The hymen is a thin membrane that covers the entrance to the vagina and appears to protect against frequent infections in the female reproductive system. Usually, girls are born with a small perforation in this membrane to allow access to the vagina, however, some may be born with the membrane completely closed, causing discomfort, especially when menstruation occurs.
Thus, many girls may not know that they have an imperforated hymen until the first menstrual period appears, as the blood cannot escape and therefore accumulates inside the vagina, generating symptoms such as severe abdominal pain and sensation weight on the bottom of the belly, for example.
In addition, the lack of perforation in the hymen also prevents sexual intercourse, making it necessary to undergo minor surgery to cut the hymen and create a perforation similar to what should have existed since birth.
Possible symptoms
The first symptoms of imperforate hymen appear during puberty and happen, mainly, due to the accumulation of menstrual blood that cannot escape through the vaginal canal. In these cases, signs may include:
- Feeling of heaviness in the bottom of the belly; Severe abdominal pain; Back pain; Difficulty urinating; Pain when evacuating.
In addition, girls who show all signs of development of puberty, but who appear to be delayed when they start menstruation, may also have an imperforate hymen and, therefore, a gynecologist should be consulted to confirm the diagnosis.
In the case of the baby, the imperforate hymen is only identified if the doctor makes a detailed genital evaluation or if the hymen forms a small pouch that is easily seen in the vagina.
How to confirm the diagnosis
The diagnosis of imperforate hymen is almost always made through observation of the vaginal canal by the doctor, after the description of the symptoms. However, there are also cases where the doctor chooses to have a pelvic ultrasound, to confirm that this is not another gynecological problem.
Since the problem has been present since birth, there are some girls whose diagnosis is made a few days after birth, while still in the maternity ward. In such cases, the parents can choose to undergo treatment or wait for the girl to grow up and reach adolescence.
How the treatment is done
The treatment for imperforate hymen is made through a small surgery, in which the doctor cuts the hymen and removes the excess tissue, creating an opening similar to the natural one.
Depending on the woman, the doctor may need to recommend using a small dilator to keep the hymen open and prevent it from closing again. This dilator is similar to a tampon and should be used for 15 minutes a day, during the recovery period.
In cases where the perforated hymen is identified in the baby by the pediatrician, the surgery can be done immediately or the parents can choose to wait for the girl to grow up, to reduce the risk of surgery complications.
