The clitoris is a nub of spongy tissue at the front of the vagina. When sexually aroused it fills with blood, and the bundle of nerves in the tissue becomes sensitive to touch.

Clitoral atrophy occurs when the clitoris stops responding to sexual arousal and no longer functions as it should. The clitoris can even disappear. This may be the result of a change in hormones or inadequate blood flow to the vagina and clitoris.

The loss of blood flow may be the result of infrequent use. Those who aren’t sexually active are more likely to experience clitoral atrophy. A major shift in hormones, such as menopause or starting hormonal birth control, may be another cause.

Clitoral atrophy is less common than vaginal atrophy. That condition occurs when a drop in estrogen causes the vaginal tissues to become dry, thin, and inflamed. It’s common with menopause.

Loss of sensation is a serious sexual issue. The clitoris is often considered a key to female orgasm. The nerves in the clitoris can produce intense sensations during sexual activity.

Read on to learn more about the symptoms of clitoral atrophy, as well as what can be done to help restore sensation and sexual function.

You’re more likely to experience the symptoms of clitoral atrophy when you’re sexually aroused. These symptoms include:

  • “disappeared” clitoris (you no longer can feel it, even when sexually aroused)
  • loss of sensation around the clitoris
  • decreased response to clitoral stimulation
  • decreased sexual drive

Clitoral atrophy can result from a lack of sexual use. If you stop having regular intercourse or frequent arousals, the clitoris may become dry and thin. It can even shrink and disappear behind the clitoral hood.

Because the clitoris relies on adequate blood flow, your doctor may recommend regular sexual activity, including masturbation. This can help restore blood flow, which may boost sensation again.

Clitoral atrophy may also occur when your testosterone level drops. Testosterone is responsible for your libido. The spongelike tissue in a clitoris also needs the hormone for proper arousal.

Testosterone levels, however, fall as menopause nears. They may also decrease when starting birth control or estrogen supplements.

Those who have a full hysterectomy may experience clitoral atrophy. Because the ovaries are responsible for producing both estrogen and testosterone, removing them could lead to a loss of testosterone. Ultimately, this could cause clitoral atrophy.

The loss of estrogen following a hysterectomy could also lead to vaginal atrophy.

Sexual health is important for your overall health. Clitoral atrophy may be an overlooked but serious cause of female sexual dysfunction.

If you’re experiencing sexual issues, talk with your doctor. They’re fully equipped to help you find answers and treatments. They can refer you to a specialist, too.

Before your appointment, create a list of symptoms you’ve recently experienced. If you’re having issues with sexual arousal, odds are you’re experiencing other issues, too. This may include muscle weakness or fatigue.

Even if you think the symptoms aren’t related to your sexual difficulty, make a note of them.

At your appointment, discuss your major concern — the sexual complaint. Then, let your doctor know about other issues you’ve experienced. They can decide if they may be related.

If they think so, they can order tests that can help determine that, or they will look for separate issues that may be happening.

There’s no single test or physical exam that can definitively diagnose clitoral atrophy. Instead, doctors may rely on a physical exam, your reported symptoms, and other tests to reach a diagnosis.

Doctors don’t always inspect the clitoris and clitoral hood during a routine physical, such as a yearly pelvic exam. So, during your appointment, your doctor may want to do a physical exam of your clitoris and possibly your vagina.

Blood tests are also useful for checking hormone levels and to determine if your testosterone is below normal. These blood tests may also help your doctor rule out other possible causes for low sexual libido at the same time.

If these tests don’t conclusively pinpoint a potential problem, your doctor may try treating the sexual complaint as if it were clitoral atrophy.

If you regain some sensation, the treatment may continue. If you don’t have any response to the treatment, you and your doctor can begin looking for other potential causes.

Treatment depends on what your doctor thinks may be responsible for the loss of sensation in the first place. Here are some of the most common treatments:

  • Have sex. Regular sexual activity can help your clitoris stay healthy and sensitive. It may help restore the feeling in the sensitive nub, too.
  • Get moving. You can also help increase blood flow with regular cardio exercise. Cardio exercise helps boost blood flow throughout the body. What’s good for the body is good for the clitoris and vagina. Regular exercise can also keep testosterone levels from dipping.
  • Try testosterone replacements. Testosterone supplements are often used as a treatment for clitoral atrophy. As a cream, pill, or injection, these options can help restore your testosterone so your body is capable of producing an adequate sexual response. Your doctor will need to prescribe these treatments.

A healthy sexual relationship relies on openness and transparency. That includes talking about what feels good — and what doesn’t.

If you’ve noticed a change in sensation during sex, talking with your partner may help the two of you find ways you can still enjoy intercourse while you work with your doctor for a treatment.

These tips may help you start the discussion:

  • Be frank. There’s no sense in hiding that something has changed. Let them know the same stimulation isn’t producing the identical response it has in the past. If you’ve already talked with your doctor, you can volunteer information about that appointment and what the doctor recommended to help restore sensation.
  • Volunteer new ideas. While letting your partner know about the change in your body’s response to clitoral stimulation, talk with them about exploring fun new options. Include different positions and types of sexual stimulation.
  • Keep an open line of communication. If clitoral orgasm has been the best option for your sexual encounters, the two of you can try other types of orgasm, including vaginal or G-spot.
  • Take the focus off orgasm. The clitoris can provide intense pleasure during sex or masturbation. However, you can still achieve a great deal of sexual satisfaction without the big O. Focus on other erogenous zones, like the nipples, head, and feet. Clitoral stimulation isn’t the only option you have.

Clitoral atrophy may be one of the most underreported sexual health issues. Treatment is possible, though. That’s why it’s important to talk with a doctor or healthcare provider when you first begin noticing symptoms.

Whether or not your symptoms are caused by a lack of blood flow or low testosterone, a doctor can help you identify the underlying cause and find a solution that works best for you.