^ 3.03.1Emans, S. Jean. "Physical Examination of the Child and Adolescent" (2000) in Evaluation of the Sexually Abused Child: A Medical Textbook and Photographic Atlas, Second edition, Oxford University Press. 61–65
^The Hymen. University of California, Santa Barbara. [2009-02-09]. （原始内容存档于2009-05-09）. The hymen oftentimes, though not always, rips or tears the first time a female engages in penetrative intercourse, which may cause some temporary bleeding and slight discomfort.
^Loeber, Olga. Over het zwaard en de schede; bloedverlies en pijn bij de eerste coïtus Een onderzoek bij vrouwen uit diverse culturen(PDF). Tijdschrift voor Seksuologie 32. 2008: 129–137 [2018-09-07]（荷兰语）. De vragenlijsten werden verzameld in de periode van maart 2005 tot maart 2006.487 Questionnaires were collected: 173 women were Dutch, 132 Middle Eastern and Moroccan, 39 African, 32 Eastern European, 39 Asian and 53 from Middle and South America.Women from the Netherlands reported much less pain and blood loss than women from foreign countries.Women from countries where blood loss often is regarded as a proof of virginity still reported in 26.5% of the cases to have had no blood loss at first intercourse. 30% of the entire group reported severe pain: especially African women (49%) and women from the Middle East and Morocco (45%) report this. 19 % of Dutch women report severe pain.The relation between blood loss and pain is different for the different groups suggesting other than biological reasons.The use of tampons prior to first intercourse did not have a significant influence on the experienced blood loss.