(170) DYNAMIC STUDY OF THE VASCULAR PHYSIOLOGY OF THE CLITORIS DURING THE SEXUAL RESPONSE CYCLE IN HEALTHY INDIVIDUALS
Authors: Valente S , Kuyumlian M , Sanchez D , Bursztein D 
Published: December 2024

Abstract

Introduction
There is a renewed interest in the study of the female genital anatomy and sexual function. Recent publications have shed light on the morphology and role of neural pathways involved in female arousal and orgasm. However, little is known about the vascularization of the clitoral complex and the physiological changes it undergoes during the sexual response cycle.

Objective
To evaluate the morphology and vascular flow characteristics of the clitoral complex, dorsal clitoral artery, and bulbous arteries in healthy non-menopausal women during baseline, arousal, and post-orgasmic stages using ultrasound and Doppler velocimetry.

Methods
We conducted a cross-sectional descriptive study between April and June 2021, recruiting healthy adult women through open calls on social media. Responders were invited to a personal interview where the informed consent process was carried out. We performed ultrasound and Doppler velocimetry measurements of the clitoral glans, vestibular bulbs, and dorsal clitoral artery at baseline. Participants were then instructed to self-stimulate their clitoris and given privacy. All measurements were then repeated during arousal and post-orgasm stages.

Results
Out of 38 women who responded, 10 were finally included in the sample. Participants taking oral contraception or any chronic medication were excluded. The median age was 28.5 years (IQR 26–34). Two participants manifested having irregular menstrual cycles. Based on the Female Sexual Function Index (FSFI) score, 9 participants had adequate sexual function (scores between 24.6 and 30.8), while one scored 21. Clitoral glans diameter measurements were as follows: Baseline median diameter 13 mm (IQR 11.3–17) and on arousal median 12.3 mm (IIC 9.5–16.5). Post-orgasm measurements for this segment were unreliable due to participants manifesting discomfort upon contact with the transductor. The transverse bulb diameter showed baseline median 10.1 mm (IQR 8.3–11), arousal 9.4 mm (IIC 9–10), and post-orgasm 9.4 mm (IIC 9–9.8). Longitudinal bulb measurements were baseline median 32.65 mm (IQR 30.5–36.8), arousal 36.35 mm (IQR 35–40), and post-orgasm 41.55 mm (IQR 36.3–44). Anteroposterior bulb measurements were baseline mean 9.29 mm (SD ± 3.58), arousal 11.04 mm (SD ± 2.88 mm), and post-orgasm 10.08 mm (SD ± 2.69 mm). Doppler measurements revealed a baseline median dorsal clitoral artery velocity of 14.25 cm/sec (IQR 12.2–19), on arousal 21.15 cm/sec (IQR 17.7–33.2), and post-orgasm 40.45 cm/sec (IQR 27–47.1). The resistance index had a mean basal value of 0.81 (SD ± 0.05), arousal 0.76 (SD ± 0.05), and post-orgasm 0.73 (SD ± 0.08).

Conclusions
During arousal, the clitoral glans diameter decreases while the vestibular bulb diameter increases. Flow speed in the dorsal clitoral artery increases while the resistance index decreases. Doppler ultrasound is a non-invasive, cost-effective method for dynamically evaluating the clitoral complex. Further studies with a larger sample are needed to establish wider reference ranges applicable to the general population.

Disclosure
No.