Hi! I’m Tori, and I’m a doctor of physical therapy who specializes in
pelvic dysfunction and I think that pelvic health and pelvic issues should both be
more openly discussed and widely understood because everyone has a pelvis!
So, today we are going to talk about the different kinds of hymens,
and expand on the symptoms associated with a specific kind—the septate hymen—as
I’ve found this to be the culprit of some pelvic dysfunction that I’ve seen in the clinic!
Hymenal tissue is a thin, membranous tissue that is located at vaginal opening. We aren’t
really sure of its function, there are some hypotheses to do with protecting
the vaginal canal from infection during embryological development, but again,
we aren’t certain. What we do know, is that hymens come in many shapes and sizes.
The most common presentation is the half moon, which allows for menstrual blood and vaginal
secretions to flow out of the vagina without issue, and it allows for tampons and other
objects or body parts to be inserted without issue as well. Now there is a such a thing
as an imperforate hymen, where the hymenal tissue completely covers the vaginal opening,
as well as a microperforate and cribriform hymen,
where there is either a single, small opening in the hymenal tissue, or several small openings.
All three of these hymen types—imperforate, microperforate, and cribriform—usually
show themselves earlier in someone’s life because their symptomology is more straightforward.
Menstrual blood and vaginal secretions either cannot or are limited in their ability to exit
the vagina, and they do not allow for tampons or other things to be inserted
into the vagina, which usually leads to their discovery and proper diagnosis.
The final hymen type—the septate hymen—is the one I want to call to your attention. This occurs when
the hymen has an extra vertical band of tissue that effectively creates two entrances to the
vaginal canal—a right- and left-sided entrance. In this case, menstrual blood and vaginal
secretions can exit the canal just fine; however, pending on where that extra band of tissue is,
someone may have no problem inserting a tampon or other, smaller objects. They may, instead,
have issues removing a tampon, or tolerating the insertion of larger things, like penises.
There’s a couple of things to consider here—first,
this band of tissue isn’t necessarily rigid, it likely has some flexibility. Second, it doesn’t
have to be right in the center of the canal, it could favor one side, making one of the entrances
larger than the other. Keeping those concepts in mind, it starts to make sense that someone could
insert a tampon, moving the band of tissue without pain or discomfort and favoring the
larger entrance, and then, as the tampon expands with blood, have difficulty or pain removing it.
The same could be said of someone’s ability to tolerate fingering,
but not penile penetration—where they feel like they’re hitting a wall, but it isn’t vaginismus.
Finally, septate hymens aren’t always so visible, sometimes they’re further in the vaginal canal,
so don’t rule it out unless you’ve had a provider perform a thorough exam,
sweeping the entire canal manually to feel for that band of tissue.
A parting word, hymenal tissue predicting virginity is utter nonsense and you can learn why,
here! That said, thank you so much for watching! Be sure to join me on the 10th and 20th of every
month for future pelvic PSAs, with surprise PSAs on the 30th, where I attempt to cover
an interesting pelvic health or pelvic issue topic in 5 minutes or less! See you next time!