What Is Clitoromegaly — Causes, Signs & Treatment

Clitoromegaly is an abnormal enlargement of the clitoris and although it’s caused by congenital or acquired conditions, doesn’t always need treatment.
Orchid Signifying Clitoromegaly
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Clitoromegaly is an abnormal enlargement of the clitoris.

While it can be caused by medical conditions or disorders, hormonal shifts, or medication, there is generally nothing harmful or dangerous about clitoromegaly itself and it is most often congenital (present at birth).

Here’s what you need to know about clitoromegaly (an enlarged clitoris):

  • Temporary clitoral swelling commonly occurs during sexual arousal or after stimulation and is not the same thing as clitoromegaly.
  • Clitoromegaly is not a dangerous medical condition on its own and we can view it the same way we would any other body part — a normal aspect of a person’s features.
  • Clitoromegaly is usually congenital (present since birth) but can also occur later in life due to hormonal changes, steroid use, or health conditions that arise.
  • While clitoromegaly is not usually harmful, some of the conditions that cause it can be, such as congenital adrenal hyperplasia, a genetic disorder that affects the adrenal glands.
  • Some causes of an enlarged or swollen clitoris, such as vulvitis (genital irritation), may require medical treatment.
  • Through surgical or medical means, some people choose to enlarge their clitoris while others decide to make it smaller. Both choices are valid and deserve support.

Clitorises come in all shapes and sizes — just like people — and having an abnormally large clit is not necessarily a sign that something is “wrong” with you.

Read on to learn more about clitoromegaly, how it presents, why it occurs, and how to make informed decisions about the trait if you have it.

Things To Know

What Is An Enlarged Clitoris (Cliteromegaly)?

An enlarged clitoris, also known as clitoromegaly {clit·or·o·meg·a·ly} [klĭt′ə-rō-mĕg′ə-lē] or a macroclitoris, refers to a clitoris that is larger than average.

If you’re wondering exactly what that means, one study found that the average size of a clitoris (including gland and body) is 18.5mm (its width times its length).

Enlargement of the clitoris is typically congenital, meaning that a person has had it since birth, but steroid or hormonal changes can cause it to occur later in life, as we’ll talk about later on.

How To Know If Your Clitoris Is Enlarged

The standard for how to measure clitoromegaly is to consider the length and width of the clitoris itself.

You may have an enlarged clitoris or receive a clitoromegaly diagnosis if the width times the length of your clitoris exceeds 35 millimeters squared.

As we mentioned earlier, the average size of a clitoris is 18.5mm squared.

If your clitoris exceeds 35mm² (width times length) and has been that way for more than one week, it’s a good indication you have an enlarged clitoris.

It’s important to note that clitoral swelling during arousal or after stimulation, however, is common and is not a sign of clitoromegaly.

What Causes Clitoromegaly?

Clitoromegaly doesn’t have a single root cause — far from it — and can result from a variety of things that include:

  • Congenital disorders (present at birth)
  • Chromosomal disorders (present at birth)
  • Medical conditions
  • Hormonal imbalances and hormone replacement therapy
  • Anabolic steroids
  • Vulvitis (genital irritation)
  • Cysts or abscesses
  • Tumors
  • The way your clitoris was “made” (meaning it’s a perfectly normal trait for you as an individual)
  • Clitoral enlargement surgery

The most common cause of congenital clitoromegaly is congenital adrenal hyperplasia (CAH), a disorder of the adrenal glands that can be serious and affects 1 in 10,000 to 16,000 people.

Other causes of congenital enlargement of the clit include a wide array of disorders of sex development (DSDs).

Multiple types of chromosomal DSDs can cause clitoromegaly in childhood and adolescence, including 46, XX and 46, XY.

Clitoromegaly may also occur later in life for a number of reasons, such as hormonal imbalances caused by polycystic ovary syndrome (PCOS), anabolic steroid use, or testosterone replacement therapy (TRT).

A clitoris can also simply appear to be enlarged due to nonhormonal causes, such as cysts, abscesses, and tumors as well as vulvitis, which can cause swelling and inflammation of the clitoris.

This is known as pseudoclitoromegaly.

Finally, some people simply have a large clitoris and it’s a normal, perfectly healthy part of their body that is not cause for concern.

A person may even choose to enlarge their clitoris for cosmetic, preferential, or gender-affirming reasons.

As with anything related to body autonomy, these choices should be left solely to the individual.

An individual should, however, receive personal and professional support to make sure they are aware of potential clit enlargement side effects and help the process go as smoothly and effectively as possible.

How Is Clitoromegaly Treated?

This is a bit of a trick question because in many cases, it’s harmless and there’s no need to treat clitoromegaly.

You can claim and even celebrate the attribute as you would with any of your other body parts.

But if you’re unhappy with the size of your clitoris for any reason or it is caused by a medical condition that does require treatment, there are numerous options available depending on the cause.

Treatment Options

Treatment for clitoromegaly or pseudoclitoromegaly may include:

  • Clitoral surgery, which is often done alongside a vaginoplasty
  • Changing medication (if a person’s clitoris is enlarged due to hormone replacement therapy or steroids, for instance)
  • Cortisone creams and Sitz baths (for temporary swelling due to vulvitis)

A person who is considering medical intervention for an enlarged clitoris can generally make decisions for themselves and consent to any recommended procedures and the risks that come with them.

Our understanding of clitoromegaly is constantly evolving.

While congenital clitoromegaly has historically been treated with early surgery, recent research shows that this can be a devastating approach. One peer-reviewed article states:

“The previous management guidelines of early genital surgery based on expected fertility outcomes and phallic functionality are being challenged due to evolving evidence. A need to move away from physician-directed early gender assignment surgeries is warranted because of poor long-term outcomes.”

When reviewing the literature on surgical intervention, it’s important to remember that much of it hasn’t caught up to our evolving understanding of gender.

A lot of the protocol still discusses gender in binary and other outdated terms, which can be harmful and misleading.

When To See A Doctor

You should contact a medical professional if you’re experiencing unwanted or sudden enlargement of your clitoris or clitoral discomfort due to:

  • Hormone replacement therapy
  • Steroid use (prescribed or otherwise)
  • Involuntary changes to the adrenals
  • Vulvitis or other genital irritation
  • An unknown medical condition

Closing Thoughts

An enlarged clitoris is not inherently a sign that something is “wrong” with an individual, and although it can be caused by a number of conditions (medical and otherwise), it doesn’t necessarily need to be “treated” in every case.

Clitoromegaly is more than just a medical term for an enlarged clitoris.

It’s a spark for a thought-provoking discussion on body autonomy, physical diversity, and our understanding of gender, science, and, at the core of it all, ourselves.