Editing Hymen (section)

==Development and histology==
The [[development of the reproductive system|genital tract develops]] during [[embryogenesis]], from the third week of [[gestation]] to the [[second trimester]], and the hymen is formed following the [[vagina]]. At week seven, the [[urorectal septum]] forms and separates the [[rectum]] from the [[urogenital sinus]]. At week nine, the [[Müllerian duct]]s move downwards to reach the urogenital sinus, forming the uterovaginal canal and inserting into the urogenital sinus. At week twelve, the Müllerian ducts fuse to create a primitive uterovaginal canal called unaleria. At month five, the vaginal canalization is complete and the fetal hymen is formed from the proliferation of the sinovaginal bulbs (where Müllerian ducts meet the urogenital sinus), and normally becomes perforate before or shortly after birth.<ref name="healey">{{cite book |last=Healey |first=Andrew |editor-last1=Mann |editor-first1=Gurdeep S. |editor-last2=Blair |editor-first2=Joanne C. |editor-last3=Garden |editor-first3=Anne S. |title=Imaging of Gynecological Disorders in Infants and Children |publisher=Springer |date=2012 |pages=21–30 |chapter=Embryology of the female reproductive tract |isbn=978-3-540-85602-3 |doi=10.1007/978-3-540-85602-3|series=Medical Radiology }}</ref>

The hymen has dense innervation. In newborn babies, still under the influence of the mother's [[hormones]], the hymen is thick, pale pink, and redundant (folds in on itself and may protrude). For the first two to four years of life, the infant produces hormones that continue this effect.<ref name="McCann">McCann, J; Rosas, A. and Boos, S. (2003) "Child and adolescent sexual assaults (childhood sexual abuse)" in Payne-James, Jason; Busuttil, Anthony and Smock, William (eds). Forensic Medicine: Clinical and Pathological Aspects, Greenwich Medical Media: London, a)p.453, b)p.455 c)p.460. {{isbn|978-1-84-110026-5}}</ref> Their hymenal opening tends to be annular (circumferential).<ref name=heger>{{Cite book | last1=Heger | first1=Astrid | author-link = Astrid Heppenstall Heger | last2=Emans | first2=S. Jean | last3=Muram | first3=David |title=Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas |edition=Second |year=2000 |publisher=Oxford University Press |page=116 |isbn=978-0-19-507425-3 }}</ref>

Post [[neonatal]] stage, the diameter of the hymenal opening (measured within the '''hymenal ring''') widens by approximately 1&nbsp;mm for each year of age.<ref>{{Cite CiteSeerX |last=Pugno |first=Perry |title=Genital Findings in Prepubertal Girls Evaluated for Sexual Abuse |date=1999|citeseerx=10.1.1.522.1894 }}</ref> During [[puberty]], [[estrogen]] causes the hymen to become very elastic and [[wikt:fimbriate|fimbriate]]d.<ref name=":1">{{Cite journal|last1=Lahoti|first1=Sheela L.|last2=McClain|first2=Natalie|last3=Girardet|first3=Rebecca|last4=McNeese|first4=Margaret|last5=Cheung|first5=Kim|date=2001-03-01|title=Evaluating the Child for Sexual Abuse|url=http://www.aafp.org/afp/2001/0301/p883.html|journal=American Family Physician|language=en|volume=63|issue=5|pages=883–92|pmid=11261865|issn=0002-838X}}</ref><ref name=":2">{{Cite book|url=https://the-eye.eu/public/Books/Medical/texts/Evaluation%20of%20the%20Sexually%20Abused%20Child%202nd%20ed%20-%20A.%20Heger%2C%20et%20al.%2C%20%28Oxford%2C%202000%29%20WW.pdf|title=Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas|date=2000|publisher=Oxford University Press|isbn=978-0-19-507425-3|editor-last=Heger|editor-first=Astrid H.|edition=2nd|location=New York|page=122|language=en|editor-last2=Emans|editor-first2=S. Jean|access-date=July 8, 2018|archive-date=July 8, 2018|archive-url=https://web.archive.org/web/20180708104703/https://the-eye.eu/public/Books/Medical/texts/Evaluation%20of%20the%20Sexually%20Abused%20Child%202nd%20ed%20-%20A.%20Heger,%20et%20al.,%20(Oxford,%202000)%20WW.pdf}}</ref>

<gallery>
File:Carunculae myrtiformes.png|Arrows point to carunculae myrtiformes ("remnants") of the hymen in a post-pubertal individual.
</gallery>

The hymen can stretch or tear as a result of various behaviors, by the use of [[tampon]]s<ref name="ucsb sexinfo"/> or [[menstrual cup]]s, [[pelvic examination]]s with a [[Speculum (medical)|speculum]], or sexual intercourse.<ref name="emans" /> Remnants of the hymen are called carunculae myrtiformes.<ref name="Knight">{{cite book|last=Knight|first=Bernard|title=Simpson's Forensic Medicine|edition=11th|year=1997|publisher=Arnold|location=London|page=114|isbn=978-0-7131-4452-9}}</ref>

A glass or plastic rod of 6&nbsp;mm diameter having a globe on one end with varying diameter from 10 to 25&nbsp;mm, called a Glaister Keen rod, is used for close examination of the hymen or the degree of its rupture. In [[forensic medicine]], it is recommended by health authorities that a physician who must swab near this area of a [[prepubescent]] girl avoid the hymen and swab the outer [[vulval vestibule]] instead.<ref name=McCann/> In cases of suspected [[rape]] or [[child sexual abuse]], a detailed examination of the hymen may be performed, but the condition of the hymen alone is often inconclusive.<ref name="Perlman"/>