Primary amenorrhea with transverse vaginal septum and scant hematocolpos: A case report

Lori Homa, Semara Thomas, Joseph Sanfilippo

Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, USA.
Department of Obstetrics, Gynecology and Reproductive Science, University of Pittsburgh School of Medicine, Pittsburgh, USA.

DOI: 10.4236/ojped.2012.21015                

Abstract

Background: A genital outflow tract obstruction is an uncommon cause of primary amenorrhea. If ovulation occurs, menstrual bleeding is prevented. Patients typically present with abdominal/pelvic pain due to hematocolpos. Absence of significant hematocolpos could indicate a secondary source of primary amenorrhea and be challenging to the clinical diagnosis. Case: 17 year-old patient with primary amenorrhea, appropriate Tanner staging secondary sex characteristics, and transverse vaginal septum presents with virtual absence of hematocolpos. After vaginal septum resection, the patient began menstruating, although only evidenced by two cycles of vaginal spotting. Conclusion: Significant hematocolpos is an expected sequella of distal outlet obstruction when collated with secondary sexual characteristics. Absence of such along with suboptimal return of menstruation reflects pathophysiology which may be attributed to a coexistent disorder of the hypothalamus or higher central nervous system function.

Keywords

Amenorrhea; Hematocolpos; Distal Obstruction; Hypothalamic Dysfunction

Conflicts of Interest

The authors declare no conflicts of interest.

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