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In acquired clitoromegaly, the main cause is endocrine hormonal imbalance affecting the adult woman, including polycystic ovarian syndrome PCOS [10] and hyperthecosis.

Acquired clitoromegaly may also be caused by pathologies affecting the ovaries and other endocrine glands. These pathologies may include virulent such as arrhenoblastoma and neurofibromatosic tumors.

Female bodybuilders and athletes who use androgens , primarily to enhance muscular growth, strength and appearance see Use of performance-enhancing drugs in sport , may also experience clearly evident enlargement of the clitoris and increases in libido.

Women who use testosterone for therapeutic reasons treating low libido, averting osteoporosis , as part of an anti-depressant regimen, etc.

Pseudoclitoromegaly or pseudohypertrophy of the clitoris "has been reported in small girls due to masturbation: manipulations of the skin of prepuce leads to repeated mechanical trauma, which expands the prepuce and labia minora, thus imitating true clitoral enlargement".

Early surgical reduction of clitoromegaly via full or partial clitoridectomy is controversial, and intersex women exposed to such treatment have spoken of their loss of physical sensation, and loss of autonomy.

In , it was disclosed in a medical journal that four unnamed elite female athletes from developing countries were subjected to gonadectomies and partial clitoridectomies after testosterone testing revealed that they had an intersex condition.

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Riesenkitzler oder Minipimmel? She must be a trans! Such fake tits and her labia looks just like a scrotum made into lips! On a scale 1 - This might be with or without manual penetration of the vagina, while other women enjoy having the entire area of the vulva caressed.

As the clitoris's external location does not allow for direct stimulation by sexual penetration, any external clitoral stimulation while in the missionary position usually results from the pubic bone area, the movement of the groins when in contact.

As such, some couples may engage in the woman-on-top position or the coital alignment technique , a sex position combining the "riding high" variation of the missionary position with pressure-counterpressure movements performed by each partner in rhythm with sexual penetration, to maximize clitoral stimulation.

During sexual arousal, the clitoris and the whole of the genitalia engorge and change color as the erectile tissues fill with blood vasocongestion , and the individual experiences vaginal contractions.

This is what leads to clitoral erection. The clitoral glans doubles in diameter upon arousal, and, upon further stimulation, becomes less visible as it is covered by the swelling of tissues of the clitoral hood.

General statistics indicate that 70—80 percent of women require direct clitoral stimulation consistent manual, oral or other concentrated friction against the external parts of the clitoris to reach orgasm.

Prominent debate over the quantity of vaginal nerve endings began with Alfred Kinsey. Although Sigmund Freud 's theory that clitoral orgasms are a prepubertal or adolescent phenomenon and that vaginal or G-spot orgasms are something that only physically mature females experience had been criticized before, Kinsey was the first researcher to harshly criticize the theory.

Irvine stated that he "criticized Freud and other theorists for projecting male constructs of sexuality onto women" and "viewed the clitoris as the main center of sexual response".

He considered the vagina to be "relatively unimportant" for sexual satisfaction, relaying that "few women inserted fingers or objects into their vaginas when they masturbated".

Believing that vaginal orgasms are "a physiological impossibility" because the vagina has insufficient nerve endings for sexual pleasure or climax, he "concluded that satisfaction from penile penetration [is] mainly psychological or perhaps the result of referred sensation".

Masters and Johnson 's research, as well as Shere Hite 's, generally supported Kinsey's findings about the female orgasm. They observed that both clitoral and vaginal orgasms have the same stages of physical response, and found that the majority of their subjects could only achieve clitoral orgasms, while a minority achieved vaginal orgasms.

On that basis, they argued that clitoral stimulation is the source of both kinds of orgasms, [93] reasoning that the clitoris is stimulated during penetration by friction against its hood.

Lombard Kelly], Kinsey, and Masters and Johnson, to mention just a few sources, there is no ignorance on the subject [of the female orgasm]," she stated in her article The Myth of the Vaginal Orgasm.

She added, "There are, however, social reasons why this knowledge has not been popularized. We are living in a male society which has not sought change in women's role.

Supporting an anatomical relationship between the clitoris and vagina is a study published in , which investigated the size of the clitoris; Australian urologist Helen O'Connell, described as having initiated discourse among mainstream medical professionals to refocus on and redefine the clitoris, noted a direct relationship between the legs or roots of the clitoris and the erectile tissue of the clitoral bulbs and corpora, and the distal urethra and vagina while using magnetic resonance imaging MRI technology.

In , they published the first complete 3D sonography of the stimulated clitoris, and republished it in with new research, demonstrating the ways in which erectile tissue of the clitoris engorges and surrounds the vagina.

On the basis of their findings, they argued that women may be able to achieve vaginal orgasm via stimulation of the G-spot, because the highly innervated clitoris is pulled closely to the anterior wall of the vagina when the woman is sexually aroused and during vaginal penetration.

They assert that since the front wall of the vagina is inextricably linked with the internal parts of the clitoris, stimulating the vagina without activating the clitoris may be next to impossible.

In their published study, the "coronal planes during perineal contraction and finger penetration demonstrated a close relationship between the root of the clitoris and the anterior vaginal wall".

The G-spot being analogous to the base of the male penis has additionally been theorized, with sentiment from researcher Amichai Kilchevsky that because female fetal development is the "default" state in the absence of substantial exposure to male hormones and therefore the penis is essentially a clitoris enlarged by such hormones, there is no evolutionary reason why females would have an entity in addition to the clitoris that can produce orgasms.

Whether the clitoris is vestigial , an adaptation , or serves a reproductive function has also been debated. It is not especially large, brightly colored, specifically shaped or selectively displayed during courtship.

He said the human clitoris "could have evolved to be much more conspicuous if males had preferred sexual partners with larger brighter clitorises" and that "its inconspicuous design combined with its exquisite sensitivity suggests that the clitoris is important not as an object of male mate choice, but as a mechanism of female choice.

While Miller stated that male scientists such as Stephen Jay Gould and Donald Symons "have viewed the female clitoral orgasm as an evolutionary side-effect of the male capacity for penile orgasm" and that they "suggested that clitoral orgasm cannot be an adaptation because it is too hard to achieve", [] Gould acknowledged that "most female orgasms emanate from a clitoral, rather than vaginal or some other , site" and that his nonadaptive belief "has been widely misunderstood as a denial of either the adaptive value of female orgasm in general, or even as a claim that female orgasms lack significance in some broader sense".

He said that although he accepts that "clitoral orgasm plays a pleasurable and central role in female sexuality and its joys," "[a]ll these favorable attributes, however, emerge just as clearly and just as easily, whether the clitoral site of orgasm arose as a spandrel or an adaptation".

He added that the "male biologists who fretted over [the adaptionist questions] simply assumed that a deeply vaginal site, nearer the region of fertilization, would offer greater selective benefit" due to their Darwinian , summum bonum beliefs about enhanced reproductive success.

Similar to Gould's beliefs about adaptionist views and that "females grow nipples as adaptations for suckling, and males grow smaller unused nipples as a spandrel based upon the value of single development channels", [] Elisabeth Lloyd suggested that there is little evidence to support an adaptionist account of female orgasm.

Chivers stated that "Lloyd views female orgasm as an ontogenetic leftover; women have orgasms because the urogenital neurophysiology for orgasm is so strongly selected for in males that this developmental blueprint gets expressed in females without affecting fitness" and this is similar to "males hav[ing] nipples that serve no fitness-related function.

At the conference for Canadian Society of Women in Philosophy , Nancy Tuana argued that the clitoris is unnecessary in reproduction; she stated that it has been ignored because of "a fear of pleasure.

It is pleasure separated from reproduction. That's the fear. The truth is that both are sexual and both are reproductive. Modifications to the clitoris can be intentional or unintentional.

They include female genital mutilation FGM , sex reassignment surgery for trans men as part transitioning , which may also include clitoris enlargement , intersex surgery , and genital piercings.

Those taking hormones or other medications as part of a transgender transition usually experience dramatic clitoral growth; individual desires and the difficulties of phalloplasty construction of a penis often result in the retention of the original genitalia with the enlarged clitoris as a penis analogue metoidioplasty.

In clitoridectomy , the clitoris may be removed as part of a radical vulvectomy to treat cancer such as vulvar intraepithelial neoplasia ; however, modern treatments favor more conservative approaches, as invasive surgery can have psychosexual consequences.

In reduction clitoroplasty, a common intersex surgery, the glans is preserved and parts of the erectile bodies are excised.

He stated that although "expectations can be standardized within these few parameters, operative techniques have not yet become homogeneous.

Investigators have preferred different operations for different ages of patients". Gender assessment and surgical treatment are the two main steps in intersex operations.

Later, it was understood that the clitoris glans and sensory input are important to facilitate orgasm," stated Atilla.

The clitoral glans's epithelium "has high cutaneous sensitivity, which is important in sexual responses" and it is because of this that "recession clitoroplasty was later devised as an alternative, but reduction clitoroplasty is the method currently performed.

What is often referred to as " clit piercing " is the more common and significantly less complicated clitoral hood piercing.

Since clitoral piercing is difficult and very painful, piercing of the clitoral hood is more common than piercing the clitoral shaft, owing to the small percentage of people who are anatomically suited for it.

The triangle piercing is a very deep horizontal hood piercing, and is done behind the clitoris as opposed to in front of it.

For styles such as the Isabella , which pass through the clitoral shaft but are placed deep at the base, they provide unique stimulation and still require the proper genital build; the Isabella starts between the clitoral glans and the urethra, exiting at the top of the clitoral hood; this piercing is highly risky with regard to damage that may occur because of intersecting nerves.

Persistent genital arousal disorder PGAD results in a spontaneous, persistent, and uncontrollable genital arousal in women, unrelated to any feelings of sexual desire.

Drugs may cause or affect clitoral priapism. The drug trazodone is known to cause male priapism as a side effect, but there is only one documented report that it may have caused clitoral priapism, in which case discontinuing the medication may be a remedy.

Because PGAD is relatively rare and, as its own concept apart from clitoral priapism, has only been researched since , there is little research into what may cure or remedy the disorder.

With regard to historical and modern perceptions of the clitoris, the clitoris and the penis were considered equivalent by scholars for more than 2, years in all respects except their arrangement.

Ancient Greek and Roman sexuality additionally designated penetration as "male-defined" sexuality. The term tribas , or tribade , was used to refer to a woman or intersex individual who actively penetrated another person male or female through use of the clitoris or a dildo.

As any sexual act was believed to require that one of the partners be " phallic " and that therefore sexual activity between women was impossible without this feature, mythology popularly associated lesbians with either having enlarged clitorises or as incapable of enjoying sexual activity without the substitution of a phallus.

In , Charles Estienne was the first writer to identify the clitoris in a work based on dissection, but he concluded that it had a urinary function.

In , Falloppio stated, "Modern anatomists have entirely neglected it The average anatomist had difficulty challenging Galen's or Vesalius's research; Galen was the most famous physician of the Greek era and his works were considered the standard of medical understanding up to and throughout the Renaissance i.

In addition to Avicenna's naming it the albaratha or virga "rod" and Colombo's calling it sweetness of Venus, Hippocrates used the term columella "little pillar'" , and Albucasis , an Arabic medical authority, named it tentigo "tension".

The names indicated that each description of the structures was about the body and glans of the clitoris, but usually the glans. While in Constantine 's treatise Liber de coitu , the clitoris is referred to a few times, Magnus gave an equal amount of attention to male and female organs.

Like Avicenna, Magnus also used the word virga for the clitoris, but employed it for the male and female genitals; despite his efforts to give equal ground to the clitoris, the cycle of suppression and rediscovery of the organ continued, and a 16th-century justification for clitoridectomy appears to have been confused by hermaphroditism and the imprecision created by the word nymphae substituted for the word clitoris.

Nymphotomia was a medical operation to excise an unusually large clitoris, but what was considered "unusually large" was often a matter of perception.

Thus the parts are cut". Caspar Bartholin , a 17th-century Danish anatomist, dismissed Colombo's and Falloppio's claims that they discovered the clitoris, arguing that the clitoris had been widely known to medical science since the second century.

Like Falloppio and Bartholin, De Graaf criticized Colombo's claim of having discovered the clitoris; his work appears to have provided the first comprehensive account of clitoral anatomy.

Toward the end of World War I, a maverick British MP named Noel Pemberton Billing published an article entitled "The Cult of the Clitoris", furthering his conspiracy theories and attacking the actress Maud Allan and Margot Asquith , wife of the prime minister.

The accusations led to a sensational libel trial, which Billing eventually won; Philip Hoare reports that Billing argued that "as a medical term, 'clitoris' would only be known to the 'initiated', and was incapable of corrupting moral minds".

Concerning other beliefs about the clitoris, Hite and found that, during sexual intimacy with a partner, clitoral stimulation was more often described by women as foreplay than as a primary method of sexual activity, including orgasm.

They looked at the terms used to describe genitalia in the PsycINFO database from to and found that penis was used in 1, sources, vagina in , while clitoris was only mentioned in They additionally analyzed 57 books listed in a computer database for sex instruction.

The students were overwhelmingly educated to believe that the vagina is the female counterpart of the penis. The authors found that the students' belief that the inner portion of the vagina is the most sexually sensitive part of the female body correlated with negative attitudes toward masturbation and strong support for sexual myths.

A study reported that, among a sample of undergraduate students, the most frequently cited sources for knowledge about the clitoris were school and friends, and that this was associated with the least amount of tested knowledge.

Knowledge of the clitoris by self-exploration was the least cited, but "respondents correctly answered, on average, three of the five clitoral knowledge measures".

The authors stated that "[k]nowledge correlated significantly with the frequency of women's orgasm in masturbation but not partnered sex" and that their "results are discussed in light of gender inequality and a social construction of sexuality, endorsed by both men and women, that privileges men's sexual pleasure over women's, such that orgasm for women is pleasing, but ultimately incidental.

In May , humanitarian group Clitoraid launched the first annual International Clitoris Awareness Week, from 6 to 12 May.

Clitoraid spokesperson Nadine Gary stated that the group's mission is to raise public awareness about the clitoris because it has "been ignored, vilified, made taboo, and considered sinful and shameful for centuries".

In , Odile Fillod created a 3D printable , open source, full-size model of the clitoris, for use in a set of anti-sexist videos she had been commissioned to produce.

Fillod was interviewed by Stephanie Theobald , whose article in The Guardian stated that the 3D model would be used for sex education in French schools, from primary to secondary level, from September onwards; [] this was not the case, but the story went viral across the world.

In a study, a questionnaire was administered to a sample of educational sciences postgraduate students to trace the level of their knowledge concerning the organs of the female and male reproductive system.

The authors reported that about two-thirds of the students failed to name external female genitals, such as the clitoris and labia, even after detailed pictures were provided to them.

In , New York artist Sophia Wallace started work on a multimedia project to challenge misconceptions about the clitoris. Based on O'Connell's research, Wallace's work emphasizes the sheer scope and size of the human clitoris.

She says that ignorance of this still seems to be pervasive in modern society. People are hungry to be able to talk about this," Wallace said.

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