Enlarged clitoris, is it clitoromegaly and what causes clitoromegaly?

Question

Hi, I am very distressed and would like some advice please. At rest my clitoris appears normal but when aroused it seems to grow visibly in size quite large and it is causing me a lot of anxiety and severe distress to the point where I’m scared of intimacy. I have seen my gynaecologist in the uk and she said my clitoris is normal and within normal range and has advised me to take Dianette cyproterone acetate ethinylestradiol as my endocrinologist has tested me for everything and diagnosed pcos.

Gary J. Alter, MD · Answer

It sounds like you do have clitoral enlargement. A clitoral hood reduction will not resolve your issue, but will make you worse if a clitoris reduction is not also done. A clitoropexy will not work, because your enlarged clitoris will pull out the sutures. Have you ever taken male hormones or had a hormone issue. You may want to see an endocrinologist to evaluate your hormone levels, but they are usually normal.

Very few surgeons perform a clitoris reduction, since it is technically challenging and is rarely taught. It is an intricate procedure, since the sensory nerves have to be carefully preserved.  I have done over 60 reductions without any loss of sensation or orgasmic ability. The clitoral reduction reduces the glans or head and also removes the erectile tissue in the shaft. After surgery, the clitoris will not stick out much or increase with arousal. The surgery is not very uncomfortable.  It takes up to 3 1/2 hours and includes clitoral hood reduction.  A labia minora reduction and/or labia majora reduction or enlargement can be done at the same time. As the inventor of the central wedge labiaplasty, I recommend this technique as it gives a very natural appearance.

Gary J. Alter, M.D.

Beverly Hills, CA - Manhattan, NY

Marco A. Pelosi III, MD, FACOG, FACS · Answer

Clitoromegaly means that the clitoris is enlarged all the time. A normal clitoris is only enlarged when it is aroused and that is what you are describing so there is no reason to be distressed. It's not broken and it doesn't need fixing or medications.

Ozgur Kartal, MD · Answer

If your doctors have examined you and said that there is no abnormality, you can trust them. The male homologue of the clitoris is the penis. Just as the penis gets erect when stimulated, the clitoris gets an erection. slightly increase in size.

Omar Quaba, MA, FRCS (Plast) · Answer

Hi and thanks for the question.
PCOS can cause clitoral enlargement as can other hormonal imbalances (but your endocrinologist has tested for these). It is also reassuring that your gynaecologist feels your clitoris is within the normal range.
Clitoral hood reduction will reduce the skin (hood) around the clitoris but it WILL NOT reduce the clitoris itself. I would follow the advice of your gynaecologist as they are best placed to advise on this issue and not plastic/ cosmetic surgeons.

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