The hymen usually covers the entrance to the vagina. The hymen has one or several openings that allow for menstrual flow after a girl begins to menstruate, and for the insertion of tampons (Figure 2.6). In a rare condition called imperforate hymen, this structure completely closes the vagi- nal opening (Adams Hillard, 2003). Imperforate hymen is often first diagnosed at puberty because it causes a blockage of menstrual discharge; it is treated surgically to create an opening through which the menstrual discharge can flow.
The hymen may tear or stretch when a woman first has sexual intercourse, which may lead to some pain and bleeding. This phenomenon has led to the traditional notion that the state of a woman’s hymen indicates whether or not she has ever engaged in coitus—that is, whether she is a virgin in one meaning of the term (see Chapter 10). One can certainly debate whether a woman’s virginity—or lack of it— should be a matter of concern to anyone besides the woman herself. In any case, the state of her hymen is not a reliable indicator of virginity. In some women the hymen undergoes changes at puberty that allow for intercourse without any tearing. Some women may have widened the opening during tampon use or athletic activities, or they may have deliberately stretched the opening with the intention of facilitating first intercourse.
In many Middle Eastern countries it is traditional for a bride’s mother or other relative to display the bloodstained sheets from a window after the bride’s wedding night, thereby proving to the community that the marriage was consummated and that the bride was indeed a virgin. Of course there may be no stain, for any number of reasons—the bride was not a virgin; she was a virgin but didn’t have an intact hymen; the couple achieved coitus without tearing of the hymen or without suf- ficient bleeding to stain the sheets; or they didn’t engage in coitus because the man ejaculated prematurely or because one or both parties were too anxious, too tired, or otherwise unable to perform the act. To guard against any of these possibilities, the mother may bring a vial of chicken blood with her.
In some Westernized regions of the Middle East, this ritual has become a light- hearted tradition. In more conservative communities, however, proof of a bride’s virginity is still so important that a woman who lacks an intact hymen may undergo an operation to reconstruct one before she marries (Bentlage & Eich, 2007).
The opening of the urethra is located between the vaginal opening and the clitoris. Given that the main function of the urethra is to pass urine, you might not consider
hymen A membrane, usually perforated or incomplete, that covers the opening of the vagina. It may be torn by first coitus or by other means.
imperforate hymen A hymen that completely closes the introitus.
urethra The canal that conveys urine from the bladder to the urethral opening.
(A) Annular hymen (B) Septate hymen
(C) Cribriform hymen (D) After childbirth
DHS 3E Figure 02.06
Figure 2.6 The hymen is highly variable in structure. Most commonly it is annular (A); that is, it has a round central opening that is large enough for passage of the menstrual flow and insertion of a tampon, but usually not large enough for coitus. (B) The opening may be crossed by a band of tissue (septate hymen) or (C) by several bands that leave numerous small openings (cribriform hymen). If the openings are very small, or are absent entirely (imperforate hymen), the outflow of vaginal secretions and menstrual fluids may be blocked. First inter- course often tears the hymen but leaves it partially intact. (D) Vaginal childbirth removes all but small remnants of the structure. Familiarity with variations in hymen structure is important for professionals who evaluate female sexual assault victims.