Let’s start with anatomy and etymology, shall we?
The clitoris is a small button-like protuberance located at the top of the labia minora (the “little lips” inside the vulva). Clitoris comes from the Greek word kleitoris, which may mean “key” or “latch” or “hook” or from a word meaning “side of a hill.”
The clitoris, as it turns out, is a tremendously important organ for sexual pleasure in females, but because its anatomy is so hidden and its purpose so inscrutable, only recently have imaging techniques begun to reveal the breadth and depth of the clitoris.
Recently I treated a patient who’d had elective breast reduction surgery. Nerve damage during the procedure had caused her to lose all sensation in her nipples. She found herself unable to have an orgasm without the extra stimulation those nerves had provided. That was a consequence she hadn't thought to ask about!
Changes in nipple sensation are possible side effects of any type of breast surgery, including elective surgery to increase or reduce breast size. Sometimes the effects are temporary, but they can be permanent. It’s important to understand these risks -- and the role your breasts play in sexual arousal and satisfaction -- when choosing breast surgery for cosmetic reasons. I don't know if my patient would have made a different choice, but she may have.
How do breasts contribute to orgasm? Some women (not most) can reach orgasm through nipple stimulation alone. Others rely on intense breast and nipple fondling to “put them over the top” during oral sex or vaginal penetration.
Like the clitoris, nipples are bundles of nerve endings that respond to touch by releasing certain hormones in the brain. One of these hormones, oxytocin, is sometimes referred to as the “cuddle hormone”: It makes us feel warm and open toward the person whose touch initiated its release in our bodies. Other hormones, including testosterone and endorphins, combine to create a surge of sexual arousal that increases blood flow to the clitoris and stimulates vaginal lubrication.
For most women, sexual foreplay is essential to getting us interested in and ready for intercourse or penetration. And for most women (82 percent in one study) breast and nipple stimulation are an essential ingredient of foreplay. We talk a lot about clitoral stimulation and vaginal maintenance for maintaining our sexual satisfaction, but other parts of our bodies also play a part in arousal and orgasm, though.
For those of us fortunate enough to retain the pleasant sensations our breasts can provide, remembering these important sites of arousal during foreplay and intercourse (warming and massage oils can work wonders here) will enhance our readiness for and enjoyment of sex -- at any age. Let's not forget to raise our focus -- to our breasts.
Fortunately, the vagina is self-cleansing; it requires very little attention. The cells on the surface of the vagina naturally regenerate or ‘turn over’ on an ongoing basis. After intercourse, semen deposited in the vagina coagulates and then slowly liquefies again and is slowly secreted.
The top of the vagina is called the vaginal cuff when the cervix has been removed as a part of a hysterectomy. Not having a cervix doesn’t change that cleansing mechanism. Douching is disruptive to this natural cleansing process, disrupting the natural, healthy environment created by ‘good bacteria’ that belong there. In this case, less is best!
If you've had your ovaries removed or are naturally menopausal, the absence of estrogen means your vagina can benefit from a moisturizer placed inside the vagina. We offer several great choices.
Writing for my gynecologist friend has included a lot of Aha! moments. I admit some of this learning makes me blush. It's not just because I blush when talking about sex—though I do. It's because I’m embarrassed when I’m caught not knowing things I think I should have known a long, long time ago.
So, I’m reading along in Dr. Barb’s enormous textbooks on female sexuality, when I come across an illustration of the clitoris, sort of like the one below. I nearly passed it over, because, what’s to know at my age? I've lived with this equipment for 50 years. I'd like to think I know my way around it.
But this illustration colored in the entire structure of the clitoris. Not just the glans, but also the shaft and the crus clitoris, or crura.
Excuse me… the shaft?... and the crura?
No.. please picture me picking my head up like a prairie dog, looking around my office, and asking the air...
"And the crura!?!”
Somehow in all my curious, bookish, research-happy past, I never learned more about the clitoris than about the little button—the glans—the part that sticks out from the prepuce at the top of the labia.
Who knew my clitoris had legs? And a shaft, even?
But yes, indeed. It's practically a little penis under that hood. With long, long legs that extend waaay back toward the perineum, which fill with blood when I’m aroused.
Now, of course, the cool, rational part of my mind tells me I have enjoyed my crura—and possibly even the shaft—because they’ve been there all along. But I would have liked to know about them from the start. I can’t help but wish for a few years back in which I could quite clearly visualize my long, leggy crura.
What can we do with this information? Well, with age, the clitoris loses some sensitivity. We may find it useful to use warming oils and gels or vibrating sex aids to increase stimulation to the clitoris as we prepare for or engage in sex.
And of course, to do that, it really does help to know where it is.
Back to the books...