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Revision as of 23:30, 14 February 2014 editFlyer22 Frozen (talk | contribs)365,630 edits WP:Dummy edit: For one, that image is of a penis, not a clitoris. Hormones cannot make a clitoris look that much like a penis, that big, and with the addition of a scrotum.← Previous edit Latest revision as of 23:06, 16 November 2024 edit undoIneffablebookkeeper (talk | contribs)Extended confirmed users22,690 editsNo edit summaryTags: Mobile edit Mobile web edit Advanced mobile edit 
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{{Short description|Unusually large clitoris}}
{{Infobox disease |
{{redirect|Pseudo-phallus|penis-like appendages in female non-human animals|Pseudo-penis|the pipefish genus|Pseudophallus}}
Name = Clitoromegaly |
{{Infobox medical condition (new)
Image = Clitoromegaly2.jpg|
Caption = | | name = Clitoromegaly
| image = ]
⚫ DiseasesDB = 30822 |
ICD10 = {{ICD10|Q|52|6|q|50}} | | caption = A person with clitoromegaly
|
⚫ ICD9 = {{ICD9|752.49}} |
ICDO = | | pronounce =
OMIM = | | field =
MedlinePlus = | | synonyms =
| symptoms =
⚫ eMedicineSubj = |
| complications =
⚫ eMedicineTopic = |
MeshID = | | onset =
| duration =
| types =
| causes =
| risks =
| diagnosis =
| differential =
| prevention =
| treatment =
| medication =
| prognosis =
| frequency =
| deaths =
}} }}
'''Clitoromegaly''' (or macroclitoris<ref>{{cite web|title=''Dorland Medical Dictionary'' |url=http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_m_01zPzhtm#12508261}}</ref>) is an abnormal enlargement of the ] that is mostly ] or acquired, though ] as a form of female genital ] is achieved through various uses of anabolic steroids, including ], and may also be referred to as ''clitoromegaly.''<ref name="Copcu"/><ref name="Atilla">{{cite journal |authors=Atilla Şenaylı, Etlik Ankara |title=Controversies on clitoroplasty |journal=Therapeutic Advances in Urology |volume= 3 |issue= 6|pages=273–277|date=December 2011|pmid=22164197 |doi=10.1177/1756287211428165 |pmc=3229251}}</ref><ref name="Perovic">{{cite journal|authors=S.V. Perovic, M.L. Djordjevic|title=Metoidioplasty: a variant of phalloplasty in female transsexuals|journal=]|volume=92|issue=9|pages=981–985|month=December|date=2003, first published online on November 24, 2003|pmid=|doi=10.1111/j.1464-410X.2003.04524.x|url=http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2003.04524.x/abstract}}</ref><ref name="Meyer">{{cite journal|authors=Walter J. Meyer, Alice Webb, Charles A. Stuart, Jordan W. Finkelstein, Barbara Lawrence and Paul A. Walker|title=Physical and hormonal evaluation of transsexual patients: A longitudinal study|journal=]|volume=15|issue=2 |pages=121–138|date=April 1986|pmid=|doi=10.1007/BF01542220|url=http://www.springerlink.com/content/t1012mjxl517884j/}}</ref> Clitoromegaly is not the same as normal enlargement of the clitoris seen during ]. '''Clitoromegaly''' (or '''macroclitoris''')<ref>{{cite web |title=''Dorland Medical Dictionary'' |url=http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_m_01zPzhtm#12508261 |access-date=2006-10-18 |archive-url=https://web.archive.org/web/20061022181659/http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_m_01zPzhtm#12508261 |archive-date=2006-10-22 |url-status=dead }}</ref> is an abnormal enlargement of the ] that is mostly ]; it is otherwise acquired through deliberately induced ] e.g. ] by use of anabolic steroids, including ].<ref name="Copcu"/><ref name="Atilla">{{cite journal |author=Senaylı A |title=Controversies on clitoroplasty |journal=Therapeutic Advances in Urology |volume=3 |issue=6 |pages=273–7 |date=December 2011 |pmid=22164197 |pmc=3229251 |doi=10.1177/1756287211428165}}</ref><ref name="Perovic">{{cite journal |vauthors=Perovic SV, Djordjevic ML |title=Metoidioplasty: a variant of phalloplasty in female transsexuals |journal=BJU International |volume=92 |issue=9 |pages=981–5 |date=December 2003 |pmid=14632860 |doi=10.1111/j.1464-410X.2003.04524.x|s2cid=11836091 }}</ref><ref name="Meyer">{{cite journal |vauthors=Meyer WJ, Webb A, Stuart CA, Finkelstein JW, Lawrence B, Walker PA |title=Physical and hormonal evaluation of transsexual patients: a longitudinal study |journal=Archives of Sexual Behavior |volume=15 |issue=2 |pages=121–38 |date=April 1986 |pmid=3013122 |doi=10.1007/BF01542220|s2cid=42786642 }}</ref> It can happen as part of a ]. It is clinically distinguishable from normal enlargement of the clitoris seen during ].

⚫ ==Anatomy==
⚫ In ''Atlas of Human Sex Anatomy (1949)''<ref>{{cite book |title=Atlas of Human Sex Anatomy |isbn=0-88275-014-3 |publisher=Williams & Wilkins Co |year=1949 |last=Dickinson |first=Robert Latou}}</ref> by ], the ''typical'' clitoris is defined as having a crosswise width of 3 to 4&nbsp;mm. (0.12 - 0.16&nbsp;inches) and a lengthwise width of 4 to 5&nbsp;mm (0.16 - 0.20&nbsp;inches). On the other hand, in Obstetrics and Gynecology medical literature, a frequent definition of clitoromegaly is when there is a CI{{definition|date=December 2011}} of greater than 35&nbsp;mm<sup>2</sup> (0.05&nbsp;inches<sup>2</sup>), which is almost twice the size given above for an ''average'' sized clitoral hood.<ref>{{cite web|title=Female Sexual Anatomy: Clitoral and Labia Size |url=http://www.the-clitoris.com/f_html/c_size.htm}}</ref>


==Presentation== ==Presentation==
⚫ Degree of genital ambiguity is commonly measured by the ],<ref>{{cite journal |author=PRADER A |title=Der genitalbefund beim Pseudohermaproditismus femininus des kongenitalen adrenogenitalen Syndroms. Morphologie, Hausfigkeit, Entwicklung und Vererbung der verschiedenen Genitalformen |trans-title=Genital findings in the female pseudo-hermaphroditism of the congenital adrenogenital syndrome; morphology, frequency, development and heredity of the different genital forms |language=de |journal=Helvetica Paediatrica Acta |volume=9 |issue=3 |pages=231–48 |date=July 1954 |pmid=13201003}}</ref> which ranges, in ascending order of masculinisation, from '''1''': ''female external genitalia with clitoromegaly'' through '''5''': ''pseudo-phallus looking like normal male external genitalia''.<ref>{{cite web|url=http://www.sickkids.ca/childphysiology/cpwp/genital/GenitalCAH.htm |title=Congenital Adrenal Hyperplasia(CAH), Prader Scale |access-date=2008-09-28 |archive-url=https://web.archive.org/web/20080509182258/http://www.sickkids.ca/childphysiology/cpwp/genital/GenitalCAH.htm |archive-date=2008-05-09 |url-status=dead }}</ref>{{Dead link|date=December 2022}}

In the most pronounced cases, clitoromegaly is a symptom of ] since the large clitoris resembles a penis.
⚫ The different grade of genital ambiguity is commonly measured by the ] classification<ref>Prader Von, A. (1954). "Der genitalbefund beim Pseudohermaproditismus femininus des kongenitalen adrenogenitalen Syndroms. Morphologie, Hausfigkeit, Entwicklung und Vererbung der verschiedenen Genitalformen." Helv. Pediatr. Acta. 9: 231-248.</ref> ranging, in ascending order of masculinisation, from '''1''': ''Female external genitalia with clitoromegaly'' through '''5''': ''Pseudo-Phallus looking like normal male external genitalia''.<ref>{{cite web|url=http://www.sickkids.ca/childphysiology/cpwp/genital/GenitalCAH.htm |title=Congenital Adrenal Hyperplasia(CAH), Prader Scale |accessdate=2008-09-28 |archiveurl = http://web.archive.org/web/20080509182258/http://www.sickkids.ca/childphysiology/cpwp/genital/GenitalCAH.htm <!-- Bot retrieved archive --> |archivedate = 2008-05-09}}</ref>


==Causes== ==Causes==
Clitoromegaly is otherwise a rare condition and can be either present by birth or acquired later in life. Clitoromegaly is a rare condition and can be either present by birth or acquired later in life.
If present at birth, ] 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. In pregnant women who received ] during pregnancy, masculinization of the fetus occurs, resulting in hypertrophy of the clitoris;<ref>{{cite journal|last=NA|first=Beischer|coauthors=Cookson T, Sheedy M, Wein P.|title=Norethisterone and gestational diabetes.|journal=Aust N Z J Obstet Gynaecol.|date=Aug 1992|volume=32|issue=3|pages=233–8|pmid=1445134|url=http://www.ncbi.nlm.nih.gov/pubmed/1445134|accessdate=7 December 2012}}</ref> however, this is rarely seen nowadays due to use of safer ]. It can also be caused by the ] ] congenital disorder known as ].<ref>{{cite journal |author=van Haelst MM, Scambler PJ, Hennekam RC |title=Fraser syndrome: A clinical study of 59 cases and evaluation of diagnostic criteria |journal=] |volume= 143a|issue= 24|pages= 3194–203|year=2007 |pmid=18000968 |doi=10.1002/ajmg.a.31951}}</ref> If present at birth, ] 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. In pregnant women who received ] during pregnancy, masculinization of the fetus occurs, resulting in hypertrophy of the clitoris;<ref>{{cite journal |vauthors=Beischer NA, Cookson T, Sheedy M, Wein P |title=Norethisterone and gestational diabetes |journal=The Australian & New Zealand Journal of Obstetrics & Gynaecology |volume=32 |issue=3 |pages=233–8 |date=August 1992 |pmid=1445134|doi=10.1111/j.1479-828X.1992.tb01954.x |s2cid=19741452 }}</ref> however, this is rarely seen nowadays due to use of safer ]. It can also be caused by the ] ] congenital disorder known as ].<ref>{{cite journal |vauthors=van Haelst MM, Scambler PJ, Hennekam RC |title=Fraser syndrome: a clinical study of 59 cases and evaluation of diagnostic criteria |journal=American Journal of Medical Genetics Part A |volume=143A |issue=24 |pages=3194–203 |date=December 2007 |pmid=18000968 |doi=10.1002/ajmg.a.31951|s2cid=25053508 }}</ref>


In acquired clitoromegaly, the main cause is endocrine hormonal imbalance affecting the adult woman, including ]<ref>{{cite web|title=Polycystic Ovarian Syndrome |author=Mukhtar I Khan, MD |accessdate=2008-09-28 |url=http://www.emedicine.com/med/topic2173.htm}}</ref> and ]. Acquired clitoromegaly may also be caused by pathologies affecting the ovaries and other endocrine glands. These pathologies may include virulent (such as ]) and ] tumors.<ref name="Horejsí">{{cite journal |author=Horejsí J.|title=Acquired clitoral enlargement. Diagnosis and treatment. |journal=Ann N Y Acad Sci. |volume=816 |pages=369–372 |year=1997 |doi=10.1111/j.1749-6632.1997.tb52163.x |pmid=9238289}}</ref> Another cause is clitoral cysts.<ref>{{cite journal |author=Linck D, Hayes MF. |journal=Obstet Gynecol. |year=2002 |volume=99 |pages=963–966 |pmid=11975977 |doi=10.1016/S0029-7844(02)01967-1 |title=Clitoral cyst as a cause of ambiguous genitalia |issue=5 Pt 2}}</ref> Sometimes there may be no obvious clinical or hormonal reason.<ref name="Copcu">{{cite journal |author=Copcu E, Aktas A, Sivrioglu N, Copcu O, Oztan Y |title=Idiopathic isolated clitoromegaly: A report of two cases |journal=Reprod Health |volume=1 |issue=1 |pages=4 |year=2004 |pmid=15461813 |pmc=523860 |doi=10.1186/1742-4755-1-4 |url=http://www.reproductive-health-journal.com/content/1/1/4}}</ref> In acquired clitoromegaly, the main cause is endocrine hormonal imbalance affecting the adult person, including ]<ref>{{cite web|title=Polycystic Ovarian Syndrome |author=Mukhtar I Khan, MD |access-date=2008-09-28 |url=http://www.emedicine.com/med/topic2173.htm}}</ref> and ]. Acquired clitoromegaly may also be caused by pathologies affecting the ovaries and other ]s. These pathologies may include virulent (such as ]) and ] tumors.<ref name="Horejsí">{{cite journal |author=Horejsí J |title=Acquired clitoral enlargement. Diagnosis and treatment |journal=Annals of the New York Academy of Sciences |volume=816 |issue= 1|pages=369–72 |date=June 1997 |pmid=9238289 |doi=10.1111/j.1749-6632.1997.tb52163.x|bibcode=1997NYASA.816..369H |s2cid=85705035 }}</ref> Another cause is clitoral cysts.<ref>{{cite journal |vauthors=Linck D, Hayes MF |title=Clitoral cyst as a cause of ambiguous genitalia |journal=Obstetrics and Gynecology |volume=99 |issue=5 Pt 2 |pages=963–6 |date=May 2002 |pmid=11975977 |doi=10.1016/S0029-7844(02)01967-1|s2cid=43432622 }}</ref> Sometimes there may be no obvious clinical or hormonal reason.<ref name="Copcu">{{cite journal |vauthors=Copcu E, Aktas A, Sivrioglu N, Copcu O, Oztan Y |title=Idiopathic isolated clitoromegaly: A report of two cases |journal=Reproductive Health |volume=1 |issue=1 |pages=4 |year=2004 |pmid=15461813 |pmc=523860 |doi=10.1186/1742-4755-1-4 |doi-access=free }}</ref>


] and athletes who use ]s, primarily to enhance muscular growth, strength and appearance (see ]), may also experience clearly evident enlargement of the clitoris and increases in ].<ref name="Freberg">{{cite book |first=Laura A.|last=Freberg|title = Discovering Biological Psychology | publisher =] |year = 2009|page=300|accessdate = November 7, 2012| isbn =978-0-547-17779-3 |url = http://books.google.com/books?id=-zyTMXAjzQsC&pg=PA300&dq=Anabolic+steroids+by+bodybuilders+and+other+athletes,+clitoris&hl=en&sa=X&ei=aP-aUP2zFYL8qAH5noHADA&ved=0CDwQ6AEwBTgK#v=onepage&q=Anabolic%20steroids%20by%20bodybuilders%20and%20other%20athletes%2C%20clitoris&f=false}}</ref><ref name="DEA"> ] and athletes who use ], primarily to ], may also experience clearly evident enlargement of the clitoris and increases in ].<ref name="Freberg">{{cite book |first=Laura A. |last=Freberg |title=Discovering Biological Psychology |publisher=] |year=2009 |page=300 |access-date=November 7, 2012 |isbn =978-0-547-17779-3 |url=https://books.google.com/books?id=-zyTMXAjzQsC&pg=PA300}}</ref><ref name="DEA">{{cite web |title=A Dangerous and Illegal Way to Seek Athletic Dominance and Better Appearance. A Guide for Understanding the Dangers of Anabolic Steroids |publisher=] |year=2004 |access-date=November 7, 2012 |url=http://www.deadiversion.usdoj.gov/pubs/brochures/steroids/public/index.html |archive-date=April 9, 2004 |archive-url=https://web.archive.org/web/20040409111211/http://www.deadiversion.usdoj.gov/pubs/brochures/steroids/public/index.html |url-status=dead }}</ref> Women who use testosterone for therapeutic reasons (treating low libido, averting ], as part of an anti-depressant regimen, etc.) may experience some enlargement of the clitoris, although the dosages warranted for these conditions are much lower.
]
{{cite web|title=A Dangerous and Illegal Way to Seek Athletic Dominance and Better Appearance. A Guide for Understanding the Dangers of Anabolic Steroids

|publisher=]|year=2004 |accessdate=November 7, 2012|url=http://www.deadiversion.usdoj.gov/pubs/brochures/steroids/public/index.html}}</ref> Women who use testosterone for therapeutic reasons (treating low libido, averting ], 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".<ref name="Copcu"/>
⚫ ==Anatomy==
⚫ In ''Atlas of Human Sex Anatomy'' (1949) by ], the ''typical'' clitoris is defined as having a crosswise measurement of 3 to 4&nbsp;mm (0.12 - 0.16&nbsp;inches) and a lengthwise measurement of 4 to 5&nbsp;mm (0.16 - 0.20&nbsp;inches).<ref>{{cite book |title=Atlas of Human Sex Anatomy |isbn=0-88275-014-3 |publisher=Williams & Wilkins Co. |year=1949 |last=Dickinson |first=Robert Latou|page={{page needed|date=April 2014}} }}</ref> On the other hand, in obstetrics and gynecology medical literature, a frequent definition of clitoromegaly is when there is a clitoral index (product of lengthwise and crosswise measurements) of greater than 35&nbsp;mm<sup>2</sup> (0.05&nbsp;inches<sup>2</sup>), which is almost twice the size given above for an ''average'' sized clitoris.<ref>{{cite web|title=Female Sexual Anatomy: Clitoral and Labia Size |url=http://www.the-clitoris.com/f_html/c_size.htm}}</ref>
==Human rights concerns==
Early surgical reduction of clitoromegaly via full or partial ] is controversial, and ] people exposed to such treatment have spoken of their loss of physical sensation, and loss of autonomy.<ref>{{Cite web| last = Holmes| first = Morgan| author-link = Morgan Holmes | title = Is Growing up in Silence Better Than Growing up Different?| work = ]| url = http://www.isna.org/node/743 | access-date = 2016-08-26}}</ref><ref>{{Cite news| last = Bastien-Charlebois| first = Janik| author-link = Janik Bastien-Charlebois | title = My coming out: The lingering intersex taboo| work = ]| date = August 9, 2015| url = https://montrealgazette.com/life/my-coming-out-the-lingering-intersex-taboo | access-date = 2016-08-26}}</ref> In recent years, human rights institutions have criticized early surgical management of such characteristics.<ref>{{Cite web| last = Méndez| first = Juan| title = Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez, A.HRC.22.53| date = February 2013| url = http://www.ohchr.org/Documents/HRBodies/HRCouncil/Regularsession/Session22/A.HRC.22.53_English.pdf}}</ref><ref>{{Citation| last1 = Council of Europe| last2 = Commissioner for Human Rights| title = Human rights and intersex people, Issue Paper| date = April 2015 | url = https://wcd.coe.int/ViewDoc.jsp?Ref=CommDH/IssuePaper(2015)1&Language=lanEnglish&Ver=original| author1-link = Council of Europe}}</ref><ref>{{Cite book| publisher = ] of National Human Rights Institutions| isbn = 978-0-9942513-7-4| last = Asia Pacific Forum of National Human Rights Institutions| title = Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics| date = June 2016| url = http://www.asiapacificforum.net/resources/manual-sogi-and-sex-charactersitics/| access-date = 2016-08-27| archive-date = 2017-01-15| archive-url = https://web.archive.org/web/20170115144950/http://www.asiapacificforum.net/resources/manual-sogi-and-sex-charactersitics/| url-status = dead}}</ref>

In 2013, it was disclosed in a medical journal that four unnamed elite female athletes from developing countries were required to receive gonadectomies and partial clitoridectomies if they wanted to continue competing after ] revealed that they had an intersex condition.<ref name="jcem2013">{{Cite journal| doi = 10.1210/jc.2012-3893| pmid = 23633205 | issn = 0021-972X | volume = 98| issue = 6| pages = –1055–E1059| last1 = Fénichel| first1 = Patrick| last2 = Paris| first2 = Françoise| last3 = Philibert| first3 = Pascal| last4 = Hiéronimus| first4 = Sylvie| last5 = Gaspari| first5 = Laura| last6 = Kurzenne| first6 = Jean-Yves| last7 = Chevallier| first7 = Patrick| last8 = Bermon| first8 = Stéphane| last9 = Chevalier| first9 = Nicolas| last10 = Sultan| first10 = Charles| title = Molecular Diagnosis of 5α-Reductase Deficiency in 4 Elite Young Female Athletes Through Hormonal Screening for Hyperandrogenism| journal = The Journal of Clinical Endocrinology & Metabolism| date = June 2013|display-authors=3| doi-access = free}}</ref><ref name="bmj2014">{{Cite journal| doi = 10.1136/bmj.g2926| issn = 1756-1833| volume = 348| issue = apr28 9| pages = –2926–g2926| last1 = Jordan-Young| first1 = R. M.| last2 = Sonksen| first2 = P. H.| last3 = Karkazis| first3 = K.| s2cid = 2198650| author-link1= Rebecca Jordan-Young | author-link3= Katrina Karkazis |title = Sex, health, and athletes| journal = BMJ| date = April 2014 | pmid=24776640}}</ref> In April 2016, the ] on health, Dainius Pūras, condemned this treatment as a form of ] "in the absence of symptoms or health issues warranting those procedures."<ref name="un2016">{{Citation| last2 = Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health| title = Sport and healthy lifestyles and the right to health. Report A/HRC/32/33| last1 = Pūras | first1 = Dainius | publisher = ] | date = April 4, 2016 | url = http://ap.ohchr.org/documents/dpage_e.aspx?si=A/HRC/32/33}}</ref>

==See also==
* ]
* ], an enlarged clitoris or other penis-like structure that is normally present in some mammal, bird, and insect species


== References == == References ==
{{Reflist}} {{Reflist}}
== External links ==

{{Medical resources
⚫ | DiseasesDB = 30822
| ICD10 = {{ICD10|N90.8}}
⚫ | ICD9 = {{ICD9|752.49}}
| ICDO =
| OMIM =
| MedlinePlus =
⚫ | eMedicineSubj =
⚫ | eMedicineTopic =
| MeshID =
}}
{{Congenital malformations of genital organs and urinary system}} {{Congenital malformations of genital organs and urinary system}}


] ]
] ]
]

Latest revision as of 23:06, 16 November 2024

Unusually large clitoris "Pseudo-phallus" redirects here. For penis-like appendages in female non-human animals, see Pseudo-penis. For the pipefish genus, see Pseudophallus. Medical condition
Clitoromegaly
A person with clitoromegaly
SpecialtyGynaecology Edit this on Wikidata

Clitoromegaly (or macroclitoris) is an abnormal enlargement of the clitoris that is mostly congenital; it is otherwise acquired through deliberately induced clitoral enlargement e.g. body modification by use of anabolic steroids, including testosterone. It can happen as part of a gender transition. It is clinically distinguishable from normal enlargement of the clitoris seen during sexual arousal.

Presentation

Degree of genital ambiguity is commonly measured by the Prader classification, which ranges, 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 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. In pregnant women who received norethisterone during pregnancy, masculinization of the fetus occurs, resulting in hypertrophy of the clitoris; however, this is rarely seen nowadays due to use of safer progestogens. It can also be caused by the autosomal recessive congenital disorder known as Fraser syndrome.

In acquired clitoromegaly, the main cause is endocrine hormonal imbalance affecting the adult person, 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. Another cause is clitoral cysts. Sometimes there may be no obvious clinical or hormonal reason.

Female bodybuilders and athletes who use androgens, primarily to enhance muscular growth, strength and appearance, 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 experience some enlargement of the clitoris, although the dosages warranted for these conditions are much lower.

Woman with clitoromegaly

Anatomy

In Atlas of Human Sex Anatomy (1949) by Robert Latou Dickinson, the typical clitoris is defined as having a crosswise measurement of 3 to 4 mm (0.12 - 0.16 inches) and a lengthwise measurement 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 clitoral index (product of lengthwise and crosswise measurements) of greater than 35 mm (0.05 inches), which is almost twice the size given above for an average sized clitoris.

Human rights concerns

Early surgical reduction of clitoromegaly via full or partial clitoridectomy is controversial, and intersex people exposed to such treatment have spoken of their loss of physical sensation, and loss of autonomy. In recent years, human rights institutions have criticized early surgical management of such characteristics.

In 2013, it was disclosed in a medical journal that four unnamed elite female athletes from developing countries were required to receive gonadectomies and partial clitoridectomies if they wanted to continue competing after testosterone testing revealed that they had an intersex condition. In April 2016, the United Nations Special Rapporteur on health, Dainius Pūras, condemned this treatment as a form of female genital mutilation "in the absence of symptoms or health issues warranting those procedures."

See also

  • Micropenis
  • Pseudo-penis, an enlarged clitoris or other penis-like structure that is normally present in some mammal, bird, and insect species

References

  1. "Dorland Medical Dictionary". Archived from the original on 2006-10-22. Retrieved 2006-10-18.
  2. ^ Copcu E, Aktas A, Sivrioglu N, Copcu O, Oztan Y (2004). "Idiopathic isolated clitoromegaly: A report of two cases". Reproductive Health. 1 (1): 4. doi:10.1186/1742-4755-1-4. PMC 523860. PMID 15461813.
  3. Senaylı A (December 2011). "Controversies on clitoroplasty". Therapeutic Advances in Urology. 3 (6): 273–7. doi:10.1177/1756287211428165. PMC 3229251. PMID 22164197.
  4. Perovic SV, Djordjevic ML (December 2003). "Metoidioplasty: a variant of phalloplasty in female transsexuals". BJU International. 92 (9): 981–5. doi:10.1111/j.1464-410X.2003.04524.x. PMID 14632860. S2CID 11836091.
  5. Meyer WJ, Webb A, Stuart CA, Finkelstein JW, Lawrence B, Walker PA (April 1986). "Physical and hormonal evaluation of transsexual patients: a longitudinal study". Archives of Sexual Behavior. 15 (2): 121–38. doi:10.1007/BF01542220. PMID 3013122. S2CID 42786642.
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External links

ClassificationD
Female and male congenital anomalies of the genitalia, including intersex and DSD
Internal
Uterine malformation
Vagina
Gonads
Testicle
Ovary
Other
Vas deferens
Other
External
Penis
Other
Categories: