Wait, What?! There can be Pain in the Clitoris?
/When thinking about the clitoris, most people think about sex, specifically, sexual pleasure. It is, after all, the most sexually sensitive part of genital anatomy in people with vulvas; 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 individuals with vulvas (Pauls, 2015). The clitoris, though, is chronically understudied – its anatomy was only recently thoroughly investigated (Pauls, 2015). The newly discovered anatomy of the clitoris lends a new meaning to the phrase “the tip of the iceberg”. The part of the clitoris that most people think of as the clitoris – the external part on the vulva – is counterbalanced by a complex and extensive internal structure made up of erectile and other tissues (Pauls, 2015). In addition, many studies are beginning to investigate what happens in the clitoris during sexual arousal via sophisticated imaging techniques (e.g., Fernández Pérez et al., 2020), including members of the SexLab in collaboration with Dr. Chivers of the Sage Lab and Dr. Stroman of the Stroman Lab. This new line of research is exciting and full of potential for rich information to be learned about the role of the clitoris in sexual pleasure and response.
One additional thing that you need to know about the clitoris is that it doesn’t only convey information about pleasurable sensations. It can also be responsible for pain: Some people experience clitoral pain as their primary sensation in this region, as opposed to pleasure. Yes, we said pain. Sure, you might be thinking, sometimes in the heat of the moment, there might be too much pressure on the clit that can be painful and unpleasant. Or maybe you hurt your clit during a straddle injury, or your clit was not happy when you were wearing too tight and ill-fitting pants for that night out. And yes, acute pain can happen in the clit, just like it can happen elsewhere on the body. But we are talking about chronic pain in the clitoris – pain that lasts more than 3 months and can occur only upon contact to the clitoris or can present all or almost all of the time (or both!).
This type of chronic clitoral pain is called clitorodynia. “Dynia” comes from the Greek work “odyne”, which means pain, and “clitoro” refers to the location of the pain, the clitoris. If you’re thinking that pain shouldn’t be a thing “down there”, know that people can have all sorts of pain in their genital area, and SexLab members study many of these types of pain. There are types of pain called vulvodynia (pain in the vulva) and scrotodynia (pain in the scrotum), for example, and of course, clitorodynia.
Much like pleasure in the clitoris, chronic pain in the clitoral area is also incredibly understudied – there are less than five published articles on clitorodynia! What we know so far about clitorodynia mostly comes from one published descriptive study from a research team at McGill University (Parada et al., 2015). They found that clitorodynia can be very distressing to the people who experience it. People with clitorodynia report reductions in how often they engage in intercourse, masturbation, and foreplay, and about 25% of people describe the impact of clitoral pain on their sex life to be “disabling”. With the clitoris playing such an important role in sexual arousal and orgasm, it makes sense that chronic clitoral pain would impact sexual functioning, but it can also impact everyday functioning. People with clitorodynia reported interference with daily activities, like sitting, exercising, and walking (Parada et al., 2015).
Despite the substantial impacts clitorodynia can have in sexual and daily functioning, there is still far too little information available. At SexLab, we are currently conducting a study looking at a variety of experiences in individuals with all types genitopelvic 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 look for the AGPP study, or contact SexLab at sex.lab@queensu.ca.
Caroline Pukall, PhD CPsych, Director of SexLab
Julianna Park, BSc, MSc student in SexLab
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 Measuring Clitoral Blood Flow. Volume Flow: A New Parameter in Clitoral Artery Doppler. The journal of sexual medicine, 17(6), 1109–1117. https://doi.org/10.1016/j.jsxm.2020.01.031
Gordon, A. S. (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, Y. M. (2015).
Clitorodynia: A Descriptive Study of Clitoral Pain. Journal of Sexual Medicine, 12(8), 1772–1780. https://doi.org/10.1111/jsm.12934
Pauls, R. N. (2015). Anatomy of the clitoris and the female sexual response. Clinical Anatomy (New York, N.Y.), 28(3), 376–384. https://doi.org/10.1002/ca.22524
Uloko, M., Isabey, E. P., & Peters, B. R. (2023). How many nerve fibers innervate the human glans clitoris: a histomorphometric evaluation of the dorsal nerve of the clitoris. The journal of sexual medicine, 20(3), 247–252. https://doi.org/10.1093/jsxmed/qdac027