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Understanding Mullerian Anomalies: Congenital Uterine Disorders

June 16, 2025

Anomaly is a medical term that means certain deviations from how a body part should function. One such rare anomaly affecting the female reproductive tract is the Müllerian anomaly. Various types of Müllerian anomalies occur due to the issues with Müllerian duct development. While this might sound worrisome, understanding the symptoms of these anomalies can help in early diagnosis and treatment.

Go through this blog to learn more about the various Müllerian anomalies, their causes, and symptoms so that you can take appropriate measures at the right time.

What are Müllerian Anomalies?

Müllerian anomalies are associated with issues in the female reproductive tract. These anomalies are seen due to the non-development of the Müllerian ducts or issues in the fusion of the ducts. The Müllerian ducts in the female fetus fuse to form the female reproductive system, such as the uterus, vagina, cervix, and fallopian tubes. These anomalies can range from the most severe ones, like the absence of a uterus, to minor ones, like an arcuate uterus. A few of these uterine malformations may affect pregnancy. However, it is key to find out the issue as early as possible by recognising the symptoms.

Categories of Müllerian Anomalies

As already described, the Müllerian anomaly is a congenital disorder. They are classified based on the impacts, symptoms, causes, and treatment methods.

Septate Uterus

This is a typical condition that arises due to the division of the uterus cavity by a septum or wall. Two variants of this condition include septate uterus and subseptate uterus. In the septate uterus, the uterus cavity is completely divided by the septum. The symptoms of this condition include complicated pregnancies, like miscarriages, preterm labour, or painful periods.

Agenesis and Hypoplasia

This is a condition wherein the female reproductive organ is underdeveloped or completely absent. This anomaly is usually seen when there is a malformation of Müllerian ducts. Amenorrhoea is the main symptom in this case. Though there is no complete cure for this type of congenital anomaly, surgery and assisted reproductive measures can bring hope to all.

Bicornuate Uterus

This is a typical anomaly wherein the shape of the uterus is different and appears to be heart-shaped. This anomaly occurs due to the incomplete merging of the Müllerian ducts during fetal development. This shape of the uterus usually causes frequent miscarriages. The usual treatment methods include a surgical approach to merge the ducts and frequent follow-ups to avoid risks during pregnancy.

Arcuate Uterus

This congenital uterine anomaly usually has a lesser impact. In this case, the top of the uterus is intended or distorted. Incomplete absorption of the uterine septum causes this. This doesn't cause much health issues or pain. In some cases, pregnancies can be high risk, resulting in preterm delivery or low birth weight of the baby.

Unicornuate Uterus

In this condition, only one-half of the uterus gets developed. This anomaly is otherwise known as a single-horned uterus. This type of anomaly is caused by the non-development of one of the Mullerian ducts in the growing fetus. This anomaly manifests as symptoms like abdominal heaviness, pelvic pain or amenorrhoea. Surgical measures are taken to resect the uterus horn.

DES-Related Uterus

This anomaly affects those whose mothers took diethylstilbestrol, a kind of synthetic estrogen. DES-related uterus is a condition in which the shape of the uterus or uterine cavity is distorted. For instance, a T-shaped uterus occurs due to DES exposure.

Uterus Didelphys

Uterus didelphys is another condition that arises due to the improper fusion of Mullerian ducts. Here, there will be the presence of a double uterus. Symptoms like pelvic pain, pressure in the lower abdomen or issues during the menstrual cycle may show up in these cases. Even though no treatment is generally needed, in certain cases, medical practitioners may suggest surgery to either resect the septum or remove the secondary or hemi-uterus.

Symptoms of Mullerian Anomalies

The symptoms associated with Müllerian anomalies include:

● Pelvic Pain

● Amenorrhoea or absence of menstruation

● Painful or abnormal bleeding during the menstrual cycle

● Inability to conceive and achieve successful pregnancy

● Miscarriages

Book an online appointment with Dr. Sushmitha Birudavolu for Pregnancy & Gynecology related issues.

Causes of Mullerian Anomalies

Müllerian anomalies in women develop before birth, while they are still in their mother’s womb. These anomalies can arise due to one or multiple factors, including:

1. Hereditary reasons, i.e., having a family history of such anomalies

2. Certain genetic factors

3. Hormonal imbalances during pregnancy

4. Use of medications like diethylstilbestrol

5. Certain viral infections

6. Hypoxia, or lack of adequate oxygen supply, during pregnancy

7. Some environmental factors

Detection and Diagnosis

It is essential for everyone to observe the changes taking place in their bodies. Especially women should check for symptoms like pain or heaviness in the abdomen or changes in the menstrual cycles. If any changes are observed, it is important to seek medical help as early as possible. After a physical examination, medical practitioners may suggest further checks like an ultrasound scan or an MRI scan for further analysis if needed. Invasive procedures for detailed analysis, like hysteroscopy or laparoscopy, might be required to verify the abnormality. Early detection of uterine disorders can help prevent complications.

Treatment Measures

Treatment of Mullerian anomalies is available to help alleviate the associated issues. However, these depend on the gravity of the symptoms and the type of anomaly. Treatment options range from a simple procedure to remove the septum to complicated reconstructive procedures that correct the structural abnormality. A few invasive procedures are done to alleviate the issues, including metroplasty, vaginoplasty or septum resection. Women who have been diagnosed with Mullerian anomalies will be put through a counselling session before the medical practitioners make any conclusive decision to perform an invasive procedure.

Adopting A Proactive Approach Towards Understanding Mullerian Anomalies

Uterine disorders can have varied causes. A few such disorders may be due to congenital health issues, such as Mullerian anomalies. Early detection can help prevent complications, making awareness an important step toward better health. By staying informed and open about these conditions, you’re not just looking after your own well-being—you’re also creating space for loved ones who may have Müllerian anomalies without knowing it. Encouraging open conversations and seeking medical guidance when needed can make all the difference in ensuring the best possible care and support.

FAQs

1. What are the symptoms of Müllerian anomalies?

The symptoms of Müllerian anomalies include either one or a combination of issues like pelvic pain, heaviness in the lower abdomen, issues in the menstrual cycle, and an inability to become pregnant.

2. Are there treatments available for women with Müllerian anomalies?

Treatments are available for women with Müllerian anomalies, and they are suggested based on the type of anomaly and its severity. Mostly, these are procedures like metroplasty, vaginoplasty or septum resection.

3. How do Müllerian anomalies impact pregnancy and childbirth?

The Müllerian anomalies may impact pregnancy and childbirth by adding complications or risks. The complications affecting pregnancy and childbirth include miscarriage, placental delivery difficulty, low birth weight of the child and preterm labour.

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