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What causes an enlarged clitoris?

There is no standard size for a clitoris, but it usually grows with sexual arousal. When a person is not aroused, a hormonal imbalance or another medical condition can cause enlargement of the clitoris.

The clitoris is a female sexual organ. It is located just above the urethra, where urine is released from the body.

The medical community refers to an enlarged clitoris as clitoromegaly or macroclitoris. This refers to a clitoris longer than 10 millimeters (mm) in an adult or 9 mm in a newborn.

A swollen clitoris in an adult is not usually a cause for concern. However, a child or newborn with a large or swollen clitoris should be evaluated by a pediatrician to rule out certain conditions.

In this article, we look at causes of clitoral enlargement at several stages of life. We also explore symptoms and treatments.

Causes in adults

Sexual excitement

Man and woman embraced on beach.
Sexual arousal causes the clitoris to swell.

An adult’s clitoris usually swells because of sexual excitement or arousal. During arousal, more blood flows to the genitals, and the clitoris can fill up and appear larger. A similar process occurs in the penis.

Blood flow quickly returns to normal after orgasm, and the clitoris returns to its usual size. If no orgasm follows arousal, it can take hours or day for the clitoris to shrink. This will not harm a person, but if the clitoris remains swollen and rubs against clothing, it can cause irritation or discomfort.

Inflammation of the vulva

An enlarged or swollen clitoris may be caused by general inflammation of the genitals. This is known as vulvitis, which describes inflammation of the vulva.

Causes of vulvitis include:

  • An allergic reaction to a product such as a laundry detergent, soap, moisturizer, or lubricant
  • An infection, such as a yeast infection or a sexually transmitted infection (STI)
  • Excessive friction during sex or masturbation

The genitals have abundant nerve endings, and overstimulation of this sensitive area can cause pain or swelling. If a person handles the genitals more gently, discomfort should subside within a day or two.

Symptoms of a yeast infection are similar to those of many STIs. See a doctor for a diagnosis and treatment.

If a person suspects that an allergic reaction is causing vulvitis, they should avoid contact with any products that might be responsible. See a doctor if symptoms do not improve within a week.

Hormone disorders

Female hormones (estrogens) and male hormones (androgens) are normally present in the body. Testosterone is one example of an androgen.

An excess of any androgen can cause the clitoris to swell. The following may be responsible for this hormonal imbalance:

Polycystic ovary syndrome (PCOS)

Woman awake at night holding stomach in pain.
Polycystic ovary syndrome may cause irregular periods and fertility problems, as well as an enlarged clitoris.

In this condition, many small cysts form on the ovaries, which cause an excess of androgens in the body. A small study from 2015 found that a larger clitoris was strongly linked to a diagnosis of PCOS.

The following factors may also indicate PCOS:

Hormone medication and lifestyle changes are usually sufficient to manage this condition.

Anabolic steroids

These steroids are used to build muscle and boost athletic endurance.

Anabolic steroid use can also lead to an excess of male hormones. This can result in:

  • an enlarged clitoris
  • extra facial hair
  • a deeper voice
  • acne
  • serious health issues that can affect the heart, liver, and kidneys

Steroids should only be used to treat designated medical conditions under a doctor’s careful supervision.

Adrenal gland tumors or growths

The adrenal glands secrete hormones. If a tumor or another type of growth form on these glands they cannot function properly. In this event, a person may develop a hormonal imbalance and an enlarged clitoris.

A person may also experience other hormone-related symptoms, such as weight gain, menstrual changes, or excessive hair growth.

Treatment for adrenal gland tumors depends on many factors, such as the size of the tumor and whether it is cancerous.


Causes in children

Several conditions can cause an enlarged clitoris in a child. Only a doctor can make a proper evaluation and diagnosis.

An enlarged clitoris in a child is usually caused by one of the following conditions:

Congenital adrenal hyperplasia

This disorder of the adrenal glands leads the body to produce too much androgen, which can result in swelling of the clitoris. It may be difficult to determine whether the genitals are male or female.

Disorders of sex development

Congenital disabilities that affect the sex organs can cause an enlarged clitoris at birth. Many additional types of developmental complication fall under this category.

Other disorders

Growths may cause the clitoris to appear unusual in size or shape. According to a 2013 report, the following factors can cause clitoral enlargement in children:

  • a lympho-angiofibroma, which is an abnormal, noncancerous growth that contains lymphatic other connective tissues
  • an epidermoid cyst, a noncancerous growth filled with fluid
  • a fibroma, a noncancerous tumor

The report stated that surgery was successful in removing the growths from these children.

A report from 2017 described a hemangioma, a noncancerous birthmark containing blood vessels, which had developed on an infant’s clitoris, causing it to appear abnormally large and red. Hemangiomas often disappear after several months or years. Surgery may not be required.


When to see a doctor

Female patient speaking to doctor about enlarged clitoris.
A doctor should be consulted when there is no obvious cause for changes in the appearance of the clitoris.

Changes in the appearance of the clitoris or other genital organs should be checked by a doctor if a person has:

  • clitoral swelling that does not go away within a couple of days
  • pain, redness, or a feeling of heat, which may be a sign of infection
  • unusual vaginal discharge
  • blisters on the genitals
  • itching
  • pain during urination
  • bleeding in the area


Outlook

If swelling of the clitoris goes away in a few days, it usually does not indicate a serious condition.

However, a child who has enlarged or swollen genitals should be evaluated by a pediatrician, to rule out certain conditions.

What causes an enlarged clitoris?

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