ABSTRACT
Objective To study the backgrounds of women requesting hymen ‘repair’, to assess the effects of extensive counselling, and the effects of hymen reconstruction.
Methods A two-centre qualitative study, consisting of a semi-structured interview, education, discussion of alternatives, and instructions for self-examination (first visit), educational examination (second visit), decision on operation or alternative (third visit), and follow-up (fourth visit).
Results Eighty-two women were interviewed at first visit. Sixty-eight women were followed until their decision to be operated upon or not. Forty-eight percent of all subjects reported a history of sexual violence, and 37% had had one or more abortions. Only 29% eventually decided to be operated. Seventeen of the 19 women who submitted to an operation and attended the follow-up visit reported no blood loss at first marital intercourse.
Conclusions Most women requesting hymen reconstruction had a history complicated by critical life events related to their request. All women were afraid they would not bleed and/or would not be ‘tight’ enough during the wedding night. For 75% of the women empowerment by means of extensive counselling resulted in a decision against operation. Hymenoplasty alone does not help women because most operated women will not bleed and because they often also have to prove to be ‘tight’ enough.
ACKNOWLEDGEMENTS
We thank all women who participated in the study for their willingness to tell their stories – often for the first time – to the authors. Several of them expressed the intention to contribute to a change of mentality within their communities. We also wish to express our gratitude to Mario ter Smitten who reviewed spelling, grammar and semantics of the article.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.