Clitoral Adhesion: Causes, Symptoms, and Treatment Options

Clitoral adhesion

Hello doctor, I have an issue with clitoral adhesion, which prevents me from retracting the clitoral hood.
I also have smegma that I cannot remove on my own, leading to recurrent infections.
When I try to clear the smegma, it causes pain, and my vulva is very sensitive, easily prone to skin breakdown and inflammation.
I'm really troubled by the clitoral adhesion, and with smegma accumulating deep under the hood, if I cannot manage this myself, will there be a similar medical procedure available?

Niming, 20~29 year old female. Ask Date: 2017/09/05

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The issue of clitoral adhesion prevents the clitoral hood from being retracted, leading to the accumulation of smegma that cannot be self-cleared, resulting in recurrent infections.
Attempting to clear the smegma causes pain, and my vulva is very sensitive, making it prone to skin breakdown and inflammation, which is truly distressing.
If I am unable to manage the clitoral adhesion and the smegma accumulation in the depths of the hood on my own (such as through sitz baths), is there a similar medical procedure available?
Answer: The vulva is very susceptible to skin breakdown and inflammation.
If clitoral adhesion prevents retraction and smegma accumulates in the depths of the hood, and if self-management is not possible, please seek assistance from a gynecologist.

Reply Date: 2017/09/05

More Info

Clitoral adhesion, also known as clitoral phimosis, is a condition where the clitoral hood (the fold of skin covering the clitoris) adheres to the clitoris itself, making it difficult or impossible for the clitoris to be exposed. This condition can lead to various complications, including pain, discomfort, and recurrent infections, as you have described. Understanding the causes, symptoms, and treatment options for clitoral adhesion is essential for managing this condition effectively.

Causes
Clitoral adhesion can occur for several reasons:
1. Hormonal Factors: In prepubescent girls, low estrogen levels can lead to a lack of lubrication and elasticity in the skin, which may cause the clitoral hood to adhere to the clitoris.

2. Infections: Recurrent infections, such as vulvovaginitis, can cause inflammation and scarring, leading to adhesion.

3. Poor Hygiene: Accumulation of smegma (a combination of dead skin cells, oils, and moisture) can lead to irritation and adhesion if not cleaned properly.

4. Skin Conditions: Conditions like lichen sclerosus or other dermatological issues can also contribute to adhesion.

Symptoms
The symptoms of clitoral adhesion can vary but typically include:
- Difficulty exposing the clitoris
- Pain or discomfort during sexual activity or when attempting to clean the area
- Recurrent infections or inflammation of the vulva
- Accumulation of smegma, leading to further irritation and potential odor

Treatment Options
If you are experiencing clitoral adhesion, it is crucial to consult a healthcare provider for an accurate diagnosis and appropriate treatment. Here are some common treatment options:
1. Topical Steroids: Your doctor may prescribe a topical corticosteroid cream to reduce inflammation and help separate the adhered skin. This treatment is often effective, especially in younger patients.

2. Gentle Manual Separation: In some cases, a healthcare provider may perform a gentle manual separation of the adhered skin. This should only be done by a qualified professional to avoid causing pain or injury.

3. Surgical Intervention: If conservative treatments fail, surgical options may be considered. This could involve a minor procedure to release the adhesion and ensure the clitoris is fully exposed.

4. Hygiene Education: Proper hygiene practices are essential in preventing the accumulation of smegma and reducing the risk of infections. Your healthcare provider can guide you on how to clean the area effectively without causing irritation.

5. Follow-Up Care: Regular follow-up appointments may be necessary to monitor the condition and ensure that it does not recur.

Conclusion
Clitoral adhesion can be a distressing condition that impacts your quality of life. It is essential to seek medical advice to explore treatment options that can alleviate your symptoms and prevent complications. Your healthcare provider can help you navigate the best course of action tailored to your specific situation. Remember, maintaining proper hygiene and following medical advice can significantly improve your condition and overall well-being. If you have any concerns or questions about the treatment process, do not hesitate to discuss them with your healthcare provider.

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