What is a septate hymen?
A septate hymen is when your hymen has an extra piece of skin or tissue down the middle, making two separate holes instead of one. The hymen is a ring-like piece of tissue that surrounds the opening of the vagina. It shouldn't cover or block your vaginal opening. If you have a septate hymen, extra hymenal tissue creates two small vaginal openings instead of one. The extra band tissue blocks your vaginal opening.
What is a hymen?
Your hymen is a tissue membrane at the opening of your vagina. It's formed during fetal development from leftover remnants of your vagina. It's thin, elastic and comes in all shapes and sizes. Most often, they are shaped like half-moons around the bottom of your vaginal opening. A typical hymen does not cover the entrance to your vagina.
Your hymen is thick when you are born but wears down over time. It gradually tears or rips due to physical activity, hormones, using tampons or having sex. This can cause symptoms in some people, but others feel nothing.
Is normal to have a septate hymen?
A septate hymen is a hymenal anomaly. Hymenal anomalies (conditions you are born with) are rare. Between 1 and 1,000 or 1 in 10,000 women are born with an irregular hymen.
How do you know if you have a septate hymen?
Only your healthcare provider can confirm a septate hymen; however, you may have signs of a septate hymen like difficulty inserting or removing tampons or painful intercourse. Most people are not aware they have a septate hymen until they are menstruating or attempting vaginal intercourse. In some cases, one of the two holes is large enough to insert a tampon.
Symptoms and Causes
What are the symptoms of a septate hymen?
Signs of a septate hymen are:
- Difficulties inserting/removing a tampon.
- Painful sexual intercourse.
- Bleeding or pain after sex (when the septate hymen tears).
What causes a septate hymen?
Septate hymens are a congenital irregularity (you are born with it). No one is sure why it occurs in some people and not in others.
Can you still have a period with a septate hymen?
Yes, you can still have a period if you have a septate hymen. This is because the two openings are large enough for blood to flow out the vagina during your period. Most people with this condition experience trouble when they use tampons to catch menstrual blood. A tampon may not go in at all, or it might not come out because the band of extra tissue acts as a barrier to removing the tampon. Sometimes people have no problems using tampons because both openings are large enough.
Diagnosis and Tests
How is it diagnosed?
Healthcare providers diagnose a septate hymen during a visual exam of your vagina. There will be an extra band of skin vertically down the hymen. It will create two distinct holes instead of one. It's most commonly diagnosed in teenagers when symptoms appear due to difficulties with menstruation or having sexual intercourse.
Management and Treatment
How is a septate hymen treated?
The extra band of tissue in a septate hymen can stretch and tear on its own. If your hymen rips or expands on its own, there may be no treatment necessary. However, if you try to push a tampon into the vagina or force sexual intercourse, the hymenal tear could be more painful and start to bleed. Having surgery to correct your septate hymen is less painful than forcing the hymen to rip or tear by inserting objects into the vagina.
A minor surgery called a hymenectomy removes extra hymenal tissue. This is performed under general anesthesia in a hospital or surgical center. You are able to go home a few hours after surgery. Most people are able to return to normal activities within a few days and resume sexual activity within two to four weeks.
During a hymenectomy, a gynecologist will cut away the extra band of hymenal tissue using scissors or a scalpel. They will then use dissolvable stitches to secure the edges of the hymen into the vaginal wall. This creates a typical hymen and exposes the vaginal opening.
There are no long-term complications of a hymenectomy, and most people will heal without any issues. Most people will resume typical menstruation, use tampons and have pain-free sexual intercourse once the extra tissue is gone.
What are the possible complications of treatment?
Like most surgical procedures, there are risks associated with a hymenectomy:
- Inflammation or swelling.
- Excess bleeding.
- Developing scar tissue.
- Injury to the vagina.
- Allergic reaction to anesthesia.
Are there any side effects of fixing a septate hymen?
Side effects of treating a septate hymen are pain and soreness in the vulvar area of your vagina. You can use over-the-counter pain relievers to help with any pain you feel afterward. Your healthcare provider may prescribe an antibiotic as a precaution.
How can I prevent a septate hymen?
There is nothing you can do to control the shape of your hymen. It's formed when you are still in your mother's womb. A septate hymen occurs when a band of extra skin stretches across the middle of your vaginal opening.
Outlook / Prognosis
Does a septate hymen hurt?
Yes, a septate hymen can cause pain. Most of the pain is associated with inserting tampons or objects into the vagina (like during sex).
When should I see my healthcare provider?
Contact your healthcare provider if you experience pain during menstruation, inability to use tampons or painful sexual intercourse.
If you've had surgery to repair a septate hymen, you should call your healthcare provider if you have signs of infection like fever, swelling or pus-like discharge.
A note from Cleveland Clinic
A septate hymen can cause painful symptoms when trying to use a tampon or have sex. Your healthcare provider can diagnose and treat a septate hymen with a safe and effective surgery that removes extra tissue from your vagina. Most people who get treatment for a septate hymen can enjoy pain-free sex and use tampons regularly.
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