The Power of Words in Female Health – (Part 2) Hymen Abnormalities: There’s More to Hymens than Virginity

Hymens meaning virginity and vaginas being vulvas – a three-parter on the concepts, misconceptions and grey areas surrounding these parts of female health 

Equally essential as the social exposé of the exterior, is clear literacy on what’s going on inside the nether regions (excuse the evasive Victorian vernacular), in formal education and beyond. 

This is where I return to the elusive hymen. Or in my case, not elusive at all, immutable. 

The euphemistic association with the physical hymen with the abstract ‘virginity’ means that it can often be swept into the figurative pile and not seen for the body part that it is. We may have evolved genetically as to no longer need an appendix, but if there is an irregularity, we know it should be examined. Similarly, the ‘purpose’ of hymens by and large (though not exclusively) feels null and void, as it is has evolved culturally by its disassociation from its marriage-related origins. The difference with the hymen, however are that the abnormalities (which there are with anything corporeal) are little discussed and little known about. This I feel is why it took me until I was 17 (six years after I first started menstruating and around four years tentatively trying and failing at using tampons) to realise that all infact was not good in the hood. 

Hymenal abnormalities are an extremely rare, congenital condition that can manifest in a variety of appearances and are by and large remedied by operations called hymenectomies. I was searching online to understand my experience better and was baffled to find that although an uncommon condition, the sources out there to educate myself with were far fewer than expected. The articles I did find are really worth a look (linked at the end of each section), but all acknowledge the same facts: that it’s rare, deplorably little talked about and needs to be discussed more widely. 

Through merely wanting to find a definition for ‘hymenectomy’ I was confronted by some huge omissions. For example, the NHS website. My operation was done on the NHS (and for this I am thankful) but if you type it into the Health A-Z it comes up as ‘no results found’. No results for ‘hymenotomy’ either. At this point I’m wondering if my surgery was a Truman Show-esque rouse. 

Luckily ‘hymen’ has some results, after asking if I meant ‘Hyman’ (someone’s name), it shows up as a highlighted word amongst Q&As about girls’ bodies and sex. Still, it’s not very promising, even though the numbers are low, I’m not the only person who’s gone into a gynaecology ward to have their hymen removed (as much as I felt like I was), and I won’t be the last. In my initial frustration I rather petulantly thought ‘that’s just great, it’s like I’m a Victorian woman and they’re ashamed to have ‘tampered’ with my ‘virginity’ so don’t acknowledge it’. I don’t actually believe this, only that was the most drastic place my mind went to. I would also never want to come across as anything but grateful for the NHS, from everything it’s done from day dot to the dire straits it’s experienced with Coronavirus this year. 

Instead it more serves to point out how these issues are kept under the rug and forgotten about over time. Again we return to how the physical fact of the hymen has been masked by the concept of virginity.   

So, what can I bring to the conversation to shed a light on hymens and hymenal abnormalities? The only statistics I am able to find are about imperforate hymens, which occur in around 1 in 1000 to 1 in 10,000 women. The impact of a hymen being imperforate is that nothing can pass the hymenal bridge, including menstrual blood. I’ve read medical case studies of girls in the early stages of puberty – no periods, but very acute lower abdominal pain from the build-up of blood. In these instances, emergency hymenectomies were carried out. Georgia Watts wrote a BBC3 article about how her first tampon put her in A&E – this is how she discovered she had a septate hymen. 

I was fortunate enough to not have a specific event that prompted the immediate need to remove my hymenal bridge. My period was regular – often painful but nothing too debilitating. I just couldn’t use tampons. From this I can assume that my hymen was microperforate (though it’s not identified in my hospital letters). My GP after examination referred me for a hymenectomy consultation, with the foresight that without it, tampons would be impossible, and sex would be traumatic. Her unwavering confidence that this was the right course of action was comforting. I cannot imagine how it would have been without it and I’m forever thankful I don’t have to.  

Image of Hymen Abnormalities taken from gyn emznote.weeby.com

I didn’t come away from my hospital consultation with that same confidence, however, as the doctor projected her discomfort at my undergoing this operation. She asked me if I swam and therefore really needed tampons. I did ballet at the time so felt like I could thus qualify requiring them (but I knew I wanted them whether leotard clad or not – as is my right!). Then there was the bizarrely out of touch statement that girls my age don’t really use tampons anyway, then a reluctance to examine me ending with the humdinger of ‘you are aware that you’ll be losing your virginity to surgery?’. I hasten to add that I have only ever been to my own hymenectomy consultation, therefore don’t know if that’s a routine (albeit dated) question. But it felt like a projection of shame that I didn’t possess, and in not possessing was in itself shameful. I do wonder if I got her on an off day as that felt like a very surreal meeting.

This rather shaky start was soothed by the next – more comforting – consultancy, sensitively done in which he concluded with that same resounding reassurance as my original examination. 

My hymenectomy was a day release surgery. I was allowed to have my mum wait with me as I was under 18 and an NHS nurse/guardian angel saw me trembling a heck of a lot with nerves so let her. They wheeled me in, put me under general anaesthetic and during a very sarcastic internal monologue – ‘well of course I get young good-looking surgeons and the lady who says girls don’t use tampons is here’ – I conked out. The procedure took probably an hour.

There was even a good cyclical karmic element. When I came to, the doctor I so dreaded to see in theatre was full of support and comfort that the operation had been successful and the right decision. I healed well after taking it easy and not using tampons until it was prescribed that I could. It’s never caused me jip since. 

. . .

Recommended article:  Georgia Watt’s article – https://www.bbc.co.uk/bbcthree/article/295423a4-dbd4-4277-af2c-7843f794eb7f

Image courtesy of Georgia Hunt

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