Hymen development

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This article is about the vaginal mucous membrane fold. For the god and other uses, see Hymen (disambiguation).

Hymen
External genital organs of female. The labia minora have been drawn apart.
Latin	hymen vaginae
Gray's	subject #270 1264
MeSH	Hymen

The hymen is a fold of mucous membrane which surrounds or partially covers the external vaginalopening. It forms part of the vulva, or external genitalia.^[1][2] A slang term for hymen is "cherry", as in "losing one's cherry" to mean losing one's virginity.^[3] It is not possible to confirm that a woman is a virgin by examining her hymen.^[3][2] In cases of suspected rapeor sexual abuse, a detailed examination of the hymen may be carried out; but the condition of the hymen alone is often inconclusive or open to misinterpretation, especially if the patient has reached puberty.^[1] In children, although a common appearance of the hymen is crescent-shaped, many variations are possible.^[1]After a woman gives birth she may be left with remnants of the hymen called carunculae myrtiformes or the hymen may be completely absent.^[4]

Contents [hide] 1 Hymenal development 2 Hymenal resorption 3 Anatomic anomalies 4 Hymens in other animals 5 Hymenorrhaphy 6 Womb fury 7 References 8 External links

[edit]Hymenal development

The genital tract develops during embryogenesis, from 3 weeks' gestation to the second trimester, and the hymen is formed following the vagina.

At week seven, the urorectal septum forms and separates the rectum from the urogenital sinus.

At week nine, the müllerian ducts move downwards to reach the urogenital sinus, forming the uterovaginal canal and inserting into the urogenital sinus.

At week 12, the müllerian ducts fuse to create a primitive uterovaginal canal.

At month 5, the vaginal canalization is complete and the fetal hymen is formed from the proliferation of the sinovaginal bulbs (where müllerian ducts meet the urogenital sinus), and becomes perforate before or shortly after birth.

In newborn babies, still under the influence of the mother's hormones, the hymen is thick, pale pink, and redundant (folds in on itself and may protrude). For the first two to four years of life, the infant produces hormones which continue this effect.^[5] Their hymenal opening tends to be annular (circumferential).^[6]

[edit]Hymenal resorption

Past neonatal stage, the diameter of the hymenal opening (measured within the hymenal ring) has historically been proposed to be approximately 1 mm for each year of age. ^[7] In children, to make this measurement, a doctor may place a Foley catheter into the vagina and inflate the balloon behind the hymen to stretch the hymenal margin and allow for a better examination. In the normal course of life the hymenal opening can also be enlarged by tampon use, pelvic examinations with a speculum, regular physical activity or sexual intercourse.^[1] Once a girl reaches puberty the hymen tends to become so elastic that it is not possible to determine whether a woman uses tampons or not by examining a hymen. In one survey only 43% of women reported bleeding the first time they had sex; indicating that the vagina of a majority of women is sufficiently opened.^[1][5]

The hymen is most apparent in young girls: at this time their hymen is thin and less likely to beredundant, that is to protrude or fold over on itself.^[8] In instances of suspected child abuse, doctors use the clock face system to describe the hymenal opening. The 12 o'clock position is below the urethra, and 6 o'clock is towards the anus, with the patient lying on her back.^[9]

Infants' hymenal opening tends be redundant (sleeve-like, folding in on itself), and may be combined with annular shaped.^[9]

By the time a girl reaches school-age, this hormonal influence has stopped and the hymen becomes thin, smooth, delicate and almost translucent. It is also very sensitive to touch; a physician who needed to swab the area would avoid the hymen and swab the outer vulval vestibule instead.^[5]

Prepubescent girls' hymenal opening comes in many shapes, depending on hormonal and activity level, the most common being crescentic (posterior rim): no tissue at the 12 o'clock position; crescent shaped band of tissue from 1–2 to 10–11 o'clock at its' widest around 6 o'clock. From puberty onwards, depending on estrogen and activity levels, the hymenal tissue may be thicker and the opening is often fimbriated or erratically shaped.^[6]

After giving birth, the vaginal opening usually has nothing left but hymenal tags (carunculae mytriformes) and is called "parous introitus".

[edit]Anatomic anomalies

Anomalies of the female reproductive tract can result from agenesis or hypoplasia, canalization defects, lateral fusion and failure of resorption, resulting in various complications.^[7]

• Imperforate:^[10][11] hymenal opening nonexistent; will require minor surgery if it has not corrected itself by puberty to allow menstrual fluids to escape.
• Cribriform, or microperforate: sometimes confused for imperforate, the hymenal opening appears to be nonexistent, but has, under close examination, small openings.
• Septate: the hymenal opening has one or more bands extending across the opening.

[edit]Hymens in other animals

Due to similar reproductive system development, many mammals, from chimpanzees and elephants to manatees and whales, retain hymens. ^[12][13]

[edit]Hymenorrhaphy

Main article: Hymenorrhaphy

In some cultures the concept of an intact hymen is highly valued at marriage.^[14][15][16] Some women in Europe undergo hymenoplasty, a restoration of their hymen.^[16]

In Korea the word for hymen translates literally as “virgin-skin” and a small industry has grown up around its surgical construction through plastic surgery. In 1994 the Korean Medical Research Center was made to pay compensation to a 40-year-old woman for extreme psychological distress after she lost her hymen during a Pap smear test. The court found that, “it is clear that the hymen is still recognized as a symbol of ‘virginity’ and keeping virginity is valued in society". ^[17] Some Korean prenatal clinics offers STD tests with hymenorrhaphy, in order to "free" women from their history of sexual experiences in the past.^[18] These surgeries are not approved by the Korean medical association.^[19]

[edit]Womb fury

• In the sixteenth and seventeenth centuries, medical researchers have used the presence of the hymen, or lack thereof, as founding evidence of physical diseases such as "womb-fury". If not cured, womb-fury would, according to these early doctors, result in death.^[20]

What is virginity worth today?

(CNN) -- Is a woman's virginity worth $3.8 million? That's how much a 22-year-old from San Diego, California, said she has been offered through an auction she announced in September.

The woman, who goes by "Natalie Dylan," set up a private auction through the Moonlite Bunny Ranch, a legal brothel in Nevada. The auction has given her lots of "business opportunities," she said.

Her top bid comes from a 39-year-old Australian, but she has no immediate plans to settle the auction, she said in a recent interview with CNN.

Some men may seek virgins because they want them as trophies, or desire purity. But as to why men would bid so much money on virginity, she said she has no answer.

"I honestly don't know what they see in it," she said.

If you think Dylan's auction amounts to prostitution, she completely agrees. She also said she's not breaking any laws -- after all, prostitution in Nevada is legal.

"I feel people should be pro-choice with their body, and I'm not hurting anyone," she said. "It really comes down to a moral and religious argument, and this doesn't go against my religion or my morals. There's no right or wrong to this

The idea that virginity has a high value harkens back to the days of early humans -- if a man has sex with a virgin woman, he knows for sure that her children will be his, anthropologists reason. In early civilizations, women were also considered the property of men, said Laura Carpenter, assistant professor of sociology at Vanderbilt University in Tennessee.

Through the 1950s in America, women were expected to remain virgins until marriage, Carpenter said. But with the availability of the pill and the IUD in the 1960s, combined with youth counterculture and gay rights movements, it became more common for women to engage in premarital sex, she said.

Attitudes shifted toward the conservative side in the 1980s with the worldwide HIV/AIDS pandemic, which made the stakes much higher for choosing a sex partner, especially for men. Abstinence-based education programs also took off around that time, with government support, she said.

Today, about 95 percent of Americans have sex before they're 25, Carpenter said. But worldwide, virgin prostitutes can claim larger fees, certain cultures still attach larger dowries to virgin brides, and some women undergo reconstructive surgery to restore their hymens.

In looking at Dylan's auction, "To some extent it's not new. The new part is the Internet," Carpenter said.

Dylan is not the first to hold a public sale for her sexual innocence. An Italian model reportedly had plans to sell her virginity for more than $1 million in September. Dylan said she was inspired by a report of a Peruvian woman who put her virginity up for sale.

Some think Dylan's auction may be indicative of a shift in the way society treats sexuality.

"In a world that is teeming with brand messages, with sponsorships everywhere, intimacy is really just the next thing to go," said Jon Ray, a 24-year-old marketing consultant in Austin, Texas, and author of the blogWho is Jon Ray?

Brett Austin Vanderzee, a 19-year-old student at Oklahoma Christian University who has pledged to stay a virgin until marriage, finds Dylan's actions somewhat appalling, but not shocking.

"It's kind of crazy, but I think it's the general direction that society has been heading in for a while," he said. "We're becoming more accepting of things that normally would have been considered unwise."

Kiara Daines, a 17-year-old from Detroit, Michigan, said she's saving herself until marriage for personal and religious reasons. Both Vanderzee and Daines said they have endured teasing from their peers because of their choice to remain abstinent.

Others say there's just too much hype around virginity. Martha Kempner, vice president for information and communications for the nonprofit Sexuality Information and Education Council of the U.S., said telling a young woman to stay"pure" misses the point that sexuality will influence her long after she loses her virginity.

"By putting the emphasis there, [on virginity], we're actually devaluing the rest of women, the rest of her, and the rest of her sexuality for the rest of her life," she said.

A recent study in the journal Pediatrics showed that religious teens who take virginity pledges are as likely to have sex before marriage as their religious peers, and less likely to use condoms or birth control when they become sexually active.

Many people say losing one's virginity has different implications for men than women. While young women see the act as a symbolic giving of themselves, young men are more prone to want to get it over with and brag about it. Similarly, says Kempner, women are taught to keep themselves "pure" and help men exercise control, while there's a "boys will be boys" attitude around men.

Do men really think that virginity is worth millions of dollars?

Audacia Ray, a 28-year-old former sex worker from New York and author of "Naked on the Internet: Hookups, Downloads and Cashing In on Internet Sexploration," is skeptical. She views Dylan's auction as a publicity stunt and doesn't anticipate she'll "continue in the industry."

The importance of a woman's virginity may vary in different cultures, but generally there's not the high value there used to be, Ray said.

"It begins to be viewed more as a burden over time -- a burden in that losing virginity is an event, so that it has to somehow mean something, which is part of the reason why people are all up in arms about Natalie," she said.

How do Dylan's friends and family feel? Dylan, who said she was raised in a conservative, non-Christian religious household, said although her mother doesn't agree with her, she still loves her as a daughter. Generally people have been supportive, Dylan said.

I've talked with my exes, some different guys, and they understand it's just a business deal, and they know me, and they know I'm not this promiscuous girl. Honestly, even if I didn't do this, I'd always be the girl who thinks prostitution is OK," she said. "I would always want to find a partner that can accept me for me."