title: Circumferential hymen elasticity. A marker of physiologic maturity.
abstract: OBJECTIVE
  To study the relationship between anatomic changes in the peripubertal female and sex hormonal maturation.
  
  
  METHODS
  Medical records were reviewed on virginal females whose first gynecologic examination occurred between ages 9 and 20 and who were examined at least twice by the same gynecologist. Speculum sizes at each visit were surrogate measures of circumferential hymenal elasticity, the anatomic change of interest.
  
  
  RESULTS
  Mean ages at the two visits for the 35 patients were 14.6 and 16.7 years, respectively, with substantial overlap in ages between visits. Average Tanner breast and pubic hair stages and speculum sizes were greater at the second visit (P < .001). At first visit, age, Tanner breast and pubic hair stages, and time elapsed from menarche, thelarche and pubarche correlated positively with larger speculum sizes (P < .10). Change in speculum size between visits was associated with younger age and lower Tanner pubic hair stages at first visit and with increases between visits in age, body mass index and Tanner pubic hair stages. Larger changes were associated with shorter elapsed time between the first visit and menarche, thelarche and pubarche.
  
  
  CONCLUSIONS
  Circumferential hymenal elasticity increases during adolescence. This anatomic change, the surrogate measure of which is specula diameter, can be used along with Tanner staging as a measure of physiologic maturity in adolescent women.
authors.affiliation: Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, New Jersey, USA.
authors.forename: S F
authors.initials: SF
authors.lastname: Pokorny
authors.forename: J G
authors.initials: JG
authors.lastname: Murphy
authors.forename: M K
authors.initials: MK
authors.lastname: Preminger
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D004548:Elasticity; D005260:Female; D005836:Genitalia, Female / Q000254:growth & development; D006197:Hair / Q000254:growth & development; D006801:Humans; D006924:Hymen / Q000033:anatomy & histology* / Q000254:growth & development; D010808:Physical Examination / Q000295:instrumentation; D011627:Puberty / Q000502:physiology*; D012189:Retrospective Studies; D012741:Sexual Maturation / Q000502:physiology*