No link found between hormonal contraception and clitoral adhesion severity
A recent study presented at the ISSWSH 2025 Annual Meeting found no significant association between hormonal contraceptive use and the severity of clitoral adhesions, though researchers emphasize the need for further investigation.
No link found between hormonal contraception and clitoral adhesion severity | Image Credit: © Antonioguillem - © Antonioguillem - stock.adobe.com.
There is not a clear connection between hormonal contraceptive use and adhesion severity, according to a recent study presented at the International Society for the Study of Women’s Sexual Health 2025 Annual Meeting in Atlanta, Georgia from February 27 to March 2, 2025.1
Understanding clitoral adhesions
Clitoral adhesions, defined as adherence of the clitoris’ prepuce to the glans, still has limited data about its source. However, research has indicated a potential association between hormones and adhesions, with other potential causes including genital cutting, chronic inflammation, and vulvar dermatological conditions.1
“Understanding the link between hormonal contraceptives and clitoral adhesions and other sexual side effects is imperative given that at least 14.1 million women will use hormonal birth control for some time,” wrote investigators.1
Health risks associated with hormonal contraceptives
Hormonal contraception has been linked to certain health risks, including stroke and heart attack.2 These correlations were found in a study earlier this year including Danish women aged 15 to 49 years between 1996 and 2001.
An incidence ratio of 1.9 was reported for ischemic stroke among patients using combined oral contraceptives with 20 µg of ethinyl oestradiol. For tablets with 30 to 40 µg, the adjusted incidence ratio was 2. These ratios were 1.6 and 2.1, respectively, for myocardial infractions.2
The labia minora and vulvar vestibule are both impacted by estrogens and androgens, highlighting hormone sensitivity from vulvar tissue.1 Therefore, the study was conducted to evaluate the link between hormonal birth control use and clitoral adhesion severity.
Study design and participants
Participants included patients of a private practice undergoing in-office lysis of clitoral adhesions (LOA) procedures between January 2021 and October 2024. Only the initial LOA and prior history were assessed in patients with more than 1 procedure during this period.1
Variables included age at LOA, contraceptive status, prior use, and the time since use. Adhesion severity in patients was classified at the time of LOA as either mild, moderate, or severe.1
Trends between contraception use and adhesion severity were assessed using a generalized linear mixed effects model to determine potential risk factors of clitoral adhesions. The strength of these relationships was evaluated through correlation coefficients.1
No significant predictors of adhesion severity among the 75 patients aged 17 to 74 years were observed in the model. Hormonal birth control use was reported by 76% of participants, all but 1 of whom had used the oral contraceptive pills for some time.1
Key findings
There was no association between the length of time on hormonal contraceptives and clitoral adhesion severity. Additionally, only weak correlations were noted for the time from birth control cessation to the LOA procedure and patient age during the LOA procedure with adhesion severity.1
There was also no correlation with adhesion severity based on the type of hormonal contraceptive used. However, investigators noted the statistical power of the evaluation may have been lowered by the limited sample size for certain contraceptive types.1
“While this study did not find a clear connection in adhesion severity to use of hormonal contraceptives, we hope future studies can examine the prevalence of adhesions, age, and underlying impacts of hormonal contraception,” wrote investigators.1
References
- Hauer G, Bottorff E, Rubin R. Hormonal contraceptive use and clitoral adhesions. Single practice analysis of 75 patients undergoing lysis of clitoral adhesions. Presented at: International Society for the Study of Women’s Sexual Health 2025 Annual Meeting. Atlanta, Georgia. February 27-March 2, 2025.
- Krewson C. Hormonal contraceptives linked to increased stroke and heart attack risk. Contemporary OB/GYN. February 13, 2025. Accessed February 28, 2025. https://www.contemporaryobgyn.net/view/hormonal-contraceptives-linked-to-increased-stroke-and-heart-attack-risk
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