When they think of the clitoris, most people think of sex, and specifically sexual pleasure. It is, after all, the most sexually sensitive part of the genital anatomy in people with a vulva. the clitoris contains more than 10,000 nerve fibers that convey sensation to the brain when stimulated (Uloko et al., 2023). Indeed, the clitoris plays a critical role in sexual arousal and orgasm in vulvar individuals (Pauls, 2015). The clitoris, however, has been chronically understudied—its anatomy has only recently been thoroughly explored (Pauls, 2015). The newly discovered anatomy of the clitoris gives new meaning to the phrase “the tip of the iceberg.” The part of the clitoris that most people think of as the clitoris – the outer part of the vulva – is offset by a complex and extensive internal structure consisting of erectile and other tissues (Pauls, 2015). Additionally, many studies are beginning to investigate what happens in the clitoris during sexual arousal through sophisticated imaging techniques (e.g., Fernández Pérez et al., 2020), including members of the SexLab in collaboration with Drs. Chivers of Sage Lab and Dr. Stroman’s Stroman Lab. This new line of research is exciting and full of potential for rich insights into the role of the clitoris in sexual pleasure and response.
An additional thing to know about the clitoris is that it does not only convey information about pleasurable sensations. It can also account for pain: Some people experience clitoral pain as the primary sensation in this area, as opposed to pleasure. Yes, we said pain. Sure, you might be thinking, sometimes in the heat of the moment, there can be too much pressure on the clitoris that can be painful and uncomfortable. Or maybe you injured your clit during a straddle injury, or your clit wasn’t happy when you wore too-tight and ill-fitting pants for that night out. And yes, sharp pain can occur in the clitoris, just as it can in other parts of the body. But we’re talking about chronic clitoral pain – pain that lasts longer than 3 months and can only occur during clitoral contact, or it can occur all or almost all of the time (or both!).
This type of chronic clitoral pain is called clitorodynia. “Dynia” comes from the Greek word “odyne”, meaning pain, and “clitoris” refers to the place of pain, the clitoris. If you’re thinking that pain shouldn’t be something “down there,” know that people can have all kinds of pain in their genital area, and SexLab members study many of these types of pain. There are types of pain called vulvar disease (pain in the vulva) and scrotodynia (pain in the scrotum), for example, and of course, clitorodynia.
Just like clitoral pleasure, chronic pain in the clitoral area is also incredibly scarce – there are less than five published articles on clitorodynia! What we know so far about clitorodynia comes mainly from a published descriptive study by a research group at McGill University (Parada et al., 2015). They found that clitorodynia can be very painful for people who experience it. People with clitorodynia report reductions in the frequency of intercourse, masturbation and foreplay, and about 25% of people describe the effect of clitoral pain on their sex life as “crippling”. With the clitoris playing such an important role in sexual arousal and orgasm, it makes sense that chronic clitoral pain would affect sexual function, but it can also affect daily functioning. Individuals with clitorodynia reported interference with daily activities such as sitting, exercising, and walking (Parada et al., 2015).
Despite the significant effects that clitorodynia can have on sexual and daily functioning, there is still very little information available. At SexLab, we are currently conducting a study looking at a variety of experiences in people with all types of genital pain, including clitorodynia. If you have clitorodynia (or any other type of pelvic pain), you can participate in the study here! For more information about this study, visit www.sexlab.ca/participate and search for the AGPP study or contact SexLab at sex.lab@queensu.ca.
Caroline Pukall, PhD CPsych, Director of SexLab
Julianna Park, BSc, MSc student at SexLab
bibliographical references
Fernández Pérez, M., Fernández Agís, I., La Calle Marcos, P., Campos Caballero, R., Molero
Rodríguez, F., González Fernández, M., & Rodríguez Torreblanca, C. (2020). Validation of a Sagittal Section Technique for Measurement of Clitoral Blood Flow. Volume flow: A new parameter in clitoral artery Doppler. The journal of sex medicine, 17(6), 1109–1117. https://doi.org/10.1016/j.jsxm.2020.01.031
Gordon, AS (2002). Clitoral Pain: The Great Unexplored Pain in Women. Journal of Sex & Marital Therapy, 28(sup1), 123–128. https://doi.org/10.1080/00926230252851249
Parada, M., D’Amours, T., Amsel, R., Pink, L., Gordon, A., & Binik, YM (2015).
Clitorodynia: A Descriptive Study of Clitoral Pain. Journal of Sexual Medicine, 12(8), 1772–1780. https://doi.org/10.1111/jsm.12934
Pauls, RN (2015). Anatomy of the clitoris and the female sexual response. Clinical Anatomy (New York, NY), 28(3), 376–384. https://doi.org/10.1002/ca.22524
Uloko, M., Isabey, EP, & Peters, BR (2023). How many nerve fibers innervate the clitoris of the human glans: a histomorphometric evaluation of the dorsal clitoris nerve. The Journal of Sexual Medicine, 20(3), 247–252.