What Is Hymenal Polyp

Overview

The physiological function of the hymen remains a mystery. Although it doesn't seem to have a known biological function, experts emphasise the role of the hymen in the protection of the vaginal mucosa from contamination by faecal and other materials at the early stage of life. 

Birth defects (present at birth) in the female reproductive system are relatively frequent. Many of them are asymptomatic, randomly discovered and require no intervention.¹ Among these defects is the hymenal polyp, a soft and tiny stalk-like growth on the hymen. The hymen is a thin membrane that surrounds the external opening of the girl's vagina. Unlike a hymenal tag, a  hymenal polyp appears at birth. It is not cancerous and usually fade away within a few weeks without treatment. In rare cases, a hymenal polyp keeps growing and requires medical intervention.

However, the pathology of the hymen is rare in daily medical practice. They are usually seen in the pediatric patient population and are sometimes a matter of medico-legal concern.¹

Causes of hymenal polyp

The experts are not sure what causes the hymenal polyps. Hymenal polyps are congenital (present at birth). They form because a group of cells becomes irregularly growing.

Hymenal polyps are generally very small, less than 5 mm. They are caused by the stimulation of estrogen in the fetal period and spontaneously regresses once estrogen levels fall to normal prepubertal levels. They are rarely seen after the age of three and very rarely can persist and become more polyploids.²

Signs and symptoms of hymenal polyp

Hymenal polyps usually do not cause health issues, but they can cause:^1,3

• Vaginal bleeding: Hymenal polyps may cause abnormal or irregular bleeding
• Vaginal discharge: In some women, vaginal discharge can be heavy and white
• Pain or discomfort: Hymenal polyps may cause pain or discomfort during physical exercise, sexual activity, sitting or standing for prolonged periods of time 
• Itching or irritation: Some women may experience itching or irritation surrounding the vaginal opening 

Most hymenal polyps are not malignant.

Management and treatment for hymenal polyps

Hymenal polyps generally disappear with no therapy. If your baby is born with a hymenal polyp, it will go away within a few weeks.⁴ In children, about 70% of hymenal polyps are resolved by age three.⁵ However, in rare cases, the hymenal polyps can persist and grow as you get older. They might rub against your clothes and cause inconvenience. If the discomfort is minor, it might not require to be eliminated. Your physician will probably advise home care, which includes:

• Taking painkillers
• Applying a cold compress
• Avoiding intense exercise until symptoms go away

If the hymenal polyps are large and cause discomfort that interferes with your daily activity, your doctor may suggest the surgical removal of the polyps.

During the surgery, your doctor will:

Give you medication to numb the area

Use a little surgical device to draw the growing

Close the lesion with one or two sutures, if necessary

And finally, use a drug to stop any bleeding if it occurs 

Diagnosis

In infants, healthcare professionals can identify hymenal polyps by observing them. Babies typically do not need any further tests. 

In adults, healthcare professionals identify hymenal polyps through a pelvic exam. You can have additional tests to validate the diagnosis or exclude other conditions. Tests may involve:

Pap test: Your healthcare provider collects a small group of cells from your cervix (the lower, narrow end of your uterus - at the top of your vagina). The laboratory inspects the cells for abnormalities.   

Biopsy: Your healthcare provider collects a little piece of tissue for a lab examination.

Hymenal tags are the result of extra hymen tissue. These tags usually stand on the border of the hymen. They are often confused for hymenal polyps.⁶ In addition, the hymenal tags can relate to tissue that remains after the hymen breaks. These tags are mostly benign and do not cause any inconvenience.

FAQs

How can I prevent hymenal polyps?

There are no methods by which we can prevent the appearance of hymenal polyps. They appear during intra-uterine life without any definite cause. The good part is that they generally go away by themselves and do not cause discomfort. However, maintaining good vaginal hygiene and avoiding activities that can result in trauma or injury to the hymen may help.

How common is hymenal polyp

It is estimated that the incidence of hymenal polyps varies between 6% and 13% among newborn girls, where 30% persists over the age of three.^5,7 

Who is at risk of hymenal polyps?

The experts are not sure what causes the hymenal polyps. Hymenal polyps are congenital (present at birth), so we can consider that all females have a 6-13% risk of being born with hymenal polyps.⁷

When should I see a doctor?

Consult a physician if you go through one of the following symptoms:

• Inflammation
• Abnormal or irregular vaginal bleeding (including postmenopausal bleeding)
• Vaginal injuries
• Discomfort (including abdominal pain or pain during sexual activity)

Summary

Hymenal polyps are small benign growths that extend from your hymen. They present at birth, and experts do not know their exact causes. Hymenal polyps are asymptomatic, and they resolve within a few weeks. In rare cases, the polyps might persist and cause discomfort, where surgical removal will be the optimal treatment option. Thus, it is important to seek medical attention if you have persistent polyps.