Posts Tagged ‘female sexuality’

Are You “Cliterate”? (Do You Have A Good Working Knowledge Of The Clitoris?)

March 18, 2017

Andrew Siegel MD  3/18/17

The clitoris—possessed by all female mammals—is a complex and mysterious organ. Even the word itself–and the way it rolls off the tongue as it is pronounced–is a curiosity.  Many men (and women as well) are relatively clueless (“uncliterate”) about this unique and fascinating female anatomical structure.  The greatest challenge of achieving cliteracy is that so much of this mysterious lady part is subterranean–in the nether regions, unexposed, under the surface, obscured from view–and therefore difficult to decipher.  

The intention of this entry is to enable understanding of what is under the (clitoral) hood, literally and figuratively. Regardless of gender, a greater knowledge and appreciation of the anatomy, function and nuances of this special and unique biological structure will most certainly prove to be useful.  In general terms, proficiency and command of geography and landmarks on the map is always helpful in directing one to arrive at the proper destination.  Consider this entry a clitoral GPS.

 

Klitoriswurzel,_Klitoris,_Klitorisschenkel

The clitoris is mostly subterranean–what you see is merely the “tip of the iceberg.”  The white lines indicate the “rest of the iceberg.”

(By Remas6 [CC0], via Wikimedia Commons)

Mountainous and Hilly Female Terrain

The vulva (the external part of the female genital anatomy) consists of hilly terrain. It is well worth learning the “lay of the land” so that it can be traversed with finesse. The mons pubis (pubic mound) is the rounded and prominent mass of fatty tissue overlying the pubic bone, derived from the Latin “mons,” meaning “mountain.” Located beneath the lower part of the mons is the upper portion of the clitoris.  The word clitoris derives from the Greek “kleitoris,” meaning “little hill.”

Mons_pubis_jpg

Lower abdomen, mons pubis and pudendal cleft

By Wikipicturesxd (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)%5D, via Wikimedia Commons

The Epicenter of Female Sexual Anatomy

The clitoris is arguably the most vital structure involved with female sexual response and sexual climax. It is the only human organ that exists solely for pleasure, the penis being a multi-tasker with reproductive and urinary roles as well as being a sexual organ. However, I would argue that nature had much more than simply pleasure in mind when it came to the design of the clitoris, with the ultimate goal being reproduction and perpetuation of the species.  If sex was not pleasurable, there would little incentive for it and pregnancies would be significantly fewer. Think about non-human mammals—what would be their motivation to reproduce if sex were not pleasurable? (Male chimps and female chimps do not sit down together and plan on having a family!)  So, pleasure is the bait and reproduction is the switch in nature’s clever scheme.

The clitoris, like the penis, consists largely of spongy erectile tissue that is rich in blood vessels. The presence of this vascular tissue results in clitoral swelling with sexual arousal, causing clitoral fullness and ultimately a clitoral “erection.”

Penile-Clitoral_Structure

Comparison of penis (left) and clitoris (right), each largely composed of spongy, vascular, erectile tissue

By Esseh (Self-made. Based on various anatomy texts.) [GFDL (http://www.gnu.org/copyleft/fdl.html), CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/) or CC BY-SA 2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/2.5-2.0-1.0)%5D, via Wikimedia Commons

Clitoral size is highly variable from woman to woman—certainly as much as penile size. A very large clitoris can resemble a very small penis.

Interesting trivia: The female spotted hyena, squirrel monkey, lemur, and bearcat all have in common a very large clitoris referred to as a “pseudo-penis.”  When erect, it appears like the male’s penis and is used to demonstrate dominance over other clan members.  

The most sensitive part of the clitoris is the “head,” which is typically about the size of a pencil eraser and located at the upper part of the vulva where the inner lips meet. Despite its small size, the head has a dense concentration of nerve endings, arguably more than any other structure in the body. Like the penis, the head is covered with a protective hood known as the “foreskin.”

The head is really the “tip of the iceberg” because the vast majority of the clitoris is unexposed and internal. The clitoris (again like the penis) has a “shaft” (although it is internal) that extends upwards towards the pubic bone. The extensions of the shaft are the wishbone-shaped “legs” that turn downwards and attach to the pubic arch as it diverges on each side. Beneath the legs on either side of the vaginal opening are the clitoral “bulbs,” sac-shaped erectile tissues that lie beneath the outer vaginal lips. With sexual stimulation, these bulbs become full, plumping and tightening the vaginal opening.

One can think of the legs and bulbs as the roots of a tree, hidden from view and extending deeply below the surface, fundamental to the support and function of the clitoral shaft and head above, comparable to the tree’s trunk and branches.

vulva

Image above by OpenStax College – Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=30148635, no changes made to original

The Clitoral Response

With sexual arousal and stimulation, the clitoris engorges, resulting in thickening of the clitoral shaft and swelling of the head. With increasing clitoral stimulation, a clitoral erection occurs and ultimately the clitoral shaft and head withdraw from their overhanging position (clitoral “retraction”), pulling inwards against the pubic bone (like a turtle pulling its head in).

Interesting trivia: The blood pressure within the clitoris at the time of a clitoral erection is extremely high, literally at hypertensive (high blood pressure) levels. This is largely on the basis of the contractions of the pelvic floor/perineal muscles that surround the clitoral legs and bulbs and force pressurized blood into the clitoral shaft and head. The only locations in the body where hypertension is normal and, in fact, desirable are the penis and clitoris.

Why The Pelvic Floor Muscles Are Vital To Female Sexual Health And Clitoral Function

During arousal the pelvic floor muscles help increase pelvic blood flow, contributing to vaginal lubrication, genital engorgement and the transformation of the clitoris from flaccid to softly swollen to rigidly engorged.  The pelvic floor muscles enable tightening of the vagina at will and function to compress the deep roots of the clitoris, elevating clitoral blood pressure to maintain clitoral erection. At the time of climax, they contract rhythmically.  An orgasm would not be an orgasm without the contribution of these important muscles.

 

Bulbospongiosus-Female

Bulbocavernosus muscle (pelvic floor muscle that supports and compresses the clitoral bulbs)

 

Ischiocavernosus-female

Ischiocavernosus muscle (pelvic floor muscle that supports and compresses the clitoral legs)

(Above two images are in public domain, originally from Gray’s Anatomy 1909)

During penetrative sexual intercourse, only a small percentage of women achieve enough direct clitoral stimulation to achieve a “clitoral” orgasm, as this is usually restricted to women with larger clitoral head sizes and shorter distances from the clitoris to the vagina. Depending on sexual position and angulation of penetration, the penis is capable of directly stimulating the clitoral head and shaft, typically in the missionary position when there is direct pubic bone to pubic bone contact. However, vaginal penetration and penile thrusting does directly stimulate the clitoral legs and bulbs and the thrusting motion can also put rhythmic traction on the labia, which can result in the clitoris getting pulled and massaged.

Interesting trivia: Magnetic resonance (MR) studies have shown that a larger clitoral head size and shorter distance from the clitoris to the vagina are correlated with an easier ability to achieve an orgasm.

The clitoris plays a key role in achieving orgasm for the majority of women. An estimated 70% of women require clitoral stimulation in order to achieve orgasm. Some women require direct clitoral stimulation, while for others indirect stimulation is sufficient. Only about 25% of women are capable of achieving orgasm via vaginal intercourse alone.

With increasing sexual arousal and stimulation, physical tension within the genitals gradually builds and once sufficient intensity and duration of sexual stimulation surpasses a threshold, involuntary rhythmic muscular contractions of the pelvic floor muscles, the vagina, uterus and anus occur, followed by the release of accumulated erotic tension and a euphoric state. Thereafter, the genital and clitoral engorgement and congestion subside, muscle relaxation occurs and a peaceful state of physical and emotional bliss and afterglow become apparent.

Clitoral orgasms are often described as a gradual buildup of sensation in the clitoral region culminating in intense waves of external muscle spasm and release. In contrast, vaginal orgasms are described as slower, fuller, wider, deeper, more expansive and complex, whole body sensations. The truth of the matter is that all lady parts are inter-connected and work together, so grouping orgasm into “clitoral” versus “vaginal” is an arbitrary distinction. Most women report that both clitoral and vaginal stimulation play roles in achieving sexual climax, but since the clitoris has the greatest density of nerves, is easily accessible and typically responds readily to stimulation, is the fastest track to sexual climax for most women.

There is a clitoral literacy movement that is gaining momentum. Please visit:

http://projects.huffingtonpost.com/cliteracy for more information on the clitoris and this campaign to foster awareness of this curious organ.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  Dr. Siegel serves as Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community that is in such dire need of bridging.

Author of MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health http://www.MalePelvicFitness.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health  http://www.TheKegelFix.com (much of the material from this entry was excerpted from this book)

The Clitoris: What’s Under The Hood?

May 7, 2016

Andrew Siegel MD 5/7/16

The clitoris is a complex and mysterious organ possessed by all female mammals. Many men (as well as a fair share of women) are clueless (“uncliterate”) about this curious, unique and fascinating structure. The intent of this entry is to provide a primer of useful knowledge so that you can understand what is under the (clitoral) hood, literally and figuratively.  Advances in imaging—especially magnetic resonance (MR)—have provided a much clearer understanding of clitoral anatomy. Whether you are a female or a male, a greater knowledge and appreciation of the anatomy, function and nuances of this special female body part will most certainly prove useful and beneficial. 

Female External Genital Anatomy

The clitoris is part of the vulva, the outer part of the female genitals. The vulva consists of the mons, outer lips, inner lips, vestibule, vaginal opening, urethral opening and the star of the show–the clitoris.

5. vulva 

(Female external genital anatomy, from The Kegel Fix, credit to illustrator Ashley Halsey)

Clitoral Geography: Mountains, Hills and Earthquakes

The vulva is home to some hilly and bumpy terrain that is well worth gaining familiarity with so it can be traversed with finesse. The word mons derives from Latin meaning “mountain” because it is the rounded and prominent fatty tissue overlying the pubic bone. The word clitoris derives from the Greek “kleitoris” meaning “little hill.”

An earthquake is the shaking of the Earth’s surface caused by the sudden release of energy resulting from movements within the earth’s crust that creates seismic waves. If a female orgasm is thought of as an “earthquake,” the clitoris is the “epicenter.” The head of the clitoris—typically only the size of a pea—is an extraordinarily dense bundle of sensory nerve fibers.

 Pleasure (and Reproduction)

The clitoris is central to the female sexual response and sexual climax, the only human organ that exists solely for pleasure, although nature has secondary motives. The clitoris is a vital part of the anatomical design used for nature’s clever “bait and switch” trick, in which the pursuit of a pleasurable activity drives reproduction of the human species and the perpetuation of life. In the mammalian kingdom, if reproduction was not associated with sexual pleasure, how much sexual activity do you think would actually occur?

Male and Female Comparative Genital Anatomy

It might surprise you how remarkably similar the female and male external genitals are. In fact, in the first few weeks of embryonic existence, the external genitals are identical. The female embryo’s external genitals are the “default” model that will remain female in the absence of masculinizing hormones. The female clitoris and the male penis are essentially the same structure, as are the female outer lips and the male scrotum. In fact, there is not much difference in appearance between a very large clitoris and a very small penis.

Although the clitoris is the female equivalent of the penis, it is exclusively a sexual organ, whereas the penis is a urinary, sexual and reproductive organ. Like the penis, the clitoris is largely composed of erectile tissue that upon arousal and stimulation engorges with blood and with increasing stimulation becomes erect. After sexual climax, the clitoris returns to its normal relaxed state.

Interesting trivia: The female spotted hyena, squirrel monkey, lemur, and bearcat all have in common a very large clitoris. When erect, it appears very similar to the male’s penis and is used to demonstrate dominance over other members of their clans. It is referred to as a “pseudo-penis.”

The Tip of the Iceberg, But Far From Frigid

 Most of the clitoris is hidden and internal. Commonly misrepresented as a “bean” or “button,” the external nub is the clitoral head, merely the “tip of the iceberg.” The iceberg metaphor is an apt one in terms of anatomy, but is off target with respect to what a clitoris is—the seat of female genital passion—with its head having a greater concentration of nerve endings than any other body part, a far cry from “ice.”

Clitoral Anatomy

The glans (head) is the external and visible part of the clitoris. It is located just above the opening of the urethra. The remainder of the clitoris is internal and consists of the clitoral shaft (body) and its extensions, known as crura (legs). The prepuce (foreskin), a hood of skin formed by the inner vaginal lips, covers the clitoral shaft.

clitoris

(Anatomy of the vulva and the clitoris by OpenStax College – Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=30148635, no changes made to original)

The crura are wishbone-shaped and are attached to the pubic arch as it diverges on each side. The shaft and crura contain erectile tissue, consisting of spongy sinuses that become engorged with blood at the time of sexual stimulation, resulting in clitoral engorgement and erection. Beneath the crura on either side of the vaginal opening are the clitoral bulbs, sac-shaped erectile tissues that lie beneath the outer vaginal lips. With sexual stimulation, they become full, plumping and tightening the vaginal opening.

One can think of the crura and bulbs as similar to the roots of a tree, hidden from view and extending deeply below the surface, yet fundamental to the support and function of the clitoral shaft and head above, comparable to the tree’s trunk and branches.

Pelvic Floor Muscles

These important muscles are critical to sexual function in general and clitoral function in particular. They control the voluntary tightening and relaxing of the vagina, increase genital blood flow, support clitoral erection and contract rhythmically at the time of orgasm. Two of the pelvic floor muscles are especially vital to clitoral function: the ischiocavernosus and bulbocavernosus muscles that surround the crura and the bulbs, respectively. They stabilize the deep roots of the clitoris and compress the roots when engaged, increasing genital blood flow and maintaining clitoral erection, since their compressions push blood from the roots back towards the shaft and glans.

3. superficial and deep PFM

(Female pelvic floor muscles, from The Kegel Fix, credit to illustrator Ashley Halsey)

The pelvic floor muscles strongly contribute to the transformation of the clitoris from flaccid to softly swollen to rigid. By compressing the roots of the clitoris, they elevate blood pressure within the clitoris to maintain clitoral swelling and erectile rigidity. At the time of climax, these muscles contract rhythmically, and an orgasm would not be an orgasm without the contribution of these muscles working together with the clitoris.

Interesting trivia: The blood pressure within the clitoris at the time of a clitoral erection is hypertensive (high blood pressure) range, accounting for the rigidity. This is largely on the basis of the contractions of the aforementioned pelvic floor muscles. The only regions of the body where hypertension is desirable are the penis and clitoris.

Sexual Function And The Clitoris

With arousal and sexual stimulation, the clitoral erectile tissue engorges, resulting in clitoral shaft thickening and swelling of the glans. With increasing clitoral stimulation, clitoral retraction occurs, in which the clitoral shaft and glans withdraw from their overhanging position, pulling inwards against the pubic bone.

When a sufficient threshold of sexual stimulation is reached, climax occurs with contraction of the pelvic floor muscles, vagina, urethra, uterus and anus.

The clitoris plays a central role in orgasm for the majority of women and for most, clitoral stimulation is necessary to achieve orgasm. Some women require direct clitoral stimulation, while for others indirect stimulation is sufficient; about 25% are capable of achieving orgasm via vaginal intercourse alone. Vaginal intercourse often results in indirect clitoral stimulation since the crura and bulbs flank the vaginal opening and these inner parts of the clitoris are stimulated with penetrative thrusting.

Interesting trivia: Magnetic resonance studies have shown that a larger clitoral head size and shorter distance from the clitoris to the vagina are correlated with an easier ability to achieve a vaginal orgasm.

There is a clitoral literacy movement that is gaining momentum. Please visit:

http://projects.huffingtonpost.com/cliteracy for more information on the clitoris and this campaign to foster awareness of this curious organ.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health– newly available on Amazon Kindle, Apple iBooks, B&N Nook and Kobo (paperback edition will be available soon).

Author page on Amazon: http://www.amazon.com/Andrew-Siegel/e/B004W7IM48

Apple iBook: https://itunes.apple.com/us/book/the-kegel-fix/id1105198755?mt=11

Trailer for The Kegel Fix: https://www.youtube.com/watch?v=uHZxoiQb1Cc

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health and Promiscuous Eating: Understanding Our Self-Destructive Relationship With Food   

Co-creator of Private Gym and PelvicRx: comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training programs. Built upon the foundational work of Dr. Kegel, these programs empower men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.  In the works is the female PelvicRx pelvic floor muscle training DVD. 

Pelvic Rx can be obtained at http://www.UrologyHealthStore.com, an online store home to quality urology products for men and women. Use promo code “UROLOGY10” at checkout for 10% discount.