'Clitoromegaly' (or macroclitoris
[1]) is an abnormal enlargement of the
clitoris (not to be confused with the normal enlargement of the clitoris seen during
sexual arousal).
Although clitoromegaly denotes just a clitoris larger than expected (thus involving some uncertainty about what can be defined as ''normal''), it is commonly seen as a
congenital anomaly of the genitalia.
In Atlas of Human Sex Anatomy (1949) by Dr.
Robert Latou Dickinson, the ''normal'' clitoris is defined as having a crosswise width of 3 to 4 mm. (0.12 - 0.16 inches) and a lengthwise width of 4 to 5 mm (0.16 - 0.20 inches). On the other hand, in Obstetrics and Gynecology medical literature, a frequent definition of clitoromegaly is when there is a CI of greater than 35 mm
2 (0.05 inches
2), which is almost twice the size given above for an ''average'' sized clitoral hood
[2].
Presentation
In the most pronounced cases, clitoromegaly is a symptom of
intersexuality since the large clitoris resembles a penis (the different grade of genital ambiguity is commonly measured by the Prader classification
[2] ranging, in ascending order of masculinisation, from '1': ''Female external genitalia with clitoromegaly'' through '5': ''Pseudo-Phallus looking like normal male external genitalia''
[3]).
Causes
Clitoromegaly is otherwise a rare condition and can be either present by birth or acquired later in life.
If present at birth, congenital adrenal hyperplasia can be one of the causes, since in this disease the adrenal gland of the female fetus produces additional androgens and the newborn baby has ambiguous genitalia which are not clearly male or female.
In acquired clitoromegaly the main cause is due to hormonal imbalance affecting the adult women, as in
polycystic ovarian syndrome (PCOS) ,
arrhenoblastoma and
Fraser syndrome).
Clitoromegaly may be acquired through use of
anabolic steroids or
testosterone supplements, both of which can cause enlargement of the clitoris. This occurs in Female to Male Transsexuals (FtM) after a period of hormone replacement therapy. Like FtM transsexuals, female body-builders who use androgens may also experience enlargement of the clitoris and increases in
libido. Women who use testosterone for therapeutic reasons (treating low libido, averting
osteoporosis, as part of an anti-depressant regimen, etc) may also experience some enlargement of the clitoris although the dosages warranted for these conditions is much lower.
Deliberately induced
clitoris enlargement, as form of female genital
body modification, is reported to be achieved through testosterone injections directly in the clitoris shaft.
Notes
1. ''Dorland Medical Dictionary'' [1]
2. Prader Von, A. (1954). "Der genitalbefund beim Pseudohermaproditismus femininus des kongenitalen adrenogenitalen Syndroms. Morphologie, Hausfigkeit, Entwicklung und Vererbung der verschiedenen Genitalformen." Helv. Pediatr. Acta. 9: 231-248.
External links
★ E. Copcu et al.
Idiopathic isolated clitoromegaly: A report of two cases. ''Reproductive Health'' 2004, '1':4 doi:10.1186/1742-4755-1-4