BASICS
- The clitoris appears larger than normal and may to protrude through the vulvar lips at the ventral commissure
- It develops from the embryonic genital tubercle in the absence of testicular testosterone production, or the conversion of testosterone by 5α-reductase to the active form, dihydrotestosterone
- The clitoris is the female homolog of the penis
- Anatomy
- Corpus cavernosum clitoris—erectile tissue
- Corpus clitoris (body of the clitoris)—5 cm in length
- Crura—attached to the ischial arch
- Glans clitoris—2.5 cm in diameter; situated in the fossa at the ventral commissure of the vulva; well-developed median sinus and lateral sinuses may be present
- Systems affected—reproductive
- May be associated with sex chromosome abnormalities
- Females
- Congenital
- Concurrent ovarian neoplasia—GTCT
- Iatrogenic drug administration—anabolic steroid, progestin
- Intersex condition
- Historical—known drug administration; female offspring of treated mare
- Enlargement of the glans clitoris beyond the expected norm
- May be visible externally as swelling of the ventral vulvar commissure
- May protrude from the clitoral fossa between labia
- May be associated with abnormal cyclicity
- May be associated with other structural genital anomalies, internal and/or external
- May be associated with stallion-like behavior and conformation
- Administration of anabolic steroids
- Progestin (altrenogest) usage for estrus control, behavior modification, and pregnancy maintenance; female progeny have associated altered gonadotropin secretion and increased clitoral size to 21 months of age; no effect on reproductive function
- Aberrant endogenous sex-steroid production—granulosa cell tumor in dam during gestation alters fetal development
- Hormonally active ovarian neoplasm in a postpubertal female—GTCT
- Mixoploidy or sex chromosome aberration—presence of testis-determining factor
DIAGNOSIS
TREATMENT
MEDICATIONS
FOLLOW-UP
MISCELLANEOUS