Clitoromegaly
| Clitoromegaly | |
|---|---|
 |
|
| A woman with clitoromegaly | |
| Classification and external resources | |
| Specialty | medical genetics |
| ICD-10 | N90.8 |
| ICD-9-CM | 752.49 |
| DiseasesDB | 30822 |
Clitoromegaly (or macroclitoris) is an abnormal enlargement of the clitoris that is mostly congenital or acquired, though deliberately induced clitoris enlargement as a form of female genital body modification is achieved through various uses of anabolic steroids, including testosterone, and may also be referred to as clitoromegaly. Clitoromegaly is not the same as normal enlargement of the clitoris seen during sexual arousal.
In Atlas of Human Sex Anatomy (1949) by Robert Latou Dickinson, the typical clitoris is defined as having a crosswise width of 3 to 4 mm (0.12 - 0.16 inches) and a lengthwise width 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 widths) of greater than 35 mm2 (0.05 inches2), which is almost twice the size given above for an average sized clitoral hood.
The different grade 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.
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.
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