But the vulva does not clean itself, and that’s why accurate nomenclature is so important. In one study, ~30% of college aged women actually had clitoral adhesions, which arise when hygiene is so inadequate that smegma accumulates and causes the distal clitoral hood to adhere to the glans. It would seem that hygiene issues are actually pervasive, no doubt thanks to poor communication regarding vulvar anatomy and hygiene.