Clinicians, however, continue to refer to changes in the hymen to assess for a history of consensual or nonconsensual sexual intercourse. We reviewed published evidence to dispel commonly held myths about the hymen and its morphology, function, and use as evidence in cases of sexual violence. An examination of the hymen is not an accurate or reliable test of a previous history of sexual activity, including sexual assault. We call on clinicians to consider the low predictive value of a hymen examination and to: 1 avoid relying solely on the status of the hymen in sexual assault examinations and reporting; 2 help raise awareness of this issue among their peers and counterparts in law enforcement and the judicial system; and 3 promote fact-based discussions about the limitations of hymenal examinations as part of clinical education for all specialties that address the sexual or reproductive health of women and girls. The online version of this article

The hymen is a thin piece of mucosal tissue that surrounds or partially covers the external vaginal opening. It forms part of the vulva , or external genitalia , and is similar in structure to the vagina. In children, a common appearance of the hymen is crescent -shaped, although many shapes are possible. During puberty , estrogen causes the hymen to change in appearance and become very elastic. The hymen can rip or tear during first penetrative intercourse , which usually results in pain and, sometimes, mild temporary bleeding or spotting.

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