An enlarged clitoris, called clitoromegaly, can range from a subtle increase in size that’s barely noticeable to a structure that resembles a small penis. What it looks like depends on the degree of enlargement and the underlying cause, but the changes follow a fairly predictable pattern as severity increases.
Normal Size and When It’s Considered Enlarged
The visible part of the clitoris (the glans) is naturally small, typically a few millimeters to about a centimeter in length when not aroused. There’s a wide range of normal, and size varies with age, hormonal shifts, and individual anatomy. Clitoromegaly is generally identified when the clitoris is noticeably larger than this typical range and continues to grow or remains persistently prominent outside of arousal.
Because there’s natural variation, mild enlargement can be difficult to distinguish from the upper end of normal. The key difference is usually that clitoromegaly involves structural growth of the tissue itself, not just temporary swelling from blood flow during arousal.
How Mild Enlargement Looks
In its earliest stage, an enlarged clitoris looks like a slightly bigger version of a typical clitoris. It may peek out from under the clitoral hood more than it used to, or the hood itself may appear fuller or more prominent. At this point, the vaginal opening, labia, and surrounding structures look normal. Most people at this stage notice the change themselves before anyone else would, often because the clitoris feels more exposed or rubs against clothing differently than before.
Moderate to Significant Enlargement
As clitoromegaly progresses, the changes become more apparent. The clitoris takes on a more cylindrical, phallic shape rather than the small rounded glans most people are familiar with. It may extend well beyond the clitoral hood and become clearly visible without spreading the labia apart.
At moderate stages, the surrounding anatomy often changes too. The labia may begin to fuse together along the back, and the vaginal opening can appear smaller or partially covered. The tissue around the clitoris can look thicker and more rugated, similar to scrotal skin. These changes happen because the same androgens driving clitoral growth also affect the surrounding vulvar tissue.
In more advanced cases, the structure can look intermediate between a clitoris and a penis, with a defined shaft. At the most extreme end, particularly in congenital adrenal hyperplasia present from birth, the external genitalia can appear fully male, with what looks like a normally formed penis and a fused, empty scrotum. Internal reproductive organs (ovaries and uterus) remain intact in these cases, but the external appearance can be indistinguishable from male anatomy.
What Causes the Changes
Clitoral enlargement is driven by excess androgens, the group of hormones that includes testosterone. The clitoris and the penis develop from the same embryonic tissue, so when androgen levels rise significantly, the clitoris responds by growing in ways that mirror penile development.
The most common causes include:
- Polycystic ovary syndrome (PCOS): The most common cause of excess androgens in adults. High levels of certain hormones cause the ovaries to produce more testosterone than normal, and elevated insulin prevents the liver from making a protein that would otherwise bind testosterone and keep it inactive. The result is more free testosterone circulating in the blood. PCOS-related enlargement tends to be mild to moderate.
- Congenital adrenal hyperplasia (CAH): A group of genetic conditions where the adrenal glands produce too much testosterone due to missing enzymes. CAH is present from birth and can cause the most dramatic changes, sometimes making the clitoris resemble a small penis in newborns.
- Anabolic steroids or testosterone therapy: Exogenous hormones can cause clitoral growth, sometimes noticeably within weeks to months of use. This is one of the more common causes in adults who don’t have an underlying hormonal condition.
Physical Sensations That Accompany the Change
An enlarged clitoris isn’t just a visual change. Because the tissue is densely packed with nerve endings, growth can make it more sensitive to touch, pressure, and friction. Some people experience increased sexual sensitivity, which may or may not be welcome. Others find that the enlarged clitoris rubs uncomfortably against underwear or tight clothing, creating irritation during everyday activities like walking, sitting, or exercising.
In some cases, the increased exposure of the glans (since it protrudes beyond the protective hood) leads to chafing or soreness. The degree of discomfort varies widely. Some people with mild enlargement notice no physical symptoms at all, while others find even moderate changes disruptive.
Is the Growth Reversible?
This depends on the cause and how long the enlargement has been present. Virilization, the broader process of developing masculine physical traits due to excess androgens, is generally reversible with appropriate treatment. Addressing the underlying hormonal imbalance can stop further growth and sometimes allow partial regression.
That said, clitoral tissue that has undergone significant structural growth may not fully return to its previous size, even after hormone levels normalize. This is especially true for enlargement caused by anabolic steroids used over long periods, or for congenital conditions like CAH where the tissue developed under high androgen exposure from the earliest stages of fetal development. The earlier the hormonal cause is identified and addressed, the more likely the changes are to be limited or partially reversible.