The Prevalence of Examiner-Diagnosed Clitoral Hood Adhesions in a Population of College-Aged Women

Objective. To determine the prevalence of clitoral hood adhesions in college-aged women. Materials and Methods. A retrospective review of medical records was conducted for 589 college-aged women undergoing a routine women's annual examination at a student health clinic by a single examiner (E.W.) using a standardized procedure. The severity of adhesions was classified and recorded by the examiner based on the extent of visualization of the clitoral glands and sulcus. Recorded age, sexual activity, contraceptive use, pregnancy, and marital status were abstracted from records. Results. Two thirds (393/589) of women were unaffected by any clitoral hood abnormality; of the affected, 58% (113/196) showed 25% involvement. Only 12% (24/196) showed adhesions involving 75% to >= 90% of the region (chi(2) = 857.1, 4 df, p < .0001). The youngest females, born after 1981, were at highest risk for being affected (compared with women born 1976-1981, adjusted OR = 1.7 [1.1, 2.6]). Relationships with other demographic and behavioral characteristics were not statistically significant. Conclusions. Adhesions may be more common than previous published reports imply. Study participants were evaluated for routine health screening and presented with few or no symptoms. These data suggest that adhesions may be a normal variant in otherwise asymptomatic college-aged women and that no treatment is necessary.