The
hymen is a fold of
mucous membraneThe mucous membranes are linings of mostly endodermal origin, covered in epithelium, which are involved in absorption and secretion. They 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...
which surrounds or partially covers the external
vaginaThe vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...
l opening. It forms part of the
vulvaThe vulva refers to the external genital organs of the female. This article deals with the human vulva, although the structures are similar for other mammals....
, or external genitalia.
Despite this, it is not possible to confirm that a
womanA woman is a female human. The term woman is usually reserved for an adult, with the term girl being the usual term for a female child or adolescent...
is a virgin by examining her hymen. In cases of suspected
rapeRape, also referred to as sexual assault, is an assault by a person involving sexual intercourse with or without sexual penetration of another person without that person's consent....
or
sexual abuseSexual abuse, also referred to as molestation, is the forcing of undesired sexual behavior by one person upon another, when that force falls short of being a sexual assault. The offender is referred to as a sexual abuser or molester...
, 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.
The
hymen is a fold of
mucous membraneThe mucous membranes are linings of mostly endodermal origin, covered in epithelium, which are involved in absorption and secretion. They 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...
which surrounds or partially covers the external
vaginaThe vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...
l opening. It forms part of the
vulvaThe vulva refers to the external genital organs of the female. This article deals with the human vulva, although the structures are similar for other mammals....
, or external genitalia.
Despite this, it is not possible to confirm that a
womanA woman is a female human. The term woman is usually reserved for an adult, with the term girl being the usual term for a female child or adolescent...
is a virgin by examining her hymen. In cases of suspected
rapeRape, also referred to as sexual assault, is an assault by a person involving sexual intercourse with or without sexual penetration of another person without that person's consent....
or
sexual abuseSexual abuse, also referred to as molestation, is the forcing of undesired sexual behavior by one person upon another, when that force falls short of being a sexual assault. The offender is referred to as a sexual abuser or molester...
, 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, although a common appearance of the hymen is
crescentIn art and symbolism, a crescent is generally the shape produced when a circular disk has a segment of another circle removed from its edge, so that what remains is a shape enclosed by two circular arcs of different diameters which intersect at two points .In astronomy, a crescent is...
-shaped, many variations are possible. After a woman
gives birthChildbirth is the culmination of a human pregnancy or gestation period with birth of one or more newborn infants from a woman's uterus...
she may be left with remnants of the hymen called
carunculae myrtiformes or the hymen may be completely absent.
Hymenal development
The genital tract develops during embryogenesis, from 3 weeks' gestation to the second trimester, and the hymen is formed following the vagina.
At week seven, the urorectal septum forms and separates the rectum from the urogenital sinus.
At week nine, the müllerian ducts move downwards to reach the urogenital sinus, forming the uterovaginal canal and inserting into the urogenital sinus.
At week 12, the müllerian ducts fuse to create a primitive uterovaginal canal.
At month 5, the vaginal canalization is complete and the fetal hymen is formed from the proliferation of the sinovaginal bulbs (where müllerian ducts meet the urogenital sinus), and becomes perforate before or shortly after birth.
In newborn babies, still under the influence of the mother's hormones, the hymen is thick, pale pink, and redundant (folds in on itself and may protrude). For the first two to four years of life, the infant produces hormones which continue this effect. Their hymenal opening tends to be annular (circumferential).
Hymenal resorption
Past neonatal stage, the diameter of the hymenal opening (measured within the hymenal ring) has historically been proposed to be approximately 1 mm for each year of age. In children, to make this measurement, a doctor may place a
Foley catheterFoley catheters are flexible tubes that are passed through the urethra during urinary catheterization and into the bladder to drain urine. They are retained by means of a balloon at the tip which is inflated with sterile water. The balloons typically come in two different sizes: 5 cc and 30 cc...
into the vagina and inflate the balloon behind the hymen to stretch the hymenal margin and allow for a better examination. In the normal course of life the hymenal opening can also be enlarged by
tamponA tampon is a mass of cotton or rayon; or a mixture of the two inserted into a body cavity or wound to absorb bodilyfluid. The most common type in daily use is disposable and designed to be inserted into the vagina during menstruation to absorb the flow of menstrual fluid...
use, pelvic examinations with a
speculumThe term speculum, Latin for "mirror," may refer to:* Speculum , a medical tool used for examining body cavities* Speculum , a journal of medieval studies published by the Medieval Academy of America...
, regular physical activity or sexual intercourse. Once a girl reaches puberty the hymen tends to become so elastic that it is not possible to determine whether a woman uses tampons or not by examining a hymen. In one survey only 43% of women reported bleeding the first time they had sex, indicating that the vagina of a majority of women is sufficiently opened.
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. In instances of suspected child abuse, doctors use the
clock faceA clock face is the part of an analog clock that displays the time through the use of a fixed numbered dial or dials and moving hands. In its most basic form, recognized universally throughout the world, the dial is numbered 1–12 indicating the hours in a 12-hour cycle, and a short hour hand...
system to describe the hymenal opening. The 12 o'clock position is below the
urethraIn anatomy, the urethra is a tube which connects the urinary bladder to the outside of the body. The urethra has an excretory function in both sexes to pass urine to the outside, and also a reproductive function in the male, as a passage for semen.The external urethral sphincter is a striated...
, and 6 o'clock is towards the
anusThe anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to expel feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest, such as bones; food...
, with the patient lying on her back.
Infants' hymenal opening tends be redundant (sleeve-like, folding in on itself), and may be combined with annular shaped.
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 vestibuleThe Vulval vestibule is a part of the vulva between the labia minora into which the urethral opening and the vaginal opening open...
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
estrogenEstrogens are a group of steroid compounds, named for their importance in the estrous cycle, and functioning as the primary female sex hormone, their name comes from estrus/oistros + gen/gonos = to generate.Estrogens are used as part of some oral contraceptives, in estrogen replacement...
and activity levels, the hymenal tissue may be thicker and the opening is often fimbriated or erratically shaped.
After giving birth, the vaginal opening usually has nothing left but hymenal tags (carunculae mytriformes) and is called "parous introitus".
Anatomic anomalies
Anomalies of the female reproductive tract can result from agenesis or hypoplasia, canalization defects, lateral fusion and failure of resorption, resulting in various complications.
- Imperforate: hymenal opening nonexistent; will require minor surgery if it has not corrected itself by puberty to allow menstrual fluids to escape.
- Cribriform, or microperforate: 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.
Hymens in other animals
Due to similar reproductive system development, many mammals, including chimpanzees and elephants to manatees and whales, retain hymens.
Hymenorrhaphy
In some cultures the concept of an intact hymen is highly valued at marriage. Some women undergo hymenoplasty, a restoration of their hymen.
In Korea the word for hymen translates literally as “virgin-skin” and a small industry has grown up around its surgical construction through plastic surgery. In 1994 the Korean Medical Research Center was made to pay compensation to a 40-year-old woman for extreme psychological distress after she lost her hymen during a Pap smear test. The court found that, “it is clear that the hymen is still recognized as a symbol of ‘virginity’ and keeping virginity is valued in society". Some Korean prenatal clinics offer STD tests with hymenorrhaphy, in order to "free" women from their history of sexual experiences in the past. These surgeries are not approved by the Korean medical association.
Womb fury
In the sixteenth and seventeenth centuries, medical researchers used the presence of the hymen, or lack thereof, as founding evidence of physical diseases such as "womb-fury". If not cured, womb-fury would, according to these early doctors, result in death.
External links
- Hymen gallery - Illustrations of hymen types
- Magical Cups and Bloody Brides the historical context of virginity
A virgin is, originally, a woman who has never had sexual intercourse. Virginity is the state of being a virgin. It is derived from the Latin virgo, which means "sexually inexperienced woman", used typically of adolescents, but also of older women, and even goddesses.As in Latin, the English word...
in a frank and easy-to-understand manner.
- 20 Questions About Virginity - Interview with Hanne Blank, author of "Virgin: The Untouched History". Discusses relationship between hymen and concept of virginity.
- Vaginismus-Awareness-Network Explanation of the hymen, myths on first-time sex, Hymenectomies and Vaginismus (Painful sex or Fear of Penetration)