Introduction:
A half-moon-shaped thin membrane that partially covers the vaginal opening of a young girl is known as a hymen. It allows space for the outflow of menstrual blood. When the hymen is partially blocking the opening of the vagina with a string-like tissue that connects the top and bottom of the vagina, it is called a septate hymen. This article explains more about the septate hymen and how hymen surgery can help.
What Is a Hymen?
The hymen is a thin, small piece of tissue that partially covers the opening of the vagina. The shape, size, and thickness of the hymen are unique to every individual and can change over time. In newborns, the hymen is normally a ring-shaped tissue surrounding the vaginal opening. It covers just the bottom of the vaginal opening in others. In rare cases, the hymen covers the entire vaginal opening and causes issues during menstruation. Over time, the hymen usually will become thinner and breaks eventually, mostly due to exercise, using tampons, or sexual intercourse. Women may experience symptoms when the hymen breaks, or they may not realize it has occurred.
What Is Septate Hymen?
A septate hymen is a thin membrane of extra tissue in the middle of the vagina that creates two tiny vaginal openings instead of one. A septate hymen makes it appear like there are two vaginal openings, although there is only one vaginal opening that is partially obstructed down the middle. The extra band of membraneous tissue blocks the opening of the vagina, which makes the use of tampons difficult, and also causes pain during sexual intercourse.
Septate hymens affect about one in 1,000 girls. A septate hymen is mostly not identified until the beginning of menstruation or sexual activity. With the presence of a septate hymen, people face difficulty in inserting or removing a tampon because of the partial blockage in the vaginal opening. It is also possible to have bleeding or pain during vaginal sex due to a hymenal tear. However, minor surgery can help remove the extra tissue and create a normal-sized vaginal opening.
A septate hymen is a type of abnormally shaped hymen. Other abnormally shaped hymens include:
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Imperforate Hymen - It covers the entire opening of the vagina.
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Cribriform Hymen - It is perforated with many small holes.
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Microperforated Hymen - It covers the opening of the vagina, even though it has a small hole in it.
What Is the Cause of Septate Hymen?
There is no known cause for the septate hymen. The septate hymens are believed to be a congenital anomaly (present during birth). It can happen when the formation of the hymen membrane is not proper during the development of the baby. The researchers are not sure why it occurs in some women and not in others.
What Are the Symptoms of Septate Hymen?
There will be no apparent signs and symptoms until puberty when a girl begins to use tampons during her menstruation. The sign and symptoms of septate hymen include:
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Difficulty in inserting or removing the tampon, mainly when the tampon has expanded due to blood.
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Bleeding or pain during sexual intercourse. This mainly occurs when the hymen tears.
How Is Septate Hymen Diagnosed?
A septate hymen may not be noticed until puberty, when the girl faces problems using tampons during her menstruation or has pain or bleeding during sexual intercourse. The healthcare providers diagnose a septate hymen during a physical exam of the vagina. During the examination, they will notice an extra band of skin that falls vertically down the hymen creating two distinct holes instead of one. It is commonly diagnosed in teenagers.
What Is the Treatment for Septate Hymen?
In most cases, as for microperforated hymen and imperforate hymen, septate hymen also requires minor surgery to remove the extra band of tissue and make a single, normal-sized vaginal opening. If the hymen expands or rips on its own, no treatment is required. However, the extra tissue may be torn during the use of tampons or sexual intercourse, which can be very painful and cause bleeding. But the surgery performed to correct the septate hymen is fairly less painful.
Hymenectomy:
Hymenectomy is a minor surgery performed to remove extra hymenal tissue. This procedure is done under general anesthesia. Normally, patients can return to work and school after a few days of undergoing this surgery. Most women can perform normal activities within a few days after surgery and resume sexual activity within two to four weeks.
A doctor will cut the extra band of hymenal tissue during this surgery using a scalpel or scissors. Then, using dissolvable stitches, the edges of the hymen are secured to the vaginal wall. This creates a normal hymen and exposes the opening of the vagina. Usually, hymenectomy has no long-term complications, and most women will heal without any issues and resume tampons use. They can have pain-free sexual intercourse after removing extra tissue with surgery.
Recovery:
Following a hymenectomy surgery, the doctor may recommend the following:
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Applying ointment or cream on the stitches to promote wound healing.
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Take prescription pain medication or over-the-counter medicine to reduce pain or discomfort during the recovery from the surgery of the septate hymen.
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Confirm with the doctor which medications, such as Aspirin tablets, should not be taken after surgery.
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Do not have sex until the wounds are fully healed. The doctor might suggest a follow-up appointment after surgery to check for recovery progress.
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Do not use tampons during the period immediately after the surgery.
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Avoid cleaning genitals excessively, especially douching.
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Try a warm sitz bath.
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To reduce swelling around the genitals, use an ice pack.
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Avoid lifting heavier objects to reduce the risk of breaking the sutures.
What Are the Complications That Can Occur After the Surgery?
Like any other surgical procedure, hymenectomy also carries some risks:
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Swelling or inflammation.
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Infection.
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Irritation and itching.
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Increased chance of bleeding.
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Scar tissue build-up.
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Injury to the vagina.
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Trauma to the urethra.
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Allergic reaction to anesthesia.
Conclusion:
Many females do not notice the septate hymen unless it limits their ability to use tampons, prevents the flow of menstrual fluids, or causes painful sex. Most of the time, if such issues are present, they go away on their own while using tampons or having sex. However, some people require minor surgery to resolve this issue. Consult your doctor to know more about the septate hymen, its treatment, and its prognosis.
