Does a Non-Surgical Treatment Option for Clitoral Adhesions Improve Satisfaction?

The clitoris, which is the part of the vulva that plays a key role in sexual stimulation and pleasure, is covered by a retractable fold of skin and mucous membrane called the clitoral hood or prepuce. Sometimes, the skin of the clitoral hood physically adheres to the glans clitoris, resulting in a clitoral adhesion, also called clitoral phimosis.

Clitoral adhesions can be mild, moderate, or severe, depending on how much of the glans clitoris is visible beneath the hood. While some women may be unbothered by mild clitoral adhesions, in other cases, these adhesions can cause symptoms such as discomfort, pain, difficulty with arousal, weakened or absent orgasm, and clitoral hypersensitivity or hyposensitivity. Furthermore, clitoral adhesions have been associated with a history of painful intercourse, yeast infections, urinary tract infections (UTIs), lichen sclerosus, genital trauma, and other sexual dysfunctions.

Surgical interventions have been used to treat clitoral adhesions from as early as 1975, but these surgeries can be invasive and have the potential to lead to complications. However, a technique known as non-surgical lysis of clitoral adhesions has since been introduced as a possible treatment option.

For this procedure, a health care provider begins by applying anesthetic to the top nerve of the clitoris. Then, they use a Jacobsen mosquito forceps to separate the glans from the clitoral hood, and clear out any smegma (dead skin cells, oil, and other fluids) that has built up in this area. After the procedure, patients may be asked to pull back the prepuce and clean the area daily, sometimes applying a topical treatment as well to prevent the adhesion from coming back.

This procedure is minimally invasive, but is it effective? In a recent study, 41 women reported on their experience with non-surgical lysis of clitoral adhesions, as well as any improvements in their sexual functioning or pain.

Of the 41 women who participated, 83% reported being satisfied with the procedure and 93% said that they would recommend the procedure to a friend with clitoral adhesions. Additionally, a majority of the women (76%) stated that they experienced an improvement in pain after receiving this treatment.

In regard to their sexual functioning, 63% noted an improvement in their sexual arousal and 64% saw an improvement in their ability to reach orgasm. Not all of the women reported having difficulties with orgasm through clitoral stimulation before the lysis of the clitoral adhesions. However, of the 16 who reported the inability to orgasm through clitoral stimulation before the procedure, 6 were able to do so afterwards. Importantly, 71% shared that their sexual satisfaction improved after treating the condition in this way.

Nevertheless, 46% of the respondents reported recurrence in clitoral adhesions, 44% reported no recurrence, and 10% were unsure. The possibility of recurrence may be a consideration for patients who are considering this procedure.

Still, the results of this study are encouraging and suggest that this non-surgical treatment option may be both safe and effective for women with clitoral adhesions. If you believe you may have a clitoral adhesion that is negatively impacting your sexual function or quality of life, consider scheduling an exam with a gynecologist or urologist who can properly diagnose you and advise you on next steps.

References:

Myers, M.C., Romanello, J.P., Nico, E., Marantidis, J., Rowen, T.S., Sussman, R.D., & Rubin, R.S. (2022). A Retrospective Case Series on Patient Satisfaction and Efficacy of Non-Surgical Lysis of Clitoral Adhesions. The Journal of Sexual Medicine, 19(9), 1412-1420. DOI: https://doi.org/10.1016/j.jsxm.2022.06.011