rupture of the hymen


The hymen is located in the middle of the vaginal vestibule, between the clitoris and the structure called commissure posterior, between the labium minors.

The appearance of the hymen changes over time with the effect of estrogen hormone after puberty. Although there are many different types of hymen such as annular (ring-shaped), crescentic (crescent-half-moon-shaped), septal, bilobatus, dentatus, fimbriatus, cripriformis, the crescentic type is the most common type of hymen. If the morphological structure of this type of hymen is examined, the hymenal tissue is attached at the 10-11 o’clock and 1-2 o’clock positions, and there is no hymenal tissue at the 12 o’clock level.

Hymen Examination Techniques

Legs lying on the hymen in the best gynecological position in frog position (frog-leg position) while visible. Before examining the hymen, the doctor puts on his gloves and gently pulls the labia, which he holds between the thumb and forefinger, outwards and downwards on both sides with the help of gauze. This movement is a very gentle movement, it is never a painful procedure as young girls often fear, and it never harms the hymen. During this examination, the pelvic muscles are not touched. If there is tension in the pelvic muscles, the vaginal vestibular structures and hymen cannot be observed.

especially in children knee-elbow position (prone knee-chest position)The posterior hymen, vagina, and anus can be seen more clearly, as the labia will be up and apart in the position where the head and chest touch the examination table and lie face down.

Younger children, on the other hand, can be easily and gently examined when held in the frog-leg position on their mother’s lap. To examine the hymen more clearly a moistened cotton-tipped swab can be used. With the help of this rod, it is possible to examine the fimbriae and the overdeveloped hymen.

In another advanced method of examining the pubertal hymen Foley catheter must use. The catheter is gently passed through the hymen opening into the vagina and the balloon of the Foley catheter is inflated, stretched with gentle traction, and lacerations or the normal anatomical structure of the hymen can be clearly evaluated.

Detection of Tearing of the Hymen

In fact, the hymen is not a symbol of virginity. Hymen tissue is usually very thin and delicate before ruberte. For this reason, many girls who participate in sports activities such as cycling, horseback riding, gymnastics and use tampons when they start menstruation are not even aware that their hymens are stretched, torn or enlarged. Since the hymen is very delicate when little girls start these sports and the hymen expands and stretches slowly over time during these sports, there is no bleeding or pain during the change in the hymen during this process.

Although it is the first time to have sexual intercourse, it can be observed that there is no bleeding from the hymen at an average rate of 20-30% and even rupture does not occur. Since some hymens are thin-sided and flexible, they can only be torn during childbirth. It is understood from the edema (swelling) and erythematous (redness) changes on the edges of the torn hymenal tissue that there is a relationship for the first time. The hymen may be torn mostly in the back. However, the anterior half of the hymen (upper part between 3 and 9 o’clock) should also be evaluated for notches and clefts. Parts of the hymen (caruncule hymenalis) resulting from rupture of the hymenal tissue should also be noted. Tears at the edges of the hymenal tissue are expressed according to the watch dials. Wound healing varies between individuals, but this usually disappears completely within a week. Bleeding may not occur in the first intercourse in those with a wide hymen, suitable for penetration and with thin edges, however, in this case, whether there is intercourse for the first time or not can often be determined by a careful and experienced gynecologist. For this reason, those who do not bleed during the first intercourse and are curious about the structure of the hymen should be examined within one week at the latest.

As mentioned before, the thin-sided hymen, which is flexible and wide, does not bleed during the first intercourse, and in some cases, the hymen does not stretch and does not deteriorate despite intercourse. As it can be understood from this, the fact that the hymen is intact does not mean that there was no previous sexual intercourse. A tear in the hymen does not always mean sexual intercourse.

Other Reasons for Tearing of the Hymen

Having ulcers in the hymen due to diseases such as diphtheria.

Sports activities that cause excessive tension in the hymen.

Falling on a hard cutting object.

Drugs used vaginally even though she is a virgin, tampons.

Extreme traumatic scratching.


Foreign body insertion.

Having undergone operations involving this region.

Risks to be Encountered After Tearing the Hymen

Bleeding:Although some bleeding is considered normal, excessive bleeding only occurs when the surrounding tissues along with the hymen are torn, and a gynecological examination is absolutely necessary.

Infection:In people with bad hygienic habits, infection in the genital organs may occur with bacteria in the vaginal canal or with various additional factors.

Fistula Formation: If the hymen tear involves the surrounding tissues, recto-vaginal or vasico-vaginal fistulas may occur. Fecal ablution or urine output can be observed through thin channels called fistulas. This is a very rare condition that requires surgery.

Repair of the Torn Hymen

After the hymen is ruptured, under general anesthesia and in sterile conditions hymenoplastyIt can be repaired using various methods by an operation called

Kiss. Dr. Kutlugul Yuksel

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