UMM FULAANAH: Assalaam alaykum doctor.

DR FULEEN: Waalykum salaam warahmatuLlaah.

UMM FULAANAH: I’m worried about my daughter. She will be 16 next month, but she has not started seeing her menses. I complained to a nurse about a year ago and she told me that we could wait until another year. I’m getting worried doc. What could be the cause of the delay?

DR FULEEN: You don’t have to worry ma’am. The nurse was right. We don’t get worried about delayed menarche until the age of 14-16, depending on other factors. By merely looking at Fulaanah, I know she is okay in terms of physical and sexual development. Her height is good enough and her breasts are appropriate for her age. We would have become worried if these features weren’t there as at the time she was 14.

UMM FULAANAH: Phew! I’m a bit relieved. But doc, there is one more thing we noticed about three months ago.

DR FULEEN: What’s that?

UMM FULAANAH: She’s been complaining about tummy pain. Initially, I thought it was a sign that her menses was going to flow, but then, nothing happened. The pain was relieved after she took some painkillers. She had this pain again last week and she was given an injection by the nurse before the pain was controlled. That was why I insisted on bringing her to you today.

DR FULEEN: That’s a very good observation. I’d like to ask you a few more questions and take your consent to examine her from head to toe, including her genitals.

UMM FULAANAH: Please go ahead doc…

10 minutes later…

DOCTOR FULEEN: Umm, I’m afraid she has a condition called IMPERFORATE HYMEN.

UMM FULAANAH: What does it mean? Is it a serious problem?

DOCTOR FULEEN: You know, there is a thin layer of flesh that surrounds the opening of the vagina. This is called the hymen. It is generally believed that the hymen can only be perforated after the first intercourse but, actually the hymen comes with its own “perforation” which allows for the exit of normal mucous fluids, and of course, flow of menses.

UMM FULAANAH: Hmm… So you’re saying, Fulaanah doesn’t have any “perforation” at all?

DOCTOR FULEEN: Exactly! It appears that her monthly cycle has been happening but there is no outlet for it to flow. That explains the cyclical pain she’s been experiencing in the past three months.

UMM FULAANAH: SubhaanaLlaah! You mean blood has been accumulating in her womb for three months?!

DR. FULEEN: It’s very likely. Initially, the blood pools in the vagina, then with time, it could flow backwards and collect in the womb, causing pain and other possible complications. But don’t worry, okay? We will perform a simple operation, make a small slit in the hymen and drain the accumulated blood. This is called HYMENECTOMY. She will be fine and her menses will flow normally afterwards.

UMM FULAANAH: Maa shaa Allaah! Can you do the operation right now? She is fasting…

DR FULEEN: Calm down Umm. We need to carry out a few tests to confirm the diagnosis and check her general health status. Then, we can do the operation.

UMM FULAANAH: OK doc. I trust that you will take good care of my daughter. Thank you so much.

DR FULEEN: You’re welcome.



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