The hymen or hymen (himen) (from the ancient Greek god of marriage and wedding Hymenaeus) is a membranous fold of tissue 2-3 mm thick, 2-3 cm inside, covering the entrance of the external genitalia in women. This tissue, which can take various shapes, is usually at the entrance of the vagina and is in the shape of a crescent and is surrounded by thin capillaries. Although the hymen is thought of as a dice because of its name, it is not actually a real membrane.
It has no anatomically known function. It is thought to prevent the entry of microorganisms into the vagina before the fertile period.
This tissue loses its integrity during the first sexual intercourse (also called the first night, nuptial, bridal night, bridal night), and as a result, a small amount of bleeding occurs. This amount of bleeding may rarely be excessive. It can be stopped by looking with a mirror and pressing the bleeding area for 10-15 minutes with cotton or gauze. If it doesn’t stop though, you may need to see a doctor. Sometimes there may be no bleeding at all. The absence of bleeding may be due to the fact that the membrane is flexible and has a structure that allows intercourse.
The hymen may lose its integrity and bleed due to cycling, horse riding, falling from a height, masturbation, and intercourse through friction.
The structure and shape of the hymen is determined during the embryonic period, 1 out of every 1000 women is born without a hymen.
Knowing about sexuality before the first intercourse will reduce fears and prejudices about this issue. One of the most important causes of vaginismus is the fear that the hymen will tear, bleed or hurt.
The hymen has many anatomical variations.
Annular Hymen (Round ring) Hymen:
The hymen is in the form of a round ring and there is a ring-shaped hole in the middle. If the hole in the middle is too large, it may preserve its integrity despite the passage of the penis, and may not bleed. In this case, it is called “hymen suitable for duhule”. Among the people, the term “flexible dice” is used.
Crecentric Hymen (Half Moon) Hymen:
The dice are half-moon shaped. In the upper part, the membrane is thinner or absent, while it is prominent in the posterior part.
Hymen with Septa (Divided) Hymen:
In the middle part of the hymen, there is an intermediate piece of tissue belonging to the membrane that divides the space.
Cribriform hymen (Multi-hole, sieve-like) Hymen:
There is more than one hole in the middle of the hymen. With this appearance, it almost resembles a “colander”.
Imperforated hymen (Without Hole) Hymen:
There is no hole in the middle of the hymen and the entrance to the vagina is completely closed. Girls with this membrane do not experience any menstrual bleeding. Normal bleeding cannot be expelled from the body and accumulates in the vagina behind the hymen. It is a very painful condition and must be opened surgically.
Microperforated hymen (Small hole) Hymen:
The hole in the middle of the membrane is very small. Sometimes it may be necessary to widen the hole with surgical intervention.
Multipar hymen (in those who have given birth) Hymen:
In women who have given birth normally, the hymen is torn due to birth and the remaining parts are called “carincle (hymen residue)”. In addition, if the hymen develops too thick or inflexible, an intervention by the gynecologist may be required, as it will create an obstacle to intercourse.
Hymen repair can be done for many reasons. We doctors do not question why he had it stitched, and we do not have the right to do so. In America, the concept of virginity is not important at all, but many women applied to us for hymen repair. The reason may be regret, boyfriend crossing the line, being forced by the partner, regretting what he did. Sometimes girls think that their bodily integrity is impaired and may demand this as a treatment. It may be that he wants it to relax psychologically. An official document is issued to women who have to undergo a vaginal examination due to medical needs, and then a repair can be made. The patient may want to forget the past. A person’s power to make changes on his own body is his own. Just as a person can have breast and nose aesthetics, he can also have an operation on the hymen.
How to Sew the Hymen?
If the tear is new, the torn ends are brought together and sutured. If more than 1 week has passed after the rupture of the hymen, it can be repaired using a different technique. This repair can be performed using radiofrequency with local anesthesia and is permanent.