Clitoromegaly
Encyclopedia
Clitoromegaly 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 typical 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 mm2 (0.05 inches2), which is almost twice the size given above for an average sized clitoral hood.
The different grade of genital ambiguity is commonly measured by the Prader
classification ranging, in ascending order of masculinisation, from 1: Female external genitalia with clitoromegaly through 5: Pseudo-Phallus looking like normal male external genitalia.
If present at birth, congenital adrenal hyperplasia
can be one of the causes, since in this condition the adrenal gland of the female fetus produces additional androgens and the newborn baby has ambiguous genitalia which are not clearly male or female. It can also be caused by the autosomal recessive
congenital disorder known as Fraser syndrome
.
In acquired clitoromegaly the main cause is due to endocrine hormonal imbalance affecting the adult women, including polycystic ovarian syndrome (PCOS) and hyperthecosis
. Acquired clitoromegaly may also be caused by pathologies affecting the ovaries and other endocrine glands. These pathologies may include virulent (such as arrhenoblastoma) and neurofibromatosic
tumors. This can also be caused by clitoral cysts. In addition, sometimes there may be no obvious or hormonal reason.
Clitoromegaly may be acquired through use of anabolic steroid
s, including testosterone
. This occurs in female to male transsexuals (FtM) after a period of hormone replacement therapy. Trans men generally consider the genital enlargement to be a desirable and expected part of medical transition. This enlargement may be complemented by surgery including metoidioplasty
or clitoral release.
Like FtM transsexuals, female bodybuilders who use androgens may also experience clearly evident 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 are much lower.
Deliberately induced clitoris enlargement
, as form of female genital body modification
, is reported to be achieved through various uses of testosterone
and more temporarily with devices such as the clitoral pump
. This may require altered masturbation
techniques.
Clitoris
The clitoris is a sexual organ that is present only in female mammals. In humans, the visible button-like portion is located near the anterior junction of the labia minora, above the opening of the urethra and vagina. Unlike the penis, which is homologous to the clitoris, the clitoris does not...
(not to be confused with the normal enlargement of the clitoris seen during sexual arousal
Sexual arousal
Sexual arousal, or sexual excitement, is the arousal of sexual desire, during or in anticipation of sexual activity. Things that precipitate human sexual arousal are called erotic stimuli, or colloquially known as turn-ons. There are many potential stimuli, both physical or mental, which can cause...
).
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
Robert Latou Dickinson
Robert Latou Dickinson was an American obstetrician and gynecologist, surgeon, maternal health educator, artist, sculptor and medical illustrator, and research scientist.-Life:...
, the typical 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 mm2 (0.05 inches2), which is almost twice the size given above for an average sized clitoral hood.
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
Andrea Prader
Andrea Prader was a Swiss scientist and physician, pediatric endocrinologist. He was one of the co-discoverers of the Prader-Willi syndrome.-Biography:...
classification ranging, in ascending order of masculinisation, from 1: Female external genitalia with clitoromegaly through 5: Pseudo-Phallus looking like normal male external genitalia.
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
Congenital adrenal hyperplasia
Congenital adrenal hyperplasia refers to any of several autosomal recessive diseases resulting from mutations of genes for enzymes mediating the biochemical steps of production of cortisol from cholesterol by the adrenal glands ....
can be one of the causes, since in this condition the adrenal gland of the female fetus produces additional androgens and the newborn baby has ambiguous genitalia which are not clearly male or female. It can also be caused by the autosomal recessive
Recessive
In genetics, the term "recessive gene" refers to an allele that causes a phenotype that is only seen in a homozygous genotype and never in a heterozygous genotype. Every person has two copies of every gene on autosomal chromosomes, one from mother and one from father...
congenital disorder known as Fraser syndrome
Fraser syndrome
Fraser syndrome is an autosomal recessive congenital disorder...
.
In acquired clitoromegaly the main cause is due to endocrine hormonal imbalance affecting the adult women, including polycystic ovarian syndrome (PCOS) and hyperthecosis
Hyperthecosis
Hyperthecosis is hyperplasia of the theca interna of the ovary. It is when an area of luteinization occurs along with stromal hyperplasia. The luteinized cells produce androgens, which may lead to hirsutism and virilization .- See also :...
. Acquired clitoromegaly may also be caused by pathologies affecting the ovaries and other endocrine glands. These pathologies may include virulent (such as arrhenoblastoma) and neurofibromatosic
Neurofibromatosis
Neurofibromatosis is a genetically-inherited disorder in which the nerve tissue grows tumors that may be benign or may cause serious damage by compressing nerves and other tissues...
tumors. This can also be caused by clitoral cysts. In addition, sometimes there may be no obvious or hormonal reason.
Clitoromegaly may be acquired through use of anabolic steroid
Anabolic steroid
Anabolic steroids, technically known as anabolic-androgen steroids or colloquially simply as "steroids", are drugs that mimic the effects of testosterone and dihydrotestosterone in the body. They increase protein synthesis within cells, which results in the buildup of cellular tissue ,...
s, including testosterone
Testosterone
Testosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands...
. This occurs in female to male transsexuals (FtM) after a period of hormone replacement therapy. Trans men generally consider the genital enlargement to be a desirable and expected part of medical transition. This enlargement may be complemented by surgery including metoidioplasty
Metoidioplasty
Metoidioplasty, sometimes referred to as a meto or meta or spelled "metaoidioplasty", is an alternative to phalloplasty for trans men...
or clitoral release.
Like FtM transsexuals, female bodybuilders who use androgens may also experience clearly evident enlargement of the clitoris and increases in libido
Libido
Libido refers to a person's sex drive or desire for sexual activity. The desire for sex is an aspect of a person's sexuality, but varies enormously from one person to another, and it also varies depending on circumstances at a particular time. A person who has extremely frequent or a suddenly...
. Women who use testosterone
Testosterone
Testosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands...
for therapeutic reasons (treating low libido, averting osteoporosis
Osteoporosis
Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
, as part of an anti-depressant regimen, etc.) may also experience some enlargement of the clitoris although the dosages warranted for these conditions are much lower.
Deliberately induced clitoris enlargement
Clitoris enlargement
Clitoris enlargement is a form of body modification which has recently gained popularity because of its potential to increase pleasure and enhance the appearance of the genitals...
, as form of female genital body modification
Body modification
Body modification is the deliberate altering of the human body for any non-medical reason, such as aesthetics, sexual enhancement, a rite of passage, religious reasons, to display group membership or affiliation, to create body art, shock value, or self expression...
, is reported to be achieved through various uses of testosterone
Testosterone
Testosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands...
and more temporarily with devices such as the clitoral pump
Clitoral pump
A clitoral pump is a sex toy designed for women's pleasure that is applied to the clitoris and/or labia to create suction and increase blood flow to the genitals...
. This may require altered masturbation
Masturbation
Masturbation refers to sexual stimulation of a person's own genitals, usually to the point of orgasm. The stimulation can be performed manually, by use of objects or tools, or by some combination of these methods. Masturbation is a common form of autoeroticism...
techniques.