Enlarged Clitoris

What does an enlarged clitoris mean?

An enlarged clitoris describes a clitoris that’s larger than it should be. The medical term for an enlarged clitoris is clitoromegaly or macroclitoris. It happens when women and people assigned female at birth (AFAB) have swelling in the erectile tissues of their clitoris. It’s normal for your clitoris to increase in size when you’re sexually aroused or during orgasm. However, it should return to its usual size shortly after. With clitoromegaly, your clitoris is swollen or enlarged for an extended period of time — a week or longer. An enlarged clitoris can be congenital (you’re born with it) or develop later in life.

What is a clitoris?

Your clitoris (clit) is the pleasure center of your reproductive system. It consists of tissue and nerves both inside and outside of your body. Stimulating your clitoris can make you feel sexually aroused. The part of your clitoris you can see and touch is just above your urethral opening (the hole you pee out of). This tiny nub of flesh is called your glans. The glans is filled with nerve endings that make it especially sensitive to touch. It measures about 3/4 inch to 1 inch in diameter. If you have an enlarged clitoris, your clitoris may be much larger than this.

What are the most common causes of an enlarged clitoris?

Clitoromegaly describes a clitoris that’s enlarged for a week or longer. The most common reason your clitoris is enlarged is sexual stimulation. When you’re aroused during sexual intercourse or foreplay, blood rushes to your genital area. This causes the tissue around your clitoris to become erect — similar to an erection in a penis. After sexual stimulation ends, your clitoris goes back to its normal size. This is a common and normal process.

However, sometimes your clitoris is enlarged for reasons not related to sexual arousal.

Common causes of an enlarged clitoris in children

An enlarged clitoris can happen in people designated female at birth from exposure to too many androgens during fetal development. Androgens are sex hormones associated with being designated male at birth. If you’re designated female at birth, having too many androgens in your body may lead to congenital adrenal hyperplasia (CAH). With CAH, your clitoris may resemble a small penis.

Congenital conditions (disorders present at birth) that affect how your sexual organs develop can also cause a child to be born with an enlarged clitoris.

Hormonal imbalances and an enlarged clitoris

Conditions that cause a hormonal imbalance can also lead to an enlarged clitoris. These include:

• Polycystic ovary syndrome (PCOS).
• Using anabolic steroids.
• Having a tumor on your adrenal gland.
• Using testosterone replacement therapy (TRT) for low libido or to increase your energy levels.

Other causes of an enlarged clitoris

Sometimes a cyst or noncancerous tumor can cause an enlarged clitoris. Additionally, any irritation to your external genitals (vulva) can cause your clitoris to swell. Vulvitis describes a swollen or inflamed vulva. Anyone with vulvitis can also develop an enlarged clitoris.

Why is my clitoral hood so big?

Some people are born with larger clitoral hoods, while others are born with smaller clitoral hoods. Your clitoral hood is a fold of skin that protects your clitoris. Without it, your clitoris would be even more sensitive to friction and rubbing, such as from your underwear.

Healthcare providers can perform clitoral hood reductions to make your clitoral hood smaller. If you’re concerned about the size of your clitoral hood, it’s best to discuss it with your healthcare provider.

Can PCOS cause clitoromegaly?

Yes. Because PCOS is a disorder that affects your hormones, it can lead to an enlarged clitoris. PCOS can cause excess androgen production in your body. Excess androgens are one of the causes of clitoromegaly.

Can you have an enlarged clitoris from too much testosterone?

Yes. Testosterone is a type of androgen. If you’re designated female at birth, having too much testosterone in your body can cause your clitoris to swell.

How is clitoromegaly treated?

It depends on the cause and other factors such as your age and preference. There are surgical and nonsurgical options for treating clitoromegaly.

Surgical treatment

A surgeon can reduce how far your clitoris protrudes with a procedure called clitoropexy (or clitoroplasty). As with all surgical procedures, there are risks to this procedure, such as infection and bleeding. It could also desensitize your clitoris, leading to a decrease in sexual pleasure.

Nonsurgical treatments

Your healthcare provider may also prescribe medications or recommend over-the-counter (OTC) creams for an enlarged clitoris. In the case of vulvitis or a swollen clitoris due to inflammation, cortisone creams or other topical creams containing estrogen may help your symptoms.

If the cause of your enlarged clitoris is your hormones or adrenal glands, your provider may recommend taking hormone therapy to reduce androgen levels in your body. This is usually the first line of treatment for children with clitoromegaly or if a person has PCOS.

How can an enlarged clitoris be prevented?

Clitoromegaly is typically unpreventable. Fortunately, an enlarged clitoris isn’t a risk factor for serious medical conditions or disorders.

How do I know if I have clitoromegaly?

The good news is that most cases of an enlarged clitoris aren’t dangerous. However, the swelling may cause uncomfortable symptoms and interfere with your daily life. Contact a healthcare provider if you have a swollen clitoris for longer than a few days.

You should also contact a provider if you notice changes in your clitoris or if you have a clitoris that:

• Seems abnormally large or is growing in size.
• Resembles a small penis when you’re aroused.
• Bleeds or itches.
• Causes pain or develops blisters or sores.

If you notice your child’s clitoris seems unusually large, talk to their pediatrician. They will evaluate and diagnose clitoromegaly.

A note from Cleveland Clinic

It’s normal for your clitoris to swell during sexual arousal. If your clitoris remains swollen or you’re born with an enlarged clitoris, you may have clitoromegaly. It’s typically not a cause for concern. However, it can cause discomfort and irritation. Contact a healthcare provider if you’re worried about the size of your clitoris or if you’re experiencing discomfort from it. A healthcare provider can treat an enlarged clitoris with surgery or medication.