title: Clitoral size and location in relation to sexual function using pelvic MRI.
abstract: BACKGROUND
  The female sexual response is dynamic; anatomic mechanisms may ease or enhance the intensity of orgasm.
  
  
  OBJECTIVE
  The aim of this study is to evaluate the clitoral size and location with regard to female sexual function.
  
  
  METHODS
  This cross-sectional TriHealth Institutional Board Review approved study compared 10 sexually active women with anorgasmia to 20 orgasmic women matched by age and body mass index (BMI). Data included demographics, sexual history, serum hormone levels, Prolapse/Incontinence Sexual Questionnaire-12 (PISQ-12), Female Sexual Function Index (FSFI), Body Exposure during Sexual Activity Questionnaire (BESAQ), and Short Form Health Survey-12. All subjects underwent pelvic magnetic resonance imaging (MRI) without contrast; measurements of the clitoris were calculated.
  
  
  METHODS
  Our primary outcomes were clitoral size and location as measured by noncontrast MRI imaging in sagittal, coronal, and axial planes.
  
  
  RESULTS
  Thirty premenopausal women completed the study. The mean age was 32 years (standard deviation [SD] 7), mean BMI 25 (SD 4). The majority was white (90%) and married (61%). Total PISQ-12 (P < 0.001) and total FSFI (P < 0.001) were higher for orgasmic subjects, indicating better sexual function. On MRI, the area of the clitoral glans in coronal view was significantly smaller for the anorgasmic group (P = 0.005). A larger distance from the clitoral glans (51 vs. 45 mm, P = 0.049) and body (29 vs. 21 mm, P = 0.008) to the vaginal lumen was found in the anorgasmic subjects. For the entire sample, larger distance between the clitoris and the vagina correlated with poorer scores on the PISQ-12 (r = -0.44, P = 0.02), FSFI (r = -0.43, P = 0.02), and BESAQ (r = -0.37, P = 0.04).
  
  
  CONCLUSIONS
  Women with anorgasmia possessed a smaller clitoral glans and clitoral components farther from the vaginal lumen than women with normal orgasmic function.
authors: Division of Urogynecology and Pelvic Reconstructive SurgeryGood Samaritan HospitalCincinnatiOHUSA. Electronic address: susan_oakley@trihealth.com.
authors: Susan H
authors: SH
authors: Oakley
authors: Division of Urogynecology and Pelvic Reconstructive SurgeryGood Samaritan HospitalCincinnatiOHUSA; Division of Urogynecology and Pelvic Reconstructive SurgeryMadigan Army Medical CenterTacomaWAUSA.
authors: Christine M
authors: CM
authors: Vaccaro
authors: Division of Urogynecology and Pelvic Reconstructive SurgeryGood Samaritan HospitalCincinnatiOHUSA.
authors: Catrina C
authors: CC
authors: Crisp
authors: Division of Urogynecology and Pelvic Reconstructive SurgeryGood Samaritan HospitalCincinnatiOHUSA.
authors: M Victoria
authors: MV
authors: Estanol
authors: Hatton Institute for Research and EducationGood Samaritan HospitalCincinnatiOHUSA.
authors: Angela N
authors: AN
authors: Fellner
authors: Division of Urogynecology and Pelvic Reconstructive SurgeryGood Samaritan HospitalCincinnatiOHUSA.
authors: Steven D
authors: SD
authors: Kleeman
authors: Division of Urogynecology and Pelvic Reconstructive SurgeryGood Samaritan HospitalCincinnatiOHUSA.
authors: Rachel N
authors: RN
authors: Pauls
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D002987:Clitoris / Q000473:pathology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009929:Organ Size / Q000502:physiology; D009948:Orgasm / Q000502:physiology*; D012725:Sexual Behavior / Q000502:physiology / Q000706:statistics & numerical data; D020018:Sexual Dysfunctions, Psychological / Q000473:pathology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014621:Vagina / Q000503:physiopathology
keywords: Clitoris; Female Sexual Dysfunction; Orgasmic Disorder; Pelvic MRI