Why am I experiencing pain in my clitoris?

Dear Readers, 

Sounds like you've gone from "ohhh" to "ouch!" While it can bring immense pleasure, the 10,000 nerve fibers in the clitoris can also offer intense pain. There are several factors that can contribute to burning, stinging, or throbbing pain in the clitoris—also known as clitorodynia—such as injury, infection, trauma, or certain medical conditions. Depending on the cause, there are a variety of treatments that may help manage or relieve the pain. 

Before identifying these reasons, it may be helpful to first review the anatomy of the clitoris. The clitoris is made up of three main parts: 

• Glans: The clitoral glans is located directly above the opening of the urethra and below the pubic bone. The clitoral hood—or prepuce—might cover some, all, or none of the glans, depending on your anatomy. 
• Body: The clitoral body is located behind the glans, and extends down into the body, splitting into two branches of erectile tissue called the crura. These two structures make up the clitoral shaft. 
• Bulbs: Clitoral bulbs are made up of erectile tissue, which become swollen, similarly to a penis, during sexual arousal. The bulbs can be found between the crura and vaginal wall. 

That said, there may be a number of reasons you’re experiencing pain in the clitoris. Some of them may include: 

• Infection. Yeast infections, urinary tract infections, bacterial vaginosis, and sexually transmitted infections (STIs) may cause clitoral pain. These infections are typically diagnosable, and symptoms can be either treated or managed. 
• Nerve conditions. Injury or compression of spinal or pelvic nerves can cause clitoral pain. These conditions are often caused by trauma, a herniated disk, or fluid-filled cysts at the bottom of the spine. 
• Skin conditions. Rashes, dermatitis, skin allergies, or cysts on or near the clitoris can cause clitoral pain. Additionally, overusing specialized vaginal hygiene products or douching can disrupt the vaginal microbiome and pH levels, which can lead to clitoral pain. 
• Central nervous system (CNS) conditions. Although uncommon, conditions such as diabetes, arthritis, multiple sclerosis, and more may cause clitoral pain. CNS conditions can interfere with how the brain processes pain signals, which may lead to pain in different parts of the body, such as the clitoris. 
• Sexual trauma. Physical or psychological trauma can contribute to clitoral pain. Some forms of vaginal trauma may include vaginal childbirth, surgery, or sexual assault, among others. 
• Hormonal imbalances. A deficiency or imbalance of estradiol and testosterone can affect tissue health, sensitivity, or atrophy in the vulva or clitoris. Additionally, an excess of androgen hormones can cause an enlarged clitoris to the point of pain or discomfort. 
• Clitoral priapism. During sexual arousal, blood rushes to the clitoris, and the erectile tissue of the clitoris can swell and become erect. In some cases, the clitoris becomes painfully erect or swollen without any sexual stimulation for several hours. Potential causes of clitoral priapism may include drug use, certain medications, or cancer. 
• Accumulation of smegma. This is a white, cheese-like substance composed of natural oils, cells, and other fluids. An accumulation of smegma can cause clitoral adhesions or the formation of keratin pearls, which are small, hardened masses of keratin and other proteins. These adhesions or keratin pearls may cause pain. 

The cause of your symptoms will help determine what treatments may be appropriate. Some of the treatment forms may include antibiotics, antifungal medications, pelvic floor therapy, anticonvulsants, or pain relievers. In some instances, steroids, hormone supplementation, or even surgery may also help. 

Speaking with a health care provider may help you learn about the cause of your pain and what additional steps or resources you can use to manage or relieve it. Depending on the cause, you may also meet with a mental health professional to work through any trauma that may be related to the pain. If necessary, they may also be able to provide support when figuring out how to speak with your partner about how it affects your sex life or finding activities that don't cause irritation or pain. 

Wishing you answers and relief,