Nov. 10, 2022 – Jill Krapf’s patients are often too embarrassed to tell her about discomfort in their clitoris.
“I ask all my patients about clitoral pain, and it’s often the first time they’ve been asked about it,” says Dr. Krapf, associate director of the Center for Vulvovaginal Disorders, a private clinic in Washington DC and New York City.
Krapf is a gynecologist who specializes in female sexual pain that affects the pelvis, vagina, and vulva.
Many of the conditions that Krapf treats have no outward symptoms that appear abnormal, but internally there are damaged or irritated nerves that can lead to hypersensitivity, unwanted excitement, or pain.
“Recent research suggests that even a herniated disk or a tear in the spine can lead to clitoral or vulvar symptoms, just like sciatic pain shooting down the leg is related to problems in the spine,” says Krapf.
Krapf was thrilled when he read about a new discovery: The clitoris has more than 10,000 nerve fibers – 2,000 more than previously reported 1976 – A medical breakthrough for a part of the body that is often neglected by science. Krapf and other physicians hope that attention to the clitoris will inspire more interest and education among people in their field. They also hope it will empower patients to seek medical help if they have problems with their clitoris.
“Women’s sexual health has historically been underfunded, especially when compared to men’s sexual health, such as B. erectile dysfunction,” says Krapf. “Optimizing vulva and vaginal health isn’t just necessary for sexual well-being.”
Blair Peters, MD, a plastic surgeon who specializes in gender-affirming care, led the to learn, which was presented at the Sexual Medicine Society of North America conference in October. Peters hopes the new information will reduce the stigma that the clitoris doesn’t deserve the same medical attention as other organs in the body.
When the clitoris is not functioning properly, a person’s physical and mental health can suffer. Paying attention to clitoral discomfort and seeing a doctor can help identify and prevent some urinary and vaginal infections.
“The fact that it took until 2022 for anyone to do this work speaks to how little attention the clitoris has received,” says Peters, an assistant professor of surgery at Oregon Health and Science University School of Medicine in Portland, OR .
What is inside?
Peters and his colleagues completed the study by harvesting clitoral nerve tissue from seven adult transgender men who had undergone gender-affirming genital surgery. The tissues were stained and magnified 1,000x under a microscope so the researchers could count the nerve fibers.
Peters says the finding is important because many surgeries occur in the groin area — such as hip replacements, episiotomies during childbirth and pelvic mesh procedures — and the renewed attention to the clitoris can help healthcare providers know where nerves are located to avoid injury medical errors are prevented.
“Nerves are at risk of being damaged if you don’t always understand where they are,” he says.
Peters hopes the new finding will help develop new surgical techniques for nerve repair and provide insight into gender-affirming phalloplasty, which is the surgical construction of a penis, often for transmasculine people.
ownership of the body part
If you have a heart problem, see a cardiologist; Brain problem, a neuroscientist. But when it comes to the clitoris, no doctor specializes in the genitals.
Urologists, gynecologists, plastic surgeons, and sex therapists all deal with potential problems that can arise with the clitoris and the body parts that surround it. But specialists like Krapf are few and far between.
It wasn’t until 2005 that Australian urologist Helen O’Connell found that the clitoris is filled with erectile and non-erectile tissue, which is often obscured by fat and bone in anatomy drawings. And it wasn’t until the early 2000s that researchers began to look seriously at the anatomy of the clitoris and how it works.
And a Study 2018 showed that when more doctors examined the clitoris, they could spot problems like adhesions or infection in that area, most of which can be treated without surgery.
A body part built for pleasure
Randi Levinson, a sex, marriage, and family therapist in Los Angeles, treats patients who experience reduced clitoral sensation or pain during sex, many of whom have recently given birth or are going through menopause.
Women often feel embarrassed when they can’t orgasm or have less clitoral sensation, but avoid seeking medical advice, she says. For some of her patients, it might help normalize discussions about female pleasure and the vast anatomy behind it.
“The more normal it is to talk about and explore women’s pleasure, the less embarrassed women feel about getting help when they’re not experiencing pleasure,” says Levinson. “I’ve had many…clients who experience pain and discomfort during sex [after pregnancy] and no longer feel joy and worry that something is wrong with them.”