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    swollen and stiff, painful clitoris...
    An_250706 posted:
    I'm a nineteen year old female. a couple days ago, my clitoris starting feeling sore. I got a good look at it today, and it's extremely swollen and firm. rather painful in certain positions, especially when I was trying to sleep last night, and sometimes when I sit or walk. most of the time it's a dull pain but it really does hurt often.

    everything looks (and smells?) normal, aside from the fact that it's twice the normal size. the rest of my vagina is fine, nothing else hurts.

    I don't shave all the time (mostly because my partner lives 100 miles away and I haven't seen him in forever hehehehehh) but I don't know if this is important, because it's never felt this way before after not shaving for a while. I tried searching online a bit and one of the reasons women experience pain like this seems to be stray hairs, but as far as I know that's not what's going on.

    I'm not currently sexually active (again, because my partner lives so far away) although I do masturbate quite a lot, but haven't for almost two weeks now simply because I haven't had the desire to.

    I don't have a regular doctor or an ob/gyn. the former is because when I turned eighteen, I lost access to my pediatrician and I never got a referral from him for either a primary care doctor or a gynecologist.

    I've washed it out (not that there's really anything to wash out, I guess) a few times, aiming the detachable shower head at it as I gently hold it open/apart. and I've just wiped it quite a bit with a damp tissue. so I don't know. I have some ~vaginal wipes~ but haven't tried those yet. whenever I shower, I just use water and a washcloth.

    I'm kind of afraid to tell my parents 'I need to see someone for this.' I don't really know if it'll go away on it's own, or if it's serious.
    Jane Harrison Hohner, RN, RNP responded:
    Dear An: There are a variety of causes for clitoral enlargement:

    1. Increased levels of male hormones--I rather doubt this is your culprit as your symptoms appeared suddenly. Increased levels of male hormones tend to progress over time and can be caused by a tumor of the ovary or adrenal gland (there would likely be other symptoms beyond clitoral).

    2. Swelling secondary to infection, yet you have no open sores or lesions.

    3. Swelling secondary to trauma, for example a bike seat.

    There are a variety of reasons for clitoral pain or tenderness:

    1. Infections such as herpes, yeast, or even a localized infection from skin bacteria.

    2. Dermatology problems which can appear in the genital area such as lichen sclerosus, lichen planus, psoriasis, or a contact dermatitis from detergent/bath products/genital cosmetics.

    3. Nerve issue where the surrounding nerves (and the clitoris has lots of nerve tissue) begin to fire inappropriately leading to a sensation of pain. Sometimes this problem can be initiated by an irritant such as herpes, yeast, or trauma to the site (eg bike seat).

    4. Persisting genital arousal syndrome--see recent citation: J Sex Med. 2009 Oct;6(10):2778-87. New insights into restless genital syndrome: static mechanical hyperesthesia and neuropathy of the nervus dorsalis clitoridis. Waldinger MD, Venema PL, van Gils AP, Schweitzer DH.

    Department of Psychiatry and Neurosexology, HagaHospital Leyenburg, Leyweg 275, The Hague2545 CH, The Netherlands.

    INTRODUCTION: Systematic study of dysesthetic and paresthetic regions contributing to persistent genital arousal in women with restless genital syndrome (ReGS) is needed for its clinical management. AIM: To investigate distinct localizations of ReGS. METHODS: Twenty-three women, fulfilling all five criteria of persistent genital arousal disorder were included into the study. In-depth interviews, routine and hormonal investigations, electroencephalographs, and magnetic resonance imaging (MRI) of brain and pelvis were performed in all women. The localizations of genital sensations were investigated by physical examination of the ramus inferior of the pubic bone (RIPB) and by sensory testing of the skin of the genital area with a cotton swab (genital tactile mapping test or GTM test). MAIN OUTCOME MEASURES: Sensitivity of RIPB, GTM test. RESULTS: Of 23 women included in the study, 18(78%), 16(69%), and 12(52%) reported restless legs syndrome, overactive bladder syndrome, and urethra hypersensitivity. Intolerance of tight clothes and underwear (allodynia or hyperpathia) was reported by 19 (83%) women. All women were diagnosed with ReGS. Sitting aggravated ReGS in 20(87%) women. In all women, MRI showed pelvic varices of different degree in the vagina (91%), labia minora and/or majora (35%), and uterus (30%). Finger touch investigation of the dorsal nerve of the clitoris (DNC) along the RIPB provoked ReGS in all women. Sensory testing showed unilateral and bilateral static mechanical Hyperesthesia on various trigger points in the dermatome of the pudendal nerve, particularly in the part innervated by DNC, including pelvic bone. In three women, sensory testing induced an uninhibited orgasm during physical examination. CONCLUSIONS: ReGS is highly associated with pelvic varices [VARICOSE VEINS OF THE GENITALS--JHH> and with sensory neuropathy of the pudendal nerve and DNC, whose symptoms are suggestive for small fiber neuropathy (SFN). Physical examination for static mechanical Hyperesthesia is a diagnostic test for ReGS and is recommended for all individuals with complaints of persistent restless genital arousal in absence of sexual desire.

    If your clitoral pain or enlargement persists please see a GYN for a more "for sure" answer. You could even start with your local county family planning clinic.

    An_250706 replied to Jane Harrison Hohner, RN, RNP's response:
    I appreciate your reply (I'm just using 'anonymous' posting 'cos I'm rather embarrassed).

    it started after I showered thursday night, I think. I've been using the same body wash for months, probably a year or so now, so I highly doubt that could've caused it. it was the second time I used head & shoulders shampoo but as far as I know, I only got it on my head. (I don't even really like H&S, it made my scalp burn when I used it for the first time.)

    I've never had any kind of yeast infection. do you know what could've caused anything like that?

    Jane Harrison Hohner, RN, RNP replied to An_250706's response:
    Dear An: If a yeast infection is severe enough for the yeast to have reached the clitoral area often there is pronounced vaginal itching and burning as well. So if you have itching and burning throughout the area then yeast would be a common culprit.

    It would be less likely for it to be the Head & Shoulders shampoo--unless you were shampooing your pubic hair as well. Truly, if your symptoms are not improving it would be preferable to have a GYN trained person do a brief exam. They can test for yeast at the same time. It's OK to discuss any masturbation concerns. In fact, if you use saliva as a lubricant, there are studies which link saliva contact to genital yeast infections (yeast is a common flora from the mouth through the entire gut).


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