In medicine, clitoral hypertrophy is understood as an abnormal enlargement of the clitoris . Women suffer from a clitoris, which partly resembles the male penis due to its unusual size. In many cases it is a congenital malformation. However, it can also develop over the course of life for a variety of reasons.
What is clitoral hypertrophy?
The typical sign of a megaloclitoris is the excessive enlargement of the clitoris. This can be so pronounced that the clitoris looks like a small penis. See AbbreviationFinder for abbreviations related to Clitoral Hypertrophy.
Clitoral hypertrophy is also referred to as megaloclitoris or clitoromegaly. The malformation is divided into four classes:
- hormonal clitoral hypertrophy
- non-hormonal clitoral hypertrophy
- a pseudo-clitoromegaly
- idiopathic clitoromegaly
There are many reasons for the development of clitoral hypertrophy. The most common cause of this malformation of the female genitals is a hormonal disorder. This is very common in younger girls. In most cases, there is a defect in the CYP21 enzyme. This enzyme influences the hormonal processes in the body. The result is reduced breakdown of the steroid hormone progesterone.
As a result, both androstenedione and testosterone are overproduced. This increased formation of androgens causes a masculinization of females.
One of the most common reasons is the so-called pseudohermaphroditism, which occurs as a result of an adrenogenital syndrome or adrenal hyperplasia. Development often occurs in early pregnancy. If the female fetus suffers from an enzyme defect, there is a disproportionate abundance of male hormones.
If this disorder occurs before the 14th week of pregnancy, pronounced hermaphroditism can result. Basically, the severity of the later clitoral hypertrophy depends on the point in time, the intensity and the duration of the influence of the androgens.
Enlargement of the clitoris can also be triggered by tumors with androgenic effects. The malignant neoplasms are not only found in the area of the ovaries, such as the hilus cell tumor and the Leydig cell tumor.
Cancers of the adrenal gland, gonadal tumors that produce steroids, and carcinosarcomas in the urinary bladder can also have masculinizing effects. In addition, Cushing’s syndrome, Fraser’s syndrome, gonadal dysgenesis, Turner’s syndrome and neurofibromatosis are among the diseases that can cause clitoromegaly.
Clitoral hypertrophy can also be caused by mechanical stimuli. Constant rubbing of the clitoris can cause inflammation. Enlargement of the prepuce and labia minora may suggest pseudo-clitoral hypertrophy.
Symptoms, Ailments & Signs
The typical sign of a megaloclitoris is the excessive enlargement of the clitoris. This can be so pronounced that the clitoris looks like a small penis. It is possible that other androgenic traits such as excessive male hairiness may occur. In addition to the enlarged clitoris, changes in the external genitalia can also occur.
If patients suffer from a very pronounced masculinization, clitoral hypertrophy can lead to the appearance of testicle-like labia and the closure of the vagina or the urogenital canal. If there are other causes of clitoral enlargement, the symptoms of the underlying disease may also appear.
Diagnosis & course of disease
A gynecologist can use a gynecological examination to determine whether there is an anatomical malformation of the female genitalia. First, an anamnesis is taken. With regard to the clinical picture, special attention is paid to the intake of medication. This rules out whether there is exposure to androgens through doping, for example.
A swab is then used to perform a microscopic examination of the vaginal and cervical secretions. The cell structures provide information about the hormone balance. Further investigations may be necessary. In order to secure the diagnosis of clitoral hypertrophy, a comprehensive hormone test is carried out. A blood sample must be taken for this. The gynecologist can also use an ultrasound scan to determine whether there is a tumor on the ovaries.
MRI or magnetic resonance therapy of the adrenal gland may be needed. Since significant postnatal clitoral enlargement is often due to significant hormonal stimulation, the presence of other androgen-producing tumors must also be ruled out. If there are no malignant neoplasms, those affected must be examined for other diseases with androgenic effects such as Cushing’s or Fraser’s syndrome.
In most cases, there are no particular health problems or complications associated with clitoral hypertrophy. This disease can either be congenital or occur throughout life. If clitoral hypertrophy occurs for no particular reason, those affected usually suffer from another underlying disease.
In most cases, clitoral hypertrophy primarily leads to psychological problems. The patients do not feel comfortable in their bodies and often suffer from inferiority complexes and reduced self-esteem. Depression and other mental upsets can also occur as a result of the disease.
Sexual life is also severely restricted by clitoral hypertrophy, since women are usually ashamed of the symptoms. There is also a lot of body hair, which can be perceived as unpleasant. The quality of life is significantly restricted by clitoral hypertrophy. If the reason for this disease is a tumor, it must be removed.
In some cases, this can also lead to a negative course of the disease if the cancer has already spread to other regions of the body. However, the symptoms can be corrected with surgery. In general, it cannot be predicted whether the patient’s life expectancy will be reduced.
When should you go to the doctor?
In most cases, clitoral hypertrophy does not cause any serious symptoms. A doctor’s visit is recommended if the malformation causes psychological problems or is generally perceived as unpleasant. Parents who notice behavioral changes or other abnormalities in their child should determine the cause. Since the disease is often kept secret by those affected, a visit to the gynecologist can be suggested if there is any suspicion. If physical symptoms occur due to the malformation, medical advice is also required.
Inflammation or pain in the intimate area must be medically clarified and treated. If other symptoms are present, clitoral hypertrophy may represent a serious condition that needs to be diagnosed. Affected girls and women should see a gynecologist. The actual treatment usually takes place in the hospital and the operation is performed by a surgeon. After the procedure, close consultation with the responsible physicians should be maintained. In the case of hormonal causes, an endocrinologist or a hormone and metabolism center should be consulted.
Treatment & Therapy
If a malformation of the clitoris is diagnosed, it must be clarified whether the disease is isolated or should be regarded as part of a symptom complex or a syndrome. The actual cause of clitoromegaly must therefore be explicitly identified. Clitoral hypertrophy can ultimately be corrected by surgery.
The plastic surgical operation techniques can ensure both subsequent sexual stimulation and a later inconspicuous appearance. Since a pathological change in the genitals can be very stressful for the affected girl, psychotherapeutic treatment should be considered later.
If hormone-producing tumors are the cause, they usually have to be surgically removed. In some cases, combinatorial procedures such as chemotherapy and radiation may be necessary. If certain enzyme defects are responsible for the malformation, hormone treatment is indicated. This therapy has an inhibitory effect on the production of androgens in the ovaries and adrenal glands.
Outlook & Forecast
The prognosis of clitoral hypertrophy is linked to the causative disorder. In most cases, the prospect of a cure is good. If there is a malformation of the clitoris, it can be corrected by surgery. It is irrelevant whether the deformity is congenital or developed as a result of an accident. A correction is equally possible in both cases and is carried out successfully in almost all cases.
Like any operation, this one is associated with various risks and side effects. Nevertheless, they are comparatively small and manageable. Some sufferers may have problems with wound healing, leading to a longer healing path. If the procedure runs without further complications, the patient can be discharged from treatment within a short time as recovered. A recurrence of clitoral hypertrophy in the course of life is considered unlikely in these cases.
If the clitoral hypertrophy is based on a tumor disease, the prognosis worsens considerably. Depending on the stage of the cancer, chemotherapy or radiation is used. Ultimately, the tumor must be removed so that the symptoms can be alleviated. If the course of the disease is unfavorable, the patient is threatened with premature death, since the cancer can spread to his body. In addition, cancer therapy is associated with numerous side effects and impairments in quality of life.
The development of clitoral hypertrophy cannot be averted preventively. The congenital malformation can only be diagnosed immediately after birth as part of the initial examination. In order to be able to keep the psychological stress caused by a reduction of the clitoris as low as possible, early recognition, diagnosis and adequate treatment are of the utmost importance. Parents should therefore make sure to attend their children’s routine medical check-ups.
In most cases, direct follow-up care is no longer necessary for clitoral hypertrophy, since the disease does not always have to be treated and is therefore not always treated. Clitoral hypertrophy should only be treated in severe cases or when there is a severe reduction in aesthetics.
In many cases, the disease itself can be treated relatively well with surgery. After such an operation, the affected person should rest and protect their body. Efforts or other physical and stressful activities should be avoided so that the body is not unnecessarily burdened. If the clitoral hypertrophy has occurred due to a tumor, regular examinations by a doctor should be carried out.
This allows other possible tumors to be identified and treated early on, so that the tumors do not spread in the woman’s body. In many cases, intensive psychological treatment is also necessary to prevent depression or other mental disorders. Loving and intensive conversations with one’s own family are particularly suitable for this. As a rule, clitoral hypertrophy does not reduce the patient’s life expectancy.
You can do that yourself
Dealing with clitoral hypertrophy in everyday life depends primarily on the underlying cause and the extent to which it is treated. In most cases, the focus is on treating and dealing with the underlying disease, if one is present.
Irrespective of this, in many cases the affected girls suffer mainly from psychological problems and feelings of shame caused by the genital malformation. It is important to strengthen self-esteem and self-confidence, to take away fears and, if necessary, to accept psychotherapeutic help. There are no means of self-help for clitoral hypertrophy itself, but the quality of life of those affected can be improved in everyday life through the measures mentioned.
Depending on the severity and cause of clitoral hypertrophy, it is also advisable for both those affected and the parents of affected girls to find out about the various treatment and therapy options. In the meantime, there are also self-help groups in some cities, internet forums and various social networks through which those affected or parents of affected girls can exchange information.