May 19 2009

Hymen

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The hymen is one of the most mysterious and misunderstood parts of the female’s anatomy. The hymen is a remnant of fetal development. Before birth it serves to protect a girl’s insides as she is developing in her mother’s uterus. If the hymen does not seal the vagina tight, things can flow inside her developing body cavity and cause all sorts of problems. So the hymen seals the hole where the vagina is, like the cap on a bottle.

From shortly before birth, it serves no purpose at all. The girl’s mother will experience a surge in estrogen that will force the hymen to form a hole. If this does not happen, menstruation and discharge will be a big problem when the girl grows up.

Few people are able to recognize a hymen when they see it. That includes the owners of the hymens. It is seldom as neat and well defined as described in medical texts or books for girls growing up. Even doctors can have problems recognizing the hymen.

The hymen changes over a woman’s lifetime, and at some stage it disappears. In some cultures and religions, it is wrongly considered as an indicator of her sexual purity. It is something that has absolutely no equivalence in the male world.

So if you see a hymen in the wild, it is well worth the effort to get the owner’s permission, make sure she is older than 18 years old, and take a good, slow and long look. It is not something you will see often. If you are the owner of a hymen, wash your hands, lock the door, get a mirror and a light and take a good look at one of the wonders of the human body. Do not be disappointed if you cannot recognize it. It is normal. The hymen is the boundary between your insides and outsides. The vaginal lining inside it is different from the skin outside it. Once it is gone, all that will be left is a little scar tissue like ring. A lot like the joint where plastic parts are joined together – literally the joint where your insides and outsides joined together.

The Word ‘Hymen’

The word Hymen is Greek and means membrane. It is also the name of the classical Greek god of marriage.

What is the Hymen

The hymen is a mucous membrane which surrounds or partially covers the external vaginal opening. It forms part of the vulva, or external genitalia. A slang term for hymen is "cherry", as in "popping one’s cherry",meaning losing one’s virginity. Despite this, it is not possible to confirm that a woman is a virgin by examining her hymen. In cases of suspected rape or sexual abuse, a detailed examination of the hymen may be carried out; but the condition of the hymen alone is often inconclusive or open to misinterpretation, especially if the patient has reached puberty. In children before puberty, the common appearance of the hymen is crescent-shaped, many variations are however possible. After a woman gives natural birth she may be left with only a few little remnants (tags) of the hymen, called carunculae myrtiformes, or the hymen may be completely absent and just a slight ridge can be felt with your finger, where it used to be.

The Hymen and Virginity

The traditional meaning of being a virgin is that you did not have intercourse yet. Intercourse is when a penis goes into a vagina. It is not masturbation, humping, fingering or oral sex. It is the ‘real’ thing – a penis INSIDE a vagina. If you had a penis inside your vagina, you are no longer a virgin. If you did not have a penis inside your vagina yet, you are still a virgin.

This definition is however more complex when a range of sexual orientations are considered. For example, when does a lesbian woman lose her virginity? Since there is no penis involved, it is difficult to say, and society is busy developing new norms. It is also a problem when he girl or woman participate in traditional foreplay activities. So is she a virgin if she has been fingered? Received oral sex? Gave oral sex? Had anal sex? These are all questions that will be answered in time. Today sexual intercourse defines the boundary between virginity or non-virginity.

Many people confuse the hymen with virginity. The theory is that the presence of the hymen is an indication of a woman’s sexual status. As soon as she has sex for the first time, her hymen will be destroyed. This view is incorrect on so many levels. While it is true that every girl is born with a hymen, she can tear or destroy her hymen in  number of non-sexual ways before her marriage. During the pre-pubertal phase, the hymen is thin and tightly stretched. Physical activities like gymnastics, martial arts, dancing, athletics, skiing, cycling, horse riding, jumping, falling, straddle injuries, water slides, water skiing, diving and cheerleading can tear the hymen. Sexual games, fingering, masturbation or curiosity can also cause a girl to tear her hymen. She is however still a virgin.

On the other hand, her hymen can stay intact or only develop a small notch during sex with a man after it thickens during puberty. so even though she may still have most of her hymen intact, she is no longer a virgin.

The Hymen and Tampons

Various studies looked at the effect of tampon usage on the hymen. The facts does not show that the hymen is destroyed by tampon usage. At the very most, if tampons are used before the estrogenation of the hymen during puberty, small notches or a slight stretching of the hymen opening can take place. After estrogenation of the hymen, a physical examination of the hymen can no longer determine if the woman is using tampons or not.

Septate Hymens

A woman with a septate hymen (two or three holes with a fleshy bridge between them) might find it difficult to use tampons. This is especially true during the removal of the tampon because of the angle that the tampon is coming out and the fact that it is bigger because of the absorbed menstrual debris. She might have to use her fingers to get the tampon out without causing pain. Whenever a woman find it difficult to remove a tampon, the use of a small mirror to see what is going on might be very useful.

A septate hymen is a malformed hymen. Because the hymen is a worthless piece of membrane, it does not matter. When her mother got the estrogen surge that caused the hymen to open before birth, only two or three holes formed, rather than one big hole. The septate hymen is normally removed by a doctor if it creates problems for the woman. This can often be done in an outpatient facility under local anesthesia. Some times a doctor will however prefer to do it under general anesthesia. Septate hymens are normally more resistant to breaking during first intercourse and it can be painful and difficult. Parts of the septate hymen might also hang down after it is torn or broken.

 

Hymen Development

Before birth

The Hymen is a thin mucus membrane that covers the entrance (or introitus) of the Vagina. It is located in the mouth of the Vagina. It is not inside the Vagina and can be seen if the labia is held open. It is formed in the female embryo where the embryonic tissue making up the vulva and the embryonic tissue making up the vagina, cervix and uterus joins together.

By the 5th month of development in the womb, the vaginal canal is complete and the hymen is formed as a solid and closed membrane sealing the vaginal canal from the amniotic fluid that the fetus lives in. It becomes perforate (have holes in it) shortly before or shortly after birth.

After birth

In newborn babies the hymen is thick, pale pink, and redundant (folds in on itself and may protrude the vaginal opening). For the first two to four years of a girl’s life she produces hormones which continue this effect. Their hymen’s opening tends to be annular (circumferential).

Infants’ hymenal opening tends be redundant (sleeve-like, folding in on itself), and may be combined with annular shaped.

Childhood

As a child, the opening of her hymen grows by about 1mm for each year of age. The hymen’s opening can also be affected by tampon use, pelvic examinations with a speculum, regular physical activity or sexual activities. Before puberty the hymen is translucent, will cover part of the vagina’s entrance and is not very elastic. Capillaries will also be visible in it. Breaking or tearing it will be painful and bloody.

The hymen is most apparent in young girls: at this time their hymen is thin and less likely to be redundant, that is to protrude or fold over on itself.

By the time a girl reaches school-age, this hormonal influence has stopped and the hymen becomes thin, smooth, delicate and almost translucent. It is also very sensitive to touch; a physician who needed to swab the area would avoid the hymen and swab the outer vulval vestibule instead.

Prepubescent girls’ hymenal opening comes in many shapes, depending on hormonal and activity level, the most common being crescentic (posterior rim): no tissue at the 12 o’clock position; crescent shaped band of tissue from 1–2 to 10–11 o’clock at its’ widest around 6 o’clock. From puberty onwards, depending on estrogen and activity levels, the hymenal tissue may be thicker and the opening is often fimbriated or erratically shaped.[6]

Puberty

The inner cells of the hymen are the same type of cells as the vagina so it is sensitive to the hormone estrogen. When a girl enters puberty her body begins to produce estrogen. The hymen will thicken and become more elastic. It will often change shape to a ring or annular shape to form a ring or part of a ring around the vagina’s opening.

This change from thin and inflexible to thick and elastic happens to the degree where it will not even be possible for a doctor to determine whether she uses tampons or not by examining a hymen. This thickening can happen right at the start of puberty or at the end, or anywhere in-between. This change determines the amount of discomfort she will experience at first sexual intercourse from the stress on her hymen.

Before this change, every time something is inserted into the Vagina (finger, vibrator, dildo or tampon), the hymen risks being torn and stretched. Any hard landing, hard bump to the genitals or hard bounce to a girl’s body can also break the hymen. Sports like dancing, gymnastics, cheer leading, horse back riding, mountain biking, skiing and many others are implicated in the premature disappearance of the hymen. Going down a water slide feet first, jumping into a pool feel first and water skiing can force water into the vaginal entrance and damage the hymen. You can think of the hymen as a wine glass in a box with cotton balls. The cotton balls and the box will absorb some knocks and bumps. At some stage however if you bump it hard enough, the glass will break.

The first time a woman has intercourse, the hymen will be stretched or torn and start to wear away. The vaginal opening will soon have nothing left of the hymen but hymenal tags (carunculae mytriformes) and is called "parous introitus".  This process will culminate with natural vaginal child birth after which no part of the hymen will be left. A small ridge can then be felt where the hymen were, but that will be all that is left.

How To Recognize a Hymen In the Wild

The Hymen has an opening in the middle. This is important for menstrual blood, cervical mucus and other secretions to leave the Vagina. Sometimes the hymen does not have a hole in it. This condition is known as an imperforate hymen and is easily remedied by a medical doctor with a scalpel.

The hole in the Hymen can take many forms. The Hymen shape is named after the shape of this hole and is called the Hymen Morphology.

The morphology of the Hymen in newborn girls were studied in Saudi Arabia. The following facts were found. All newborn baby girls had Hymens. 60% had an annular shape, 22% were sleeve-like, 12.5% were fimbriated, 4.9% crescentric and 0.6% other shapes.

As girls gets older and the hormones present in their bodies change, the thickness, color and morphology of the Hymen can change.

A few Hymen facts:

  • All girls are born with a hymen
  • The absence of a hymen does not indicate that the woman had sex. The Hymen can break in numerous other ways.
  • When the Hymen tear, it only bleeds sometimes (43% of the time).
  • Often the tearing of the Hymen does not have any pain associated with it.
  • Sometimes the Hymen will not tear and prevent intercourse from being attempted. In such cases a doctor will have to open the hole in he hymen surgically.
  • Notches, clefts and tears in the hymen is not an indication of sexual abuse by itself. Other collaborating evidence is needed.
  • The hymen have meaning in most cultures and in some cultures the absence of the Hymen in an unmarried woman is considered a major problem. All these opinions are flawed and is meaningless in real life.
  • After the estrogen surge during puberty. The hymen will not break or tear due to athletic activities or tampon use. The elasticity of the hymen will ensure that it stays intact.

 

The Hymen is a Mucus Membrane. So what is a Mucus Membrane?

Mucus membranes line various body cavities that are exposed to the external environment and internal organs. It is at several places continuous with skin: at the nostrils, the lips, the ears, the genital area, and the anus. The sticky, thick fluid secreted by the mucous membranes and gland is termed mucus. The term mucous membrane refers to where they are found in the body and not every mucous membrane secretes mucus. Body cavities featuring mucous membrane include most of the respiratory system, the head of the penis (glans) and glans clitoris, along with the inside of the prepuce (foreskin) and the clitoral hood, are mucous membranes. The urethra is also a mucous membrane. The secreted mucus traps the pathogens in the body, preventing any further activities of diseases.

 

Statistics

The morphology of the Hymen in newborn girls were studied in Saudi Arabia. The following facts were found. All newborn baby girls had Hymens. 60% had an annular shape, 22% were sleeve-like, 12.5% were fimbriated, 4.9% cresentric and 0.6% other shapes.

 

Hymen Morphology

 

Problem Hymens

Anomalies of the female reproductive tract can result from agenesis or hypoplasia, canalization defects, lateral fusion and failure of resorption, resulting in various complications.[7]

    * Imperforate:[10][11] hymenal opening nonexistent; will require minor surgery if it has not corrected itself by puberty to allow menstrual fluids to escape.
    * Cribriform, or micro-perforate: sometimes confused for imperforate, the hymenal opening appears to be nonexistent, but has, under close examination, small openings.
    * Septate: the hymenal opening has one or more bands extending across the opening.

 

 

1000px-Hymen_en.svg

Common Hymen Morphology (Shapes)

(License: By Hymen_ger.svg: *Typy_panenských_blan.svg: FollowTheMedia derivative work: Gloecknerd (talk) derivative work: Gloecknerd (Hymen_ger.svg) [CC-BY-SA-3.0 (www.creativecommons.org/licenses/by-sa/3.0/) or GFDL (www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons)

 

Born-Again Virgins

In some cultures an intact hymen is highly valued at marriage. Some women undergo hymenoplasty to restore their hymen.

In these countries a small industry has grown up around hymen reconstruction through plastic surgery. Woman can be shunned by society for not having pain and bleeding during her wedding night. Unfortunately these very same societies encourage the men to have sex before marriage.

Some small self-help devices are also sold to release ‘blood’ from the vagina during first intercourse.

Slang Terms

  • Cherry
  • Maidenhead

References

   1. Emans, S. Jean. "Physical Examination of the Child and Adolescent" (2000) in Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas, Second edition, Oxford University Press. 61-65
   2. Perlman, Sally E.; Nakajima, Steven T. and Hertweck, S. Paige (2004). Clinical protocols in pediatric and adolescent gynecology. Parthenon. pp. 131.
   3. "Hymen". Discovery.com. http://health.discovery.com/centers/sex/sexpedia/hymen.html. Retrieved on 2009-02-02. "Knowing the facts about the hymen can help women dispel the myth that it proves virginity, freeing them from the negative effects of popular mythology. Having accurate information about the hymen can assist in normalizing a woman’s fears about her body and help promote greater self-acceptance."
   4. Knight, Bernard (1997). Simpson’s Forensic Medicine (11th edition ed.). London: Arnold. pp. 114.
   5. McCann, J; Rosas, A. and Boos, S. (2003) "Child and adolescent sexual assaults (childhood sexual abuse)" in Payne-James, Jason; Busuttil, Anthony and Smock, William (eds). Forensic Medicine: Clinical and Pathological Aspects, Greenwich Medical Media: London, a)p.453, b)p.455 c)p.460.
   6. Heger, Astrid; Emans, S. Jean and Muram, David (2000). Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas (Second edition ed.). Oxford University Press. pp. 116.
   7. "Imperforate Hymen". Web MD. http://emedicine.medscape.com/article/269050-overview. Retrieved on 2009-02-02. "Different normal variants in hymenal configuration are described, varying from the common annular, to crescentic, to navicular ("boatlike" with an anteriorly displaced hymenal orifice). Hymenal variations are rarely clinically significant before menarche. In the case of a navicular configuration, urinary complaints (eg, dribbling, retention, urinary tract infections) may result. Sometimes, a cribriform (fenestrated), septate, or navicular configuration to the hymen can be associated with retention of vaginal secretions and prolongation of the common condition of a mixed bacterial vulvovaginitis."
   8. Muram, David. "Anatomical and Physiologic Changes" (2000) in Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas, Second edition, Oxford University Press. 105–7.
   9. Pokorny, Susan. "Anatomical Terms of Female External Genitalia" (2000) in Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas, Second edition, Oxford University Press. 110.
  100. Encyclopedia of Jewish Medical Ethics. 2003. ISBN 1583305920. http://books.google.com/books?id=aaklGZAID08C&pg=PA1115&dq=hymen&lr=&ei=SFeDSbi_H4buMqrIjbgF. "Occasionally, the hymen is harder than normal or it is complete and sealed without there being … This condition is called imperforate hymen and, at times …"
  11. DeCherney, Alan H.; Pernoll, Martin L. and Nathan, Lauren (2002). Current Obstetric & Gynecologic Diagnosis & Treatment. McGraw-Hill Professional. pp. 602. ISBN 0838514014. http://books.google.com/books?id=9xD0inFiEIAC&printsec=frontcover#PPA602,M1. "Imperforate hymen represents a persistent portion of the urogenital membrane … It is one of the most common obstructive lesions of the female genital tract. …"
  12. Blank, Hanne (2007). Virgin: The Untouched History. Bloomsbury Publishing. pp. 23. http://books.google.com/books?ei=GX-AScSHI4rONcO9oEw&id=shq1AAAAIAAJ&dq=Virgin%3A+The+Untouched+History&q=toothed+whales&pgis=1#search_anchor.
  13. Blackledge, Catherine (2004). The Story of V. Rutgers University Press. ISBN 0813534550. http://books.google.com/books?id=f2d-11Y_u3cC&pg=PP250&dq=guinea+pig+hymen&ei=ocSAScWgCaasNZivuZgO. "Hymens, or vaginal closure membranes or vaginal constrictions, as they are often referred to, are found in a number of mammals, including llamas, …"
  14. "Muslim women in France regain virginity in clinics". Reuters. http://www.reuters.com/article/wtMostRead/idUSL2532025120070430?pageNumber=2&sp=true. "’Many of my patients are caught between two worlds,’ said Abecassis. They have had sex already but are expected to be virgins at marriage according to a custom that he called ‘cultural and traditional, with enormous family pressure’."
  15. "The Hymen". University of California at Santa Barbara. http://www.soc.ucsb.edu/sexinfo/article/the-hymen. Retrieved on 2009-02-09. "The hymen can have very important cultural significance in certain cultures because of its association with a woman’s virginity."
  16. "In Europe, Debate Over Islam and Virginity". The New York Times. June 11, 2008. http://www.nytimes.com/2008/06/11/world/europe/11virgin.html?_r=1&scp=1&sq=hymen&st=nyt&oref=slogin. Retrieved on 2008-06-13. "’In my culture, not to be a virgin is to be dirt,’ said the student, perched on a hospital bed as she awaited surgery on Thursday. ‘Right now, virginity is more important to me than life.’"
  17. Park, J. I., Compensation for hymen lost: Not loss of virginity but a medical accident. Chosun Daily Aug 1994
  18. http://www.yunlee.co.kr
  19. International Encyclopedia of Sexuality, South Korea by Hyung-Ki Choi, M.D., Ph.D., and Huso Yi, Ph.D.
  20. Berrios GE, Rivière L. (2006) ‘Madness from the womb’. History of Psychiatry. 17:223-35.
  21. The linkage between the hymen and social elements of control has been taken up in Marie Loughlin’s book Hymeneutics: Interpreting Virginity on the Early Modern Stage published in 1997

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