I Think My Daughter has an Imperforate Hymen. What Happens Now?

The hymen is often central to discussions about women's sexuality. An intact hymen as the ultimate proof of virginity is a myth that remains very prevalent.

Not much is said about the imperforate hymen, but this is an issue worthy of discussion, especially its effect on teenage girls. Being cognizant of the cultural connotations around the hymen is important when talking with your teenage daughter. You want to make sure you are creating a judgment-free zone so she feels comfortable sharing her symptoms.

What is an imperforate hymen?

The hymen is a thin membrane that stretches across the opening of the vagina. It can rip or tear during intercourse, through tampon use or other various activities such as horseback riding and swimming. An imperforate hymen occurs when there is no opening to the vagina present. It is an uncommon congenital anomaly with an incidence rate of approximately 0.05 to 0.1 percent that is easily diagnosed at birth. Medical intervention for the condition only occurs when symptoms persist.

Congenital factors of an imperforate hymen

A congenital condition is any condition that a person is born with. The imperforate hymen occurs when the hymen fails to have an opening, completely sealing the vagina. It is usually an incidental finding first diagnosed at birth or in early childhood.

Evidence of the condition is usually a bulge in the hymenal membrane caused by a buildup of normal mucus in the vagina that cannot drain. There are no hereditary indications associated with an imperforate hymen and the cause of the condition is unknown.

How the imperforate hymen affects menstruation

If the imperforate hymen is not diagnosed in early childhood or before, your daughter may first realize she has a problem when she hits puberty. Because an imperforate hymen seals the vaginal opening, it will prevent menstrual flow. Your teenage daughter will probably complain of abdominal or back pain, amenorrhea, fullness in the lower abdomen and difficulty urinating or having a bowel movement.

To help prepare your daughter for the diagnosis, let her know the doctor will review her health history and symptoms and then do a physical examination. The exam is painless and does not include an internal pelvic exam.

How is an imperforate hymen treated?

Surgery is needed to remove the excess hymenal tissue. Dissolvable stitches will be placed to prevent the formation of scar tissue. The procedure can be done in one day and, barring any complications, doesn't generally require an overnight hospital stay.

Your medical professional will decide when the surgery is done depending on your daughter's symptoms. Surgery will not be recommended for a newborn or young girl unless there is fluid collection or an infection. Surgery is often delayed until after the onset of puberty because there is more surface area for an operation. The presence of estrogen makes the tissue more pliable and relaxed. Estrogen also helps to facilitate surgical repair and healing.

When preparing your teenage daughter for the surgery, you can reassure her with the following facts:

1. There are usually no long-term issues after the surgical correction.
2. Her periods will be comfortable after surgery, and she will be able to use tampons if she wants.
3. Surgery won't prevent her from giving birth in the future.

Teenage girls are already dealing with many physical and emotional changes. There is also often a struggle around physical appearance and trying to fit in. Realizing there may be one more thing that makes them different from their peers can be scary. As a parent, the best way you can support your daughter is reassuring her so she understands exactly what is happening to her body and what to expect, along with making sure she receives the appropriate medical care for her condition.