Hymen

The hymen, namely HYMEN with its Latin name, is the “god of marriage and wedding”, the son of Dionysus and Aphrodite in Greek and Roman mythologies. Since the wedding night is dedicated to this God, the hymen is also called by the same name. (The feature of this god is that he has wings and carries a torch in his hand)

The medical name (Latin) of the hymen, which has varying degrees of sociological importance in almost all societies, is “Hymen”. It is of great importance, especially in Muslim countries, as it is seen as a criterion of whether there is a previous sexual relationship.

Even today, due to the absence of bleeding in the first intercourse after marriage, many of our girls are brought to the gynecologists for hymen examination by being held by the arms unjustly, thinking that they are not virgins. In this case, these young girls are humiliated and unfortunately have to start their marriage with a very bad memory; often due to insecurity, their marriages may result in divorce in a short time.

Throughout the historical development of mankind, many societies have seen hymen as a symbol of purity and untouchedness, that is, “virginity”. Extensions of this belief are still common in many societies around the world, just like our own.

Until very recently, young female students who were to be placed in boarding schools at the time of starting high school in our country were required to undergo a hymen examination as per the regulations, and they could only be registered with the “virginity” reports prepared by gynecologists. With the new legal regulations, these disgraceful practices have been abolished.

What does the hymen do?
The physiological (functional) function of the hymen has not been fully explained until now and it is generally thought that it does not have a special function.

However, some researchers have suggested that the hymen prevents the entry of microorganisms and foreign bodies into the vagina.

In forensic medicine, it is used in the diagnosis of children who have been exposed to sexual violence or abuse. Today, the hymen has a “sociological function” rather than a physiological function.

Anatomy
The hymen is the tissue fold that anatomically forms the vagina and forms the entrance to the vagina of tissue called “mucosa”. In other words, the hymen is not in the vagina, but at the entrance of the vagina, approximately 1-1.5 cm inside the lips and is connected to the small lips.

This structure is considered as one of the external genital formations. The anterior surface facing outward resembles the skin, and the posterior facing inside the vagina resembles the mucosa.

The hymen, which is found in almost all girls, may rarely be present at birth. The tissue, which is harder in childhood, changes and gains flexibility due to the release of estrogen hormone with puberty.

The above picture shows the genitals of an 18-year-old girl from a frontal view. The hymen is a thin structure located 1-1.5 cm inside the vaginal entrance.

The hymen does not completely close the vaginal entrance, there is a hole in the middle that allows menstrual blood and vaginal secretions to flow out. The shape and structure of this hole is used to determine the hymen types.

The shape, thickness and elasticity of the hymen vary greatly between individuals.

Types of Hymen
The hymen has many anatomical variations.

Apart from shape, hymen can also be classified according to the character of the hole and free edge, the thickness and strength of the membrane.

The hymen is usually torn with the first intercourse, foreign body or examination. During the first sexual intercourse, since the hole in the middle of the hymen is smaller than the diameter of the penis, the ring-shaped membrane is torn in several places and a small amount of bleeding occurs. These tears become nebbed within a few days and there is no more bleeding. Very rarely, bleeding may occur during a few intercourse following the first intercourse.

Sometimes, even if there is no relationship, the free edge of the hymen is not straight and there are notches. Approximately 20% of women may have congenital notches of this type, called “natural notches”, which do not go down to the base of the membrane. Detection of natural notches is important in terms of hymen examinations and forensic virginity reports.[newpage]

WE’LL ASK AND ANSWER BEFORE YOU ASK

Does the hymen necessarily bleed during the first sexual intercourse?
No. Although the hymen is partially flexible, it is an anatomical structure rich in vessels that are easily torn and bleed during the first intercourse inside the vagina.

However, the unique structure of the hymen allows the entry of the penis in some women and even if they have intercourse more than once, the membrane does not rupture. Such dice are called “duhule (passable) dice”. It is popularly referred to as the “elastic membrane”. In this case, the membrane will only rupture after normal delivery.

On the other hand, due to important structural differences between individuals, bleeding may not occur at the first sexual intercourse in those whose hymen is extremely flexible or if there are structurally few vessels on the membrane.

Sometimes, there may be no vessels in the area where the rupture occurred in the first intercourse, or very small vessels may coagulate immediately, so that no bleeding may be observed.

Does losing virginity cause pain ?
Some women may experience a significant amount of pain during the first intercourse. This is related to the fact that the hymen is thicker than normal and the person’s pain threshold is low.

However, in general, there is no unbearable discomfort during the rupture of the hymen. Here, the behavior and approach of the man is also extremely important. The first relationship inevitably causes anxiety and fear in every woman. The man’s slow, understanding and gentle behavior ensures that the event is painless.

In addition, as it should be in every relationship, the part called “foreplay” in the first relationship will be extended as much as possible and ensure that the vagina is wet enough, will cause the relationship to be more comfortable and painless.

How much is the bleeding?
The amount of bleeding is usually very small and stops on its own in a short time. However, very rarely, if bleeding does not stop as a result of the exposure of a vein behind the hymen, surgical intervention may be required.

In some cases, severe and non-stop bleeding may occur as a result of tears at the entrance of the vagina or even deep (“Coit tears”). In such cases, suturing with surgical intervention is required.

Does bleeding necessarily occur when the hymen is broken?
No. In some cases, there may be no bleeding, although the membrane may rupture.

Does bleeding indicate that the hymen is broken?
No. In some cases, the hymen does not deteriorate, but there may be tears or abrasions on the outer parts and bleeding may occur from these areas.

Can the hymen be broken in any other way than intercourse?
The hymen can also be torn by objects that enter the vagina and whose width is larger than the ring in the middle of the hymen. However, rarely, activities such as horse or bicycle riding, ballet that requires wide opening of the legs can also be impaired or damaged after accidents and traumas.

Does masturbation damage the hymen?
No. Unless an attempt is made to insert something into the vagina, external masturbation does not break the hymen.

Does the hymen heal on its own?
No. Once the hymen is damaged, it does not repair itself afterward, even if there is no intercourse.

Can it be understood when the hymen is broken?
Whether the tear is an old tear (after 7 days) or a new tear (before 7 days) can be determined by examination of the hymen. However, if more than 7-8 days have passed (in old tears), it cannot be understood when the membrane is broken with the first intercourse.

How do you know if the hymen is broken?
It is not possible to understand whether the hymen is damaged by the presence of bleeding or not, this can only be understood by an examination. The examination is an extremely short and painless procedure. For this, your doctor observes the hymen by pulling the big lips with gauze.

There is no hymen self-exam. You can see the hymen with the mirror, but interpreting it requires experience.

In some cases, even a gynecologist may not be able to decide on this and may need a “colposcopic examination”. Colposcope is a device that enables the examination of the vagina, cervix and external genital organs by magnifying them with a microscope. It can be difficult to decide on virginity, especially in hymen with a “natural notch”.

Can a person be found to be a virgin with ultrasound, MRI or Computed Tomography?
No. All these methods are incomprehensible. It can only be understood by a gynecological examination performed by an experienced gynecologist.

Can pregnancy occur without breaking the hymen?
Yes. Pregnancy does not necessarily impair hymen formation. Pregnancy can occur even though a flexible membrane, as previously described, is intact in a full sexual intercourse.

Another possibility is that the man ejaculates very close to the hymen, although it is also rare. Since sperm are cells that move with their flagella, they can pass from the entrance of the vagina to the cervix and from there to the tubes, encountering the egg and uniting (as a result of fertilization) and initiate pregnancy, including ectopic pregnancy.

For these reasons, even if there is no complete relationship (with ejaculation), the chance of pregnancy seems low, but this chance is never zero.

Is it possible to be examined or to have an abortion without breaking a hymen?
Yes. “Speculum examination” or even abortion can be performed without damaging the hymen structure in people with a suitable membrane structure – that is, with a wide opening.

Is it possible for a virgin woman to have a gynecological examination?
One of the most important stages of the gynecological examination is the speculum examination to observe the vagina and cervix. In daily medical practices, this procedure is mostly not applied in the examination of virgins and the manual examination is done from the rectum.

On the other hand, it is possible to take a vaginal culture in almost all virgin young girls and girls with discharge problems.

“On the first night it is necessary to pay attention to what?
In the first night, or more broadly, in the first sexual intercourse, there are important duties that fall on both men and women. The prerequisite for this first experience to be beautiful and evoking good feelings when remembered is for the woman to feel psychologically comfortable and ready. In addition, trust in the opposite sex partner is extremely important.

Your first sexual experience is not necessarily painful. When the woman relaxes enough and the man is gentle and tolerant, a painless first experience is most likely to occur.

The man should be patient and the process called “foreplay” should be extended and the vagina should be sufficiently wetted. This will make it easier for the penis to enter the vagina. In addition, over-the-counter medicines sold as lubricating gels (=lubricants) can also be applied to the genital area before intercourse.

One of the most important fears of women in their first experience is getting pregnant. Therefore, it is ideal for the man to use a condom or to have intercourse after the woman consults her doctor and starts using an appropriate contraceptive method.

Can the hymen be repaired?
Yes. The hymen can be repaired and this procedure is called “hymenoplasty (hymenoplasty)” or “hymenorraphy”. For this, it does not matter when or how many times you have intercourse. Even in women who have given birth, the hymen can be repaired.
It can only be understood by a gynecologist or forensic doctor that the hymen has been repaired.

In fact, it is impossible to completely repair and restore the damaged membrane. This tissue, which is extremely thin, usually does not hold stitches. The large number of microorganisms in the environment can easily infect the wound site.

On the other hand, a new hymen can be made with pieces (“vaginal flaps”) taken from the vaginal wall. Although the legal and moral dimension of this situation is controversial, it can sometimes be life-saving in societies like ours, where even murders due to virginity are common.

Controversy continues all over the world about hymen repair. But there is no consensus on how necessary this “artificial virginity” is.

Especially western authors think that this is an extremely unnecessary procedure, while some think that the procedure is not ethically different from plastic surgery.

Ladies who want hymen repair (hymenoplasty); They state that they need this in order to maintain their social status, happiness and even their lives depending on the social environment they live in.

When should the surgery be done?
This depends on the type of surgery to be performed. Some surgeries are independent of marriage and can be done anytime (long-term repair), while others can be done 2-4 days before marriage (short-term repair).

The procedure is a relatively simple operation that usually lasts for 20-30 minutes and can be performed under general anesthesia (by anesthetizing) or local anesthesia (by anesthetizing). In addition to the skill and experience of the person performing the procedure, the chance of success varies according to the person’s vagina condition.

Can every gynecologist perform hymen repair surgery?
No. Many gynecologists do not perform this operation in principle. However, there are doctors and clinics that perform this surgery in almost every country in the world, including the United States. Hymen operations are among the operations that maintain and increase their currency in recent years, just like operations related to vaginal aesthetics.