Overall it is usually unlikely that women in this condition will become pregnant, because when the vagina is absent, the uterus is almost always absent as well.
In 1988, a 15-year-old girl living in the small southern African nation of Lesotho, after puzzling doctors with her symptoms of labor pains, actually gave birth by Caesarean to a healthy baby boy. She didn’t have a vagina, only a shallow skin dimple. (The case report of this event was published in the British Journal of Obstetrics and Gynaecology, and more details can be read here)
Her birth defect was Mayer-Rokitansky-Küster-Hauser syndrome and her ability to become pregnant was very surprising. Review of her records revealed a previous hospitalization 278 days earlier with a knife wound to her stomach. The average pregnancy lasts 280 days. Further inquire into the matter brought to the surface that prior to the abdomen stabbing she was caught in act of performing fellatio with her present boyfriend, by her previous boyfriend. (Which thus led to the unfortunate knife fight.)
She arrived at the hospital with an empty stomach and two holes from a stab wound that opened her stomach up to her abdominal cavity. It’s reported that the doctors washed her stomach out with a salt solution and stitched her up. The case authors wrote that it was plausible that spermatozoa gained access to her reproductive organs through the injured gastrointestinal tract.
Typically because sperm needs a low acid (high pH) environment to survive, and the low pH of stomach acid isn’t an ideal, and more correctly a location for sperm to die; it’s noted that sperm does come in a protective fluid. Ejaculation provides a nourishing medium meant to protect it because it must make it out of the acidic environment of the vagina before reaching more friendly territory at the cervix and in the uterus. Long way to go, but not clearly not impossible. Fertilization characteristically takes place in the fallopian tubes but sperm can swim up and out of the reproductive organs into the abdominal cavity. In this particular class it was concluded that the sperm could also be taken up by the fallopian tube, as could a fertilized egg.
In 1983 She Magazine published an article about a woman, Susan, who in fact did not learn about her absence of a vagina until after many years passed without the arrival of her period. Doctor insisted until she was 18, that she was simply a late starter. They first sought to find answers in a hormonal imbalance and thought to jolt Susan’s hormones into action so an endocrinologist’s put her on the pill for a month; without results. That lead to a referral with the assumption that it it wasn’t hormone related, perhaps it was physiologically motivated. Wrong again. The actual reason why she had not yet menstruated was that she had no vagina, and only a vestigial uterus. Upon her diagnosis Susan’s preferred course of treatment was one that 50% of women at that time where making, and did not opt for surgery. She overcame her condition successfully though the previously explained dilatation, or pressure technique. (to read all about Susan story in further depth, click here.)
Back to the Discovery Channel and this Francis’ lady who motivated this (hopefully) informative posting; if you’re interested her particular absent vagina story (and her boyfriend/hubby (???)’s reaction) by all means tune into the new season of Strange Sex (check your local time and listing; season premiere is Aug 31!!) The show isn’t just about absent lady parts. http://health.discovery.com/
(image via: http://www.freestockimages.net/)