What Is Imperforate Hymen? Symptoms, Causes, Diagnosis, Treatment, and Prevention

This condition is one of the most common types of blockages of the vagina.

An imperforate hymen is a condition in which the hymen covers the entire opening of the vagina, sealing it shut.

The condition is a congenital disorder, meaning that it's something a girl is born with. No one knows why it happens.

What Is the Hymen?

The hymen is a thin membrane that usually covers part of the opening of the vagina. It typically has an opening that widens as a girl approaches puberty.

Hymens may have different shapes, with the most common shape being a half moon.

The presence of a hymen doesn't indicate "virginity." In fact, some girls are born without a hymen.

The hymen can stretch or tear during sexual intercourse, tampon insertion, sporting activities, or medical procedures.

Signs and Symptoms of Imperforate Hymen

Doctors often diagnose imperforate hymen in girls shortly after birth, but some girls may not know they have it until puberty.

In a pubescent girl, lack of a first menstrual period may be a sign of an imperforate hymen.

An imperforate hymen typically doesn't cause any problems until a girl gets her period. At this point, the hymen membrane can block menstrual blood from flowing out of the vagina.

This blockage may cause:

• A painful mass or a feeling of fullness in the lower abdomen or pelvis (from the buildup of menstrual blood in the vagina)
• Stomach pain
• Back pain
• Difficulty urinating
• Painful bowel movements

How Is Imperforate Hymen Diagnosed?

An imperforate hymen can often be diagnosed with a simple pelvic exam.

During a pelvic exam, your doctor will have you lie on your back with your knees bent and your feet up on a pair of supports called stirrups. The doctor will inspect your genitals for any abnormalities.

If you appear to have an imperforate hymen, your doctor may recommend some additional tests — such as a pelvic ultrasound — to make sure there aren't other problems contributing to your symptoms.

Treatment and Medication Options for Imperforate Hymen

An imperforate hymen can be fixed with a minor surgical procedure.

Surgery to remove an imperforate hymen can be performed in infants, but some parents opt to wait until closer to puberty. Girls recover from the surgery within a few days.

The doctor will make a small cut in the hymen to remove the extra tissue and create a normal-sized opening for the vagina. If there's old menstrual blood stuck in the vagina, the doctor will remove it at this time.

The doctor may insert a small ring at the entrance of the vagina to prevent the opening from closing.

Sometimes dilators are used to keep this incision open. A dilator looks like a tampon, and it's inserted into the vagina for about 15 minutes each day during recovery from the surgery.

After the surgery, you'll be able to have normal menstrual periods and can use tampons.

Surgery to remove an imperforate hymen won't affect a girl's future ability to have vaginal intercourse or have children.