"I Had No Idea": This Doctor's PSA About Health And Hygiene Is Vital For Anyone With A Vagina
"I’m a 33-year-old woman who has great hygiene and was raised by a nurse practitioner. If I didn’t know this, I’m confident many others might not either."
"I’m a 33-year-old woman who has great hygiene and was raised by a nurse practitioner. If I didn’t know this, I’m confident many others might not either."
"I’ve always used my fingers to spread the tissue to rinse thoroughly but I was never taught to pull the hood back every shower to rinse underneath. I found myself reading about adhesions not too long ago, and I was shocked to discover upon further inspection that my hood is fused to my clit, and I had no idea. It’s now been over a month of cleaning it properly, and I’ve seen about a 4mm reduction in the adhesion.
I just wanted to put this out there, even if it just helps one person, because my mind is blown over this. I had no ‘symptoms,’ sex has been totally normal for me. I truly don’t know how long it’s even been like this, as I realize I was never even educated properly on clitoral anatomy, only every other part of my anatomy."
Many commenters expressed that they had absolutely no idea this could even happen, with one person writing, "I have a foreskin?"
Another person wrote, "I always thought I had a microscopic clit, but now I’m wondering if I have clitoral adhesion..."
"In appearance, it’s like a hard but kinda of squishy little white ball and doesn’t have to be that big to start hurting. I can’t even see mine with a mirror because the skin covers it and won’t pull back, but I can’t feel when it’s a problem. To remove it, they give injections around the area to numb it and pick/cut it out of there. It leaves the skin very raw but heals up within a day or two."
"And so every pediatrician, urologist, and primary care doctor knows what phimosis is, they know how to treat it, and we typically treat it with stretching maneuvers and sometimes topical steroids. If it gets so bad, it can lead to circumcision in early childhood or early adulthood. And this is something where every sort of doctor who takes care of men knows what to do."
She continued, saying, "All of the parts of the clitoris have analogous structures to the penis and are made of the same tissues, the same muscle, the same nerves and so clitorises have hoods, they have foreskins, prepuce is another word for it. And we have no research about what to do [for clitoral adhesions]."
She said, "Mild means you can see most of the head of the clitoris but not the whole thing because the sides get kind of stuck to the hood. Moderate means you can see a little bit of a head, but it's pretty covered over, and severe is like you really can't see any of the head of the clitoris. It's totally covered over with the hood."
Dr. Rubin has sample photos of clitoral adhesions ranging from mild to severe on her website, if it helps to have a visual aid. Note that the images are NSFW, for obvious reasons.
There's not enough research yet into what causes clitoral adhesions, but Dr. Rubin has a few hypotheses. She says it's possible that there's a hormonal component, as changes in testosterone levels during menopause or while taking birth control pills could affect the clitoris. Clitoral adhesions may also be linked to other conditions that cause dryness or inflammation in the genital area.
Unfortunately, gynecologists don't routinely look at the clitoris during a pelvic exam, and most don't know how to treat clitoral adhesions. If you suspect that you have a clitoral adhesion and you'd like to get medical care, Dr. Rubin recommends looking on the International Society for the Study of Women's Sexual Health website (ISSWSH.org) to find a more informed provider in your area.
"Can you see here the whole head of your clitoris? Can you see the corona, because your doctor has never looked for it. Doctors are not trained or taught how to do this exam. Which again, can you imagine if I was taught not to do a penis exam as a urologist?"
But there's still so much more research that needs to be done. Dr. Rubin says, "We need research to figure out how to prevent them from coming back, because they can reoccur. So we need research about who this happens to and why it happens. We need research about other techniques and other ways we could prevent them."