An imperforate hymen is a rare condition when your hymen completely covers the opening to your vagina. It’s considered a congenital anomaly (this means you were born with it). The hymen usually surrounds the opening of the vagina. If you have an imperforate hymen, this tissue blocks the opening so there is no hole present.
Your hymen is a small, thin membrane at the opening of your vagina. It’s leftover fragments of tissue from when your vagina was formed during fetal development. No one is quite sure what purpose a hymen serves, but some think it developed to help prevent bacteria from getting into the vagina.
The hymen changes over time. It’s thick at birth but loses its stretch over time due to hormones, physical activities or inserting tampons. Most hymens form a ring around your vaginal opening at birth, but then recede to just cover a small bottom portion of the vaginal opening. Your hymen is the same color as the skin around your vagina (flesh-colored). Hymens are more noticeable in infants because it hasn’t had time to wear down.
An imperforate hymen is rare and only occurs in about .5% of women.
If you have an imperforate hymen, you may not know until you reach puberty and start having issues with menstruation. Blood becomes trapped inside your vagina during menstruation because your hymen covers the exit out of your uterus. This can cause pain and other symptoms because the period blood becomes trapped inside your vagina.
Symptoms are caused by blood backing up into your vagina, uterus or fallopian tubes and can include:
An imperforate hymen can be detected in infants during a physical exam of the vagina or in a person’s teen years after puberty has occurred.
No one knows why some people develop an imperforate hymen. It’s something you are born with that happens while you are still in your mother’s womb. The hymen should open during fetal development. In the case of an imperforate hymen, this doesn’t occur.
If you have an imperforate hymen, you are usually still ovulating and menstruating, but the blood has nowhere to go. Blood becomes stuck in your vagina, and eventually, in your uterus or fallopian tubes. You don’t have a typical period when you have an imperforate hymen because the blood is blocked from exiting your vagina.
An imperforate hymen is diagnosed during an exam. This can happen when a baby is a newborn or later during the teen years. When a newborn has an imperforate hymen, it can often be seen as a small bulge. In teens, imperforate hymens are diagnosed once symptoms start or during a routine gynecological exam.
Healthcare providers diagnose an imperforate hymen by performing a visual exam of the vulva, hymen and vaginal opening. They will be able to see the hymenal tissue covering the vaginal opening. An ultrasound may be ordered to see the tissue better and confirm the condition.
Dr. Guerette performs a minor surgery called a hymenectomy can open or remove your hymen. This is a short, safe procedure done as an outpatient.
During a hymenectomy, Dr. Guerette will surgically open and reconstruct the hymen. The trapped blood will be drained. Dr. Guerette will then use absorbable stitches to secure the hymenal tissue into the vaginal wall and create an opening to ensure it heals correctly.
In some cases, Dr. Guerette will recommend a dilator in your vagina to prevent the hole from closing post-surgery. This is a tampon-shaped device worn in the vagina for several minutes a day or as prescribed by your healthcare provider.
There are no long-term complications of a hymenectomy, and most people will heal without any issues. You will get a menstrual period and be able to use tampons. Sex, pregnancy and childbirth are not affected by hymenectomy most of the time.
You should be able to menstruate normally. There are no long-term effects after fixing an imperforate hymen. Those who have treatment are able to have sex, get pregnant and deliver a baby.
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