Hymen surgery

The Hymen: a thin membrane in the vagina

The hymen is a thin, delicate membrane. You can compare it to skin but much thinner and consisting of elastic and fibrous tissue. It partially covers the opening (introitus) of the vagina in most girls. It is a remnant from the development as a foetus, of the membranes of the vagina and urogenital sinus at their point of fusion.

In younger women, the hymen is very vascular. In menopausal women it has become very thin. In adult virginal women, the hymen surrounds the vaginal opening more or less completely.

Function of the hymen

The biological function of the human hymen is still uncertain. Scientists hypothesize that it protects the vagina from infection in infants. It has to be incomplete, in order to allow the outflow of menstrual blood at the onset of puberty.

The social function of the hymen, however, has been and still is a mythical symbol of virginity in many cultures.

Rupture of the hymen

Rupture of the hymen normally occurs during first intercourse (coitus) or rape. But many girls and teens tear, or otherwise dilate, their hymen for instance:

• During sports like bicycling, horseback riding, gymnastics etc.
• Inserting tampons.

A girl may not even be aware that a hymen tear has occurred, since there may be little or no blood loss, nor pain.

The Hymen usually tears posteriorly or posterolaterally into two or more portions. Commonly, rupture of the hymen is accompanied by slight bleeding, which stops spontaneously. Occasionally, a larger vessel can bleed profusely, possibly even leading to shock and requiring a blood transfusion. Even in severe cases, bleeding can usually be controlled by applying direct pressure to the bleeding point. Only very rarely surgical assistance is required.

In case of a wide or elastic hymen, the hymen may not be lacerated even with repeated coitus, particularly in case of a thin penis. In fact, many cases of pregnancy have been reported in women in whom the hymen has not been ruptured.

Some women are born without even a trace of a hymen.

Virgin: restoring virginity?

The term "virgin" typically means someone who has never had sexual intercourse, specifically the penis entering the vagina.

A man loses his virginity the first time his penis enters the vagina. Similarly, a woman loses her virginity the first time a penis enters her vagina

Being a virgin is not about whether a woman's hymen is intact or broken. Restoring virginity, for that matter, is not possible.

It used to be that on her wedding night, if a woman's first sexual intercourse was painful and left blood on the sheets, this was proof that she was a virgin.

Restoration of the Hymen

It is not uncommon for the gynaecologist-on-call to be consulted by a blushing young female surrounded by a whole horde of male relatives demanding that she be examined. She did not bleed during sexual intercourse on her wedding night, and the men all want to know “why”.

A simple reassurance of the doctor may save in cases like this the girl’s honour. The bride probably had an elastic hymen, which many women do anyway, and in such case she wouldn't bleed. Surgeons construct or restore hymens mostly for cultural reasons. This can be very important for some.

The procedure comes under a number of names such as: Hymenorrhaphy, hymenoplasty, reconstruction of the hymen, hymen restoration, Hymen replacement surgery or restoration of the hymenal ring.

Restoration of the hymen is done on an outpatient basis, under local anesthesia or sedation.

Hymen surgery

Simple repair

Restoring the hymen consists of piecing together the remnants by closing the tear. It is a very simple procedure that must be done three to seven days before the wedding.
The tissue is simply pulled together. The result is not meant to last. In this type of surgery, definite healing is rare because the hymen is relatively avascular.

Alloplant

A Tear-through biomaterial can be inserted. This is also a temporary measure, carried out shortly before marriage in certain cultures.

Hymen reconstruction

When the hymenal remnants are insufficient and definitive repair is envisaged by approximating the undermined hymen remnants or a vaginal flap. This produces vascular bands across the introitus.