Clitoral enlargement refers to an excessive development of the clitoris. It can be the symptom of a genetic disease or a pathology in the adrenal glands.
The clitoris, its size, its development remains a delicate subject within our society, and refers to a norm that would not be truly individualized. As part of a medical consultation, the subject of the size of the clitoris is therefore not easy to address for parents and children alike and remains a sensitive subject for doctors. Clitoral enlargement can be the symptom of a genetic disease or pathology in the adrenal glands… It remains rare and requires appropriate management at the time of diagnosis and according to the age of the patient.
Definition: what is clitoral hypertrophy?
Clitoral enlargement is the medical term for excessive development of the clitoris. “There are articles in the scientific literature, in which standards for the size of the clitoris have been established. When a doctor talks about clitoral enlargement it means that the appearance, volume or growth of a little girl’s clitoris appeals to her“explains one of the members of the children’s endocrinology and diabetes department at Bicêtre Hospital. The clinical examination of the clitoris must be delicate and carried out with the authorization of the child or his parents if he is not old enough to consent. Clitoral enlargement should be differentiated from clitoral hood enlargementa more frequent and commonplace situation.
What are the symptoms of clitoral enlargement?
In the majority of cases, there are no symptoms related to clitoral enlargement. In very rare situations, the growth of the clitoris at puberty, exceptionally, may be associated with rare variations in genital development. “The adolescent can consult at this time, perhaps expressing pain or discomfort“.
What are the causes of clitoral enlargement?
The causes of an enlarged clitoris are multiple and depend on the age at which the diagnosis is made.
Clitoral enlargement may be the mode of revelation of an adrenal tumour. The evolution of symptoms is generally rapid. Medical care is urgent. Maternity and later in childhood, the pediatrician who observes a child with an enlarged clitoris will look for signs of ae congenital adrenal hyperplasia, disease systematically detected a few days after birth on the blotter in maternity wards in France. “There are mild forms of this genetic disease that can escape screening“. More rarely, a large clitoris in a child can lead to the diagnosis of variation in genital development in a female or male child whose antenatal development was not normal.
Faced with clitoral hypertrophy, hormone assays remain decisive. If they are abnormal, examinations ofimaging or genetic testing will be prescribed according to the diagnostic orientation.
Depending on the diagnosis, the management is different: when faced with an adrenal tumor, a surgery will be programmed; in congenital adrenal hyperplasia, the treatment is medical and will be offered to avoid other more severe symptoms. “Clitoral enlargement should never be operated on : we wait for the child to grow up to discuss it with him…“.
Thank you to the children’s endocrinology and diabetes department at Bicêtre Hospital, Kremlin-Bicêtre.