Clitoromegaly - Causes

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 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.

Deliberately induced clitoris enlargement as a form of female genital body modification is achieved through various uses of anabolic steroids, including testosterone, and may also be referred to as clitoromegaly. This occurs in female to male transgender (FtM) individuals 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.

Female bodybuilders and athletes who use androgens, primarily to enhance muscular growth, strength and appearance (see Use of performance-enhancing drugs in sport), 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.) experience some enlargement of the clitoris, although the dosages warranted for these conditions are much lower. Pseudoclitoromegaly or pseudohypertrophy of the clitoris "has been reported in small girls due to masturbation: manipulations of the skin of prepuce leads to repeated mechanical trauma, which expands the prepuce and labia minora, thus imitating true clitoral enlargement". Temporary enlargement may result from use of a clitoral pump.