Editor—We agree with Paterson-Brown that education about the hymen is urgently needed.1 However, there is no evidence from the study by Emans et al2 that the “appearances [of hymens] relate to tampon use,” only that speculum examinations were rated as easy in 56% of the examinations of non-sexually active tampon users compared with 26% of the non-sexually active pad users and 81% of the sexually active females studied.
Furthermore, an opportunity to educate inexperienced health professionals regarding the elasticity of the postpubertal hymen has been missed; the study by Emans et al found that 19% of the sexually active postpubertal females had no visible abnormalities of the hymen. This has long been appreciated by forensic physicians who give evidence in court regarding serious sexual assaults. The practice of reconstructing “the hymens of adolescent girls who are no longer virgins but wish to appear so”3 only serves to perpetuate the myth that the hymen is necessarily torn after sexual intercourse.
References
- 1.Paterson-Brown S. Should doctors reconstruct the vaginal introitus of adolescent girls to mimic the virginal state? Commentary: Education about the hymen is needed. BMJ. 1998;316:461. doi: 10.1136/bmj.316.7129.461. . (7 February.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Emans SJ, Wood ER, Allred EN, Grace E. Hymenal findings in adolescent women: the impact of tampon use and consensual sexual activity. J Pediatr. 1994;125:153–160. doi: 10.1016/s0022-3476(94)70144-x. [DOI] [PubMed] [Google Scholar]
- 3.Logmans A, Verhoeff A, Bol Raap R, Creighton F, van Lent M. Should doctors reconstruct the vaginal introitus of adolescent girls to mimic the virginal state? Who wants the procedure and why. BMJ. 1998;316:459–460. doi: 10.1136/bmj.316.7129.459. . (7 February.) [DOI] [PMC free article] [PubMed] [Google Scholar]