What is “unusually large” for a baby’s clitoris?

The clitoris is typically about 6 mm long in a newborn girl. A clitoris longer than 9 mm is considered unusual in the medical literature (Oberfeld et al, Clitoral size in full term infants. Am J Perinatol 6:453, 1989; Riley and Rosenblaum, Clitoral size in infancy. J. Pediatr 96:918, 1980). Like small penis, any attempt to define limits for usual or unusual clitoris size are subjective and depend on how the size is measured. The medical term for unusually large clitoris is clitoromegaly.

 

 What causes unusually large clitoris?

Any situation in which the fetus is exposed to unusually high levels of androgens such as testosterone can enlarge the clitoris as it develops from the genital tubercle (see Development of the external genitals). This could result from a genetic disorder of the fetus, such as congenital adrenal hyperplasia, or the female fetus may be exposed to androgens from the mother, either ingested (for example in body-building supplements) or as a result of endocrine imbalance.

  • See also (links not yet active):

> 45,X/46,XY mosaicism

> Environmental influences

> Drugs and environmental modulators of androgen action

 

 How common is it?

We have been unable to find this information. 

 

 Is it a cause for concern?

The size of the clitoris at birth is not a reliable guide to how large it will be in adulthood, and a large clitoris is not, in itself, cause for concern. However, a very large clitoris, as defined above, may compromise sexual function or fertility. A pediatrician can advise on the relative severity of the condition, and whether it may be a symptom of irregularities in other aspects of sexual development.

 

 What is usually done about it?

A large clitoris may be an indicator of more widespread sexual ambiguity, or be part of a genetic syndrome such as Fraser syndrome (van Haelst et al, Fraser syndrome: A clinical study of 59 cases and evaluation of diagnostic criteria. Am J Med Genet 143a (24): 3194, 2007), and so might warrant further medical tests.

If the clitoris is so large that it causes concern to the parents or pediatrician, surgery to reduce its size is an option, although the type of operation to be done must be carefully considered as it is important to avoid damage to nerves that may be needed for sexual enjoyment in adult life. There are also legal and ethical issues with any surgery of this kind being carried out without the direct consent of the person affected (as discussed under Ambiguous genitalia).

Readers are advised to seek the services of a qualified medical practitioner when considering any diagnostic or treatment options. See Disclaimer.

 

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Last updated: 16 July 2015

Edit history: Author P. Koopman 9/12; revised PK 5/13, 10/13