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Imperforate Hymen

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The Hymen is the passage to the vagina. It is a thin membrane which covers a portion of the vagina and is usually present in all women, barring a few exceptions, as some women don’t have a hymen at all. Hymen acquired a sort of sacral character, as the humankind progressed and conservatives started treating it as if associated with the women’s respect. Factually speaking, the hymen starts expanding when a girl crosses puberty and can be stretched even during sports, or tampon insertion, or in the course of sexual intercourse.

The presence of hymen becomes problematic for a woman when it covers the entire vagina, almost sealing it. This medical condition is referred to as Imperforate Hymen or in simpler terms, a hymen without an opening.

Out of all hymenal misconfigurations witnessed among women, Imperforate Hymen is one of them. No doubt, it is troublesome and requires treatment as soon as diagnosed. However, with the ongoing advances in medical science, it has become something not to be afraid.

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What are the Causes of Imperforate Hymen?

Imperforate Hymen is a congenital disorder, i.e., it is present right from birth with an approximate incidence of 0.05-0.1%. It may occur during the development of the embryo when the hymenal membrane fails to develop properly or does not perforate. Family history has been traced in very rare cases, but usually, genetic markers are not tied to Imperforate Hymen.

What are the Symptoms of Imperforate Hymen?

Some of the issues which women with Imperforate hymen face are:

  • ● Abdominal or pelvic pain, which occurs cyclically
  • ● A sensation of fullness in the lower belly, as the Imperforate Hymenblocks the blood from flowing out
  • ● Amenorrhea, i.e., menstruation does not happen despite puberty and other signs of adolescence, such as developing breasts
  • ● Retention of urine or painful urination
  • ● Bowel issues such as constipation

Other symptoms might include low back pain, nausea, and diarrhea. It is extremely important to visit a Gynaecologist if these issues persist.

How is Imperforate Hymen Diagnosed?

It can be diagnosed right away during infancy through ultrasonography, and if not, it is diagnosed in adolescent girls post-menarche when any of the above-stated symptoms appear, specifically amenorrhea or urinary retention. A routine examination of genitalia during childhood is strongly recommended for early diagnosis of any such abnormality. Once you visit a doctor, your external genitals will be inspected to trace the hymen, and a pelvic examination will be carried out. In the case of Imperforate Hymen, a blue membrane will be seen due to the collection of menstrual blood.

If the diagnosis is delayed, it may result in severe complications, such as urinary tract infections due to mucus buildup, inflammation in the inner abdomen, problems in conceiving, painful intercourse, endometriosis (a medical condition in which the tissues that cover the inner layer of the uterus grow outside it), and instances of reverse bleeding in the reproductive organs.

How is Imperforate Hymen Treated?

To relieve the symptoms, the doctor might advise the intake of contraceptive pills so that the menstrual cycle can be stopped temporarily to prevent the accumulation of blood. Painkillers may be given for relieving the pain. In extreme situations, the hymen is removed by surgical interventions. Incisions are made in the hymen to remove the extra membrane. Often, they are removed from their base, and the fluid is drained out of the vaginal canal. To keep the incision open, dilators are inserted in the vagina every day for 10-15 minutes till you recover from surgery. In some cases, you may require additional surgery for vaginal septum repair and vaginoplasty.

Though the surgery can be done at infancy as well, doctors and usually parents opt for delaying the procedure till puberty. The entire procedure of curing Imperforate Hymen is known as “Hymenectomy”.

What is the Results of Imperforate Hymen Treatment?

The result is meant to be positive. You will have a regular menstruation cycle after the surgery and can use tampons during your periods. A healthy sexual life awaits you, and the surgery won’t affect your ability to conceive a baby.

What are the Risks Associated with Imperforate Hymen treatments?

Some of the risks associated after surgery are:

  • ● Reclosure of the opening in case of lack of expertise on the part of the surgeon.
  • ● Vaginal adhesion or adhesion in the vaginal canal.
  • ● Damage to urethral sphincter (muscles which control the outlet of urine) or to the urinary bladder.
  • ● Cicatricial stenosis (abnormal contraction of the scar) in the upper vagina.

However, these risks arise largely in case of medical negligence and that, too, rarely. A second Hymenectomy might be required in some cases.

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Can Imperforate Hymen be Treated without Surgery?

In the case of newborns, if symptoms are not visible, most probably, the doctor won’t recommend surgery. It will only be required if the fluid starts accumulating, further aggravating the situation. However, in the case of adolescent girls, surgery would be required to avoid further complications.

Can Imperforate Hymen Reduce the Chances of Pregnancy?

If not diagnosed at an early stage, it can result in endometriosis (a situation in which tissues cover the outside layer of the uterus), which in turn reduces the chances of fertility. After a successful surgery, there will be no obstacles to your motherhood.

Is Imperforate Hymen Inherited From Older Generations?

This is extremely rare. No genetic mutations have been held responsible for its occurrence.

Does Imperforate Hymen Affect Periods?

Yes, it results in painful periods or even a situation where you might have no periods at all. Since the blood gets collected in the vagina but does not flow out due to Imperforate Hymen, it results in infections in the genitals.

What Does a Normal Hymen Look Like?

The hymen is normal if it does not obstruct the passage to the vagina entirely. Complications arise when this passage gets blocked. Normally, hymen is in the shape of a half-moon, which allows the menstrual blood to flow out easily.

How Much Time is Required to Recover from the Surgery?

It takes around six weeks to be entirely fit and for the marks of the surgery to vanish.


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