The hymen is an area of tissue that represents the opening to the vagina. The hymenal tissue is a ring-like form of tissue which has a hole within the center, present at birth.

What is an imperforate hymen?

When no hymenal opening is present, a membrane covers the area of the hymen and this is called an imperforate hymen. An imperforate hymen needs to be surgically corrected.

When and how is an imperforate hymen diagnosed?

An imperforate hymen is usually diagnosed either in the newborn baby or at the time of menarche (the first period).

In the newborn period there may be a bulge of the hymenal membrane due to a blockage of the drainage of normal mucus from the baby's vagina. The baby has mucus production due to the mother's hormones which are still circulating within the baby's bloodstream. The mother's estrogen stimulates the production of mucus within the baby's vagina. Due to the blockage, the mucus cannot drain and thus a white bulge may appear at the location of the normal opening to the vagina.

Alternatively, an imperforate hymen may not be identified until some point in childhood or at the time of a normal first menstrual period. A young woman with an imperforate hymen, which has not been surgically corrected, will not have a normal menstrual period as there is a blockage and the blood cannot come out of the vagina. This blockage may be associated with abdominal pain, back pain, or difficulty with urination.

How is an imperforate hymen corrected?

An imperforate hymen can be surgically corrected in the newborn period with a resection of the excess hymeneal tissue. Alternatively, an imperforate can be corrected at the time of diagnosis in childhood or during the time of the first menstrual period. The procedure is normally a "day surgery" type of procedure to remove the excess hymeneal tissue and place sutures to avoid scar tissue formation and a reblockage of the hymeneal orifice.

Are there long term problems after surgery?

Once the imperforate hymen has been surgically removed, there should be no long term issues. The vagina will function normally, the woman will be able to have sexual intercourse and the fact that the woman had an imperforate hymen does not interfere with her ability to have future children.