The hymen is a ring of membranous tissue with a small
central opening. It is situated just behind the labia, at the mouth of the
vagina.
During first-time sexual intercourse the ring is
dilated and usually torn, sometimes causing pain and bleeding. With repeated
intercourse and maturation of the genitalia, the hymen disappears completely. A patient
at this stage is somewhat presumptively described as having a “marital”
vagina.
There is a normal variation in hymenal
configuration, and those engaging in pediatric sexual assault examinations must be aware
of these variants.
Injuries other than hymenal tears are
not usually seen following consensual first-time sex. In forced sexual assault,
however, there may be bruising, abrasion or splits of the vaginal and labial tissues, or
peri-vaginal or peri-anal skin. In this situation such injuries, in addition to hymenal
rupture, would be signs of penetration or so called loss of
virginity.
In males there is no reliable sign of loss of
virginity, unless there has been rough forced sexual assault, in which case there may be
injury to the male genitalia.
Finally, in a mature woman of
reproductive age who is a virgin, the hymen may be completely absent such that she would
falsely appear to have lost her virginity. This is because the hymen can be torn during
vigorous sports and masturbatory activity, and, even in the absence of these activities,
has a tendency to involute over time.
The reference defines
the hymen, and gives schematic diagrams showing the normal variants of hymenal
anatomy.
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