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| {{about|the vaginal membrane|the village|Himen, Iran|other uses}} | |||
| {{Use mdy dates|date=November 2016}} | |||
| {{Infobox anatomy | |||
| | Name = Hymen | |||
| | Latin = hymen vaginae | |||
| | GraySubject = 270 | |||
| | GrayPage = 1264 | |||
| | Image = Gray1229.png | |||
| | Caption = External genital organs of female. The labia minora have been drawn apart. | |||
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| | Precursor = | |||
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| | Artery = | |||
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| | Lymph = | |||
| | MeshName = Hymen | |||
| | MeshNumber = A05.360.319.779.479 | |||
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| }} | |||
| The '''hymen''' is a ] that surrounds or partially covers the external ]l opening. It forms part of the ], or ], and is similar in structure to the vagina.<ref name=emans /><ref name="Perlman">{{Cite book|last1=Perlman|first1=Sally E. | last2=Nakajyma | first2=Steven T. | last3=Hertweck| first3=S. Paige |title=Clinical protocols in pediatric and adolescent gynecology|year=2004|publisher=Parthenon |page=131 |isbn=1-84214-199-6 }}</ref> The hymen does not seem to have a specific physiological function or purpose.<ref>{{cite book|last=Blank|first=Hanne|title=Virgin: The Untouched History |url=https://books.google.com.au/books?id=V6IPvgFKGFUC&pg=PA72|edition= |year=2008|publisher=Bloomsbury Publishing |location= |page=72 |isbn=9781596917194}}</ref> In children, although a common appearance of the hymen is ]-shaped, many shapes are possible. Normal variations of the hymen range from thin and stretchy to thick and somewhat rigid; or it may also be completely absent.<ref name=emans/> | |||
| The hymen often, though not always, rips or tears the first time a female engages in ], which may cause some temporary bleeding and slight discomfort.<ref name="ucsb sexinfo"/> The hymen can also stretch or tear as a result of various other behaviors; for example, it may be lacerated by disease, injury, medical examination, ] or physical exercise. The hymen does not regenerate itself after it is torn,<ref>{{cite web |url=http://www.lehmiller.com/blog/2015/1/29/sex-question-friday-is-it-possible-for-a-woman-to-become-a-virgin-again |title=Sex Question Friday: Is It Possible For A Woman To Become A Virgin Again? |author=Dr Justin J. Lehmiller |date=February 6, 2015 |accessdate=2016-11-24 }}</ref> but may be surgically restored in a procedure called ]. For these reasons, the state of the hymen is not a conclusive indicator of ],<ref name="Perlman"/><ref name="Knight"/> though it continues to be considered so in certain cultures. | |||
| ==Development and histology== | |||
| The ] during ], from the third week of ] to the ], and the hymen is formed following the ]. At week seven, the ] forms and separates the ] from the ]. At week nine, the ]s move downwards to reach the urogenital sinus, forming the uterovaginal canal and inserting into the urogenital sinus. At week twelve, the Müllerian ducts fuse to create a primitive uterovaginal canal called unaleria. At month five, the vaginal canalization is complete and the fetal hymen is formed from the proliferation of the sinovaginal bulbs (where Müllerian ducts meet the urogenital sinus), and normally becomes perforate before or shortly after birth.<ref name="healey">{{cite book |last=Healey |first=Andrew |editor-last1=Mann |editor-first1=Gurdeep S. |editor-last2=Blair |editor-first2=Joanne C. |editor-last3=Garden |editor-first3=Anne S. |title=Imaging of Gynecological Disorders in Infants and Children |publisher=Springer |date=2012 |pages=21–30 |chapter=Embryology of the female reproductive tract |isbn=978-3-540-85602-3 |doi=10.1007/978-3-540-85602-3}}</ref> | |||
| The hymen has no nerve innervation. In newborn babies, still under the influence of the mother's ], the hymen is thick, pale pink, and redundant (folds in on itself and may protrude). For the first two to four years of life, the infant produces hormones that continue this effect.<ref name="McCann">McCann, J; Rosas, A. and Boos, S. (2003) "Child and adolescent sexual assaults (childhood sexual abuse)" in Payne-James, Jason; Busuttil, Anthony and Smock, William (eds). Forensic Medicine: Clinical and Pathological Aspects, Greenwich Medical Media: London, a)p.453, b)p.455 c)p.460.</ref> Their hymenal opening tends to be annular (circumferential).<ref name=heger>{{Cite book | last1=Heger | first1=Astrid | authorlink = Astrid Heppenstall Heger | last2=Emans | first2=S. Jean | last3=Muram | first3=David |title=Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas |edition=Second |year=2000 |publisher=Oxford University Press |page=116 |isbn=0-19-507425-4 }}</ref> | |||
| Past ] stage, the diameter of the hymenal opening (measured within the hymenal ring) widens by approximately 1 mm for each year of age.<ref name="WebMD" /> During ], the hymenal opening can also be enlarged by ] or ] use, ]s with a ], regular physical activity or sexual intercourse.<ref name=emans/> Once a girl reaches puberty, the hymen tends to become very elastic. | |||
| The hymen can stretch or tear as a result of various behaviors, such as the insertion of multiple fingers or items into the vagina, and activities such as gymnastics (doing 'the splits'), or horseback riding.<ref name="ucsb sexinfo"/> Remnants of the hymen are called carunculae myrtiformes.<ref name="Knight">{{cite book|last=Knight|first=Bernard|title=Simpson's Forensic Medicine|edition=11th|year=1997|publisher=Arnold|location=London|page=114|isbn=0-7131-4452-1}}</ref> | |||
| A glass or plastic rod of 6 mm diameter having a globe on one end with varying diameter from 10 to 25 mm, called Glaister Keen rod, is used for close examination of the hymen or the degree of its rupture. In forensic medicine, it is recommended by health authorities that a physician who must swab near this area of a prepubescent girl avoid the hymen and swab the outer ] instead.<ref name=McCann/> In cases of suspected ] or ], a detailed examination of the hymen may be performed, but the condition of the hymen alone is often inconclusive.<ref name="Perlman"/> | |||
| ==Anatomic variations== | |||
| ] | |||
| Normal variations of the hymen range from thin and stretchy to thick and somewhat rigid; or it may also be completely absent.<ref name=emans>Emans, S. Jean. "Physical Examination of the Child and Adolescent" (2000) in ''Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas'', Second edition, Oxford University Press. 61–65</ref><ref name="McCann"/> The only variation that may require medical intervention is the imperforate hymen, which either completely prevents the passage of menstrual fluid or slows it significantly. In either case, surgical intervention may be needed to allow menstrual fluid to pass or intercourse to take place at all. | |||
| Prepubescent girls' hymenal openings come in many shapes, depending on hormonal and activity level, the most common being crescentic (posterior rim): no tissue at the 12 o'clock position; crescent-shaped band of tissue from 1–2 to 10–11 o'clock, at its widest around 6 o'clock. From puberty onwards, depending on ] and activity levels, the hymenal tissue may be thicker, and the opening is often ]ted or erratically shaped.<ref name=heger/> In younger children, a torn hymen will typically heal very quickly. In adolescents, the hymenal opening can naturally extend and variation in shape and appearance increases.<ref name=emans/> | |||
| Variations of the female reproductive tract can result from ] or hypoplasia, canalization defects, lateral fusion and failure of resorption, resulting in various complications.<ref name="WebMD">{{cite web|url=http://emedicine.medscape.com/article/269050-overview |title=Imperforate Hymen |accessdate=2009-02-02 |quote=Different normal variants in hymenal configuration are described, varying from the common annular, to crescentic, to navicular ("boatlike" with an anteriorly displaced hymenal orifice). Hymenal variations are rarely clinically significant before menarche. In the case of a navicular configuration, urinary complaints (e.g., dribbling, retention, urinary tract infections) may result. Sometimes, a cribriform (fenestrated), septate, or navicular configuration to the hymen can be associated with retention of vaginal secretions and prolongation of the common condition of a mixed bacterial vulvovaginitis. |publisher=] }}</ref> | |||
| * ]:<ref>{{Cite book|last= |first= |authorlink= |vauthors= |title=Encyclopedia of Jewish Medical Ethics |year=2003 |publisher= |quote=Occasionally, the hymen is harder than normal or it is complete and sealed without there being ... This condition is called imperforate hymen and, at times ... | url=https://books.google.com/?id=aaklGZAID08C&pg=PA1115&dq=hymen |isbn=1-58330-592-0 |author1= Steinberg, Avraham |author2= Rosner, Fred }}</ref><ref>{{Cite book|last=DeCherney |first=Alan H. |authorlink= |author2=Pernoll, Martin L. |author3=Nathan, Lauren |title=Current Obstetric & Gynecologic Diagnosis & Treatment |year=2002 |publisher=McGraw-Hill Professional| page=602 |quote=Imperforate hymen represents a persistent portion of the urogenital membrane ... It is one of the most common obstructive lesions of the female genital tract. ... |url=https://books.google.com/?id=9xD0inFiEIAC&printsec=frontcover#PPA602,M1 |isbn=0-8385-1401-4 }}</ref> hymenal opening nonexistent; will require minor surgery if it has not corrected itself by puberty to allow menstrual fluids to escape. | |||
| * Cribriform, or microperforate: sometimes confused for imperforate, the hymenal opening appears to be nonexistent, but has, under close examination, small perforations. | |||
| * Septate: the hymenal opening has one or more bands of tissue extending across the opening. | |||
| ==Cultural significance== | |||
| {{weasel|section|date=August 2016}} | |||
| The hymen is often attributed important cultural significance in certain communities{{which|date=August 2016}} because of its association with a woman's ].<ref name="ucsb sexinfo">{{cite web|url=http://www.soc.ucsb.edu/sexinfo/article/hymen |title=The Hymen |accessdate=2009-02-09 |quote=The hymen can have very important cultural significance in certain cultures because of its association with a woman’s virginity. |publisher=] }}</ref> In those cultures{{which|date=August 2016}}, an intact hymen is highly valued at marriage in the belief that this is a proof of virginity.<ref name="ucsb sexinfo" /><ref>{{Cite news|url=http://www.reuters.com/article/2007/04/30/us-muslimwomen-europe-virginity-idUSL2532025120070430?pageNumber=2&sp=true |title=Muslim women in France regain virginity in clinics |publisher=Reuters |quote='Many of my patients are caught between two worlds,' said Abecassis. They have had sex already but are expected to be virgins at marriage according to a custom that he called 'cultural and traditional, with enormous family pressure'. | date=April 30, 2007}}</ref><ref name=europe/> | |||
| Some women undergo ] to restore their hymen for this reason.<ref name=europe>{{Cite news|first= |last= |authorlink= |vauthors= |title=In Europe, Debate Over Islam and Virginity |url=http://www.nytimes.com/2008/06/11/world/europe/11virgin.html?_r=1&scp=1&sq=hymen&st=nyt&oref=slogin|quote='In my culture, not to be a virgin is to be dirt,' said the student, perched on a hospital bed as she awaited surgery on Thursday. 'Right now, virginity is more important to me than life.' |work=] |date=June 11, 2008 |accessdate=2008-06-13 | first1=Elaine | last1=Sciolino | first2=Souad | last2=Mekhennet}}</ref> | |||
| ==Womb fury== | |||
| In the 16th and 17th centuries, medical researchers used the presence of the hymen, or lack thereof, as founding evidence of physical diseases such as "womb-fury", i.e. ]. If not cured, womb-fury would, according to these early doctors, result in death.<ref>Berrios GE, Rivière L. (2006) 'Madness from the womb'. ''History of Psychiatry''. 17:223-35.</ref><ref>The linkage between the hymen and social elements of control has been taken up in Marie Loughlin's book published in 1997</ref> | |||
| <!--==Modern perspective==In late 2005, Monica Christiansson, former maternity ward nurse and Carola Eriksson, a PhD student at ] announced that according to studies of medical literature and practical experience, the hymen should be considered a social and cultural myth, based on deeply rooted stereotypes of women's roles in sexual relations with men. Christiansson and Eriksson support their claims by pointing out that there are no accurate medical descriptions of what a hymen actually consists of. Statistics presented by the two state that fewer than 30% of women who have gone through puberty and have consensual intercourse bleed the first time. Christiansson has expressed an opinion that the use of the term "hymen" should be discontinued and that it should be considered an integral part of the vaginal opening.<ref> {{sv icon}}</ref>--> | |||
| ==Other animals== | |||
| Due to similar reproductive system development, many mammals have hymens, including chimpanzees, elephants, manatees, whales, horses and llamas.<ref>{{Cite book|last=Blank |first=Hanne|authorlink=Hanne Blank|url=https://books.google.com/?id=shq1AAAAIAAJ&dq=Virgin%3A+The+Untouched+History&q=toothed+whales | title=Virgin: The Untouched History |year=2007|publisher=] |page=23 |isbn=1-59691-010-0 |accessdate=2013-11-09}}</ref><ref>{{Cite book|last=Blackledge |first=Catherine |authorlink= |title=The Story of V |year=2004 |publisher=] |quote=Hymens, or vaginal closure membranes or vaginal constrictions, as they are often referred to, are found in a number of mammals, including llamas, ... | url=https://books.google.com/?id=f2d-11Y_u3cC&pg=PP250&dq=guinea+pig+hymen |isbn=0-8135-3455-0 }}</ref> | |||
| ==See also== | |||
| <!-- THIS SECTION IS ONLY FOR LINKS TO OTHER WIKIPEDIA ARTICLES --> | |||
| *] | |||
| ==References== | |||
| {{Reflist|2}} | |||
| ==External links== | |||
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| *—the historical context of ] | |||
| *—Interview with Hanne Blank, author of ''Virgin: The Untouched History''. Discusses relationship between hymen and concept of virginity. | |||
| * Radiology (US - ultrasound) of Hydrocolpos | |||
| * at the American Family Physician | |||
| * Scarleteen, Sex education for the real world | |||
| * | |||
| * | |||
| {{Female reproductive system}} | |||
| ] | |||