THE CLITORIS

The clitoris, one of the most sensitive areas of a female's genitals, is located just beneath the point where the top of the inner lips meet. The only directly visible part of the clitoris is the head or clitoral glans, which looks like a small, shiny button. This head can be seen by gently pushing up the skin, or clitoral hood, that covers it. The clitoral hood also hides the clitoral shaft, the spongy tissue that branches internally like an inverted V into two longer parts or crura. The crura lead to the bony pelvis. The clitoris is richly endowed with nerve endings, which make it highly sensitive to touch, pressure, and temperature. It is unique because it is the only organ in either sex whose only known function is to focus and accumulate sexual sensations and erotic pleasure.

The clitoris is often regarded as a miniature penis, but this notion is sexist and incorrect. The clitoris has no reproductive, or urinary function and does not usually lengthen like the penis when stimulated, although it does become engorged. The clitoris and the penis, however, are derived embryologically from the same tissues.

The size and appearance of the clitoris vary considerably among women, but there is no evidence that a larger clitoris provides more intense sexual arousal. Contrary to the opinion of some physicians, masturbation rarely causes enlargement of this organ.

Clitoral circumcision — surgical removal of the clitoral hood — has been said to improve female sexual responsivity by exposing the clitoral glans to more direct stimulation. We believe, however, that this procedure is rarely useful since it has two major drawbacks: (1) the clitoral glans is often exquisitely sensitive to direct touch, to the point of pain or irritation (in this Sense, the clitoral hood serves a protective function), and (2) during intercourse the thrusting of the penis indirectly stimulates the clitoris by moving the inner lips of the vagina, causing the clitoral hood to rub back and forth across the clitoral glans. A less drastic procedure than circumcision is advocated by several sexologists to improve some women's sexual responsiveness. A probe is used to loosen adhesions or thickened secretions (smegma) between the clitoral hood and clitoral glans. In more than thirty years of practice, we have seen very few cases that required such an approach and remain skeptical about the use of this procedure on a routine basis.

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