Editing Hymen (section)

==Anatomic variations==

Normal variations of the hymen range from thin and stretchy to thick and somewhat rigid.<ref name=emans>{{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|pages=61–65|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><ref name="McCann"/>  An [[imperforate hymen]] occurs in 1-2 out of 1,000 infants.<ref>{{Cite book|url=https://books.google.com/books?id=H7Z-lD9cXBEC&q=vaginal+labial+fusion&pg=PA139|title=Blueprints Obstetrics and Gynecology|last1=Callahan|first1=Tamara L.|last2=Caughey|first2=Aaron B.|date=2009|publisher=Lippincott Williams & Wilkins|isbn=978-0-7817-8249-4|language=en}}</ref><ref>{{Cite journal|last1=Lardenoije|first1=Céline|last2=Aardenburg|first2=Robert|last3=Mertens|first3=Helen|date=2009-05-26|title=Imperforate hymen: a cause of abdominal pain in female adolescents|journal=BMJ Case Reports|volume=2009|pages=bcr0820080722|doi=10.1136/bcr.08.2008.0722|issn=1757-790X|pmc=3029536|pmid=21686660}}</ref> The only variation that may require medical intervention is the imperforate hymen, which either completely prevents the normal passage of menstrual fluid or slows it significantly. In either case, surgical intervention may be needed to allow menstrual fluid to pass or intercourse to take place at all.<ref>{{Cite web|title=Imperforate hymen |year=2021 |publisher=[[United States National Library of Medicine]] |website=medlineplus.gov |url=https://medlineplus.gov/ency/patientinstructions/000708.htm}}</ref>

Prepubescent hymenal openings come in many shapes, depending on hormonal and activity level, the most common being crescentic (posterior rim): no tissue at the 12 [[Clock position|o'clock position]]; crescent-shaped band of tissue from 1–2 to 10–11 o'clock, at its widest around 6 o'clock. From puberty onwards, depending on [[estrogen]] and activity levels, the hymenal tissue may be thicker, and the opening is often fimbriated or erratically shaped.<ref name=heger/> In younger children, a torn hymen will typically heal very quickly. In adolescents, the hymenal opening can naturally extend and variation in shape and appearance increases.<ref name=emans/>

Variations of the female reproductive tract can result from [[Müllerian agenesis|agenesis]] or hypoplasia, canalization defects, lateral fusion and failure of resorption, resulting in various complications.<ref>{{Cite web|title=Congenital Anomalies of the Hymen |publisher=[[Brigham and Women's Hospital]] |website=brighamandwomens.org |url=https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/congenital-anomalies/hymen-anomalies}}</ref>
* [[Imperforate hymen|Imperforate]]: hymenal opening nonexistent; will require minor surgery if it has not corrected itself by puberty to allow menstrual fluids to escape.<ref>{{Cite web|title= Imperforate Hymen|publisher=[[Mount Sinai Hospital (Brooklyn)]] |website=mountsinai.org |url=https://www.mountsinai.org/health-library/special-topic/imperforate-hymen}}</ref>
* Cribriform, or microperforate: sometimes confused for imperforate, the hymenal opening appears to be nonexistent, but has, under close examination, small perforations.<ref>{{Cite web|title= Cribriform Hymen|publisher=[[Texas Children's Hospital]] |website=texaschildrens.org |url=https://www.texaschildrens.org/health/cribriform-hymen}}</ref>
* Septate: the hymenal opening has one or more bands of tissue extending across the opening.<ref>{{Cite web|title=Septate Hymen |publisher=[[Boston Children's Hospital]] |website=childrenshospital.org |url=https://www.childrenshospital.org/conditions-and-treatments/conditions/s/septate-hymen}}</ref>
* [[Tight hymenal ring]]: the hymen is rigid and the introitus tight. <ref name="Berek2007">{{cite book|editor=Jonathan S. Berek|others=Emil Novak|title=Berek & Novak's Gynecology|chapter-url=https://books.google.com/books?id=P3erI0J8tEQC&pg=PA459|volume=2007|issue=935|year=2007|publisher=Lippincott Williams & Wilkins|isbn=978-0-7817-6805-4|page=459|chapter=Benign Diseases of the Female Reproductive Tract}}</ref>