Navigating sex and pleasure is never linear. High highs, low lows and the unexpected are to be expected. This rings especially true when it comes to women’s health.
The clitoris has more than 10,000 nerve fibres and its sole function is to provide sexual pleasure. Yet it has long been relegated to the sidelines of sexual anatomy (Australian urologist Helen O’Connell was the first to create an internal and external map of the clitoris in 1998).
There’s still so much to be discovered and destigmatised about the clitoris — and clickbait videos that prey off fears of sexual dysfunction don’t do anything to help the cause.
“Use your clitoris before it disappears!” pipes up a peppy Australian in Lili Reinhart’s TikTok stitch that’s been watched 5.7 million times. “IT CAN DISAPPEAR? OH HELL NO,” reads the top comment, liked by over 25,000 people. “New fear unlocked,” reads another comment.
Clitoral atrophy is real — and so is the fear of experiencing it. The condition sees the clitoris stop responding to sexual arousal or stimulus. In some cases, it can also shrink or disappear altogether.
Dr Raelia Lew, a fertility specialist, gynaecologist and founder of Lovers, shares that clitoral atrophy is common. “[It] happens to some degree in all women after menopause in the absence of local topical oestrogen replacement or body-wide menopause hormone therapy,” she tells Refinery29.
“Clitoral atrophy happens as part of a syndrome known as urogenital atrophy, where female genital tissues lose their fullness, become smaller in size and more delicate, in the absence of local concentrations of the hormone oestrogen.”
Normal’s sex coach Georgia Grace explains in a TikTok video that clitoral atrophy can also happen after a substantial change in hormones, like starting hormonal birth control. “Or it might also be due to inadequate blood flow to the clitoris and the vagina,” she adds.
While there isn’t much research out there about who is more likely to be exposed to clitoral atrophy, experts suggest that people who are less sexually active have a higher likelihood of experiencing this condition.
The deterioration or disappearance of a sex organ undoubtedly triggers alarm bells for people who own a clitoris. And while having this information readily available is helpful for building awareness, fear-mongering is not.
@alicewillliams
“When we’re speaking about all things sex, pleasure and touching yourself, I think it’s really important that we do so from a space that isn’t instilling fear in others,” Grace continues. “Often we hear these kinds of messages growing up: ‘don’t masturbate too much because you might lose your orgasm, but if you don’t masturbate at all, then you’ll lose your clit’. These conflicting messages can instil a sense of fear and shame and confusion as to what we should be doing with our bodies.”
26-year-old Anne* can point to a shift in her sex drive after she started on the contraceptive pill when she was 17. As a teenager, her hormones were “wild” and she used to masturbate “a fair bit” but after going on the pill, her desire to self-pleasure waned.
“I remember the first time someone went down on me and expecting fireworks but feeling absolutely nothing,” she tells Refinery29. Her second boyfriend made her feel like something was ‘wrong’ with her.
“It took months before finding out what clitoral atrophy was and I remember feeling absolute fear around the ‘use it or lose it’ discourse.”
Anne
“Sex became a tense point in our relationship as he felt inadequate that he couldn’t make me come. It started a lot of introspection and a feeling that something was wrong with me (which I later learnt was anorgasmia), but I remember one day holding a mirror up to my vulva and realising that I couldn’t see my clitoris at all.”
After that, Anne started paying more attention to her clitoris, which she noticed didn’t swell or increase in size when aroused. “It was really, really small and wasn’t really all too visible in any state… It took months before finding out what clitoral atrophy was and I remember feeling absolute fear around the ‘use it or lose it’ discourse,” she says.
Various factors, like coming off the pill, getting a vertical clitoral hood piercing and seeing a sex therapist, helped Anne regain the use and feeling of her clitoris.
“Quite commonly, women experiencing clitoral atrophy can have considerable benefit from the application of topical oestrogen formulations,” Lew says, adding that “oestrogen can be applied in the form of a prescription cream”.
“While the clitoral atrophy was physical, the anorgasmia it caused was psychosomatic and took a lot of time and patience to work through. I eventually enlisted the help of a sex therapist and made relearning my body a priority,” Anne says.
One of the tools her sex therapist left her with was keeping a masturbation journal, where she’d track what worked and what didn’t work while self-pleasuring. About a year on, Anne noticed her clitoris size had increased.
Seeking professional help is the top piece of advice from Grace. Pairing that with personal practices that allow you to become attuned to your body can foster a holistic approach to managing clitoral atrophy. “[You can try] body mapping or genital mapping, the process of looking, touching and observing sensation that is or isn’t present,” Grace tells Refinery29.
“Practis[e] sex positive affirmations, which are phrases you repeat that act as ongoing reminders of how you want to start thinking, feeling or behaving. Mirror work is used in a range of therapies, it is often used as a method of developing self-love, self-care and a more dynamic relationship with your body. It can feel confronting, intimidating or a little embarrassing but it can also be insightful, intimate and exciting.”
@itsnormalco Can you really lose it if you don’t use it? Georgia Grace explains @gspot._ #atrophy #wellnesstips #australia @alicewillliams ♬ Chill Vibes – Tollan Kim
When ready, Grace recommends masturbation as a place to start rebuilding clitoris function and sexual enjoyment. “It’s likely you’ll need to learn or relearn what pleasure feels like in your body as well as explore how to build arousal,” she says. Grace recommends full-body masturbation practices like belly breathing, engaging the pelvic floor, doing pelvic tilts, hip circles, full-body touches, edging and audio to assist here.
More than just the physical hurdles to overcome, clitoral atrophy carries a heavy mental burden for many. Anne recalls feeling completely “defective” while navigating her condition. “I felt like I didn’t trust [my body] or know it, and a big part of the healing process was unlearning all that negativity,” she confides.
“Now that I’ve regained use of my clitoris, I don’t take it for granted and feel really, really lucky. But the past was super isolating and I just want anyone in the same boat to know that they’re not alone and there’s nothing to be embarrassed about.”
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