Imperforate hymen is a birth defect in which the hymen covers the vaginal opening completely. This condition is generally detected when girls do not experience menstruation even though they have entered puberty.
Hymen or hymen is a thin lining in the vagina that is shaped like a donut or crescent moon. Normally, there is a small hole in the hymen which functions to drain blood during menstruation . However, in the imperforate hymen, this pinhole does not form.
Imperforate hymen is rare and only occurs in 1 in 1,000 female births.
Causes of Imperforate Hymen
Imperforate hymen occurs when the hymen fails to open or forms an opening during fetal development. However, it is not known exactly what causes this condition. Hymen imperforate is also not passed from parent to child.
Symptoms of Imperforate Hymen
Symptoms of an imperforate hymen usually do not appear until girls reach puberty and should be menstruating .
Some of the symptoms that usually appear are:
- Not having menstruation ( amenorrhea ) , even though other signs of puberty have appeared
- Severe stomach pain
- Bloating or a feeling of fullness in the lower abdomen
- Urinating is painful, especially at the start of the menstrual cycle
- Constipation ( constipation )
- Back pain
Although symptoms usually appear at the start of puberty, symptoms of an imperforate hymen can also appear in infants. Symptoms that can appear are protruding hymen.
When to see a doctor
Immediately take your child to the doctor if he has entered puberty but has not yet experienced his first menstruation, especially if this condition is accompanied by other symptoms of imperforate hymen.
Early examination is needed so that conditions can be detected properly so that complications that can occur can be prevented.
Diagnosis of Imperforate Hymen
Imperforate hymen can be diagnosed as a newborn or at the start of puberty in a child. However, it is more difficult to diagnose an imperforate hymen in the newborn.
Meanwhile, for children in puberty, the doctor will conduct questions and answers about the symptoms experienced, medical history, and the patient's menstrual history. After that, the doctor will do a physical examination, especially in the vaginal area, hymen and vulva.
To make a diagnosis, the doctor will do a scan, such as an ultrasound or MRI of the pelvis. In this examination, the doctor can see the condition of the tissue in the hymen area.
Imperforate Hymen Treatment
To treat an imperforate hymen, the doctor will perform a hymenectomy surgery. This operation aims to open the vaginal opening by making a small incision in the hymen. Before surgery, the doctor will first give the patient general anesthesia.
After making the incision, the doctor will clean the trapped blood in the vagina. The hymen that has been opened will be sewn to the left and right sides to keep it open.
After surgery, the doctor will give you a vaginal stretcher (dilator) that you need to insert into your vagina for a few minutes every day. The tool is installed to prevent the hymen from closing again. In addition, the doctor will give antibiotics and pain relievers after surgery.
Please note, hymenectomy surgery is generally recommended to be performed when the child enters puberty. This is done because the vaginal area in children is wider than in infants. In addition, the level of the child's estrogen hormone is also higher than that of the baby so that it can speed up the healing process.
Imperforate hymen complications
If not treated properly, an imperforate hymen can cause the following complications:
- vaginal infection
- Infection of the uterus or fallopian tubes (adnexitis)
- Kidney disorders
Meanwhile, hymenectomy surgery rarely causes complications. Patients who have undergone this operation can experience menstruation, have sex, and can give birth normally.
Prevention of Imperforate Hymen
Given that the cause is unknown, imperforate hymen is difficult to prevent. However, if your daughter hasn't menstruated by the age of 15 even though there are signs of puberty , take her to the doctor immediately to be examined. If treated as early as possible, the risk of developing severe complications can be prevented.