Hematocolpos Explanations

Hematocolpos is an accumulation of blood in the vagina, which is usually associated with menstrual bleeding and in most cases is due to hymenal atresia. In many cases, a clear hump forms on the patient’s lower abdomen, which is due to the expansion. The treatment is surgical and eliminates the backwater responsible structure.

What is hematocolpos?

According to abbreviationfinder, menstruation is periodic bleeding from the uterus, also known as menstrual bleeding or periods. From the first day of menstruation, the Graafian follicle begins to mature, which ultimately leads to ovulation. During menstruation, the uterus prepares itself for the implantation of a fertilized egg.

On average, a woman excretes 65 to a maximum of 200 milliliters of fluid during menstruation. In addition to blood, the excreted fluid contains secretions and remnants of the mucous membrane of the uterus. In the so-called hematocolpos, the menstrual blood collects in the vagina. In hematocolpos, however, the blood does not back up in the direction of the uterus.

If the backlog of blood reaches into the lumen of the uterus, this is referred to as a so-called hematometra or hematometrocolpos. Hematocolpos does not necessarily have to be related to menstruation, but can also be caused by other blood in the vagina. The accumulation of menstrual blood, however, is the most common variant of the phenomenon.


Hematocolpos is usually causally related to what is known as hymenatresia. This phenomenon is a congenital malformation of the hymen. In women with hymenal atresia, the vagina is completely closed by the hymen. This phenomenon corresponds to a form of gynatresia, in which an inhibition malformation closes cavities and ducts of the female genital organs.

The consequence of this is the symptomless hydrocolpos, in which fluid collects in the vagina. The accumulated fluid usually consists of secretions from the vaginal lining. In this context, blood can also collect in the vagina during the period. In the case of hematocolpos, the menstrual blood only accumulates in the vagina due to the inhibition malformation.

In hematometra, it backs up into the uterus. Closure of the vagina by hymenatresia or gynatresia is the basis of hematocolpos. Causal associations also exist with Robinow syndrome, the so-called uterus didelphys or any duplication of the vagina and uterus.

Symptoms, Ailments & Signs

Women with hematocolpos suffer from an accumulation of blood within the vagina that is otherwise relatively asymptomatic. Those affected sometimes complain of a palpable hump on the lower abdomen that feels like a tumor. This hump is actually a flare. This widening is even clearly visible in some cases.

Patients usually do not experience pain. Nevertheless, many of those affected feel clearly worried and are psychologically stressed accordingly. In exceptional cases, the patients do not turn to a doctor for a long time because they are ashamed of the blood congestion and want to hide their problem from the public.

Still other women have been used to the blood congestion since the first menstrual period and consider the condition to be physiological normality. Sometimes it is only the hump in the area of ​​the lower abdomen that moves them to consult a doctor.

Diagnosis & course of disease

Hymenatresia is usually diagnosed before hematocolpos is diagnosed. In most cases it is an incidental finding. Hematocolpos itself is diagnosed by the doctor using ultrasound. A bleeding mass in the area of ​​the lower abdomen must be distinguished.

A collection of pus in the vagina in the sense of a pyocolpos must also be considered in the differential diagnosis. The prognosis of patients with hematocolpos is favorable. As a rule, the cause of hymenatresia can be treated well.


In most cases, hematocolpos does not cause any particular complications or pain in the patient. In many cases, the disease remains undetected at first and only becomes visible to the woman during her menstrual period. It is not uncommon for hematocolpos to be mistaken for a tumor, which can lead to a panic attack or general inner restlessness in many people.

This reduces the quality of life for a short period of time and can lead to depression and other psychological problems in many patients. It is not uncommon for the partners of those affected to suffer from hematocolpos. In most cases, it is not possible to treat or remove hematocolpos if there are no particular symptoms. Complications can arise when there is inflammation of the genitals.

Removal involves surgical intervention that removes the hematocolpos. There are no particular complications or pain. Psychological symptoms sometimes require therapy. Life expectancy is not limited by the disease. Even after the treatment, there are usually no particular symptoms.

When should you go to the doctor?

Women who notice a bump on the lower abdomen should consult the gynecologist. The gynecologist can carry out an examination and clearly diagnose or rule out the hematocolpos. If it is actually a blood congestion, treatment is usually initiated immediately. If the symptoms have another cause, the survey should be carefully monitored. If it increases in size, further examination by a specialist is indicated.

In some cases, hematocolpos does not pose a risk to the patient. Treatment is required only if the blood stasis causes pain or general discomfort. If signs of inflammation are noticed, hematocolpos must be treated immediately. Women suffering from hymenal atresia are prone to develop hematocolpos. Blood congestion in the vagina can also occur in connection with Robinow syndrome and any duplications of the vagina and uterus. If these risk factors are present, a preventive examination should be carried out by the responsible gynecologist.

Treatment & Therapy

Hematocolpos does not necessarily have to be treated as long as it does not burden the patient. However, if the patient feels impaired or stressed by the blood congestion, therapy to rule out subsequent psychological problems is indicated. In addition, the therapy may be necessary if the regular congestion of blood promotes inflammation or bacterial colonization of the genitals.

Drug-based conservative solutions are not available for therapy. The only treatment option is an invasive causal therapy, which resolves the cause of the blood congestion through an operation. Since the cause is usually an anomaly of the hymen, this structure is opened during the operation. The causal treatment therefore corresponds to an operative transection of the abnormal hymen or the pathologically obstructing membrane.

If an acquired, scarred closure of the vagina has been identified as the primary cause of the phenomenon, surgical removal of the scar tissue takes place. The operation is performed under general anesthesia and requires admission to the hospital. In the aftermath, slight pain is to be expected, which can, however, be well controlled by the administration of painkillers.

If the hematocolpos has already caused psychological problems, the patient is advised to undergo psychotherapy. In the case of inflammation due to the phenomenon, symptomatic therapy must take place before the causal therapy, in which the inflammation is reduced. In the case of an inflammation in the abdomen, there is a contraindication for the operation.


In most cases, hematocolpos is due to hymenal atresia. Since this is usually a prenatal inhibition malformation, it is difficult to prevent the phenomenon.


The importance of follow-up care depends on the treatment method and the extent of the symptoms. In many cases, hematocolpos does not need to be treated at all because the affected women perceive the burden as marginal. As part of the initial diagnosis, the doctor informs his patient about the harmlessness of a small accumulation of blood. There are no restrictions.

However, if the affected women find the accumulation of menstrual blood in the vagina distressing, surgical intervention can provide relief. This usually gives a satisfactory result. Aftercare immediately after the operation includes taking painkillers.

The drugs reduce the short-term consequences of the procedure. An ultrasound image is taken to confirm the success of the treatment. In practice, scheduled follow-up examinations after a successful intervention are of no particular relevance. This distinguishes hematocolpos from cancerous diseases. Because a new formation is not possible; either the blood collection exists or it does not.

It is also not a life-threatening condition. Some women delay treatment out of shame, which can lead to psychological problems. Even after they have subsided, these psychological signs can persist. In psychotherapy, self-confidence can then be strengthened and difficulties discussed.

You can do that yourself

As a rule, direct self-help is not possible in the case of hematocolpos. Medical treatment is essential for this condition in order to prevent further complications and symptoms. Since in most cases this complaint does not cause pain or other symptoms, no painkillers have to be taken.

In many cases, the disease is mistaken for a tumor, since swelling also develops. However, those affected should keep calm and have an examination carried out by a gynecologist to clarify the exact cause of the swelling. As a rule, this is a hematocolpos, which can be removed easily and without complications.

If the patient is suffering from psychological problems, the support of friends and acquaintances is very helpful, whereby psychological treatment can of course also be carried out. No special therapy is necessary after the treatment. Those affected can usually continue to live after the procedure and are not bound by any restrictions. Sexual intercourse can then be continued without further ado. However, treatment by a doctor is definitely necessary for hematocolpos.