Hymen

The hymen does not have a single "correct" shape. Its morphology can vary significantly among patients, which is a physiological phenomenon.

The most commonly encountered types are:

• Annular – with a central opening; the most common form.
• Crescentic – with an asymmetrically located opening. 
• Cribriform – having multiple small openings.
• Septate – presence of a band of tissue dividing the opening. 
• Elastic – stretchable, often does not rupture.
• Imperforate – absence of an opening; a pathological condition requiring surgical intervention.

Knowledge of the type of hymen is clinically significant because some variants (e.g., imperforate or septate) can cause:

• Disruptions in menstrual blood flow,
• Painful symptoms,
• Problems with tampon application,
• Discomfort during intercourse.

Defloration refers to the rupture or stretching of the hymen. It is most commonly associated with first intercourse, however, from a medical standpoint, it is a descriptive term rather than a diagnostic one.

Defloration can also occur as a result of:

• Intensive physical activities (e.g., horseback riding, gymnastics),
• Mechanical injuries,
• Gynecological examinations or procedures,
• Use of tampons or menstrual cups.

It is important to highlight:

• Bleeding is not a rule - many women do not experience any,
• Absence of pain is common,
• An elastic hymen may not rupture at all.

From a medical perspective, defloration has no clinical significance, although its interpretation may be burdened with cultural and emotional context.

Hymenoplasty is a surgical procedure involving the reconstruction of the hymen. It is performed for reasons such as:

• psychological,
• cultural or religious,
• less commonly
• aesthetic or personal.

The procedure:

• is conducted under local anesthesia,
• involves stitching together remnants of the hymen or creating a new structure from the vaginal mucosa tissues,
• usually lasts 30–60 minutes,
• does not affect fertility or sexual functions.

The effect of the reconstruction is temporary and lasts until the hymen is broken again. The decision to undergo hymenoplasty should be preceded by a thorough medical consultation, taking into account both medical aspects and the psychological well-being of the patient.

The removal of the hymen (hymenotomy or hymenectomy) is a medical procedure performed exclusively for health indications.

The most common indications:

• imperforate hymen,
• recurrent pain,
• menstrual disorders,
• difficulty with intercourse or gynecological examinations.

Procedure characteristics:

• short duration,
• local anesthesia,
• minimally invasive,
• quick recovery period.

The procedure aims to improve the patient's comfort and health, rather than for aesthetic intervention.

The procedures for hymen restoration involve various surgical techniques, selected individually based on the anatomy and expectations of the patient.

Methods used:

• stitching the remnants of the hymen (short-term reconstruction),
• reconstruction using vaginal mucosal tissues (long-term effect).

It should be clearly stated:

• the procedure does not restore the "original state", but merely creates an anatomical structure with a similar appearance,
• the effect is functional-anatomical, not diagnostic,
• the procedure does not impact future pregnancies or childbirth.

From a medical viewpoint, these procedures are not necessary, but in certain situations, they may play a significant role in supporting the psychological well-being of the patient. The key remains an informed decision based on reliable information, rather than social pressure or myths concerning the anatomy of the female body.