Hymen Variants

What Are Hymen Variants?

Hymen is a thin piece of tissue located at the opening of the vagina. The hymen needs to be open to allow menstrual blood and normal secretions to exit the vagina. Hymens come in different shapes.

What Are the Different Types of Hymen Variants?

Imperforate Hymen

A condition in which the hymen fails to open up and therefore completely covers the opening to the vagina, blocking menstrual blood and secretions from flowing out. An imperforate hymen may be noted at birth, but more commonly is diagnosed during puberty. An adolescent girl with an imperforate hymen typically presents with no menstrual period and abdominal or pelvic pain. This is due to the vagina being filled with menstrual blood that cannot exit. The patient may also have urinary symptoms - such as urinary frequency, urinary urgency, or feelings of incomplete voiding.

Microperforate Hymen

A condition in which the hymen has a very small opening. Menstrual blood and vaginal secretions can flow out of the vagina, but the patient may have difficulty or inability to use tampons or have vaginal intercourse. In some cases, a teen with a microperforate hymen may not realize that she has a very small opening. If she is able to place a tampon into her vagina, she may not be able to remove it when it becomes filled with blood.

Cribiform Hymen

A condition in which the hymen has several very small openings. Menstrual blood and vaginal secretions can flow out of the vagina, but the patient will be unable to use tampons or have vaginal intercourse.

Septate Hymen

A septate hymen occurs when the hymen has a band of extra tissue in the middle that causes two small vaginal openings instead of one. Menstrual blood and vaginal secretions can flow out of the vagina, but the patient may have difficulty or inability to use tampons or have vaginal intercourse. In some cases, a teen with a septate hymen may not realize that she has extra tissue. If she is able to place a tampon into her vagina, she may not be able to remove it when it becomes filled with blood.

What Is the Treatment for Hymen Variants?

Treatment of a hymen variant (imperforate, microperforate, septate or cribiform hymens) is a minor outpatient procedure, called a hymenectomy – during which the gynecologist removes the excess tissue, leaving a vaginal opening that is the appropriate size. Once the extra tissue is removed, it does not grow back.

The gynecologist may perform the procedure in the office or operating room depending upon the amount of hymen tissue that needs to be removed and patient comfort. Patients do very well with this procedure and have little or no pain after hymenectomy.