Imperforate: hymenal opening nonexistent; will require minor surgery if it has not corrected itself by puberty to allow menstrual fluids to escape. Cribriform, or microperforate: sometimes confused for imperforate, the hymenal opening appears to be nonexistent, but has, under close examination, small perforations. Septate: the hymenal opening has one or more bands of tissue extending across the opening. Trauma
Historically, it was believed that first sexual intercourse was necessarily traumatic to the hymen and always resulted in the hymen being "broken" or torn, causing bleeding. However, research on women in Western populations has found that bleeding during first intercourse does not invariably occur. In one cross-cultural study, slightly more than half of all women self-reported bleeding during first intercourse, with significantly different levels of pain and bleeding reported depending on their region of origin. Not all women experience pain, and one study found a correlation between the experience of strong emotions – such as excitement, nervousness, or fear – with experiencing pain during first intercourse.In several studies of adolescent female rape victims, where patients were examined at a hospital following sexual assault, half or fewer of virgin victims had any injury to the hymen. Tears of the hymen occurred in less than a quarter of cases. However, virgins were significantly more likely to have injuries to the hymen than non-virgins.In a study of adolescents who had previously had consensual sex, approximately half showed evidence of trauma to the hymen. Trauma to the hymen may also occur in adult non-virgins following consensual sex, although it is rare.
Causes
The most common cause of temporary lymphocytopenia is a recent infection, such as the common cold.Lymphocytopenia, but not idiopathic CD4+ lymphocytopenia, is associated with corticosteroid use, infections with HIV and other viral, bacterial, and fungal agents, malnutrition, systemic lupus erythematosus, severe stress, intense or prolonged physical exercise (due to cortisol release),   rheumatoid arthritis, sarcoidosis, multiple sclerosis, and iatrogenic (caused by other medical treatments) conditions. Lymphocytopenia is a frequent, temporary result from many types of chemotherapy, such as with cytotoxic agents or immunosuppressive drugs. Some malignancies that have spread to involve the bone marrow, such as leukemia or advanced Hodgkins disease, also cause lymphocytopenia. Another cause is infection with Influenza A virus subtype H1N1 (and other subtypes of the Influenza A virus) and is then often associated with Monocytosis; H1N1 was responsible for the Spanish flu, the 2009 flu pandemic and in 2016 for the Influenza-epidemic in Brazil. The SARS disease caused lymphocytopenia. Among patients with laboratory-confirmed COVID-19 in Wuhan China through January 29th, 2020, 83.2 percent had Lymphocytopenia at admission.Large doses of radiation, such as those involved with nuclear accidents or medical whole body radiation, may cause lymphocytopenia. Diagnosis
Lymphocytopenia is diagnosed when the complete blood count shows a lymphocyte count lower than the age-appropriate reference interval (for example, below 1.0 x 10(9)/L in an adult). Prognosis
Lymphocytopenia that is caused by infections tends to resolve once the infection has cleared.