A longitudinal study of hymenal development from 3 to 9 years of age

Purpose: To document hymenal characteristics associated with normal development in girls between 3 and 9 years of age. Study design: The hymens of 93 children without a history of sexual abuse were examined and photographed at 3 and 5 years of age; 80 children were reexamined at 7 and 61 at 9 years of age. Hymenal features recorded included periurethral and vestibular bands, notches, transections, longitudinal intravaginal ridges, external ridges, mounds, and tags. Transhymenal diameters were measured as well as the tissue at 3, 6, and 9 o'clock positions. Changes in hymenal measurements over time were analyzed using the general estimating equation approach to repeated measures. Results: Crescentic configuration became more common as the children aged (P < .01). The number of mounds and intravaginal ridges observed per child as well as the size of the transhymenal diameter increased as the sample aged. The mean amount of tissue at the 6 o'clock position significantly changed over time (P < .01). However, no significant changes were observed in the number of tags, periurethral or vestibular bands, notches, external ridges, or amount of tissue present at the 3 or 9 o'clock position. Conclusions: Few changes occur in the morphologic features of the hymen between 3 and 9 years of age.