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Sexual stimulation and arousal

The clitoris has an abundance of nerve endings, and is the human female's most erogenous part of the body. When sexually stimulated, it may incite sexual arousal, which may result from mental stimulation (sexual fantasy), activity with a sexual partner, or masturbation, and can lead to orgasm. The most effective sexual stimulation of this organ is usually manually or orally, which is often referred to as direct clitoral stimulation; in cases involving sexual penetration, these activities may also be referred to as additional or assisted clitoral stimulation.

Direct stimulation involves physical stimulation to the external anatomy of the clitoris – glans, hood, and shaft. Stimulation of the labia minora, due to it being connected with the glans and hood, may have the same effect as direct clitoral stimulation. Though these areas may also receive indirect physical stimulation during sexual activity, such as when in friction with the labia majora, indirect clitoral stimulation is more commonly attributed to penile-vaginal penetration. Penile-anal penetration may also indirectly stimulate the clitoris by the shared sensory nerves (especially the pudendal nerve, which gives off the inferior anal nerves and divides into two terminal branches: the perineal nerve and the dorsal nerve of the clitoris).

Due to the glans' high sensitivity, direct stimulation to it is not always pleasurable; instead, direct stimulation to the hood or near the glans is often more pleasurable, with the majority of women preferring to use the hood to stimulate the glans, or to have the glans rolled between the labia, for indirect touch. It is also common for women to enjoy the shaft being softly caressed in concert with the occasional circling of the glans. This might be with or without digital penetration of the vagina, while other women enjoy having the entire vulva caressed. As opposed to the use of dry fingers, stimulation from well-lubricated fingers, either by vaginal lubrication or a personal lubricant, is usually more pleasurable for the external clitoris.

As the clitoris' external location does not allow for direct stimulation by penetration, any external clitoral stimulation while in the missionary position usually results from the pubic bone area. As such, some couples may engage in the woman-on-top position or the coital alignment technique, a sex position combining the "riding high" variation of the missionary position with pressure-counterpressure movements performed by each partner in rhythm with sexual penetration, to maximize clitoral stimulation. Same-sex female couples may engage in tribadism (vulva-to-vulva or vulva-to-body rubbing) for ample or mutual clitoral stimulation during whole-body contact. Pressing the penis in a gliding or circular motion against the clitoris or stimulating it by the movement against another body part may also be practiced. A vibrator (such as a clitoral vibrator), dildo or other sex toy may be used. Other women stimulate the clitoris by use of a pillow or other inanimate object, by a jet of water from the faucet of a bathtub or shower, or by closing their legs and rocking.

During sexual arousal, the clitoris and the rest of the vulva engorge and change color as the erectile tissues fill with blood (vasocongestion), and the individual experiences vaginal contractions. The ischiocavernosus and bulbocavernosus muscles, which insert into the corpora cavernosa, contract and compress the dorsal vein of the clitoris (the only vein that drains the blood from the spaces in the corpora cavernosa), and the arterial blood continues a steady flow and having no way to drain out, fills the venous spaces until they become turgid and engorged with blood. This is what leads to clitoral erection.

The prepuce has retracted and the glans becomes more visible. The glans doubles in diameter upon arousal and further stimulation becomes less visible as it is covered by the swelling of the clitoral hood. The swelling protects the glans from direct contact, as direct contact at this stage can be more irritating than pleasurable. Vasocongestion eventually triggers a muscular reflex, which expels the blood that was trapped in surrounding tissues, and leads to an orgasm. A short time after stimulation has stopped, especially if orgasm has been achieved, the glans becomes visible again and returns to its normal state, with a few seconds (usually 5 – 10) to return to its normal position and 5 – 10 minutes to return to its original size. If orgasm is not achieved, the clitoris may remain engorged for a few hours, which women often find uncomfortable. Additionally, the clitoris is very sensitive after orgasm, making further stimulation initially painful for some women.