Hymenectomy

What is a hymenectomy?

A hymenectomy (also called a hymenotomy) is a minor surgical procedure that opens or removes your hymen. It’s usually performed to correct a malformation of the hymen that’s present at birth. The hymen is a piece of tissue near the opening of your vagina. Your hymen is flexible, thin and stretches over time. Most people’s hymens will naturally open before puberty to allow for menstruation to occur. However, some people are born with a hymen that has formed irregularly. The size, shape or thickness can prevent them from having normal menstruation, inserting a tampon or having sexual intercourse. A hymenectomy corrects these irregularities.

Why would you have a hymenectomy?

A hymenectomy treats congenital conditions of the hymen and other rare disorders. Conditions of the hymen can affect menstruation, sexual intercourse and can cause pain. Your healthcare provider may recommend a hymenectomy to treat these congenital hymenal conditions:

• Cribriform hymen: A condition where your hymen contains many small holes.
• Imperforate hymen: When your hymen completely covers the opening to your vagina.
• Microperforate hymen: When your hymen covers your entire vaginal opening except for a tiny hole.
• Septate hymen: Your hymen has an extra piece of tissue, giving it the appearance of two hymens.

Some hymen abnormalities are discovered at birth, while others aren’t diagnosed until puberty when a young person has issues with menstruation or inserting a tampon. When you can’t menstruate, it can cause blood to back up into your uterus, fallopian tubes and abdomen. In rare cases, blood building up in your abdomen is life-threatening. Other times a hymenectomy is performed later in life when a person is experiencing pain during sex.

What does a hymenectomy treat?

A hymenectomy treats conditions of the hymen that can interfere with regular menstruation. These congenital disorders can make it hard for period blood to flow out the vagina because the hymen is blocking its exit. A hymenectomy opens or removes your hymen to allow for normal menstruation and the use of tampons. In some cases, a hymenectomy allows you to have pain-free sexual intercourse.

What happens before a hymenectomy?

Your healthcare provider will examine your hymen to diagnose the irregularity and determine treatment. They’ll go over the details of the procedure, including pre-operative and post-operative instructions to follow at home. The surgery is considered minor and is treated as an outpatient procedure, meaning you won’t have to spend the night in the hospital. Ask your healthcare provider if you should stop taking any medications in the days leading up to your surgery. They may ask you to restrict food and beverages for at least 12 hours before a hymenectomy.

Do you go under anesthesia for a hymenectomy?

You’ll receive local anesthesia to the area around your hymen (the vulvar area of the vagina). You may be given other sedative medications or pain relievers. General anesthesia is typically not required for a hymenectomy. Your healthcare provider will make that determination based on the complexity of the procedure.

What happens during a hymenectomy?

The first thing that happens is you’ll change into a hospital gown. Then, you’ll get sedative medication or anesthesia.

During a hymenectomy, a gynecologist will use scissors or a scalpel to cut excess hymenal tissue. They’ll then use absorbable stitches to close the incision. Stitches should prevent the area from bleeding. Depending on the size and shape of the hymenal tissue, your incision may be just below your vaginal opening or around your entire opening.

A hymenectomy lasts less than an hour, and you’re usually able to go home afterward.

What happens after you have a hymenectomy?

You’ll go to a recovery area for monitoring after a hymenectomy. Before you go home, make sure to understand your instructions for recovery, including what activities or medications to avoid. Your healthcare provider will likely recommend the following:

• Don’t insert anything into your vagina for at least two to four weeks or when cleared by your healthcare provider.
• You can take warm sitz baths several times a day to help with discomfort and promote healing.
• Don’t lift anything heavy or engage in exercise until you’re cleared by your healthcare provider.
• You can usually take over-the-counter (OTC) pain relievers. Ask your healthcare provider which medicine is best. Avoid taking aspirin as it can interfere with clotting.
• Some healthcare providers will recommend a topical cream or spray to use in the area.
• You can usually bathe or shower normally after the surgery. Take extra care when washing and drying around the incision.
• Schedule a follow-up appointment with your healthcare provider.

Complete healing can take a couple of months, but most people can get back to normal activities within two to four weeks. Talk to your healthcare provider at your follow-up appointment about any discomfort or pain you’re feeling.

What are the advantages of having a hymenectomy?

A hymenectomy can alleviate pain and help with regular menstruation. Some of the things you can expect after the procedure are:

• Pain-free sex (if you were feeling discomfort during sex).
• Relief of problems associated with having your vaginal opening blocked.
• Menstruation.
• Ability to use tampons.

What are the risks of having a hymenectomy?

Like most surgical procedures, there are risks associated with a hymenectomy. Some of the risks include:

• Inflammation or swelling.
• Heavy bleeding.
• Developing scar tissue.
• Injury to the area around the hymen.
• Allergic reaction to the medications used.

How long does it take to recover from a hymenectomy?

It doesn’t take long to recover from a hymenectomy. Most people can resume their normal activity levels within a few days. Sexual intercourse isn’t recommended for at least two to four weeks to allow the stitches to dissolve and the area around the vaginal opening to heal. You’ll have a follow-up appointment with your healthcare provider within two to four weeks.

What can I do at home to help me recover from a hymenectomy?

You may experience minor bleeding or vaginal discharge for up to a week after the procedure. If discomfort to the area persists after a week or two, talk to your healthcare provider as it might indicate an issue. Some of the best things you can do at home after a hymenectomy are:

• Take over-the-counter pain medicine.
• Apply a numbing cream or spray to the area.
• Use an ice pack or wear a cold sanitary pad.
• Take sitz baths several times a day.

What is the long-term outlook for a hymenectomy procedure?

A hymenectomy has a high success rate without any issues afterward. Most people who have the procedure can menstruate, use tampons and have pain-free sex. Some studies show you could be at an increased risk for pregnancy complications. Otherwise, there are minimal complications associated with a hymenectomy.

When should I see my healthcare provider?

It’s normal to feel minor discomfort after a hymenectomy. Taking a warm sitz bath can help with healing and provide some relief. Seek medical care if you have any of these symptoms:

• A fever that doesn’t go down with the use of pain relievers.
• Pus-like vaginal discharge.
• Heavy bleeding.
• A rash or redness in the area.
• Painful urination.
• Dizziness or feeling like you might faint.

A note from Cleveland Clinic

A hymenectomy fixes irregularities of the hymen. Your healthcare provider can diagnose conditions of the hymen and explain how the procedure works. After the surgery, you can expect to menstruate normally, use a tampon and have pain-free sex. It’s a low-risk procedure with positive outcomes.