The hymen (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; “Hymenaios.” It forms part of the vulva, or external genitalia. The most common formation of the hymen is crescentic or crescent-shaped, although several other formations are possible. After a woman gives birth she may be left with remnants of the hymen called carunculae myrtiformes or the hymen may be completely absent.
Types
There are several different formations of the hymen, some more common than others. In about 1 in 2000 females, the hymen fails to develop any opening at all: this is called an imperforate hymen and if it does not spontaneously resolve itself before puberty a physician will need to make a hole in the hymen to allow menstrual fluids to escape. A hymenotomy may also be required if the hymen is particularly thick or inelastic as it may interfere with sexual intercourse.
The shape of the hymen is easiest to observe in girls past infancy but before they reach puberty: at this time their hymen is thin and less likely to be redundant, that is to protrude or fold over on itself.
When describing the shape of a hymen, a clock face is used. The 12 o’clock position is below the urethra, and 6 o’clock is towards the anus, which is based on the patient lying on her back.
Most common forms of the hymen:
- crescent-shaped, crescentic, or posterior rim: no hymenal tissue at the 12 o’clock position; narrow band of tissue starts at 1 or 2 o’clock going clockwise, is at its widest around 6 o’clock, and tapers off at 10 or 11 o’clock
- annular, or circumferential: the hymen forms a ring around the vaginal opening; especially common in newborns
- redundant; sometimes sleeve-like: folds in on itself, which sometimes causes it to protrude; most common in infancy and at/following puberty due to estrogen levels;can be combined with other type such as “annular and redundant”
Less common forms:
- fimbriated or denticular: an irregular edge to the hymenal orifice; more likely at an age when estrogen is present
- septate: the hymen has one or more bands extending across the opening
- cribriform, or microperforate: the hymen stretches completely across the vaginal opening, but is perforated with several holes
- labial, or vertical: hymen has an opening from the 12 to the 6 o’clock positions and can look similar to a third set of vulvar lips
- imperforate: hymen completely covers vaginal orifice; will require minor surgery if it has not corrected itself by puberty to allow menstrual fluids to escape
The hymen is torn or stretched by penetrative sex, and more so when a woman gives birth vaginally.
- parous introitus refers to the vaginal opening which has had a baby pass through it and consequently has nothing left of its hymen but a fleshy irregular outline decorating its perimeter; these tags are called carunculae mytriformes
Source of picture: http://content.answers.com/main/content/wp/en/5/58/Hymen_virginal.jpg
Source of article: http://en.wikipedia.org/wiki/Hymen
Imperforate hymen: An imperforate hymen can be diagnosed at birth but sometimes the diagnosis isn’t made until the teen years. An imperforate hymen 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 hymen: A microperforate hymen 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 hymen 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 hymen: A septate hymen 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 hymen may have trouble getting a tampon in or trouble getting a tampon out. The treatment for a septate hymen is minor surgery to remove the extra band of tissue and create a normal sized vaginal opening.
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