NEWS 5
ausdoc. com. au 16 MAY 2025
NEWS 5
‘ Women’ s anatomy was not considered normal’
PHOTO: EMILIA PREDEBON
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Professor Helen O’ Connell.
Rachel Fieldhouse WHEN a young trainee surgeon was swotting in the 1980s, she noticed some unscientific and disparaging descriptions of female anatomy in the textbooks.
One was Last’ s Anatomy, which described the female sex organ as a“ failure” of male genital formation.
“ I had studied anatomy several times over a long period of time, but the more time I spent with this book, the more I became aware of its deficiencies,” Professor Helen O’ Connell tells Australian Doctor.
“ Anatomically, we knew where the clitoris was, but there was almost nothing written about it.
“ There would be add-on comments about the differences between males and females, but it was framed in a way where there was male anatomy and then the departure from male anatomy.“ That was a red flag to me.” Professor O’ Connell has since been credited as the first person to comprehensively and accurately map the sex organ.
The project occurred to her while studying for a master’ s degree at the University of Melbourne in 1989.
She had come across the book A New View of a Woman’ s Body, written by feminists in the healthcare sector eight years earlier.
“ They would look at each other’ s anatomy and then make up an idea of what the true anatomy should be based on that,” she says.
“ They said they did not have access to cadavers, and I thought,‘ That is something we could do at the University of Melbourne.’”
After becoming Australia’ s first female urological surgeon in 1994, she moved to the US for a fellowship, where much of her clinical work involved preserving nerves for men experiencing erectile dysfunction.
But no-one knew whether female nerves were the same.
“ We did not know, but we should have known. So that was the first study I did looking at the nerve anatomy.”
She soon identified a need for broader study of the clitoris and embarked on a 10-year research journey that culminated in a dissertation and a landmark review in The Journal of Urology, both published in 2005.
The review was one of the first articles offering a complete anatomical description of the clitoris, with pictures of the organ from different perspectives and detailed descriptions of the surrounding ligaments, nerves and neurovascular bundles.
Professor O’ Connell and her colleagues described the clitoris as a multiplanar structure extending from the partly external“ button-like” glans deep into the epithelium, labial fat and fascia.
“ It is impossible to convey clitoral anatomy in a single diagram showing only one plane, as is typically provided in textbooks,” the team wrote.
They also found no evidence that the controversial G spot was a distinct structure and posited that the erectile tissue wrapping around the distal urethra and vagina might be the source of sensitivity.
Professor O’ Connell was recognised for her work by the World Association for Sexual Health. Medical textbooks were also updated, including Last’ s Anatomy and Gray’ s Anatomy.
She is now a consultant urologist, professor of surgery and researcher at the University of Melbourne.
Twenty years after her groundbreaking work, Professor O’ Connell says misconceptions surrounding the clitoris persist.
For example, she says there is still a misunderstanding of vestibular bulbs: the elongated erectile soft tissue on either side of the vaginal opening, which can cause complications after labioplasty.
“ The clitoris or labia minora actually arises from these bulbs, so it is at risk during these cosmetic procedures, and that does not seem to be appreciated, particularly by cosmetic surgeons.
“ You are removing tissue that down the track is going to become potentially atrophic, and then that area is going to be much more distorted over time.”
Asked why it had taken so long to fully map the anatomy of the clitoris, Professor O’ Connell says it was because of the underpinning cultural failure to
‘ Anatomically, we knew where the clitoris was, but there was almost nothing written about it.’
recognise the clitoris as the female sexual organ.
“ What has happened over the past few decades is an acceptance that, generally speaking, if a woman wants to have an orgasm, you are going to have to stimulate the clitoris and vulval area rather than directly stimulate the vagina,” she says.
“ It is clear that sexual medicine has moved away from trying to make women fit a model that just does not exist.”
J Urol 2005; 1 Oct. J Sex Med 2013; 1 Jun. Am J Obstet Gynecol 2023; 22 Feb.
Trimbow 100 / 6 / 10 & 200 / 6 / 10 are indicated for maintenance treatment; in adults with asthma not adequately controlled with a maintenance combination of medium dose or high dose ICS / LABA respectively, and who experienced ≥1 exacerbation( s) in the previous year. Trimbow 100 / 6 / 10 is indicated in adults with moderate to severe COPD who are not adequately treated by ICS / LABA or LABA / LAMA. 1
PBS Information: Authority required( STREAMLINED). Severe Asthma. Chronic Obstructive Pulmonary Disease( 100 / 6 / 10 mcg presentation only). Criteria Apply. Refer to PBS for full information.
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Abbreviations: COPD: chronic obstructive pulmonary disease; ICS: inhaled corticosteroid; LABA: long-acting beta 2 agonist; LAMA: long-acting muscarinic antagonist; PBS: Pharmaceutical Benefits Scheme; pMDI: pressurised metered dose inhaler. References: 1. Trimbow Approved Product Information. 2. Pharmaceutical Benefits Scheme( PBS). www. pbs. gov. au. Chiesi Australia Pty Ltd, Hawthorn East, VIC. 3123, Australia. Tel: + 61 3 9077 4486; Fax: + 61 3 8672 0792; Email: medinfo. au @ chiesi. com. Copyright © Chiesi 2025. All rights reserved. Date of preparation: January 2025. AU-TRI-2500008. CHIE00211C.
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