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Posts Tagged ‘anatomy’

Let’s start with anatomy and etymology, shall we?

The clitoris is a small button-like protuberance located at the top of the labia minora (the “little lips” inside the vulva). Clitoris comes from the Greek word kleitoris, which may mean “key” or “latch” or “hook” or from a word meaning “side of a hill.”

The clitoris, as it turns out, is a tremendously important organ for sexual pleasure in females, but because its anatomy is so hidden and its purpose so inscrutable, only recently have imaging techniques begun to reveal the breadth and depth of the clitoris.

  1. The clitoris and the male penis are “homologous,” which means they have similar biological structures. They’re made of the same stuff. Like the penis, the clitoris has a very sensitive head or glans (that’s the part you can see peeking out), a shaft that extends into a woman’s body, an external hood that is like the foreskin. But there’s also a whole bunch of stuff inside, and that’s now referred to as the “clitoral network”—a complicated internal structure that winds around the vulva and into the vagina and is composed, like the penis, of erectile and other tissues.
  2. The clitoral network has perhaps twice as many nerve endings as the penis (about 8,000 vs. 4,000), and when aroused, may affect 15000 more, making it extremely sensitive and critical sexual pleasure. In fact, some sources suggest that the G-spot is really part of the clitoral network.
  3. Genetic makeup, steroid overdose, and testosterone use can cause clitoral enlargement, which is called clitoromegaly.
  4. The clitoris becomes larger after childbirth, and it stays sensitive throughout the lifespan, including after menopause, although both Dr. Barb and Dr. Oz say you have to use it or lose it. (Hear that, gals!)
  5. The clitoris is the only human organ that has no function other than sexual pleasure.
  6. Other female mammals also have clitorises of various sizes. (That of the female bonobo is big enough to “waggle” when she walks, according to this article.)  Female spotted hyenas are the only mammal whose clitoris is used for urination, sex, and birthing young (ye gads!), making both sex and birth quite challenging and acrobatic for hyenas.
  7. In cultures that practice female genital mutilation (FGM), the clitoris and sometimes all or part of the labia minora is ritually cut off, often unhygenically and without anesthetic. The practice is rooted deeply in some Middle Eastern and North African cultures and has to do with ideas about purity, modesty, and female sexual desire.
  8. As you might imagine, the clit has accrued a lot of colorful names: rosebud, cherry pit, love bud, nubbin, doorbell, bald man in a boat. In some Middles Eastern countries, it may be called a sesame seed, lentil, or chickpea, depending on its size.
  9. During sexual arousal, the entire clitoral network becomes engorged, just like a penis. This includes tissue within the vagina and labia minora. Everything swells.
  10. Most women (something like 70 percent) can’t orgasm with vaginal stimulation alone, which leads us to the necessity of clitoral stimulation to dependably orgasm. There are lots of tricks to help this along.

Stay tuned. We’ll follow up with another installment.

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Recently I treated a patient who’d had elective breast reduction surgery. Nerve damage during the procedure had caused her to lose all sensation in her nipples. She found herself unable to have an orgasm without the extra stimulation those nerves had provided. That was a consequence she hadn’t thought to ask about!

Changes in nipple sensation are possible side effects of any type of breast surgery, including elective surgery to increase or reduce breast size. Sometimes the effects are temporary, but they can be permanent. It’s important to understand these risks — and the role your breasts play in sexual arousal and satisfaction — when choosing breast surgery for cosmetic reasons. I don’t know if my patient would have made a different choice, but she may have.

How do breasts contribute to orgasm? Some women (not most) can reach orgasm through nipple stimulation alone. Others rely on intense breast and nipple fondling to “put them over the top” during oral sex or vaginal penetration.

Like the clitoris, nipples are bundles of nerve endings that respond to touch by releasing certain hormones in the brain. One of these hormones, oxytocin, is sometimes referred to as the “cuddle hormone”: It makes us feel warm and open toward the person whose touch initiated its release in our bodies. Other hormones, including testosterone and endorphins, combine to create a surge of sexual arousal that increases blood flow to the clitoris and stimulates vaginal lubrication.

For most women, sexual foreplay is essential to getting us interested in and ready for intercourse or penetration. And for most women (82 percent in one study) breast and nipple stimulation are an essential ingredient of foreplay.  We talk a lot about clitoral stimulation and vaginal maintenance for maintaining our sexual satisfaction, but other parts of our bodies also play a part in arousal and orgasm, though.

For those of us fortunate enough to retain the pleasant sensations our breasts can provide, remembering these important sites of arousal during foreplay and intercourse (warming and massage oils can work wonders here) will enhance our readiness for and enjoyment of sex — at any age. Let’s not forget to raise our focus — to our breasts.

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Fortunately, the vagina is self-cleansing; it requires very little attention. The cells on the surface of the vagina naturally regenerate or ‘turn over’ on an ongoing basis. After intercourse, semen deposited in the vagina coagulates and then slowly liquefies again and is slowly secreted.

The top of the vagina is called the vaginal cuff when the cervix has been removed as a part of a hysterectomy. Not having a cervix doesn’t change that cleansing mechanism. Douching is disruptive to this natural cleansing process, disrupting the natural, healthy environment created by ‘good bacteria’ that belong there. In this case, less is best!

If you’ve had your ovaries removed or are naturally menopausal, the absence of estrogen means your vagina can benefit from a moisturizer placed inside the vagina. Yes, Replens, or KY Liquibeads are all great choices.

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Writing for my gynecologist friend has included a lot of Aha! moments. I admit some of this learning makes me blush. It’s not just because I blush when talking about sex — though, I do. It’s because I’m embarrassed when I’m caught not knowing things I think I should have known a long, long time ago.

So, I’m reading along in Dr. Barb’s enormous textbooks on female sexuality, when I come across an illustration of the clitoris, sort of like the one below. I nearly passed it over, because, what’s to know at my age? I’ve lived with this equipment for 50 years. I’d like to think I know my way around it.

But this illustration colored in the entire structure of the clitoris. Not just the glans, but also the shaft and the crus clitoris, or crura.

Excuse me… the shaft?… and the crura?

No.. please picture me picking my head up like a prairie dog, looking around my office, and asking the air…

“The shaft?!”

“And the crura!?!”

Somehow in all my curious, bookish, research-happy past, I never learned more about the clitoris than about the little button — the glans — the part that sticks out from the prepuce at the top of the labia.

Who knew my clitoris had legs? And a shaft, even?

But yes, indeed. It’s practically a little penis under that hood. With long, long legs that extend waaay back toward the perineum, which fill with blood when I’m aroused.

Now, of course, the cool, rational part of my mind tells me I have enjoyed my crura — and possibly even the shaft — because they’ve been there all along. But I would have liked to know about them from the start. I can’t help but wish for a few years back in which I could quite clearly visualize my long, leggy crura.

What can we do with this information? Well, with age, the clitoris loses some sensitivity. We may find it useful to use warming oils and gels or vibrating sex aids to increase stimulation to the clitoris as we prepare for or engage in sex.

And of course, to do that, it really does help to know where it is.

Back to the books…

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