Painful Clit

Painful Clit




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Painful Clit
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Suzannah Weiss is a freelance writer focused on gender and sexuality whose work has appeared in The Washington Post, New York Magazine, and more.
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The clitoris is exquisitely sensitive and is the center of most vulva-owners’ pleasure, so it can be frustrating, if not outright devastating, if yours is causing you discomfort. Research on clitoral pain is limited, but it occurs enough that there’s a clinical term for it: clitorodynia . 
Clitorodynia can present in many different ways: Some may experience constant pain, while others may only experience pain when the clitoris is touched. Some may have a mild soreness, while others experience a sharp stabbing sensation. The presentations vary because the causes do as well. 
If you’re suffering from any of these symptoms, help is available. Read on for info about what can cause clitoral pain and how it can be treated.
“There are actually many causes of clitoral pain, including infections like yeast and herpes, conditions that cause inflammation like lichen sclerosus , vulvar cancer, nerve damage, trauma to the vulva (horseback riding, cycling), changes in hormones, and vulvodynia , a chronic pain condition that can involve the clitoris,” says OB/GYN Lyndsey Harper, founder and CEO of Rosy Wellness . You’ll have to see a professional to figure out what’s causing your pain, but here’s some information about a few of the most common causes: 
Hormonal deficits: If your body isn’t producing enough of the hormones estradiol and testosterone, your vulva and clitoris can atrophy — that is, lose tissue–says Erin Hardiman, a physical therapist at t he Pelvic Health and Rehabilitation Center . “ Poor tissue integrity and health can result in pain and hypersensitivity to touch,” says Hardiman. If your doctor suspects this is the case for you, they can order blood tests to check your hormone levels.
Infection: Tissue irritation from a yeast infection can cause pain and itchiness throughout the vulva, including the clitoris, says Hardiman. A herpes outbreak around the clitoris can similarly sometimes create clitoral pain, says urologist Kelly Casperson . In these cases, the clitoral pain will be treated by treating the infection, usually with medication. 
It may take some persistence to find the right diagnosis and treatment, but clitoral pain isn’t ever something you just have to live with.
Pudendal neuralgia: Pudendal neuralgia is a term for pain, burning, or numbness in the pelvis caused by irritation or damage of a nerve. Sometimes, the nerve gets irritated due to tightness and tension in the pelvic floor muscles, says Hardiman. A pelvic floor physical therapist can help diagnose and treat conditions like this. 
Dermatological conditions: Certain skin conditions can also create pain if they affect the skin of the clitoris, says Hardiman. One of these conditions is lichens sclerosis, which causes thin, white patches of skin in the genital area. Another is lichens planus, where the immune system attacks skin cells, creating purplish, itchy bumps. A vulvar dermatologist can help diagnose and treat conditions like these. 
Trapped or pulled skin: “The clitoris has a foreskin, or a clitoral hood, just like a penis does,” explains Casperson. “And just like the penis’s skin can get stuck or trapped or pulled, the clitoris can get that way, too.” This is most common for those who have low estrogen, like those who have experienced or are about to experience menopause, but could also result from hormonal birth control. “Some birth control pills can just lower your hormones enough that that skin gets a little atrophic, and then it kind of gets stuck on top of your clitoris,” says Casperson.
Keratin pearls: Sometimes, smegma or other discharge gets trapped under the clitoral hood and can get stuck to the clitoris or hood, says Hardiman. These pieces of discharge are called keratin pearls and can be broken up and removed using a probe in a doctor’s office.
Persistent genital arousal disorder (PGAD): This is when “the clitoris is wrongly giving signals of stimulation that are very distressing for people because they’re not in a sexual context,” says Casperson. And to make matters worse, it can cause pain as well as arousal. PDAG itself can have multiple causes, from nerve compression to hormonal imbalances, that will be treated in order to calm the sensation. 
Nerve compression : If someone is frequently riding a bike, horseback riding, or partaking in other activities that put pressure on the genitals, they can experience pelvic pain due to compression — or squishing — of the nerves, says Casperson. Ceasing these activities and resting the area can help the nerves heal. 
Lack of lubrication : If the pain is only during sexual activity, the issue could be as simple as a lack of lubrication. “The clitoris is not a self-lubricating organ,” says Casperson. “Too much friction can cause distress and pain.” Using lube — for clitoral stimulation as well as penetration — may help with the pain in this case. 
Sexual trauma: Pain can be a direct result of a physical trauma or, less directly, could be related to emotional trauma, says Erin Pritchard, owner and clinical counselor at Sea Glass Counseling and Consultation . “Our bodies store traumatic memories and experiences in all sorts of places,” she says. “For some people, their body might be holding onto traumatic material within the pelvic area, and that traumatic pain might present itself in the clitoris.” If someone has a history of sexual trauma, they may see a therapist along with a doctor. 
Casperson recommends seeing a gynecologist or urologist trained in female sexual health to get to the root of your pain. “You can always start with your primary care doctor, but if you don’t get anywhere, stepping up and finding an expert is the way to go,” she says.
“You should first consult with a gynecologist to rule out/in an infection, a dermatological condition, hormonal insufficiency, and/or other pathology of the vulva,” says Hardiman. If they suspect pudendal neuralgia, they may refer you to a specialist, either a doctor or a pelvic floor physical therapist. “If the suspicion is that the clitoral pain is due to muscular dysfunction, then you should consult with a pelvic floor physical therapist,” says Hardiman. 
“A licensed physical therapist that specializes in pelvic health can evaluate if there are contributions from the nerve that leads to the clitoris or the muscles that are adjacent to it,” says pelvic floor physical therapist Heather Jeffcoat. “Physical therapists will work on neural mobility, myofascial restrictions , and associated conditions that may be present with clitorodynia, such as urinary urgency or frequency.”
Before seeing your doctor, it may be helpful to jot down some things you’ve noticed about your pain, says Harper. Some questions she suggests answering for yourself are: “When did the pain begin? Is it intermittent or constant? Was it associated with any known infection or injury? Have you had recent pelvic surgery or pregnancy? Is there associated burning or itching? Is the pain worse when touching the clitoris? Is there anything that makes the pain better?”
“The treatment depends on the cause, so [treatments for clitoral pain] can vary from treating an infection to treating a skin condition, addition of hormones, or a procedure,” says Harper. Infections are usually treated with medication, while hormonal imbalances can be treated with hormonal supplementation, says Hardiman. Nerve issues may require a combination of treatments, including medications, pelvic floor physical therapy, and nerve-directed therapies.
Seeing a psychotherapist may also be helpful if you’re experiencing distress or shame around your pain or think it may be trauma-related, says Pritchard. “Therapy certainly can be helpful for resolving any negative messages that this pain is causing people to believe about themselves.”
It’s a frustrating reality that not all doctors take sexual problems, especially those experienced by people with vulvas, seriously. “Unfortunately, many doctors don’t get the training we need to help women with sexual problems,” says Harper. If your doctor isn’t able to help, she suggests seeking out a specialist in sexual medicine or pelvic pain. You also may be able to get a referral to a competent doctor from a pelvic floor physical therapist, says Hardiman. 
Jeffcoat recommends searching pelvicpain.org to find physicians with experience treating pelvic pain. You can also go to the International Society for the Study of Women’s Sexual Health website to find providers who will take sexual health seriously, says Casperson.
It may take some persistence to find the right diagnosis and treatment, but clitoral pain isn’t ever something you just have to live with. Find a provider who you trust and can open up to, and work together to figure out what’s causing your pain and identify a treatment you feel comfortable with.
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The Centers for Vulvovaginal Disorders
Washington, DC • New York City


Odyne was the "Greek goddess of pain." Therefore, the term vulvodynia literally means "vulvar pain." Vulvodynia is currently defined as "vulvar discom ...


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The doctors at the Centers for Vulvovaginal Disorders (CVVD) have treated over 2,000 patients with lichen sclerosus. This up-to-date webinar presented ...


Lichen planus is an inflammatory, autoimmune disorder of the skin and mucous membranes. While there are multiple clinical variants that may involve th ...


Lichen simplex chronicus (aka: neurodermatitis, pruritis vulvae, squamous hyperplasia, and hyperplastic dystrophy) is the end stage of an itch- scratc ...


This condition, also called levator ani syndrome or (and previously called vaginismus) is a common cause vestibulodynia (pain of the vestibule) and dy ...


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Almost all women, at least once in their lives, experience the uncomfortable symptoms of vaginal itching, burning, and discharge. It is common wisdom ...


Endometriosis (endo meaning "inside" and metra, “womb”) is a common cause of menstrual-related pelvic pain and pain with intercourse impacting up to 1 ...


Interstitial Cystitis (IC), also called Painful Bladder Syndrome (PBS), is linked to dyspareunia (pain with intercourse) and is thought of as contribu ...


Desquamative inflammatory vaginitis (DIV) is a fairly rare condition in the spectrum of different causes of vaginitis. It’s also one that that is poor ...


Human Papilloma Virus (HPV) is the most common sexually transmitted infection in the United States. There are many different types of HPV. Some of w ...


Vulvar Intraepithelial Neoplasia (VIN) is a precancerous skin condition of the vulva that is becoming increasingly common in women age of 40 and over. ...


Genital herpes is a common sexually-transmitted infection caused by the Herpes Simplex Virus (HSV). It often causes painful blisters that may occur i ...


Chronic pelvic pain involving the sensory distribution of the pudendal nerve is called pudendal neuralgia. This can be a severely painful and disablin ...


Persistent genital arousal disorder (PGAD), is associated with unrelenting, unwanted, persistent, intrusive, and spontaneous sensations such as pressu ...


“Clitorodynia” is an abnormal pain of the clitoris. Typical symptoms are a sharp, stabbing pain or a rawness/irritation of the clitoris that can be ex ...


The medical term for decreased libido is hypoactive sexual desire disorder (HSDD). HSDD is one of the most common forms of sexual dysfunction in women ...


Arousal is a physiological response to internal or external sexual stimuli. Genital arousal involves an increase in vulvovaginal lubrication, engorge ...


Chronic pelvic pain describes pain anywhere below the umbilicus and between the hips that lasts for at least six months. There are many causes of chr ...


Plasma Cell Vulvitis (also known at Zoon’s vulvitis) is a very rare chronic, inflammatory disorder of the vulva. Bright red mucosal plaques on the vul ...


Aphthous ulcers (also known at Lipschutz ulcers) are deep, painful genital ulcers with a yellow base that occur most commonly in young Caucasian women ...


Pruritus vulvae simply refers to itching of the vulva. Persistent vulvar pruritis is relatively common and may have a number of causes, including vul ...


Vulvar granuloma fissuratum describes recurrent splitting or tearing of the vulvar skin. It is often associated with vulvar skin conditions that caus ...

“Clitorodynia” is an abnormal pain of the clitoris. Typical symptoms are a sharp, stabbing pain or a rawness/irritation of the clitoris that can be exacerbated by touch, walking, wearing tight underwear or moving at certain angles. The most common cause of clitorodynia is a build up of Keratin Pearls (a hard, grain-of-sand like material) between the clitoris and the hood of the clitoris (prepuce). Additional causes of clitorodynia include skin diseases affecting the vulva such as lichen sclerosus or lichen planus, a herniated disc or cyst in the sacral or lumbar spine, injury of the pudendal nerve or the dorsal clitoral branch of the pudendal nerve.
The treatments options for clitorodynia depending on the cause of the pain. The treatment for the Keratin Pearl excision may be done in-office or in the operating room (depending on the severity of clitoral adhesions between the clitoris and prepuce). The procedure consists of breaking up the adhesions with a fine metal probe and then removing the Keratin Pearls. Patients have some mild post-operative discomfort during the healing process, but will have quick resolution of their sharp, stabbing clitoral pain.
If the cause of the clitorodynia is neuropathic in nature, oral tricyclic antidepressants, such as amitriptyline, nortriptyline, and desipramine can be used. These medications “numb nerves” thereby decreasing the clitoral pain.  The dosages of tricyclic antidepressants used for clitorodynia are significantly less than those used for depression. Alternatively, anticonvulsants such as Neurontin (gabapentin) and Lyrica can be used to treat neuropathic causes clitorodynia and they typically have fewer side effects than tricyclic antidepressants.
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Why Does My Clit Hurt? The clit is made to feel good. But what if it feels bad? Clitoris pain is common, but you don’t have to tolerate it. Explore causes of clit pain and their solutions.
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The clitoris has just one purpose, and that is pleasure. So experiencing frequent clitoral pain (officially called clitorodynia) can be confusing and upsetting. There are many factors that can lead to a sore clit, including irritation from hygiene products, your unique anatomy, and certain medical conditions. If you’re experiencing clit pain, you don’t have to suffer: Figuring out what’s causing it can help you find relief.
The clitoris is more than a bump a couple inches above the vagina—that part is just the head (glans). The rest of the clit is internal, with two “legs” that wrap around each side of the vagina ( 1 ). The penis and the clitoris have a similar number of nerve endings, but in the clit they’re condensed into a much smaller space, making it even more sensitive ( 2 ).
Because there are so many nerve endings bundled together in the external clitoris, some people are hypersensitive to clitoral stimulation: This sensitivity can contribute to discomfort in the clit. In some cases, direct touch to the clitoris can be painful just because it’s so sensitive. 
Some people experience changes in the sensitivity of their clit in response to sexual arousal: It may be very sensitive before they get turned on, less sensitive when they’re super aroused, and hypersensitive again after orgasm ( 3 ). If this is the case for you, start out slowly, stroking around the clit and over the clitoral hood, rather than touching it directly. 
Many clits need a warm-up period before progressing to firmer pressure. Start with slow, gentle touch, increasing the pressure and speed only if it feels good. 
If you’re having sex with a partner, it can be easier to tell them what you like if you’ve already figured it out for yourself. Exploring the kinds of sensations that feel best for your clitoris through self-pleasure can be helpful in reducing discomfort and guiding your partner.
Using lubricant during clitoral stimulation can increase your comfort and help to prevent clit pain. Dryness increases friction, which can be painful for some people, especially those with sensitive clits. You can use your own natural wetness, transferring vaginal fluid from your vag
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