So, here you are, minding your own business, and I bring up the topic of clitoral atrophy.  You must be thinking, I did not know it was a thing.  Well, not only is it a thing, but it is a primary cause of female sexual dysfunction and can devastate a woman’s sense of femininity and ability to achieve pleasure. 

The clitoris is more than a part of the female genitalia.  Indeed, it is the heart and soul of a woman’s sexual pleasure.  Undeniably, we must thank Hippocrates for being one of the first to document the importance of clitoral stimulation for female orgasms. He reportedly referred to the clitoris as “the servant who invites guests.”  Thank you, Sir.  

Unfortunately, sometimes, the clitoris becomes less responsive to stimulation and begins to shrink or atrophy. In this post, we discuss what clitoral atrophy is, its causes and symptoms, when to speak to a healthcare provider, and how to treat it at home. We also give a brief anatomy of the clitoris and how you can show it some loving regularly to prevent atrophy.

Please note that the information provided here is for general education and is not meant as medical advice or to contradict advice from your healthcare provider.

Female Anatomy-The Clitoris and Friends

Before we talk about clitoral atrophy, it is important to do a brief anatomy of the clitoris.  While we often think of the clitoris as that tingly bump covered by the labia majora and nestled above the vagina, it is best described as the “clitoral complex.”  Indeed, it has seven distinct parts:

1. Glans
2. Hood/prepuce
3. Suspensory ligament
4. Body/corpora
5. Crura
6. Root
7. Bulbs

Notably, although there are several components, the glans is the only external, visible part. 

In addition to the “clitoral complex,” the urethra and vagina make up the female genitalia.  Thus, sometimes our nether regions are also referred to as the “clitoral urethra complex” and the “clitourethrovaginal complex” in peer-reviewed studies.

Sexual Pleasure in Women

Regardless of the fancy scientific words, the clitoris, urethra, and vagina all share the same circulatory and nervous systems. Most importantly, they move together during sex.  A woman’s sexual pleasure has four distinct phases:

1. Desire
2. Arousal
3. Climax or orgasm
4. Resolution

 Notably, the clitoris is the unabashed star of the show in the last three phases.

Clitoral Orgasms versus Vaginal Orgasms

So, what’s the talk about the different types of orgasms?  Well, we have already established that the sole purpose of the clitoris is sexual arousal and pleasure.  Indeed, most women do not achieve a climax if the clitoris is not stimulated. 

However, some women experience vaginal orgasms when the Grafenberg spot (G-spot) inside the vagina is stimulated.  However, a 2017 study reported that there might not be a G-spot, per se.  Instead, what we call the G-spot is part of a pleasure network that extends from the clitoral complex.

Either way, it’s all good.

What is Clitoral Atrophy?

Approximately 40% of women worldwide report some type of sexual problem that causes them personal distress. Unfortunately, when most people think of sexual dysfunction, they think of male erectile dysfunction (ED). Additionally, the topic of low libido and the underlying cause is often missing when we discuss women’s health.   

Atrophy occurs when the clitoris shrinks and loses its firmness.   As a result, it loses its sensitivity and stops responding to sexual stimuli such as rubbing, licking, etc.  Since the sole function of the clitoris is sexual pleasure, sex is no longer enjoyable.  Unfortunately, in extreme cases, the tip of the clitoris may shrink and disappear into the clitoral hood because of a lack of blood flow. The clitoris also takes on a paler color due to low blood flow.

What Are Vaginal Atrophy and Labia Atrophy?

Clit atrophy, labial atrophy, and vaginal atrophy are distinct but related conditions. Indeed, they are all rooted in hormonal changes and decreased estrogen levels.

Vaginal atrophy occurs when the lining of the vagina weakens and becomes dry and inflamed. Indeed, symptoms include pain and discomfort during sexual intercourse.

Labial atrophy occurs when the lining of the labia minora weakens and becomes dry and inflamed. Indeed, symptoms include frequent urination and urge incontinence. It is a common and underreported condition.

What Causes Clitoral Atrophy?

This condition is caused primarily by infrequent sexual activity, hormonal changes, and decreased blood flow to the clitoris.  

Infrequent Sexual Intercourse and Masturbation

The saying, “if you don’t use it, you lose it,” also applies to the clitoris.  Of course, this reference is more for middle-aged and older women than for young, nubile ones.  Without regular stimulation, the clitoris may become dry and flaccid.  If you don’t have sexual intercourse regularly, then consider masturbation with or without a sex toy. 

Low Testosterone Level

The hormone testosterone plays a significant role in a woman’s sexual drive and ensures good clitoral arousal.  Thus, over time, women with low testosterone levels may experience clitoral atrophy and loss of sexual desire.   Additionally, they often experience vaginal dryness, itching, mood swings, and even weight gain.  Testosterone levels often drop in women taking birth control pills and estrogen supplements. Some women apply a small amount of testosterone cream to the vulva to boost blood flow and restore sensitivity to the clitoris. However, there is not enough scientific research to support this.

Menopause

Many menopausal and postmenopausal women experience genitourinary syndrome of menopause (GSM).  Wow, that’s a mouthful.  This is a collection of symptoms due primarily to a drop in estrogen.  Indeed, GSM causes changes to the clitoris, labia majora, labia minora, vaginal canal urethra, and bladder.

Testosterone levels also decrease with age.  Thus, it is unsurprising that some menopausal women experience loss of sensation, decreased sexual satisfaction, and anxiety about clitoral atrophy. 

Unfortunately, some estrogen supplements that reduce menopausal symptoms may also lower testosterone levels.  Thus, your doctor may ask you to do some blood tests to assess your hormone levels.  Then, they can make a proper diagnosis and recommend the best treatment.  

Hormonal Birth Control

Estrogen is often the main ingredient in oral contraceptives (the pill) and vaginal rings.  They also lead to a drop in testosterone levels.  These are the most popular birth control methods among sexually active young women.  Thus, they should tell their doctor if they have decreased sensation in the clitoris and vagina or if sex becomes less pleasurable.

Hysterectomy

Clitoral atrophy is very common in women with ovaries removed in a total hysterectomy.  Indeed, this occurs because the ovaries produce estrogen and testosterone.  Thus, when the ovaries are removed, women automatically go into surgical menopause.

What are the Symptoms of Clitoral Atophy?

Unfortunately, many gynecologists do not regularly ask women about their sex drive, sexual satisfaction, or the lack of sensation during sex.   Instead, sexual health issues are reduced to birth control, infections, breast examinations, and cancer prevention.  Undeniably, these are all worthy things.  However, you are responsible for your libido and must advocate for yourself.  So, talk to your doctor if you notice any of the symptoms: 

• Low libido or sex drive
• Loss of natural lubrication
• Vaginal dryness
• Thinning of the vaginal walls
• Reduced or no sensation during sex
• Burning
• Itching
• Pain or discomfort during sex
• Urinary urgency
• Frequent urinary tract infection
• Change in color and size of the clitoris

Undeniably, if left untreated for too long, the clitoris can retreat and fuse with the hood.  This makes it even more difficult to stimulate the clitoris.

Home Treatments for Clitoral Atrophy

As mentioned previously, if not treated early, it can cause painful intercourse and loss of sexual drive.  Unfortunately, in the worst cases, the clitoris not only stops responding to sexual arousal or stimulus and may even disappear.  Here are some home treatments to help alleviate your symptoms.

Kegel Exercises

A strong pelvic floor improves overall genital health and blood flow to the sex organs.  The pelvic floor muscles support the bladder, uterus, intestines, and rectum.   These muscles often weaken with aging, pregnancy, childbirth, chronic coughing, and chronic constipation.  Signs of weak muscles include:

• Leaking drops of pee (urine) while laughing, coughing, and sneezing
• Having a strong, sudden urge to pee
• Leaking small amounts of feces

Read here for more information on discretely doing Kegel exercises a few times a day.

Women often use Kegel balls and other equipment to treat urinary incontinence, tighten the vaginal walls, and increase sexual pleasure. Some of the ones you may like include:

• Kegel balls
• Thigh master hip trainer Kegel exerciser
• Yoni egg
• Electric pelvic muscle exerciser

Read: How to Stop Peeing While Laughing, Sneezing, and Coughing

Regular Sexual Activity

Engaging in regular penetrative sexual activity (alone or with a partner) helps to maintain the health and firmness of the vaginal and clitoral tissues. Be sure to use a generous amount of lubricant for easier penetration and to ease any discomfort. Some of the ones you may like include:

• Astroglide water-based gel lubricant
• Astroglide water-based liquid lubricant
• K-Y gelly water-based lubricant
• Shibari water-based lubricant

Creams and Gels

Many women find that using stimulating or arousal creams and gels often results in greater sensitivity, orgasmic capacity, and overall sexual satisfaction. These products are available over the counter at your local pharmacy and online. Some of the ones you may like include:

• K-Y tingling water-based lubricant
• Trojan arouse and please lubricants
• Horny Honey arousal cream
• Hello Cake tingle to mingle serum

Your doctor may also prescribe some type of topical cream or gel.

Vibrators and Clit Suckers

Sex toys have evolved over the last decade in the types of materials, designs, and functions.   While traditional, G-spot, and rabbit vibrators may stimulate the tip of the clit, they are often not enough to prevent or treat atrophy.  Indeed, even the best ones leave most of the clitoral complex untouched. 

Thus, clitoral suction (or clit suckers) are the ideal sex toys for clit atrophy.  More women are adding clit suckers to their sexual self-care toolboxes because they deliver deep vibration and sonic pulses to the entire genital region.  In addition to delivering toe-curling, full-body orgasms, they work great on treating atrophy. Remember to use a generous amount of lube.

Some of the ones you may like include:

• Tracy’s dog clitoral-sucking vibrator
• Tracy’s dog clitoral-sucking vibrator and G-spot stimulator
• Rose sex stimulator
• Rabbit G-spot vibrator
• 2-in-1 G-spot vibrator

Hormonal Therapy

In many cases, clitoral atrophy is due to changes in hormone levels. Your doctor might recommend or prescribe the following to improve clitoral health, rejuvenate vaginal tissues, restore lubrication, and improve libido.

• Estrogen cream, gel, patch, or vaginal ring
• Testosterone cream
• DHEA supplement or cream
• Oxytocin nasal spray or injection

Please consult your doctor before using any over-the-counter hormone treatment

Cardiovascular Exercises

Doing regular cardiovascular exercises like walking, running, swimming, and cycling is needed for overall health and well-being.  Indeed, doing at least 30 minutes a day on most days of the week increase your heart rate and overall blood circulation. 

Healthy Lifestyle

Maintaining a healthy lifestyle can help improve overall genital health.

• Consume a healthy diet
• Get regular exercise
• Get 7-8 hours of sleep at night
• Stop smoking
• Consume no more than 1-2 drinks a day

Medical and Surgical Treatment for Clitoral Atrophy

Several genital rejuvenation procedures can be used to treat clitoral atrophy,

Clitoral Derma Fillers

Hyaluronic acid fillers are injected into the clitoris to increase its size, firmness, and sensitivity. This is a minimally invasive in-office treatment. Fillers can also be injected into the labia minora and G-spot to increase sensitivity,

Platelet-rich Plasma (PRP) V-Shot

The PRP V-Shot is a minimally invasive in-office procedure that uses plasma-rich proteins and growth factors to enhance sexual health and treat several sexual dysfunctions in women. The solution is injected into the clitoris, labia minora, and the G-spot.  Specifically, it:

• Increases the sensitivity of the clitoris
• Improves libido
• Increases natural lubrication
• Tightens the vaginal opening
• Reduces urinary incontinence

Clitoral Unhooding or Clitoral Hood Reduction

This surgical procedure reduces the hood or skinfold that protects the clitoris. Care is taken to trim excess shin without disturbing the tissues and nerves of the clitoris. Indeed, this increases clitoral sensation and enhances sexual pleasure.

How to Talk to Your Partner about Clitoral Atrophy

Women who experience clitoral atrophy often avoid sexual intimacy with their partners.  Indeed, they often feel embarrassed, insecure, and “less than.”  In turn, partners may feel rejected and stop initiating any type of intimate contact.  Undeniably, talking about sexual health and feelings with a partner can be difficult.  However, a healthy and satisfying sexual relationship depends on honest and open communication. 

Here are some tips for talking to your partner about clitoral atrophy:

Choose a Comfortable Environment

Choose a time and place where you both feel relaxed.  It’s best not to bring up the issue at bedtime or when your partner initiates sex. 

Be Open and Honest

Start by telling your partner about your change in sexual desire, feelings, and experiences.  Then. explain to them what clitoral atrophy is and how it affects you.  Be clear about your needs and concerns and what does and does not work for you.

Engage in Active Listening

Be respectful and listen to your partner’s feelings, questions, and concerns. 

Find Mutual Solutions

Work together to find ways to improve sexual pleasure and intimacy.  If you are still interested in having sex, be open to exploring new positions, techniques, or other forms of sexual intimacy. Don’t forget that you have other erogenous zones that would love a little more attention.  These include the nipples, feet, neck, ears, and other sensitive areas.  You may also still enjoy vaginal penetration.  It’s a good idea to use lots of lubrication to prevent discomfort from thinning or dry vaginal tissues.   

Talk Openly About Using Sex Toys

Using sex toys is often a game changer for many couples.  Notably, vibrators and clitoral suction toys add excitement while treating one of the root causes of clitoral atrophy–blood flow.

Seek Professional Help

Consider asking your partner to go with you to your next appointment.  They may appreciate hearing about clitoral atrophy and the treatment from your doctor.  Additionally, a sex therapist or couples counselor can help you find solutions to your sexual concerns.

Frequently Asked Questions

How common is clitoral atrophy?

There is little data on the incidence and prevalence of clitoral atrophy. However, it is reported that 40% of women worldwide report some type of sexual dysfunction.

Does the clitoris disappear with age? After age 70?

No. The clitoris does not disappear with age. However, it tends to shrink and become smaller as part of the normal aging process and hormonal changes. This is less likely to happen to older women who use hormone replacement therapy and who are sexually active (alone or with a partner).

When should I see a doctor about clitoral atrophy?

You should see a doctor if you have a low libido, experience discomfort during sex, lose sensitivity in the clitoris, the clitoris has a paler color, or the clitoris feels smaller and less firm.

Can clitoral atrophy be fixed?

Yes. Most cases are treated with hormone therapy. Surgery or derma fillers are also options.

Can PCOS cause clitoral atrophy?

Some women with PCOS report clitoral atrophy. It’s important to talk to your doctor for a proper diagnosis and personalized treatment plan.

Now, It’s Your Turn

Well, I hope you feel more educated about clitoral atrophy, its causes, and treatment options. It’s essential to seek medical attention early to get a proper diagnosis and the best treatment for you. Indeed, your healthcare provider will give you a personalized treatment plan to restore sensation. Your doctor may recommend hormonal therapy, topical creams, and genital rejuvenation procedures. Undeniably, an early diagnosis and adherence to treatment lead to improvement in overall sexual function and satisfaction.

Note: The information provided here is for general education and is not meant to contradict advice from your healthcare provider.  It’s important to consult a healthcare provider for a proper diagnosis and a personalized treatment plan.

I think you will also enjoy the blog posts on progesterone-rich foods for PMS and menopause, natural remedies for vaginal dryness,  magnesium for menopause,  essential oils for menopause, apple cider vinegar for hot flashes, and intermittent fasting for women over 40.

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