Patient's question:
When I first had sexual intercourse, I didn't bleed. In subsequent sexual encounters, I also didn't get pregnant without contraception, and my menstruation is normal. What could be the reason for this? I have been having sexual intercourse for almost a year now. Could it be a serious illness?Doctor's answer:
Hello: The hymen is a thin layer of mucous membrane covering the vaginal opening, containing connective tissue, blood vessels, and nerve endings. It often tears during the first sexual intercourse but can also be ruptured due to vigorous activities like horseback riding, resulting in bleeding and pain. The size and thickness of the hymen vary from person to person, and in rare cases, some individuals with a naturally thicker hymen may not experience bleeding during sexual intercourse.Infertility refers to women of reproductive age who remain childless after living with their spouse for more than two years without using contraception, known as primary infertility. If a woman has previously given birth or has not conceived again for more than two years after a miscarriage or abortion, it is referred to as secondary infertility.
Common Causes:
If either partner or both partners have systemic or genital diseases, it can lead to infertility. The main reasons for female infertility include:
(1) Systemic Diseases: Severe chronic conditions and endocrine disorders.
(2) Reproductive Organ Diseases: This is the most common cause of infertility.
1. Developmental Abnormalities: Uterine underdevelopment or malformations, congenital absence of the vagina, transverse vaginal septum, etc., can affect intercourse or hinder sperm entry.
2. Inflammations: Vaginitis and cervicitis can alter vaginal pH, making it unsuitable for sperm survival, while endometritis can affect embryo implantation; tubal inflammation causing lumen obstruction can impede fertilization.
3. Tumors: Uterine fibroids may sometimes block or compress fallopian tubes, reducing the chance of conception; submucosal and intramural fibroids can cause endometrial changes, hindering embryo implantation.