These developmental issues may involve any part of the reproductive tract such as the vagina, cervix, uterus, or ovaries. In this discussion, we shall focus on developmental problems involving the vaginal opening.
Development of the female genital tract occurs at around the fourth and fifth weeks of the pregnancy and continues up until week 20.
Problems that may occur during development of the genital tract include the following issues:
- Mutated or missing genes - defects in genes can result in the body not producing an important enzyme called 21-hydroxylase. This enzyme is needed by the adrenal glands of the body to produce the hormones aldosterone and cortisol which influence the appearance of the external genitalia. Lack of 21-hydroxylase will result in the outer vagina appearing like the external genitalia found in boys.
- Using certain medications and drugs during the pregnancy - medications such as diethylstilbestrol (DES) which was previously used to help prevent miscarriages and early labour was noted to interfere with the development of the female genital tract.
Conditions that affect the Vaginal Opening
Certain conditions can cause either the vaginal opening to stay closed or for the vagina to not develop entirely.
These may include the following problems:
- Cloacal abnormalities - in the early stages of foetal development, the vagina, rectum, and urinary tract all empty into a single tube known as the cloaca. If this anatomical structure persists and does not divide into the mentioned separate openings, then the baby girl is born with only one opening at the area near the rectum.
- Fused labia - here, the folds of tissue around the opening of the vagina are fused together.
- Imperforate hymen - this is a condition where the thin tissue that normally partly covers the opening to the vagina completely covers this opening. The result is a very painful swelling of the vagina. Other variations of an imperforate hymen include a very small opening to the vagina or tiny small holes in the hymen. This condition may only be discovered around puberty when the affected girl starts to menstruate but no or very little blood passes out of the vagina, or they start to complain of lower abdominal swelling and pain as a result of blood building up in the uterus.
- Problems involving the vagina - some females may be born without a vagina or the opening of the organ may be blocked by cells that are located higher up in the vaginal vault than where the hymen is situated. The condition associated with a missing vagina is called Mayer-Rokitansky-Hauser syndrome where the baby is born missing part of or all of her internal reproductive organs.
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