Clitoromegaly

Clitoromegaly means your clitoris is larger than typical. It happens when you have swelling in the erectile tissues of this organ. You may be born with an enlarged clitoris or develop it later in life.

It’s normal for your clitoris to increase in size when you’re sexually aroused or during orgasm. But it should return to its usual size shortly after. With clitoromegaly, your clitoris is swollen or enlarged for a week or longer.

This may be uncomfortable — both physically and mentally. Your clitoris may rub against clothing or cause pain during sex and/or exercise. It can negatively affect your body image, too.

Nonsurgical or surgical treatment may help.

What are the most common causes of clitoromegaly?

Clitoromegaly has many possible causes. But most of them are due to hormonal imbalances. If you have too many androgens (sex hormones associated with males), they can make your clitoris grow. These hormonal imbalances cause other symptoms, too, not just an enlarged clitoris.

Healthcare providers generally put the causes into two groups:

• Congenital (primary): You’re born with it.
• Acquired (secondary): You develop it later in life.

It typically isn’t preventable.

Congenital causes

Causes of clitoromegaly that are present at birth include:

• Congenital adrenal hyperplasia (CAH): This genetic condition leads to an excess of androgens. It can cause an enlarged clitoris that resembles a small penis.
• Disorders of sexual development (DSDs): These are conditions where your reproductive organs and genitals are “mismatched” at birth. They can happen due to chromosomal, gonadal or genital differences.
• Beckwith-Wiedemann syndrome: This is a rare genetic disorder that affects your child’s growth, including the size of their clitoris.

Acquired causes

Causes of clitoromegaly that develop later in life can include:

• Polyendocrine metabolic ovarian syndrome (PMOS): Too many androgens from your ovaries
• Androgen-secreting tumors: Too many androgens from ovarian or adrenal gland tumors
• Outside (exogenous) hormone exposure: Anabolic steroid use or coming into contact with testosterone gel
• Vulva irritation (vulvitis): Irritation in your external genitalia due to infection, allergic reactions or injuries
• Cysts or tumors in your vulva: Noncancerous tumors, cysts or hemangiomas on or near your clitoris

How is it treated?

Treatment for clitoromegaly depends on the cause and other factors, like your age and preference. There are nonsurgical and surgical options.

Nonsurgical treatments

If the cause is hormonal, your provider may recommend taking hormone therapy to reduce androgen levels in your body.

If you have vulvitis, cortisone creams or other topical creams containing estrogen may help.

Surgical treatment

A surgeon can reduce how far your clitoris sticks out with a procedure called clitoroplasty.

As with all surgical procedures, it has risks, like infection and bleeding. It could also desensitize your clitoris, leading to a decrease in sexual pleasure.

Getting this surgery is a very personal decision. Your healthcare team will walk you through the pros and cons. Don’t hesitate to ask questions.

What are the possible complications or risks of not treating it?

Most cases of an enlarged clitoris aren’t dangerous. But it may cause uncomfortable symptoms and interfere with your daily life. It may impact you emotionally as well.

If you’re having a hard time coping with this difference, reach out to a mental health professional for help.

When should I see a healthcare provider?

Contact a healthcare provider if you have a swollen clitoris for longer than a few days.

See a provider if your clitoris:

• Seems abnormally large or is growing
• Looks like a small penis when you’re aroused
• Bleeds or itches
• Is painful or has blisters or sores

If you notice your child’s clitoris seems unusually large, talk to their pediatrician.