Anatomy-Lexicon

hymen

definition

The hymen (Hymen) is a thin layer of connective tissue. It encloses or covers the opening of the vagina. The hymen can have many different shapes. It's a holdover from girls' embryonic development. It usually has an opening through which the menstrual blood can drain. During the first sexual intercourse (defloration), but also in everyday life, it can tear further, which may be associated with pain or blood discharge.

Anatomy of the hymen

The hymen (Hymen) is a fold of connective tissue and is quite elastic. The hymen becomes the external female genital (vulva) and sometimes referred to as the boundary between the external and internal genitalia. It can enter the vagina (vagina), the so-called introitus vaginae. Usually, however, it surrounds him more like a marginal hem. It is about 1-2 cm behind the vaginal entrance.

There are usually one or more openings in the hymen. There are many forms of hymen, e.g.

ring-shaped (Hymen annularis),
crescent-shaped (Hymen semilunaris) or
sickle-shaped (Hymen falciformis).
Also hymen with many small openings (Hymen cribiformis) or
with a strand of connective tissue in the middle and two openings on the side (Hymen septus) are described.

The different variations of the hymen are all normal. However, a completely closed hymen is problematic (Hymen impferforatus, Hymenal atresia).
As a result, the menstrual blood cannot flow out when the menstrual period starts and it builds up in the vagina and possibly the uterus. In this case, a small surgical procedure is indicated to create an opening in the hymen.

The hymen is a remnant of the fusion of two embryonic structures, the urogenital sinus and the Müllerian duct (paramesonephric duct). It contains little or no nerves.

Read also under:

Vaginal entrance
Menstrual period

What is the function of the hymen?

The hymen has no or only a negligible function.
There is the assumption that the hymen would protect the vagina and the uterus from external influences such as Protect pathogens. However, this thesis cannot be scientifically proven.

The meaning of the hymn is often more cultural. For example, an intact hymen that breaks during first sexual intercourse (defloration) and causes bleeding is viewed in some cultures as evidence of a woman's virginity. This is particularly important when the virginity of a woman prior to marriage is given a high cultural value. However, bleeding during the first sexual intercourse is not a guide to this question.

In the vast majority of women, the hymen has openings anyway, which may only be widened during the first intercourse. This does not necessarily lead to bleeding. The bleeding could also be caused by an injury to other genital areas, such as the lining of the vagina. In addition, in rare cases women who have had sex can bleed from hymen injuries.

The hymen has torn - what to do?

A tearing of the hymen is usually not a medical problem and does not require further therapy. The hymen can be damaged by injuries, e.g. tear during the first sexual intercourse (defloration), but sometimes only when a child is born. This is possibly. associated with pain and discharge of blood. However, these symptoms should subside quickly. The hymen is usually not so well supplied with blood that it leads to greater blood loss with possibly serious consequences.

However, if the bleeding does not stop or the pain persists, a gynecologist should be consulted. It is then possible that the symptoms stem from an injury to other parts of the female genitals. Infection with pathogens such as Fungal or bacteria should be excluded if the discharge and pain persist.

Restore hymen

There are several methods to restore a hymen. However, it should be noted that there is no medical reason for any of these methods. A torn hymen usually heals without any problems and is not a medical problem. One method of restoration is hymen reconstruction or hymenorraphy.

During an outpatient operation, the hymen is sewn so tightly with self-dissolving threads that it is likely to tear and bleed during the next sexual intercourse. For this, however, vessels must grow into the hymen, which can take up to 3 months.

A faster method to appear to restore a torn hymen is the so-called hymen tissue thickening. A kind of hymen implant is used, which can be felt as a resistance during sexual worship. In addition, the implant then releases a red liquid (gelatin) that is similar to blood. This effect occurs immediately after the surgical procedure.

In addition, it is also possible for a hymen to grow back together to its original shape on its own. However, this is not the case after every tear.

Read more about this under: Hymen reconstruction

Can you have the hymen sewn?

There are methods by which the hymen is "sewn" back together. They are called Hymenal reconstruction or hymenorraphia. However, this is not a complete sewing up of the hymen. This would lead to considerable problems for girls and women who are already menstruating. In this surgical procedure, the hymen is sutured so that it is so narrower than before.

There is no medical reason for a hymenal reconstruction as the hymen has no function. If such an operation is nevertheless desired, it is usually for socio-cultural reasons.

The procedure is usually an outpatient operation. It takes up to an hour and is performed under local anesthesia, but sometimes also under general anesthesia. Sutures are used that will self-resolve some time after the operation. During the operation, parts of the hymen or the lining of the vagina are sewn together so that they form a seam around the entrance to the vagina (introitus vaginae). This seam is made so tight that it is likely to cause an injury during sexual intercourse that will result in bleeding. For this it is necessary that small blood vessels (capillaries) grow into the restored (reconstructed) hymen.

In most cases this happens after a reconstruction, but it cannot be guaranteed. In the same way, bleeding after coitus cannot be guaranteed even after hymenal reconstruction, since the hymen is very elastic and may develop. just stretches without tearing and bleeding. It should also be noted that hymenal reconstruction takes time to take effect. Because capillaries first have to grow into the operated hymen, which can take several weeks to months.

Further information on this topic can be found at: Hymen Restoration - You Should Know That!

Remove hymen from doctor

It is possible to have the hymen removed by a doctor. This small surgical procedure is called hymenectmia. It is usually carried out on an outpatient basis and under local anesthesia.

Hymenectmia is necessary when the hymen completely closes the vaginal outlet (Hymen imperforatus). In addition, a particularly stable hymen that barely stretches can cause permanent pain during sex or when inserting tampons. A hymenectomy is then also indicated.

To avoid pain during the first sexual intercourse, it is not performed. In any case, the hymen only tears in every second woman, and the pain is usually less severe and quickly over.

Do you injure the hymen with a tampon?

To insert a tampon, the hymen has to be passed as it is only about 1-2 cm behind the vaginal entrance. However, a tampon should be inserted about a hand's width, although there are great individual differences. However, pushing a tampon past hardly poses a risk of injury to the hymen if some measures are observed. The tampon should be inserted carefully, slowly and without force. In addition, it is important to ensure that the correct size tampon is used - then wearing a tampon is also much more comfortable.

The hymen is very elastic and usually expands when a tampon is inserted. In healthy women, there is always an opening through which the tampon can pass. It is theoretically possible that the hymen is injured by a tampon, but whether this actually happens is scientifically controversial.

In some women, the hymen has no opening (hymenal atresia). This is a condition in need of treatment because menstrual blood cannot flow out. If a tampon is nevertheless to be inserted, this often does not succeed. In this case, a gynecologist should be consulted. This applies even if inserting or removing a tampon is associated with great pain or difficulty.

Can the hymen tear while exercising?

Whether the hymen can tear during sport is scientifically controversial. On the one hand, the hymen is very elastic and it is relatively protected behind the labia (labia pudendi). On the other hand, it is conceivable that vigorous exercise could lead to severe stretching and possibly tears.

However, it should be noted that the hymen of healthy women always have openings anyway. A tear can therefore often hardly be distinguished from a natural opening, especially because hymen have very variable shapes.

Pain in the hymen

The hymen is usually only supplied by a few nerves. Injuries to the hymen should therefore normally only result in brief, not too violent pain. These pains can e.g. occur when a girl or woman has sexual intercourse for the first time.

However, this is not always the case, only about half of all women have their hymen torn the "first time".
Other reasons for hymen pain could be that the hymen is very stable and has only a very small opening. As a result, it does not stretch or tear. Then the introduction of e.g. Tampons, or even sex, lead to persistent pain. In this case, a gynecologist can make a small incision under local anesthesia to expand the hymen or even remove it completely (hymenectomy).

In addition, in the case of pain in the genital area, possible infections with pathogens such as fungi or bacteria should always be considered. Fungi such as Candida albicans in particular can trigger an infection before the first sex, as they occur naturally on human skin.
A gynecologist should therefore be consulted if there is a burning sensation, pain or discharge.

In addition, worries, fears and insecurity, which are more common in relation to sexuality, can also lead to pain. Nevertheless, an organic (somatic) cause should always be clarified in the event of severe, persistent pain.

Learn more at: Vaginal pain

Can you see the hymen?

The hymen is mostly visible. It is one of the external female sexual organs (vulva) and lies approx. 1-2 cm behind the vaginal entrance. This is usually moved by the great labia (labia majores) and the small labia (labia minores).

In order to look at the hymen you have to spread both labia to the sides. Then you can see directly at the vaginal entrance, behind which the hymen can be found. For this it is helpful to use a mirror and lamp for adequate lighting. A hand mirror can be held between the spread legs with one hand, the other hand holds the labia to the side. Alternatively, you can crouch over a mirror lying on the floor and thus represent the vaginal entrance in the mirror.

The hymen can be recognized as cloudy skin, sometimes also as a fold of connective tissue. Its color is similar to that of the surrounding structures. It can often be difficult to see hymen in the mirror. The hymen can have very different shapes and is sometimes only a small border around the vaginal entrance, or it cannot be seen at all.
However, that doesn't mean it is torn.Rather, it is also a normal variant that many women and girls already have before their first sexual intercourse (defloration).

Color of the hymen

The hymen consists of a connective tissue skin or skin fold. It often has a similar color to the skin surrounding it on the outer geital area of the woman (vulva) or the sheath (vagina) behind it.

In newborns, it is usually light pink, but darkens a little over time. Nevertheless, it usually retains its rosy color. It should be noted, however, that the color of the hymen, as well as its shape, is very variable and there is no “ideal” color.