What do MRI and ultrasound studies reveal about clitoral anatomy and its relation to vaginal sensation?
Executive summary
Magnetic resonance imaging (MRI) and ultrasound studies consistently show the clitoris is a multilayered internal-external complex — glans, body, crura, bulbs and root — that lies ventral and lateral to the urethra and anterior vaginal wall and forms an integrated clitoro‑urethro‑vaginal unit (often called the clitoral complex) visible on pelvic MRI [1][2][3]. Functional imaging and sonographic work further indicate that stimulation or engorgement of these clitoral and periurethral tissues can be engaged during vaginal penetration, supporting an anatomical basis for why anterior vaginal wall stimulation can produce sexual sensation in many women [4][5][6].
1. MRI maps the hidden parts: the clitoral complex revealed
High‑resolution pelvic MRI studies demonstrate that most clitoral tissue is internal — a body with paired crura and bulbs attached broadly to the pubic arch — and that different imaging planes (axial, sagittal, coronal) reveal distinct components, with MRI protocols and even vaginal opacification (ultrasound gel) improving visibility of the glans and deeper erectile tissues [2][7][1].
2. The clitoris, urethra and anterior vagina are anatomically connected
Multiple MRI and dissection‑based reports describe the clitoris as centrally attached to or closely related to the urethra and anterior vaginal wall, producing a triangular or clustered complex of erectile tissue that surrounds the distal urethra and borders the anterior vagina — the anatomical substrate invoked in concepts like the “clitoral‑urethrovaginal complex” or the so‑called G‑spot area [2][5][8].
3. Imaging during arousal and intercourse: contact and engorgement patterns
Dynamic MRI and ultrasound captured during coitus or arousal show preferential mechanical contact of the penis with the anterior vaginal wall and evidence of clitoral and periurethral vascular engorgement during sexual arousal, findings that researchers have used to argue the clitoris and anterior vagina act functionally as a unit during penetration [4][6][5].
4. Correlations with sensation and orgasm: what imaging suggests (and where it’s inconsistent)
Some MRI studies report morphologic correlates with sexual function — for example, differences in clitoral glans area or distances from the vaginal lumen in women reporting anorgasmia versus orgasmic women — suggesting anatomy measurable by MRI may influence vaginally‑mediated orgasm [1]. However, the literature is not uniform: different studies have found opposing associations between clitoral complex size and orgasmic function, and authors repeatedly caution that methodological limits (small samples, variable imaging techniques, reliance on self‑reported sexual function) prevent definitive causal claims [9][8].
5. Ultrasound adds physiology but has limits
Transperineal and dynamic ultrasound studies have been used to show movement, pressure effects, and blood‑flow changes in clitoral structures during voluntary contractions, stimulation, or intercourse, and some small pilot studies found decreased clitoral sensory thresholds with arousal — physiologic signals that complement MRI anatomy [10][6][11]. Still, ultrasound is operator dependent and small studies mean findings are exploratory rather than conclusive [8][11].
6. Where imaging cannot yet prove sensation pathways and the remaining controversies
Imaging can map structure and observe vascular/positional changes but cannot directly record subjective sensation or definitively assign which tissue produces orgasmic perception; MRI authors have acknowledged that in some dynamic studies it was not possible to distinguish the vaginal wall, urethra, and clitoris with certainty, and psychophysical links remain inferential [12][5]. Consequently, competing interpretations persist: one view emphasizes a dominant clitoral origin for orgasm, another highlights an integrated clitoral‑anterior vaginal sensory arm, and methodological differences and small cohorts leave room for debate [2][4][9].
Conclusion
The weight of MRI and ultrasound evidence establishes the clitoris as an extensive internal‑external erectile organ intimately related to the anterior vaginal wall and urethra, and shows these structures can be mechanically and physiologically engaged during arousal and intercourse — providing an anatomical and functional basis for vaginally‑associated sensation in many women — while also underscoring that imaging alone cannot settle subjective sensation causation and that study heterogeneity limits definitive clinical conclusions [2][5][8].