Nerves are made of bundles of thin nerve
fibers, also known as axons. Nerves -which carry electrical impulses between
the brain and the rest of the body -enable people to feel and respond to
stimulus such as touch.

The clitoris is the only known human organ
that has the singular purpose of providing pleasure. While the tip of its small
shaft -the highly sensitive part of the clitoris, also known as the clitoral
glans -is found outside the body, much of the clitoris is located internally.
Below the surface is the dorsal nerve, the main nerve responsible for clitoral
sensation. The dorsal nerves are symmetrical, tube-like structures that travel
on top of the clitoral shaft and then run downward on either side, like a
wishbone.

More than 10,000 nerve fibers enable the
pleasurable sensations created by the human clitoris, according to new Oregon
Health & Science University-led research presented at a joint scientific
meeting of the Sexual Medicine Society of North America and the International
Society for Sexual Medicine.

This finding is the result of the first known
count of human clitoral nerve tissue. It’s also about 20% more than the
often-quoted estimate of 8,000 nerve fibers, which is believed to be derived
from livestock studies.

Blair Peters, M.D., an assistant professor of
surgery in the OHSU School of Medicine and a plastic surgeon who specializes in
gender-affirming care as part of the OHSU Transgender Health Program, led the
research and presented the findings. Peters obtained clitoral nerve tissue from
seven adult transmasculine volunteers who underwent gender-affirming genital
surgery. Tissues were dyed and magnified 1,000 times under a microscope so
individual nerve fibers could be counted with the help of image analysis
software.

Peters collected samples from one side of
dorsal nerve tissue, a small amount of which is typically trimmed during
gender-affirming phalloplasty procedures. An average of about 5,140 dorsal
clitoral nerve fibers were counted among the samples. Knowing the dorsal nerve
is symmetrical, the average was multiplied by two to arrive at an estimate of
10,281 nerve fibers for the human clitoral dorsal nerve. Because the clitoris
also has other, smaller nerves beyond the dorsal nerve, Peters noted the human
clitoris actually has more nerve fibers in total.

“It’s startling to think about more than
10,000 nerve fibers being concentrated in something as small as clitoris,”
Peters said. “It’s particularly surprising when you compare the clitoris to
other, larger structures of the human body. The median nerve, which runs
through the wrist and hand and is involved in carpal tunnel syndrome, is known
for having high nerve fiber density. Even though the hand is many, many times
larger than the clitoris, the median nerve only contains about 18,000 nerve
fibers, or fewer than two times the nerve fibers that are packed into the
much-smaller clitoris.”

While the penis has been widely studied, the
vulva -which includes the clitoris, labia majora and labia minora – is poorly
understood. Medical science hasn’t historically paid much attention to the
sexual function of people with vulvas, which has led to a significant knowledge
gap in the field of sexual health.

Peters studies clitoral nerves to improve outcomes
for phalloplasty surgery, which creates a new penis for transmasculine
patients. He aims to use the findings to improve sensation for surgical
patients by better selecting nerves to connect during phalloplasty procedures,
as well as to develop new surgical techniques to repair injured nerves.

The findings could also help reduce accidental
nerve damage for patients who undergo an aesthetic procedure known as
labiaplasty, which reduces the size of inner flaps of skin on either side of
the vaginal opening.

“Better understanding the clitoris can help
everyone, regardless of their gender identity, but it’s important to
acknowledge this research is only possible because of gender-affirming
surgeries and transgender patients,” Peters said. “There’s something profound
about the fact that gender-affirming care becoming more commonplace also
benefits other areas of health care. A rising tide lifts all boats. Oppressing
or limiting transgender health care will harm everyone.”

Moving forward, Peters is also interested in
studying and counting nerve fibers in a pleasure-inducing part of the penis:
the tip, which is also known as the glans penis. That knowledge could improve
clitoral construction in gender-affirming genital surgeries for transfeminine
patients, and also help clinicians better understand comparable nerve
structures between the clitoris and the penis.

Reference:

Maria Uloko, Paige Isabey, Blair Peters. How
many nerve fibers innervate the human clitoris? A histomorphometric evaluation
of the dorsal nerve of the clitoris, abstract presentation by Blair Peters, 2
p.m. ET Oct. 27, 2022, 23rd annual joint scientific meeting of Sexual Medicine
Society of North America and International Society for Sexual Medicine, https://issmsmsna2022.org/program/program/?persons=4928&q=.

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