Cribriform Hymen

Overview

What is a cribriform hymen?

Your hymen is a thin, fleshy membrane that surrounds the opening of your vagina. A cribriform hymen means that your hymen has multiple small perforations (holes). The condition is congenital, meaning someone is born with it.

What are the different types of hymen?

Usually, your hymen has one hole in it. The hole is big enough for blood to exit during menstruation and for tampon use.

But there are other types of hymen, such as:

  • Cribriform hymen: Your hymen has multiple small holes instead of one moderate-sized hole.
  • Imperforate hymen: Your hymen completely covers the opening to your vagina.
  • Microperforate hymen: The membrane almost completely covers the opening to your vagina, with just one small opening.
  • Septate hymen: The membrane has an extra piece of tissue in the middle, creating two small and separate openings to your vagina.

Is cribriform hymen common?

Cribriform hymen, imperforate hymen, microperforate hymen and septate hymen aren’t common conditions.

Symptoms and Causes

What causes cribriform hymen?

A cribriform hymen occurs when the hymen doesn’t form properly during fetal development. But scientists don’t yet understand what causes the abnormality.

What are the symptoms?

With a cribriform hymen, secretions can flow out of your vagina, such as blood from periods (menstruation). But blood may come out slower than usual, which means that periods may last longer than normal (perhaps by four to seven days).

Having a cribriform hymen also makes it difficult for people to comfortably insert an object into their vagina. For example, you may experience:

  • Bleeding or pain during sexual intercourse.
  • Inability to insert a tampon or remove it.
  • Pain when inserting or removing a tampon.

Some people with cribriform hymen also may experience abdominal pain or lower back pain.

Diagnosis and Tests

How is it diagnosed?

Cribriform hymen may be detected at birth during a physical examination of the newborn. But it’s often not noticed until puberty or later. A healthcare provider can make the diagnosis by looking closely at your hymen during a pelvic exam. This is usually performed by a gynecologist, a specialist in the female reproductive system.

Management and Treatment

Can cribriform hymen be corrected?

Not all cribriform hymens require treatment. But you may choose to have your hymen surgically corrected if the condition interferes with:

  • Menstrual flow.
  • Pelvic exams and tests that help you monitor your health, such as Pap smears.
  • Sex.
  • Tampon use.

The surgery, called hymenectomy, is a minor procedure performed in a doctor’s office, clinic or operating room. Your healthcare provider cuts away the extra tissue, leaving only one opening that’s normal size.

Your healthcare provider will talk to you about options for anesthesia to control pain during the procedure. You may need stitches afterward, which usually dissolve on their own.

How long does it take to recover from a hymenectomy?

You can go home the same day as a hymenectomy, and recovery takes a few days to a few weeks. You may have some discomfort when the anesthesia wears off. You also may have light bleeding from the surgical area.

Your healthcare provider will give you instructions about how to take care of yourself after a hymenectomy. They may include limiting certain activities, such as:

  • Bathing.
  • Exercising.
  • Having sex.
  • Using tampons.
Care at Cleveland Clinic

Prevention

How can I prevent cribriform hymen?

There’s no way to prevent cribriform hymen or other types of abnormal hymen.

Outlook / Prognosis

What can I expect if I have this condition?

A cribriform hymen can cause pain and limit activities, but it’s not a dangerous condition.

Sometimes the issue goes away on its own as a child grows. The hymen also may tear during intercourse or tampon insertion, which may solve the problem.

Can a cribriform hymen come back after treatment?

If you choose to have a hymenectomy to treat cribriform hymen, the extra tissue won’t grow back.

Living With

When should I talk to a healthcare provider about my hymen?

Cribriform hymen may not produce any symptoms at all. But if you experience any pain or abnormal bleeding near your vagina, or periods that are longer than usual, talk to your healthcare provider.

What can I ask my doctor?

If you want to know more about your hymen, consider asking a healthcare provider the following questions:

  • What type of hymen do I have?
  • Is it safe to use tampons and have intercourse?
  • Would you recommend surgery?
  • When should I call a doctor?

A note from Cleveland Clinic

A cribriform hymen means that the hymen has multiple small perforations (holes). If you have pain or difficulty with menstrual flow, sexual intercourse or tampon use, talk to your healthcare provider. A minor surgical procedure may be able to help.

Last reviewed by a Cleveland Clinic medical professional on 01/13/2022.

References

  • American College of Obstetricians and Gynecologists. Diagnosis and Management of Hymenal Variants. (https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/06/diagnosis-and-management-of-hymenal-variants) Accessed 1/13/2022.
  • Habek D, Arbanas G, Jukic V. An Unusual Case of Infertility: Urethral Coitus Due to Cribriform Hymen. (https://pubmed.ncbi.nlm.nih.gov/28831666/) Arch Sex Behav. 2018 Apr;47(3):811-813.
  • Radiopaedia. Hymen. (https://radiopaedia.org/articles/hymen?lang=us) Accessed 1/13/2022.

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