The hymen (comes from the Greek humen, which means “membrane”) is a membrane of the female genitalia which partially closes the entrance to the vagina.

The hymen is a thin membrane that separates the vagina from the vulva. It is a thin fold of the mucous membrane that partially closes the vagina, about 1 cm from the entrance. It is pierced with a more or less narrow orifice to allow the rules to flow.

Very vascularized structure, it can bleed when it breaks during the first sexual intercourse.

However, not all girls bleed (40% of young women report not having bled) (3). Each hymen is different, there are some very flexible which do not bleed and others very rigid which can bleed under the pressure of the penis (see after Pathologies and Prevention).

The hymen has no physiological role. It corresponds to an embryonic vestige of the membrane which separates in the embryo the two parts of the vagina of different origins.

The hymen is different from one woman to another. There are different types:

• Imperforate hymen: membrane that covers the entrance to the vagina. The rules cannot then flow. This case requires an incision of the hymen to perforate it.
• Microperforated hymen: the membrane almost entirely covers the entrance to the vagina, the perforation of the hymen being very small. Usually the period passes, but young women will not be able to insert or remove a tampon because of the too small size of the hymen. In this case, a small incision in the hymen is needed to enlarge its opening.
• Double-windowed hymen: the membrane has two small openings on the vagina instead of just one. It only takes minor surgery to remove a small strip of tissue to create a normal orifice.
• Hymen cribriform: membrane pierced with multiple small orifices.
• Sclerotic hymen: thick and resistant membrane that interferes with sexual relations.
• Complacent hymen: elastic membrane that expands without bleeding and without tearing.
• Hymen absent

Visual examination : the hymen is visible to the naked eye in the young virgin woman by spreading the labia minora.

Hymenotomy : surgical intervention which consists of the incision of the hymen in order to enlarge it. In some girls, the hymen is too thick, too rigid or not perforated enough, so the incision is necessary.

Hymenorrhaphy : provisional reconstruction of the hymen by forming a thin membrane at the entrance to the vagina by suture. A hymen is present but the bleeding is reduced. In some cultures, young girls who have already had sex resort to this operation to “recreate” virginity (see Symbolic below). It is advisable to carry out this operation three to seven days maximum before the wedding.

Hymenoplasty : definitive reconstruction of the hymen by surgical intervention. The operation consists of using the remains of the hymen to reconstruct the hymen. It leaves no visible trace, healing is complete after one month. This reconstruction lasts as long as there is no new sexual intercourse.

The hymen is the symbol of virginity. In many cultures, an intact hymen is a sign of chastity and purity (6). It appears important that young girls “prove” their virginity on the wedding night (7), which often results in the tradition of the bloodstained sheet exhibited the day after the wedding.

For women who have had sexual intercourse before marriage, it may therefore appear important, for these cultural and religious reasons, to have surgical reconstruction of the hymen (hymenorrhaphy or hymenoplasty) (8).