What is hymen (HM) and Where is it?
HM is a thin membrane that surrounds the opening to vagina. HM could be in different
shapes. The most common HM is shaped like a half moon. This shape allows menstrual
blood to flow out of a girl's vagina.
According to Wikipedia the HM (also called maidenhead) is a fold of mucous membrane
which surrounds or partially covers the external vaginal opening. Its name comes from the
ancient Greek for "hymenaeus," which means "vaginal-flap." It was also the name for the
Greek god of marriage, later also the Greek god of membranes.
During development of the fetus (at early stages) there is no opening into the vagina at all.
The thin layer of tissue that covers the vagina at this time usually divides to a certain extent
prior to birth, forming the HM.
In general newborn babies, who are still under the influence of the mother's hormones, have
thick HM. Usually at that time HM is pale pink and redundant (folds in on itself and may
protrude). During first 2-4 years of life, the baby produces hormones which continue keeping
HM in the same conditions.
By the time girls reach school-age, this hormonal influence has stopped and the HM
becomes thin, smooth and delicate. HM is very sensitive to touch.
Starting from puberty onwards the appearance of the HM is affected by increased
concentration of estrogens. HM thickens and becomes pale pink. It is very well vasculated (a
lot of small vessels and capillaries). During first sexual contacts usually HM is ruptures and
most girls are facing bleeding (volume depends on the type and shape of the HM) - it is the
time of "loosing virginity".
There is a surgical procedure that can repair the HM so that it is intact. The procedure,
known as hymenoplasty, has become a popular procedure for some females.
Types of HM
Type of the HM is genetically determined and different girls have different types of HM. As it
was already mentioned - HM is a thin membrane that surrounds the opening to vagina and
the most common (normal) HM is shaped like a half moon.
The anatomical illustration of the female external sexual organs (including HM) is
demonstrated in the graphic above.
In some cases HM has different shapes which could create problems for first intime contacts
and/or for use of some contraceptives and/or for use of tampons.
Imperforate HM
An imperforate HM can be diagnosed at birth but sometimes the diagnosis isn't made until
the teen years. An imperforate HM is a thin membrane that completely covers the opening to
a young girl's or young woman's vagina. Menstrual blood cannot flow out of the vagina. This
usually causes the blood to back up into the vagina and the abdomen (belly) resulting in
abdominal and/or back pain. Some teens may also have pain with bowel movements and
difficulty passing urine.
The treatment for an imperforate hymen is minor surgery to remove the extra hymenal tissue
and create a normal sized vaginal opening so that menstrual blood can flow out of the vagina.
Microperforate HM
A microperforate HM is a thin membrane that almost completely covers the opening to a
young women's vagina. Some menstrual blood may be able to flow out of the vagina but the
opening is very small. A teen with a microperforate HM usually will not be able to get a
tampon into her vagina and may not realize that she has a very tiny opening. If she is able to
put a tampon into her vagina she may not be able to remove it when it becomes filled with
blood. The treatment is minor surgery to remove the extra hymenal tissue making a normal
sized opening for menstrual blood to flow out.
Septate HM
A septate HM is when the thin hymenal membrane has a band of extra tissue in the middle
that causes two small vaginal openings instead of one. Teens with a septate HM may have
trouble getting a tampon in or trouble getting a tampon out. The treatment for a septate HM is
minor surgery to remove the extra band of tissue and create a normal sized vaginal opening.
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