An imperforate hymen occurs in 1-2 out of 1,000 infants. Normal variations of the hymen range from thin and stretchy to thick and somewhat rigid. ![]() Anatomic variations Various types of hymen (the shaded areas represent the vaginal opening) In cases of suspected rape or child sexual abuse, a detailed examination of the hymen may be performed, but the condition of the hymen alone is often inconclusive. In forensic medicine, it is recommended by health authorities that a physician who must swab near this area of a prepubescent girl avoid the hymen and swab the outer vulval vestibule instead. Ī glass or plastic rod of 6 mm diameter having a globe on one end with varying diameter from 10 to 25 mm, called a Glaister Keen rod, is used for close examination of the hymen or the degree of its rupture. Remnants of the hymen are called carunculae myrtiformes. The hymen can stretch or tear as a result of various behaviors, by the use of tampons or menstrual cups, pelvic examinations with a speculum, sexual intercourse, insertion of multiple fingers or items into the vagina, and activities such as gymnastics (doing 'the splits'), horseback riding or trauma caused by a "straddle injury". Īrrows point to carunculae myrtiformes ("remnants") of the hymen in a post-pubertal individual. During puberty, estrogen causes the hymen to become very elastic and fimbriated. Post neonatal stage, the diameter of the hymenal opening (measured within the hymenal ring) widens by approximately 1 mm for each year of age. Their hymenal opening tends to be annular (circumferential). For the first two to four years of life, the infant produces hormones that continue this effect. 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). At month five, 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 normally becomes perforate before or shortly after birth. At week twelve, the Müllerian ducts fuse to create a primitive uterovaginal canal called unaleria. 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 seven, the urorectal septum forms and separates the rectum from the urogenital sinus. The genital tract develops during embryogenesis, from the third week of gestation to the second trimester, and the hymen is formed following the vagina. Therefore, the state of the hymen is not a reliable indicator of virginity, though " virginity testing" remains a common practice in some cultures, sometimes accompanied by hymen reconstruction surgery to give the appearance of virginity. Historically it was believed that first penetration was necessarily traumatic, but now sources differ on how common tearing or bleeding are as a result of first intercourse. Minor injuries to the hymen may heal on their own, and not require surgical intervention. The hymen can rip or tear during first penetrative intercourse, which usually results in pain and, sometimes, mild temporary bleeding or spotting. Very rarely, it may be completely absent. ![]() ![]() Normal variations of the post-pubertal hymen range from thin and stretchy to thick and somewhat rigid. During puberty, estrogen causes the hymen to change in appearance and become very elastic. Each shape in the natural range has a Latinate name. In children, a common appearance of the hymen is crescent-shaped, although many shapes are possible. The term comes straight from the Greek, for 'membrane'. ![]() It forms part of the vulva, or external genitalia, and is similar in structure to the vagina. A small percentage are born with hymens that are imperforate and completely obstruct the vaginal canal. The hymen is a thin piece of mucosal tissue that surrounds or partially covers the vaginal opening.
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