All About The Female Genitals and Female Sexuality 3

Clitoral adhesions

Less commonly discussed than vulval aroma, sebum, smegma, and clitoral adhesions are worthy of brief discussion. The clitoris has much in common with the penis, including glands that produce sebum, an oily secretion which accumulates into smegma. This has been put forward as spurious justification for routine circumcision, but is rarely discussed in relation to the clitoris. 

Smegma can become a problem if it accumulates beneath the clitoral hood - in fact, it can cause pain or  irritation and eventually cause the clitoral glans and hood to adhere to each other. These adhesions may prevent the clitoral hood from moving smoothly over the clitoral glans during sexual stimulation; this can make orgasm and sexual pleasure hard to achieve. If a clitoris is insensitive as a result of adhesions, and does not respond to sexual stimulation, a woman may think her clitoris is somehow not working.

Like the immature foreskin, the clitoral hood is often attached to the glans in young girls; this is not a matter of any concern unless there is any infection. The labia may also be adherent to each other, but once again, this is not a matter of concern because these issues usually resolve at puberty under the influence of extra estrogen. Apparently, a reduction in estrogen levels at the time of the menopause can cause adhesions to recur. 

Sebum

Glands inside the clitoral hood and on the tissues of the vulva secrete sebum, which serves as a lubricant and barrier against infection. Sebum is responsible for the smooth and shiny look of the clitoral glans and the inner surfaces of the vulva. In excess, sebum becomes smegma. Sebum is a normal substance and serves a valuable purpose; it does not mean a vulva is dirty or unwashed. Only accumulations of sebum need to be washed away, which can be done by daily gentle washing.  Antibacterial soaps are unhelpful - a "sterile" vulva and vagina are at risk of infection.

Sebum and smegma may smell as a result of bacterial action - this can be an attractive smell, unless it is left unwashed for a few days! Men like the natural smell of a woman, and although women may be brought up to think of it as unclean, the vulva does have these natural scents associated with it. A woman who is in tune with her body will recognize the pattern of changing scent and taste of her vulva as she moves through her menstrual cycle.

Sebum may accumulate and form small hard lumps under the clitoral hood, which irritate both the clitoral glans and clitoral hood. Sexual activities may then be painful. The irritation may result in an urge to  masturbate, a sensation not to be confused with the urge to relieve an engorged or erect clitoris resulting from sexual arousal. (Of course, mild itching or irritation in the clitoral area may be a sign of yeast infection.) If the clitoral hood is long and covers the glans completely or cannot be retracted completely so the glans is exposed, clitoral adhesions can be obscured from view. The smegma may also accumulate in  infants and preadolescent girls, which can cause frequent rubbing which looks like masturbation.

Stimulation of the Clitoris

The clitoris is most pleasurably sensitive to rubbing rather than direct pressure. Pressing on the clitoral glans may produce very little in the way of erotic sensation. A vulval massage moves the clitoral hood rhythmically move across the glans, and is similar to the motion required to make a woman orgasm while having sex. Obviously, the clitoral glans must be lubricated to permit this motion, and sebum fulfills this function.

Many women will use a lubricant on their vulva and clitoris before massage, masturbation and sex. We recommend Probe or Astroglide. If the clitoral hood does not cover the glans of the clitoris, it may dry out and undergo keratinization, just like a circumcised penis. This does not seem to affect sexual pleasure, but female circumcision - removal of the clitoral hood - which used to be practiced for non-orgasmic women as a treatment for anorgasmia - is not recommended in any way whatsoever.

Pre-Orgamic & Orgasmic Women

Research has suggested releasing clitoral adhesions helps about one preorgasmic woman in three experience orgasm for the first time. But this is a very small number: so much so, Masters and Johnson suggest this procedure is unnecessary. If you are pre-orgasmic and your glans is concealed then you may wish to get a medical opinion but you may prefer to try a program for becoming fully orgasmic. In fact, minor adhesions can be released without the need for a doctor's help; repeatedly pulling with gentle but firm pressure in a hot bath may help; there is also a steroid cream used to release foreskin adhesion in men which may help; you may also wish to massage a lubricant or antibacterial ointment into or up your clitoral hood  perhaps twice a day.

Hoods which conceal the clitoral glans can be modified by repeatedly stretching them; alternatively a doctor may remove adhesions with a probe between the glans and hood, using a local anesthetic; most women will never need this because their clitoral hood moves easily.  Of course, the easiest way to prevent adhesions is to stop smegma building up.