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Hymen and vaginismus

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Can a hymen cause vaginismus?

Typically, NO — but, read on.

The hymen is a thin, vascularized membrane, an embryonic remnant of the vaginal separation from the urogenital sinus = the tissue that forms the genitals. The hymen will usually perforate during embryonic development and will vary in thickness, size, and shape from one female to another. The hymen does not regenerate (grow back)!

There are 3 typical variations of hymeneal presence (excluding anomalies):

  1. An imperforate hymen, which means it did not perforate (did not develop an opening within it). An imperforate hymen is uncommon, and is typically diagnosed during onset of menstruation when the blood that cannot ‘come out’ of the body keeps accumulating on the inside. This is a painful and a potentially life-threatening situation that needs immediate medical attention.
  2. A partially-intact hymen, which means that there is leftover hymeneal tissue present, typically between the 4 o’clock and the 8 o’clock, if we use that description. The opening within the hymen can be large enough to accommodate a tampon or a finger, or so small that even the pinky (smallest finger) will not pass through. A partially-intact hymen can be elastic and responsive to stretch (common), or fibrous and rigid (less common).
  3. Minimal or no hymen, even in the absence of vaginal penetration! Despite it being quite common, there is no explanation for it; bike riding or gymnastics are not the cause…

Imperforate and rigid hymens require a hymenectomy, a simple procedure during which the hymen is removed.

An partially-intact elastic hymen will respond to vaginal penetration, may it be a finger, tampon, gyno exam, or intercourse. There may be initial discomfort and/or bleeding, but not necessarily as not all hymens react the same. So, when it comes to intercourse, do not assume that the first-time will be painful or bloody!

Note: the presence of a hymen cannot be established just by looking at the vaginal opening. Clinicians who attempt a gynecologic exam inationon a woman with vaginismus will often interpret her tight (and anxious!) vaginal opening as an intact hymen and offer a hymenectomy as a solution… Remember: a digital (finger) exam is necessary to arrive at a definitive conclusion!

The presence of a hymen does not cause vaginismus. It may restrict or limit vaginal access, but the woman will typically be cool about her vagina and able to face vaginal management without distress.

So when may the presence of a hymen bring about vaginismus? When the woman is

  • Anticipating pain upon first-time penetration (but maybe it won’t really hurt?)
  • Is anxious about ‘breaking’ the hymen (maybe there is no hymen?)
  • Cannot handle physical discomfort (maybe there will be none?)
  • Cannot handle the site of blood (maybe it won’t bleed?)
  • Stressed about an unknown; what will it be like to have something inside my vagina?
  • Forced into having intercourse/losing her virginity

*   *   *   *   *   *
On a humorous note, check the following quote from a book by the name of Sex Revelations and The New Eugenics, published in 1936 by two physicians, Whitehead and Hertel:  “Regarding the hymen… It sometimes grows again in widows, or in women who have been a long time separated from their husbands…”

 

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  • Leslie says:

    I’m 47 and this has been going on since the first time I had sex. If I’ve had sex within a week or so of the last time I had sex, I’m fine. If it’s been longer, it feels like my hymen is tearing and it’s painful (even when fully aroused and with only one finger inside). I mean, it IS tearing, though not like it needs stitches but it definitely bleeds a tiny bit and there are sore areas that sting when I pee and it hits it. It’s on the underside nearest the anus, not always the same spot but in the same general area, and usually heals in a few days. Even a ton of lube doesn’t help. What is going on? I mean, it can’t actually regrow right? And why does it seem OK (no pain or tearing feeling) when I’m having sex on a regular basis (with the same guy) vs occasionally (with the same guy)? And it doesn’t hurt at all internally, like I’m not aroused or like my vagina is clamped down too tight or any of that, the sex part is the same as every other time we have sex, just the ‘hymen’ seems to tear if it’s been longer than 2 weeks between sessions. Also, doesn’t seem to matter what time of the month, so I don’t think hormones are the issue. I’m also not on any medications or BC. Any ideas?

    • Ditza Katz says:

      Being that you had intercourse, there is no hymen to tear. However, your tissue around the vaginal opening may be the one in question. Make sure to see your OBGYN for an examination and discussion.

  • Becca says:

    I am newly married and was/is virgin, and my wedding night was a nightmare. With practice we have gotten better, but he can only insert one finger. Two fingers is painful and my husband describes a string like thing around his fingers and it hurts. I am shy about going to the doctor and worried about pain that could be caused by an exam.

    • Ditza Katz says:

      Vaginismus is a real medical condition and you should definitely speak with your doctor about it. Alternatively, we’ll be happy to help if coming to us is an option; let us know by contacting our office at doctors@womentc.com or +1.516.576.1118

  • Sarah says:

    Okay so I’ve did a test to see if my hymen was still intact… wasn’t too sure if I was.. I went to the Drs and I was told it’s “partially intact”. The partially doesn’t keep me reasssured. Does it mean that it’s still in untouched condition ?

    • Ditza Katz says:

      A partially intact hymen means that some of it is still in place (not gone). It also suggests that a penis was not inside you or the entire hymen would have been gone. Not sure about the ‘untouched’ because anything that goes into the vagina (finger, tampon) ‘touches’ it.

  • Elizabeth says:

    I dont know if i av a hymen cos i dnt feel anything on the outside of my virgina but wen i insert my finger into my virgina i feel something not too hard and shifting inside i can even push it more inside. Could that be the hymen or it is part of the virgina or im not born wth a virgina? Please reply. Thank you

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