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Help! I Can’t Feel My Clitoris. Now What?

Help! I Can’t Feel My Clitoris. Now What?

Introduction

“Help! I can't feel my clitoris!”. Have you ever experienced this, plugged the statement into Google looking for hope and answers, only to come up short? We feel you! That's why today's post is exclusively dedicated to this topic.

*This post is evidence-based; I draw on the medical literature to share what you need to know about vulvar lichen sclerosus and clitoral sensation. Importantly, what I share is my interpretation of the science and data.

**If you found this post helpful, we’d love your support to continue providing important education like this. Make a donation today, volunteer with us, or share our posts in your support groups.

What is the Clitoris

OK, first and foremost, because we address, “I can't feel my clitoris–help!”, we need to talk about what the clitoris is.

The clitoris is a small, highly sensitive organ located at the top of the vulva (see the diagram below for visual reference). It is made of erectile smooth muscle tissue that is dense with thousands of nerve endings. The clitoris can be a little deceptive; it seems quite small looking from the outside. From the outside, you can see the clitoral glans and the clitoral hood. The glans is the small dot-looking part; the hood is the skin that lies on top of the glans. Everyone's anatomy is different; the size of the glans and hood can vary per person. The clitoris has an internal component as well. Internally, the clitoris includes the shaft, the bulbs, and the crus. The inner parts of the clitoris form a wing shape extending downward along the sides of the vaginal opening.

Graphic design image of a clitoris, including the hood, glans, shaft, crus, bulbs, urethral and vaginal openings indicated with arrows pointing to the part.

The primary function of the clitoris is to provide sexual pleasure. The clitoris plays a role in arousal, pleasure, and orgasm.

How Can Vulvar Lichen Sclerosus Affect the Clitoris

Symptoms

The clitoris can be affected by vulvar lichen sclerosus (VLS). For example, you can experience symptoms like itch and pain on and around the clitoral area. Scratching the area can cause damage to the skin, causing it to thicken and/or fissure. Fissures around the clitoris can be painful. Keratin pearls–learn more about those here–can cause tremendous pain and distress.

Clitoral Phimosis

Another thing that can happen to people with VLS is something called clitoral phimosis. Clitoral phimosis happens when the hood of the clitoris sticks to or scars over the clitoral glans (Myers et al., 2022).

Two important things to note. First, having VLS does not guarantee you will develop clitoral phimosis; there are definitely people with VLS who do not have this. Second, having clitoral phimosis does not guarantee reduction or loss of sensation. Some folks have moderate-severe clitoral phimosis but have no difficulties with sensation, arousal, and orgasm. Other people have mild phimosis but experience a significant loss of sensation. Everyone is different.

In skin with no phimosis, if you were to try to pull back the hood of the clitoris, the hood would glide back with ease to reveal the glans. If there is phimosis present, you may experience resistance and difficulty in pulling the hood back, and you may have a hard time seeing the glans. In my case, I had severe phimosis. When I would try to pull back the hood, my skin was so thick, stiff, and rigid that it barely moved, and the glans could not be seen at all.

For those curious about the different grades, real images can be found in a blog post by Dr. Rachel Rubin. Again, there are images of real clitorises on this page. If this does not feel supportive of your mental health, please refrain from viewing.

Loss of Clitoral Sensation


Clitoral phimosis can lead to reduced clitoral sensation. Maybe you feel that when you masturbate, you don't feel pleasure sensations as strong as you used to. Perhaps you experience difficulty in clitoral arousal or muted orgasms. This can happen to some people because of the scar tissue that covers the glans. The way I like to explain it is to imagine picking up a hot cup of coffee with your bare hands. The heat sensation from the hot coffee will be strong. Now, imagine picking that same cup up again, only this time you are wearing a thick pair of ski gloves. Suddenly, the hot sensation is not nearly as strong as when you held the cup with your bare hands.

Experiencing muted orgasms and reduced clitoral sensation can be emotionally distressing, causing depression and anxiety. It's crucial to recognize the emotional impact of these physical changes, often overlooked in medical discussions. Addressing and understanding these effects is vital for holistic well-being.

Help! I Can't Feel My Clitoris

First of all, if you are experiencing a reduction in clitoral sensation, you are not alone. Many of us in the community (myself included) have experienced this. And, while we still have a long way to go, there are some options to help restore sensation.

Determine Physical Causes

First, it is important to identify the cause(s) of the reduction in sensation. Physically, this could include clitoral phimosis or hormonal changes (e.g., changes associated with menopause). If possible, try to get evaluated by a vulvar specialist or sexual medicine doctor to identify the physical cause(s) and then develop a tailored treatment plan to help restore sensation. This plan may involve clitoral myofascial release, non-surgical lysis of adhesions, and surgical lysis of adhesions. If you are not familiar with these procedures, then check out this video I did reviewing three evidence-based ways to unfuse your clitoris. Unfusing the clitoris may be able to restore sensation. If your healthcare provider suspects hormonal changes are contributing to the lack of sensation, topical hormone therapy may be prescribed.

Wait…What About Sex Toys?

If you watch that video to the end, you'll notice there is a bonus section where I discuss sex toys as a way to potentially unfuse. The reason I say ‘potentially' is because this has no been studied in a thorough way yet. However, my hypothesis is that the gentle vibrations and movement of the clitoral tissues may be able to gently break through some of the scar tissue.

Identify Psychosocial Contributors

If you follow me on Instagram, you know I'm a big proponent of the biopsychosocial model.

What's that, you ask?

The biopsychosocial model is a way of understanding health and illness by considering biological, psychological, and social factors. For example, the biological aspect involves physical injuries or genetics. In the case of vulvar lichen sclerosus, this would be things like fusing, clitoral phimosis, absorption, scarring, etc. The biological piece can also include hormones. The psychological aspect includes emotions and thoughts about VLS, such as feeling frustrated that your orgasms are muted because of VLS. Finally, the social aspect takes into consideration how your relationships and societal factors impact your well-being. For example, if you have a strained relationship and your partner often dismisses your pain, this can cause resentment and potentially lead you to pull away and avoid sexual intimacy.

The biopsychosocial model recognizes that health isn't just about our bodies, but it is also about our minds and the world around us. This model promotes a more holistic understanding of health.

Therefore, it's important to identify the psychological and social aspects that may be contributing to the loss of clitoral sensation, difficulty with arousal, and/or muted orgasms. This may not be easy to do, but a trained therapist, or, ideally, a sex therapist, will be able to guide you through the process and then help you address this piece so that you can reclaim your sexuality. A sex therapist can also guide you in working with vibrators by providing you with certain exercises to help reconnect you with your body and pleasure.

Work with a Sexual Medicine Doctor and/or Sex Therapist

Graphic design image of a patient and doctor discussing sexual health.

OK, so I've spoken about the importance of identifying all the causal factors contributing to your decreased clitoral sensation and then treating them. However, both of these require trained professionals. Now, you might be wondering, great, where do I find these professionals? I won't sugarcoat this, finding specialists can be hard and possesses accessibility for many depending on geographical and financial circumstances. Depending on your country, these appointments may have long wait times. Take your time looking through the various directories and calling offices with insurance questions before settling.

If you are looking for a sexual medicine doctor, the International Society for Sexual Medicine has an international provider directory, which you can search through here.

If you are looking for a vulvar specialist, you may consider the Center for Vulvovaginal Disorders and Haven Center. You can also browse LSSN's provider directory, but be mindful that not everyone on there is a sexual medicine/vulvar specialist healthcare provider (call their office to check).

If you are looking for hormone/menopause support, you can search the North American Menopause Society's provider directory here.

Finally, if you are looking for a sex therapist, there are a few options.

  1. Doctor's referral. Some doctors have a list of licensed sex therapists and can send a referral. This may help with some insurance policies.
  2. Ask your pelvic floor physical therapist. It's not a guarantee, but they may have connections in their network and be able to suggest a couple of names or clinics.
  3. Google. Yup. Trusty ol' Google here to save the day, again. This is actually how I found my sex therapist. First, I Google ‘sex therapy near me'. I live in one of the largest cities in Canada, so unsurprisingly, a few sexual health/sex therapy clinics popped up.
  4. Psychology Today has a directory of therapists. You can filter by location, type of therapist (e.g., sex therapist), etc.

For more sexual health resources + a FREE PDF template for vetting sex therapists, click here.

There is Hope

If you are experiencing loss of sensation, trust me, I know how upsetting and scary this can be. I struggled with this for years. It wasn't until I had an appointment with an incredibly knowledgeable and open vulvar specialist and found a pelvic floor physical therapist who worked with patients with clitoral phimosis that I started to see light at the end of the tunnel.

I followed a specific protocol–topical testosterone applied to the clitoris and clitoral myofascial release daily for 8 weeks–and by the end of it, I went from severely fused to completely unfused. I did notice an increase in sensation, which I was very grateful for. If you want to read more about my experience with unfusing, you can read the blog post here.

Conclusion–Help! I Can't Feel my Clitoris

In sum, we've reviewed the anatomy and function of the clitoris, how VLS affects the clitoris, and different options to help restore sensation to the clitoris.

Share your clitoral health and VLS journey in the comments below.

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Reach Out To Me

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Sources Cited

Aerts L, Rubin RS, Randazzo M, Goldstein SW, Goldstein I. Retrospective Study of the Prevalence and Risk Factors of Clitoral Adhesions: Women's Health Providers Should Routinely Examine the Glans Clitoris. Sex Med. 2018 Jun;6(2):115-122. DOI: 10.1016/j.esxm.2018.01.003. Epub 2018 Mar 17. PMID: 29559206; PMCID: PMC5960030. Link here.

Cleveland Clinic – Smegma, – accessed December 7th, 2022.

Flynn AN, King M, Rieff M, Krapf J, Goldstein AT. Patient Satisfaction of Surgical Treatment of Clitoral Phimosis and Labial Adhesions Caused by Lichen Sclerosus. Sex Med. 2015 Nov 13;3(4):251-5. doi: 10.1002/sm2.90. PMID: 26797058; PMCID: PMC4721030.

Goldstein AT, Burrows LJ. Surgical treatment of clitoral phimosis caused by lichen sclerosus. Am J Obstet Gynecol. 2007 Feb;196(2):126.e1-4. doi: 10.1016/j.ajog.2006.08.023. PMID: 17306650.

Kilgore, Rachel, “Specific Myofascial Release as a Treatment for Clitoral Phimosis”, 2016. 

Krapf JM, Mitchell L, Holton MA, Goldstein AT. Vulvar Lichen Sclerosus: Current Perspectives. Int J Women's Health. 2020 Jan 15;12:11-20. doi: 10.2147/IJWH.S191200. PMID: 32021489; PMCID: PMC6970240.

Morrison, Pamela MS, PT, DPT, BCB-PMD, IMTC1; Kellogg Spadt, Susan Ph.D., CRNP, IF, CST2; Goldstein, Andrew MD3. The Use of Specific Myofascial Release Techniques by a Physical Therapist to Treat Clitoral Phimosis and Dyspareunia. Journal of Women's Health Physical Therapy: January/April 2015 – Volume 39 – Issue 1 – p 17-28DOI: 10.1097/JWH.0000000000000023

Myers MC, Romanello JP, Nico E, Marantidis J, Rowen TS, Sussman RD, Rubin RS. A Retrospective Case Series on Patient Satisfaction and Efficacy of Non-Surgical Lysis of Clitoral Adhesions. J Sex Med. 2022 Sep;19(9):1412-1420. doi: 10.1016/j.jsxm.2022.06.011. Epub 2022 Jul 20. PMID: 35869023.

Rubin, Rachel. “New Research on Clitoral Adhesions”, 2022. Link to the blog post here.

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