New views on the functional morphology of human clitoris

Authors: M. Miko 1;  L. Urban 2;  M. Kajanová 2;  Š. Polák 1;  I. Varga 1
Authors‘ workplace: Ústav histológie a embryológie LF UK, Bratislava, prednosta doc. MUDr. Š. Polák, CSc. 1;  Gynekologicko-pôrodnícke oddelenie, ForLife Všeobecná nemocnica, Komárno, primár MUDr. F. Tóth, PhD. 2
Published in: Ceska Gynekol 2014; 79(2): 147-155


The clitoris is the female external sexual organ and is composed of erectile bodies. The distal portion of the vagina, clitoris and urethra form an integrated entity sui generis. All these components share a common vasculature and nerve supply and during sexual stimulation they respond as one functional unit. The clitoris is closely linked to the mechanism of sexual arousal in women. Glans has a dense network of receptors, innervated often with a several nerves at the same time - taking care of tactile sensitivity, thus, standing on the begining of the journey, which culminates in orgasm. Nervus dorsalis clitoridis, which is a branch of n. pudendus, takes care of sensitive innervation. For blood suply is responsible a. clitoridis, which is a branch of a. pudenda interna. The most common congenital developmental anomalies of the clitoris include: clitoromegaly, penis-like clitoris and bifid clitoris. All, however, are among the relatively rare birth defects.

Mechanism of orgasm gets attention between both laic and scientific community, although to this date there are speculations about its exact mechanism. There is relevant opinion, influenced by Freud‘s doctrine, which strictly recognizes two kinds of female orgasms – vaginal and clitoral, and, according to proponents of this theory, only the second mentioned is caused by stimulation of the clitoris. The second school unifies the term orgasm and claims that only clitoral stimulation (digital, penile, cunnilingus) and contraction of striated perineal muscle are responsible for orgasm, whether the glans (external part) or the body of the clitoris from the vaginal approach is stimulated. Therewithal, special term for mythical and still undocumented (despite many attempts and bold claims about its finding) G spot (named after Ernst Gräfenberg, a German doctor who predicted the existence of this place) is redundant.

Important role in the regulation of female sexuality and responsiveness play a hormonal influences and varying concentrations of neurotransmitters.

clitoris, anatomy of clitoris, development of clitoris, orgasm, sexuality


1. Adamkov, M., Varga, I. Female reproductive system. In Adamkov, M. (ed.) Introduction to functional histology: Textbook. Second revised and updated ed. Turany: P + M Turany, 2013, 425 p.

2. Akbiyik, F., Kutlu, AO. External genital proportions in prepubertal girls: a morphometric reference for female genitoplasty.J Urol, 2010, 184, 4, p. 1476-81. doi: 10.1016/j.juro.2010.06.023.

3. Allen, L., Rodjani, A., Kelly, J., et al. Female epispadias: are we missing the diagnosis? BJU Int, 2004, 94, 4, p. 613–615.

4. Battaglia, C., Battaglia, B., Mancini, F., et al. Cigarette smoking decreases the genital vascularization in young healthy, eumenorrheic women. J Sex Med, 2011, 8, 6, p. 1717–1725. doi: 10.1111/j.1743-6109.2011.02257.x.

5. Battaglia, C., Nappi, RE., Mancini, F., et al. 3-D volumetric and vascular analysis of the urethrovaginal space in young women with or without vaginal orgasm. J Sex Med, 2010, 7, 4 Pt 1, p. 1445–1453. doi: 10.1111/j.1743-6109.2009.01650.x.

6. Battaglia, C., Nappi, RE., Sisti, G., et al. The role of 3-D ultrasonography in the evaluation of menstrual cycle-related vascular modifications of the clitoris. A prospective pilot study. J Sex Med, 2009, 6, 10, p. 2715–2721. doi: 10.1111/j.1743-6109.2009.01430.x.

7. Bouali, O., Mouttalib, S., Abbo, O. Jr., et al. Unusual duplicate bladder exstrophy in a female newborn: a case report. J Pediatr Surg, 2012, 47, 8, p. e9–11. doi: 10.1016/j.jpedsurg.2012.03.067.

8. Brody, S., Klapilova, K., Krejčová, L. More frequent vaginal orgasm is associated with experiencing greater excitement from deep vaginal stimulation. J Sex Med, 2013, 10, 7, p. 1730–1736. doi: 10.1111/jsm.12153.

9. Brody, S., Weiss, P. Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis. J Sex Med, 2010, 7, 8, p. 2774–2781. doi: 10.1111/j.1743-6109.2009.01469.x.

10. Buisson, O., Foldes, P., Paniel, BJ. Sonography of the clitoris. J Sex Med, 2008, 5, 2, p. 413–417. doi: 10.1111/j.1743-6109.2007.00699.x

11. Carlson, BM. Human embryology and developmental biology. 4th ed. Philadelphia: Mosby Elsevier 2009, 544 p.

12. Cartwright, R., Elvy, S., Cardozo, L. Do women with female ejaculation have detrusor overactivity? J Sex Med, 2007, 4, 6, p. 1655–1658.

13. Caruso, S., Cianci, A., Malandrino, C., et al. Ultrastructural and quantitative study of clitoral cavernous tissue from living subjects. J Sex Med, 2011, 8, 6, p. 1675–1685. doi: 10.1111/j.1743-6109.2011.02253.x.

14. Costa, RM., Miller, GF., Brody, S. Women who prefer longer penises are more likely to have vaginal orgasms (but not clitoral orgasms): implications for an evolutionary theory of vaginal orgasm. J Sex Med, 2012, 9, 12, p. 3079–3088. doi: 10.1111/j.1743-6109.2012.02917.x.

15. Cour, F., Droupy, S., Faix, A., et al. Anatomy and physiology of sexuality. Prog Urol, 2013, 23, 9, p. 547–561. doi: 10.1016/j.purol.2012.11.007.

16. Čihák, R. Anatomie 2. Druhé, upravené a doplnené vyd. Praha: Grada, 2002, 488 s.

17. Davidson, JK. Sr, Darling, CA., Conway-Welch, C. The role of the Grafenberg Spot and female ejaculation in the female orgasmic response: an empirical analysis. J Sex Marital Ther, 1989, 15, 2, p. 102–120.

18. Dudek, RW. High-yield embryology. 4th ed. Baltimore: Lippincott Williams & Wilkins 2010, 158 p.

19. Eknoyan, G. Michelangelo: art, anatomy, and the kidney. Kidney Int, 2000, 57, 3, p. 1190–1201.

20. Eknoyan, G., De Santo, NG. Realdo Colombo (1516–1559). A reappraisal. Am J Nephrol, 1997, 17, 3–4, p. 261–268.

21. Federative international programme on anatomical terminology. terminologia embryologica: international anatomical terminology. Thieme 2013, p. 1–312. ISBN-10: 3131701412.

22. Foldes, P., Buisson, O. The clitoral complex: a dynamic sonographic study. J Sex Med, 2009, 6, 5, p. 1223–1231. doi: 10.1111/j.1743-6109.2009.01231.x.

23. Frimberger, D. Diagnosis and management of epispadias. Semin Pediatr Surg, 2011, 20, 2, p. 85–90. doi: 10.1053/j.sempedsurg.2011.01.003.

24. Gerhard, J. Revisiting „the myth of the vaginal orgasm“: the female orgasm in American sexual thought and second wave feminism. Fem Stud, 2000, 26, 2, p. 449–476.

25. Giraldi, A., Marson, L., Nappi, R., et al. Physiology of female sexual function: animal models. J Sex Med, 2004, 1, 3, p. 237–253.

26. Glickman, SE., Cunha, GR., Drea, CM., et al. Mammalian sexual differentiation: lessons from the spotted hyena. Trends Endocrinol Metab, 2006, 17, 9, p. 349–356.

27. Haddad, NG, Vance, GH, Eugster, EA, et al. Turner syndrome (45x) with clitoromegaly. J Urol, 2003, 170, 4 Pt 1, p. 1355–1356.

28. Hannan, JL., Cheung, GL., Blaser, MC., et al. Characterization of the vasculature supplying the genital tissues in female rats. J Sex Med, 2012, 9, 1, p. 136–147. doi: 10.1111/j.1743-6109.2011.02508.x.

29. Hennekam, RC., Allanson, JE., Biesecker, LG., et al. Elements of morphology: standard terminology for the external genitalia. Am J Med Genet A, 2013, 161, 6, p. 1238–1263. doi: 10.1002/ajmg.a.35934.

30. Hines, TM. The G-spot: a modern gynecologic myth. Am J Obstet Gynecol, 2001, 185, 2, p. 359–362.

31. Holomáňová, A., Brucknerová, I. Anatomické názvy I. Latinsko-anglicko-slovenský slovník. Bratislava: Vydavateľstvo Elán, 2001, 94 s.

32. Horejsí, J. Acquired clitoral enlargement. Diagnosis and treatment. Ann N Y Acad Sci, 1997, 816, p. 369–372.

33. Chovancová, D. Novorodenecký skríning na Slovensku. Pediatr Prax, 2007, 1, s. 13–16.

34. Kachlík, D., Čech, P., Musil, V., Báča, V. České tělovědné názvosloví. Návrh české anatomické nomenklatury podle poslední revize mezinárodně platné latinské anatomické nomenklatury. Brno: Tribun EU, 2010, 170 s.

35. Karatas, OF., Baltaci, G., Ilerisoy, Z., et al. The evaluation of clitoral blood flow and sexual function in elite female athletes. J Sex Med, 2010, 7, 3, p. 11851189. doi: 10.1111/j.1743-6109.2009.01569.x.

36. Korda, JB., Goldstein, SW., Sommer, F. The history of female ejaculation. J Sex Med, 2010, 7, 5, p. 1965–1975. doi: 10.1111/j.1743-6109.2010.01720.x.

37. Kratochvíl, S. Sexual stimulation and the female orgasm. Ces Psychiatr, 1993, 89, 4, p. 191–199.

38. Kratochvíl, S. Vaginal and clitorial excitability in females. Ces Gynekol, 1975, 40, 6, p. 432–437.

39. Kurth, ME. Incomplete duplication of the female external genitalia or double clitoris. Am J Surg, 1958, 96, 4, p. 596–599.

40. Maravilla, KR., Heiman, JR., Garland, PA., et al. Dynamic MR imaging of the sexual arousal response in women. J Sex Marital Ther, 2003, 29, Suppl. 1, p. 71–76.

41. Maravilla, KR., Yang, CC. Magnetic resonance imaging and the female sexual response: overview of techniques, results, and future directions. J Sex Med, 2008, 5, 7, p. 1559–1571. doi: 10.1111/j.1743-6109.2008.00839.x.

42. Martin-Alguacil, N., Schober, JM., Sengelaub, DR., et al. Clitoral sexual arousal: neuronal tracing study from the clitoris through the spinal tracts. J Urol, 2008, 180, 4, p. 1241–1248. doi: 10.1016/j.juro.2008.06.009.

43. Martin-Alguacil, N., Pfaff, DW., Shelley, DN., Schober, JM. Clitoral sexual arousal: an immunocytochemical and innervation study of the clitoris. BJU Int, 2008, 101, 11, p. 1407–1413. doi: 10.1111/j.1464-410X.2008.07625.x.

44. Monlleó, IL., Zanotti, SV., Araújo, BP., et al. Prevalence of genital abnormalities in neonates. J Pediatr (Rio J), 2012, 88, 6, p. 489–495. doi:10.2223/JPED.2237.

45. Moszkowicz, D., Alsaid, B., Bessede T., et al. Neural supply to the clitoris: immunohistochemical study with three-dimensional reconstruction of cavernous nerve, spongious nerve, and dorsal clitoris nerve in human fetus. J Sex Med, 2011, 8, 4, p. 1112–1122. doi: 10.1111/j.1743-6109.2010.02182.x.

46. Nanka, O., Sedý, J., Jarolím, L. Sulcus nervi dorsalis penis/clitoridis: its reliability as a character for sex determination of isolated human pubic bones. Prague Med Rep, 2007, 108, 2, p. 167–176.

47. Netter, FH. Atlas of human anatomy, 5th ed. Philadelphia, PA: Saunders-Elsevier, 2010, 624 p.

48. Oakley, SH., Mutema, GK., Crisp, CC., et al. Innervation and histology of the clitoral-urethal complex: a cross-sectional cadaver study. J Sex Med, 2013, 10, 9, p. 2211–2218. doi: 10.1111/jsm.12230.

49. O‘Connell, HE., Eizenberg, N., Rahman, M., Cleeve, J. The anatomy of the distal vagina: towards unity. J Sex Med, 2008, 5, 8, p. 1883–1891. doi: 10.1111/j.1743-6109.2008.00875.x.

50. O‘Connell, HE., Sanjeevan, KV., Hutson, JM. Anatomy of the clitoris. J Urol, 2005, 174, 4 Pt 1, p. 1189–1195.

51. O‘Connell, HE., DeLancey, JO. Clitoral anatomy in nulliparous, healthy, premenopausal volunteers using unenhanced magnetic resonance imaging. J Urol, 2005, 173, 6, p. 2060–2063.

52. Omar, HA., Hummel, M., Jones, EA., Perkins, KC. Hypoplastic external genitalia in association with X; autosome chromosome translocation. J Pediatr Adolesc Gynecol, 1999, 12, 3, p. 161–164.

53. Ostrzenski, A. G-spot anatomy: a new discovery. J Sex Med, 2012, 9, 5, p. 1355–1359. doi: 10.1111/j.1743-6109.2012.02668.x.

54. Pastor, Z. G spot – myths and reality. Ces Gynek, 2010, 75, 3, s. 211–217.

55. Pastor, Z. Female ejaculation orgasm vs. coital incontinence: A systematic review. J Sex Med, 2013,10, 7, p. 1682–1691. doi: 10.1111/jsm.12166.

56. Phillip, M., De Boer, C., Pilpel, D., et al. Clitoral and penile sizes of full term newborns in two different ethnic groups. J Pediatr Endocrinol Metab, 1996, 9, 2, p. 175–179.

57. Pizzi, M., Fassan, M., Cimino, M., et al. Realdo Colombo‘s „De Re Anatomica“: the renaissance origin of the term „placenta“ and its historical background. Placenta, 2012, 33, 8, p. 655–657. doi: 10.1016/j.placenta.2012.03.004.

58. Podesta, M., Urcullo, J. Perineal mobilization of the common urogenital sinus for surgical correction of high urethrovaginal confluence in patients with intersex disorders. J Pediatr Urol, 2008, 4, 5, p. 352–358. doi: 10.1016/j.jpurol.2008.02.009.

59. Porzionato, A., Macchi, V., Stecco, C., et al. The anatomical school of Padua. Anat Rec (Hoboken), 2012, 295, 6, p. 902–916. doi: 10.1002/ar.22460.

60. Puppo, V. The G-spot does not exist. Response by V. Puppo to the article „O. Buisson: the G-spot and lack of female sexual medicine“. Gynecol Obstet Fertil, 2011, 39, 4, p. 266–267. doi: 10.1016/j.gyobfe.2011.02.017.

61. Puppo, V., Gruenwald, I. Does the G-spot exist? A review of the current literature. Int Urogynecol J, 2012, 23, 12, p. 1665–1669. doi: 10.1007/s00192-012-1831-y.

62. Puppo, V. Anatomy and physiology of the clitoris, vestibular bulbs, and labia minora with a review of the female orgasm and the prevention of female sexual dysfunction. Clin Anat, 2013, 26, 1, p. 134–152. doi: 10.1002/ca.22177.

63. Rabe, T. Memorix – Gynekologie. Praha: Scientia Medica, 1994, 336 s.

64. Rabinerson, D., Horowitz, E. G-spot and female ejaculation: fiction or reality? Harefuah, 2007, 146, 2, p. 145–147, 163.

65. Rees, MA., O‘Connell, HE., Plenter RJ., Hutson, JM. The suspensory ligament of the clitoris: connective tissue supports of the erectile tissues of the female urogenital region. Clin Anat, 2000, 13, 6, p. 397–403.

66. Sadler, TW. Langman´s medical embryology. 11th ed. Baltimore:Lippincott Williams & Wilkins 2010, 385 p.

67. Sedý, J., Nanka, O., Spacková, J., Jarolím, L. Clinical implications of a close vicinity of nervus dorsalis penis/clitoridis and os pubis. J Sex Med, 2008, 5, 7, p. 1572–1581. doi: 10.1111/j.1743-6109.2008.00796.x.

68. Senaylı, A. Controversies on clitoroplasty. Ther Adv Urol, 2011, 3, 6, p. 273–277. doi: 10.1177/1756287211428165.

69. Shih, C., Cold, CJ., Yang, CC. Cutaneous corpuscular receptors of the human glans clitoris: descriptive characteristics and comparison with the glans penis. J Sex Med, 2013, 10, 7, p. 1783–1789. doi: 10.1111/jsm.12191.

70. Speiser, PW., White, PC. Congenital adrenal hyperplasia.N Engl J Med, 2003, 349, 8, p. 776–788.

71. Stringer, MD., Becker, I. Colombo and the clitoris. Eur J Obstet Gynecol Reprod Biol, 2010, 151, 2, p. 130–133. doi: 10.1016/j.ejogrb.2010.04.007.

72. Tantibhedhyangkul, J., Copland, SD., Haqq, AM., Price, TM. A case of female epispadias. Fertil Steril, 2008, 90, 5, p. 2017.e1-3. doi: 10.1016/j.fertnstert.2007.12.055.

73. Toesca, A., Stolfi, VM., Cocchia, D. Immunohistochemical study of the corpora cavernosa of the human clitoris. J Anat, 1996, 188, Pt 3, p. 513–520.

74. Tubbs, RS., Linganna, S., Loukas, M. Matteo Realdo Colombo (c. 1516–1559): the anatomist and surgeon. Am Surg, 2008, 74, 1, p. 84–86.

75. Uckert, S., Albrecht, K., Kuczyk, MA., et al. Phospho-diesterase type 1, calcitonin gene-related peptide and vasoactive intestinal polypeptide are involved in the control of human vaginal arterial vessels. Eur J Obstet Gynecol Reprod Biol, 2013, 169, 2, p. 283–286. doi: 10.1016/j.ejogrb.2013.02.012.

76. Van der Putte, SC. Penislike clitorises with megalourethras in nonvirilized female fetuses and a newborn. A histopathologic study and its bearing on their pathogenesis. J Pediatr Surg, 2009, 44, 11, p. 2223–2229. doi: 10.1016/j.jpedsurg.2009.07.024.

77. Verkauf, BS., Von Thron, J., O‘Brien, WF. Clitoral size in normal women. Obstet Gynecol, 1992, 80, 1, p. 41–44.

78. Yamada, G., Satoh, Y., Baskin, LS., Cunha, GR. Cellular and molecular mechanisms of development of the external genitalia. Differentiation, 2003, 71, 8, p. 445–460.

79. Yang, CC, Cold, CJ, Yilmaz, U, Maravilla, KR. Sexually responsive vascular tissue of the vulva. BJU Int, 2006, 97, 4, p. 766–772.

80. Zaviacic, M. The female prostate. Update 1999. Bratisl Lek Listy, 2000, 101, 5, s. 312–313.

81. Zaviacic, M. The adult human female prostata homologue and the male prostate gland: a comparative enzyme-histochemical study. Acta Histochem, 1985, 77, 1, p. 19–31.

82. Zaviacic, M., Ablin, RJ. The G-spot. Am J Obstet Gynecol, 2002, 18, 2, p. 519–520.

83. Zaviačič, M., Whipple, B., Šišovský, V., et al. Od pohlavného vzrušenia k orgazmu ženy species Homo sapiens: sexuologické parametre orgazmového procesu. Prakt Gyn, 2011, 15, s. 101–107.

84. Zuntová, A., Horejsí, J. Histological structure of the peniform clitoris in congenital adrenogenital syndrome. Ces Patol, 1993, 29, 1, p. 36–40.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account