Clitoral Size and Location in Relation to Sexual Function Using Pelvic MRI

Abstract

Introduction The female sexual response is dynamic; anatomic mechanisms may ease or enhance the intensity of orgasm. Aim The aim of this study is to evaluate the clitoral size and location with regard to female sexual function. Methods This cross-sectional TriHealth Institutional Board Review approved study compared 10 sexually active women with anorgasmia to 20 orgasmic women matched by age and body mass index (BMI). Data included demographics, sexual history, serum hormone levels, Prolapse/Incontinence Sexual Questionnaire-12 (PISQ-12), Female Sexual Function Index (FSFI), Body Exposure during Sexual Activity Questionnaire (BESAQ), and Short Form Health Survey-12. All subjects underwent pelvic magnetic resonance imaging (MRI) without contrast; measurements of the clitoris were calculated. Main Outcome Measures Our primary outcomes were clitoral size and location as measured by noncontrast MRI imaging in sagittal, coronal, and axial planes. Results Thirty premenopausal women completed the study. The mean age was 32 years (standard deviation [SD] 7), mean BMI 25 (SD 4). The majority was white (90%) and married (61%). Total PISQ-12 (P < 0.001) and total FSFI (P < 0.001) were higher for orgasmic subjects, indicating better sexual function. On MRI, the area of the clitoral glans in coronal view was significantly smaller for the anorgasmic group (P= 0.005). A larger distance from the clitoral glans (51 vs. 45 mm, P= 0.049) and body (29 vs. 21 mm, P= 0.008) to the vaginal lumen was found in the anorgasmic subjects. For the entire sample, larger distance between the clitoris and the vagina correlated with poorer scores on the PISQ-12 (r = −0.44, P= 0.02), FSFI (r = −0.43, P= 0.02), and BESAQ (r = −0.37, P= 0.04). Conclusion Women with anorgasmia possessed a smaller clitoral glans and clitoral components farther from the vaginal lumen than women with normal orgasmic function.

Measurements of female genital appearance in Chinese adults seeking genital cosmetic surgery: a preliminary report from a gynecological center

“…Nevertheless, Huffman et al concluded an increase in clitoral size in normal female subjects, from childhood to the fourth decade of life to the postmenopausal years [12]. Several studies [13,14] also support clitoral tissue being responsive to serum hormones. A recent study [14] in women matched by age and body mass index revealed that women with self-reported anorgasmia had a significantly smaller clitoral glans and greater distance from the clitoral complex to the vaginal lumen on pelvic MRI.…”

“…Several studies [13,14] also support clitoral tissue being responsive to serum hormones. A recent study [14] in women matched by age and body mass index revealed that women with self-reported anorgasmia had a significantly smaller clitoral glans and greater distance from the clitoral complex to the vaginal lumen on pelvic MRI. Such findings support clitoral characteristics having an impact on female sexual symptoms.…”

A Comprehensive Review of the Clitoris and Its Role in Female Sexual Function

“…Sonography has also shown that the clitoral roots undergo movement and pressure when the vagina is penetrated and perineal contractions ensue [10]. Furthermore, MRI studies have demonstrated larger clitoral glans size and shorter distance from the clitoris to the vaginal lumen in women endorsing normal orgasmic function [59]. Likewise, as previously mentioned, women with shorter clitoral-urethral distances were better able to achieve VAO [29].…”

Acupuncture in Premenopausal Women With Hypoactive Sexual Desire Disorder: A Prospective Cohort Pilot Study

“…Women 18 to 55 years old were eligible if sexually active (defined as at least four sexual encounters in the month before enrollment), were in a monogamous relationship, and had a documented diagnosis of HSDD as the primary cause of FSD (defined as a non-adjusted score ≤ 6 in the desire domain [range = 0–10] of the Female Sexual Function Index [FSFI] questionnaire) 12 . Exclusion criteria included postmenopausal women (defined as absence of menstruation in the prior 12 months), pelvic pain or dyspareunia as the primary cause of FSD (defined as a non-adjusted score ≤ 6 in the pain domain [range = 0–10] of the FSFI), prior hysterectomy and/or oophorectomy, history of chemotherapy and/or pelvic irradiation, use of hormonal contraception or hormone replacement therapy, active skin infection or disease preventing insertion of acupuncture needles, known allergy to acupuncture needles, or blood dyscrasia.…”