How to Deal with Having an Imperforate Hymen

Co-authored by Carrie Noriega, MD

Last Updated: November 22, 2023 References

The hymen is a membrane, or thin area of tissue, that covers part of the opening of the vagina. It usually has an opening that widens as a girl approaches puberty.^{[1]
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Research source} An imperforate hymen is when the hymen covers the entire opening of the vagina, sealing it shut.^{[2]
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Research source} About 1 out of 2,000 women are born with this condition, which isn't caused by anything specific but just happens.^{[3]
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PubMed Central
Journal archive from the U.S. National Institutes of Health

Go to source} Girls with an imperforate hymen have to get it fixed with an easy surgery, after which it's like a regular hymen and should cause no more problems.

Method 1

Method 1 of 3:

Confirming You Have an Imperforate Hymen

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1
See your gynecologist if you have monthly cramping but no period. Imperforate hymens are often diagnosed in newborn babies, but if not you might not notice a problem until you get your first period. If you have an imperforate hymen you will not have a normal period because the hymen is blocking the blood from coming out of the vagina. You will still have menstrual cramps, though, so if you have abdominal pain every month but no period you should get checked.
- You might also have other symptoms like back pain, difficulty urinating, or constipation.
- Some girls will be able to feel a hard mass in the lower abdomen below the belly button, which is the menstrual blood stuck in the uterus.^{[4]
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Talk to your doctor if you haven't gotten your period by age 14 to 16. Girls get their first period at a younger age now than girls used to in the past. The average age for first periods in the United States, for example, is 12 to 13 years old.^{[5]
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Research source} Guidelines recommend seeing a gynecologist if you have not gotten your first period by age 14 1/2 to 16 1/2^{[6]
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- African-American girls often mature faster and get their periods a year earlier, whereas Caucasian girls tend toward the older end of that range.^{[7]
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3
Talk to your doctor if you grow breasts and body hair but don't get your period. Other than going by age, you can watch for signs that your body is changing with puberty. Two big things that indicate puberty are needing your first real bra and getting armpit and/or pubic hair. At this point you will probably start your period within 3 to 6 months if you haven’t already. If you don’t get your period within two years of these changes, see your doctor.^{[8]
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- A "real" bra means one with a cup size attached to it, like 34B, as opposed to small, medium, or large.
^{[9]
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Mayo Clinic
Educational website from one of the world's leading hospitals

Go to source} There are a number of reasons this could be, but one of them is an imperforate hymen.
5
Have a pelvic exam to get diagnosed. During a pelvic exam, your doctor will have you lie on your back with your knees bent and your feet in supports called stirrups. The doctor will assess your vagina by looking and feeling.
- If it looks like you have an imperforate hymen, your doctor might do a test called a pelvic ultrasound to make sure there aren't any other problems causing your symptoms.^{[10]
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  Go to source} Ultrasounds don’t hurt, it’s similar to how we look at babies in the womb!

Method 2

Method 2 of 3:

Getting Treated Medically

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An imperforate hymen can be repaired with a minor surgery, and you can go home on the same day. Your surgeon will cut a very small hole in your hymen to replicate the regular opening for the vagina, and he or she will take out any old period blood that has been stuck in the uterus.^{[11]
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Research source} It’s a safe and easy procedure and girls recover from the surgery within a few days.
Your doctor might put a small ring in the opening so that it doesn't close up after surgery. If not, dilators are used to keep the incision open after the procedure. A dilator is a small tampon-like object that you place in the vagina for about 15 minutes every day while you're recovering.^{[12]
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Don’t be surprised to see some more dark, thick, old blood coming out of your vagina for several days to a week after the procedure. This is normal and safe. You might also have mild cramps during this time.^{[13]
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4
Take over-the-counter medicine for discomfort during recovery. You can take Ibuprofen, Aspirin or Aleve for cramping. You doctor might also give you a jelly with pain-relieving lidocaine in it. You can apply this lightly to the area of your vagina if you’re sore, and a few minutes before you have to pee.^{[14]
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- It’s okay to take a bath while recovering. It might feel soothing and will help keep the area clean. Use a hair dryer on the cool setting to dry the sore area and avoid the scratchiness of a towel.
- After surgery, your doctor may also prescribe a topical estrogen cream for you to use to help the area heal and prevent scar tissue from forming.
At this visit your healthcare provider will check the area for signs of inflammation or infection. He or she can also answer any questions you have.^{[15]
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Fever, bad pain that isn’t helped by medicine, and pus are signs of infection, and you should seek care immediately.^{[16]
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MedlinePlus
Collection of medical information sourced from the US National Library of Medicine

Go to source}
You might know this if the dilator will not go in or it hurts a lot when you try.^{[17]
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MedlinePlus
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Method 3

Method 3 of 3:

Coping with Your Condition

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Once your imperforate hymen has been surgically repaired there should be no long term problems. Your vagina will function normally, you will have normal periods and be able to use tampons, and you will be able to have sexual intercourse. Having a history of an imperforate hymen will not make it harder to have children in the future.
Having a hymen doesn't mean someone is a "virgin." Some girls are born without a hymen. Yes, the hymen can stretch or tear during sex, but this can also happen when using tampons, during sports, or during some medical procedures.^{[18]
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Research source} Don’t feel like having the surgery takes away your virginity or changes who you are.
While procedures that make only a small cut in the hymen to “preserve virginity” may exist, the opening often closes up again causing unnecessary pain and the need to repeat the procedure. Cultural views about virginity and how the hymen should look should be discussed with your doctor, but should not stop you from getting the appropriate surgery.^{[19]
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4
Talk to your loved ones. It might feel difficult to discuss sex with your partner if you're in an intimate relationship, but it will help to let him or her know that the pain and trouble you're having with sex is normal for your condition and can be fixed.
- Talking to friends and family can help relieve stress about the condition or the surgery. You can always ask loved ones to go to the doctor with you to better understand your condition.
- Remember that having an imperforate hymen wasn't caused by anything you did or your mom did during pregnancy. It just happens, and isn't that uncommon!
Since there are lots of young ladies out there with the same condition, it might help to read about their experience or share your own.

Expert Q&A

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Question

I'm 25 years old, I have an intact hymen, and I haven't had a period yet. What can I do?

Carrie Noriega, MD
Board Certified Obstetrician & Gynecologist
Dr. Noriega is a Board Certified Obstetrician & Gynecologist and medical writer in Colorado. She specializes in women’s health, rheumatology, pulmonology, infectious disease, and gastroenterology. She received her MD from the Creighton School of Medicine in Omaha, Nebraska and completed her residency at the University of Missouri - Kansas City in 2005.

Carrie Noriega, MD

Board Certified Obstetrician & Gynecologist

Expert Answer

At age 25 it is very unlikely that your lack of periods is caused by an imperforate hymen, which is the complete covering of the vaginal opening. Women who still have an intact hymen will have enough of an opening to the vagina to pass their menstrual blood. If you are not having periods at age 25 and not pregnant then you should get an evaluation by a doctor.

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Question

I am 58 years old, and I no longer have an imperforate hymen. BUT my mom told me many years ago (she is gone now) that the pediatrician told her to use a washcloth on me as an infant and open what must have been this type of hymen tissue up. Any knowledge of this "treatment" anywhere?

Carrie Noriega, MD
Board Certified Obstetrician & Gynecologist
Dr. Noriega is a Board Certified Obstetrician & Gynecologist and medical writer in Colorado. She specializes in women’s health, rheumatology, pulmonology, infectious disease, and gastroenterology. She received her MD from the Creighton School of Medicine in Omaha, Nebraska and completed her residency at the University of Missouri - Kansas City in 2005.

Carrie Noriega, MD

Board Certified Obstetrician & Gynecologist

Expert Answer

This type of treatment is more commonly used to treat what is called labial adhesions. This is when the labia or outer lips of the vagina essentially stick together. You can use gentle traction or pulling to help separate the labia which sounds like what your mom was doing with the washcloth.

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Warnings

Late discovery of an imperforate hymen or not getting the surgery for a long time may lead to pain, infections, hydronephrosis (urine backing up in the kidneys) and endometriosis (endometrial tissue growing outside the uterus), conditions that can make it harder to have children in the future.^{[20]
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