March 11, 2016 by Jane Chalmers And Cat Jones, The Conversation
Don’t know much about the clitoris? It’s probably not your fault. Did
you know the clitoris is a large and complex organ? If not, it's
probably not your fault: in anatomical textbooks, few words and diagrams
are devoted to understanding the clitoris. Most label the very small
portion of the organ visible on diagrams of the vulva, when in fact it's
almost entirely under the skin.
Studies
of historical anatomical textbooks have shown that depictions of the
clitoris were significantly limited and often omitted completely from
the mid-19th into the 20th century.
During these times there
were ideologies and subsequent theories relating to women's bodies that
likely encouraged and sustained censorship of the clitoris. For
instance, there was
Freud's now defunct theory
that clitoral stimulation was a sign of sexual immaturity and neurosis.
Women were also taught not to enjoy sex; women had sex for reproductive
purposes, while men had sex for pleasure.
These fallacies led to the neglect of the clitoris in research, literature and the public domain.
Although
more recent research
and feminist lobbying have improved the quality of information on the
clitoris in current textbooks, most texts are still brief. These include
minimal information, or information only on the external portion of the
clitoris (the glans). This brevity has impacts on health care for women
with clitoral and related pain.
This figure, published in 2014, depicts the clitoris as only the external clitoral glans and prepuce (hood).
What is the clitoris?
The clitoris
lies at the junction of the labia minora (the inner lips of the vulva),
just above the urethra. It is made up of four main parts: the glans,
body, two crura and two bulbs. The glans is the only external part of
the clitoris and is covered by a hood of skin.
The body,
corpora, crura and bulbs of the clitoris are all made up of erectile
tissue and converge below the glans. The body of the clitoris is
generally 1-2cm wide and 2-4cm long.
The crura extend laterally
from the body of the clitoris and are on average around 5-9cm long. The
bulbs of the clitoris are generally 3-7cm long and lie between the body,
crura and the urethra.
The clitoris is highly innervated, with
twice as many nerve endings as the penis, and receives a rich blood
supply. This rich blood supply allows the erectile components to swell
up, with the body and glans of the clitoris becoming up to
three times larger during arousal – and you thought a penile erection was impressive!
Foetus genital and
reproductive organs
are differentiated at six weeks' gestation. While the clitoris and
penis arise from the same group of cells in a zygote, we now know they
clearly have different forms and functions.
Left: the clitoris
from an anterior view. All four parts of the clitoris are visible in
this view: the glans (external portion), the body, the bulbs and the
crura. Right: the clitoris from a side view. Only one crus (plural:
crura) and bulb …
moreThe
penis has an obvious and well-researched role in the reproductive and
urinary systems, while the function of the clitoris is usually stated as
being purely for pleasure.
However, few studies have actually
investigated the function of the clitoris. The close proximity of the
clitoris to the urethra and vagina has led to suggestions that it plays a
much larger role than sexual pleasure, such as assisting in maintaining
immune health.
What we don't know can hurt us
Censoring
the clitoris in textbooks means doctors and other health-care
professionals won't be equipped to treat patients with clitoral
concerns. Women are at risk of
sexual dysfunction
(such as lack of desire or arousal, decreased lubrication, inability to
orgasm) from operations on their urinary and reproductive organs. This
shows doctors need more in-depth knowledge, and we need further research
into understanding the anatomy of the clitoris.
Because of its
delicate yet complex make-up, the clitoris is prone to infections,
inflammation and diseases. Some common examples are itching and soreness
due to thrush infections, swelling due to bruising or inflammation, and
pain of unknown origin (called clitorodynia).
Although it is not often spoken about, clitoral and vulvar pain are
very common in women.
Educating patients about their condition can
improve pain outcomes.
Yet this may be difficult for doctors treating conditions such as
clitorodynia, given they may not be receiving adequate information about
the clitoris themselves.
On average,
one-third
of university-aged women are unable to find the clitoris on a diagram.
We frequently use synonyms of females' reproductive organs as derogatory
terms ("pussy" to mean weak, "cunt" to mean an unpleasant person) and
many
women are often not comfortable using anatomically correct terms.
More than
65% of women
say they feel uneasy using the terms vagina and vulva. Instead they use
code names such as "lady parts", even when discussing gynaecological
issues with their doctors.
Given there is
evidence to suggest our sense of body ownership can influence pain, perhaps this lack of
body ownership over the clitoris helps to explain why conditions such as clitorodynia are common.
