Clitoral hypertrophy, known as clitoromegaly, is a disorder that involves an excessive enlargement of this structure beyond the limits of physiology. The vast majority of clinical situations in which this disorder is diagnosed is diagnosed immediately after delivery, rarely at a later stage of development. What are the causes, symptoms, and treatments for an enlarged clitoris?
Excessive clitoral growthcan be hormonal or non-hormonal, it can be congenital or acquired. But let's start at the beginning: what is the clitoris and what is its hypertrophy? The clitoris is one of the elements of the genital organs found in women, the morphology corresponds to the male penis. It consists of even corpus cavernosum, forming the shaft, while the top of the structure is the so-called acorn. The clitoris is covered with an epithelium richly innervated and vascular.
It is very difficult to determine the correct size of the organ, on the basis of data based on statistical research it has been established that the size of the non-erect organ should not exceed 0.5 cm. Thus, any clitoris that grows larger than when sexually aroused is considered oversized. It causes a feeling of psychological discomfort for women and may cause pain during intercourse.
Causes of an enlarged clitoris
Excessive clitoral growth is by far the most common congenital and occurs during embryogenesis. An example of a clinical situation that leads to excessive organ growth is congenital adrenal hyperplasia. On the other hand, in the etiology of the disease, acquired factors are not excluded, for example in the course of neoplastic conditions of the ovary or abscess-like inflammatory changes. The importance of the endocrine system is admitted. In many cases, determining the cause of the hypertrophy is difficult and most likely multifactorial, which is referred to as idiopathic. To sum up, the causes of clitoral hypertrophy are:
- hormonal disorders, i.e. congenital adrenal hyperplasia, polycystic ovary syndrome, tumors of the gonads, adrenal glands or bladder
- non-hormonal causes - abscess, hypertrophy in premature babies, cavernous hemangioma
- alleged clitoral enlargement
- idiopathic
Clitoral hyperplasia diagnosis
Due to the coexistence of clitoral hypertrophy with some neoplastic diseases, the diagnosis and etiology is very important and the diagnostic process should not be delayed. This allows for quick implementation of therapeutic procedures. Sometimes the symptom of clitoral hypertrophy is not isolated and occurs in the coincidence of hirsutism, that is, excessive hair in places unusual for a woman, but also other signs of virilization. The latter include a changed voice timbre, androgenetic alopecia, i.e. male pattern baldness, and a change in body shape from female to more male.
In the latter case, it is a clear confirmation of the hormonal etiology of the disorder and most likely it results from the excessive concentration of androgens in the body. This is known as hyperandrogenization. Then the best confirmation of the diagnosis is the determination of the concentration of androgens, incl. serum testosterone. In order to determine the origin of the increased concentration of androgens, a test with dexamethasone is performed.
Clitoral hyperplasia may be the first sign of a developing neoplastic process. The best diagnostic method is then imaging tests, i.e. computed tomography of the abdominal cavity and pelvis, ultrasound is not very effective in this case. Diagnostics is carried out very often right after birth. In each female fetus with clearly marked virilization features, it is advisable not only to determine the hormonal balance in the blood serum, but also the urinary hormone metabolites. There are also tests in the field of diagnostic imaging, such as ultrasound, genitoscopy, and genitography. Sometimes genetic diagnosis is indicated.
Clitoral hyperplasia treatment
Therapeutic management of clitoral hyperplasia depends on the etiology of the disorder, therefore, in most cases, it is referred to as causal treatment. If the etiology results from hormonal disorders, substitution of the missing substances is recommended, which should reverse the negative effects of androgens. Clitoral hyperplasia neoplasms require surgical intervention.
The best known method of reducing the size of the clitoris is partial surgical resection. The satisfactory cosmetic effect of the treatment has a positive effect on the mental state of women suffering from this disorder. Unfortunately, such a procedure may disturb the blood supply and vascularization of the organ, which translates into the quality of sexual intercourse after the procedure.