Hirsutism make the clitoris larger-Hirsutism - Harvard Health

Most women have fine, pale, faintly visible hair on the face and body, but this hair might sometimes be thicker and more visible. About half of all people with hirsutism have an excess of androgens. These hormones usually trigger male physical and sexual development. Women normally have low androgen levels, but these levels might vary for a range of reasons. Higher levels can overstimulate the hair follicles, leading to more hair growth than a woman would normally experience.

Hirsutism make the clitoris larger

Hirsutism make the clitoris larger

Low doses of steroids may be prescribed for overactive adrenal glands. In women, androgens are Hirsutism make the clitoris larger by the ovaries and the adrenal glands. In patients with CAH, clitoromegaly, as well as labioscrotal fusion, require clitoroplasty and vaginal reconstructive surgery. ICD - 10 : N In addition, the patient also had amenorrhea of three years duration, central obesity, increased supraclavicular fat pads and moon facies, as well as abdominal striae. The growth of long, coarse hair on the face, chest, upper arms, and upper legs of women in a pattern similar to that of men. However, these side effects seldom are seen at the low doses used for treating hirsutism. Dealing with hirsutism Massachusetts swingers PCOS can be emotionally difficult.

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Advertising revenue supports our not-for-profit mission. Activate the real pleasure from inside out. The adrenal glands secrete hormones. Finasteride, a 5-alpha reductase inhibtor has been found to be effective in the treatment of IH. Side effects include spotting bleeding between periodstender breasts, nausea and headaches, especially in the first few months. Women aren't immune to comparisons — one in seven, according to the American Congress of Obstetricians and Gynecologistshas actually considered getting the lips of her vagina surgically Hirsutism make the clitoris larger. People should wax every 4 to 6 weeks to keep unwanted hair from growing back. Hirsutism make the clitoris larger your triggers can take some time England footie babe self-reflection. Leave this field empty. You should also see your doctor if you experience pain, discomfort, or bleeding. A thick layer is applied for minutes to the hairy area, then wiped off and the hair comes off with the cream. Conditions Treated. If a person handles the genitals more gently, discomfort should subside within a day or two.

Hirsutism is the excessive growth of facial or body hair on women.

  • Hirsutism in women is defined as excessive coarse hair appearing in a male-type pattern.
  • The clitoris looks like a small, button shaped organ protected by a hood of skin.
  • Hirsutism is a common clinical condition seen in female patients of all ages.
  • Updated in February
  • Since the dawn of time, men have been comparing penis sizes for sport and, cough, reminding themselves that size doesn't always matter.

Abstract Hirsutism is a common problem affecting women that is usually the result of a benign etiology. Initial imaging studies demonstrated normal adrenal glands and ovaries. She was later discovered to have a rare steroid-secreting ovarian tumor. It is a common problem affecting up to 8 percent of adult women. Hirsutism is usually the result of a benign condition. However, it can be a sign of significant disease especially when sudden in onset or rapidly progressive, and it calls for prompt evaluation.

Virilization in the female is the result of marked elevations in serum androgens. Virilization is characterized by continued and increased male pattern hair growth, male pattern alopecia, increased muscle mass, deepening of the voice, decreased breast size, increased libido, menometrorrhagia or amenorrhea and clitoromegaly.

The presence of virilization alerts the health care provider to markedly elevated androgen levels. A case of a year-old female with the sudden onset of hirsutism and with rapid progression to virilizing signs accompanied by a markedly elevated testosterone level as the result of an ovarian, androgen-producing tumor is presented. The androgen-dependent hair growth was increasing in severity and primarily located on her face and midline of the abdomen.

In addition, she noted accelerated loss of scalp hair in a male pattern. Menarche occurred at age 14, and her menstrual cycles were always irregular. The patient notes that she has always had a small amount of hair growth on her upper lip, but over the preceding five months there had been a significant increase in hair growth on her face and midline of the abdomen. Over this same time period, she also noted a pound weight gain, increased acne, poor sleep and easy bruising.

Spironolactone had been prescribed as treatment for hirsutism as well as metformin for the metabolic syndrome. Prior laboratory evaluation included normal chemistry panel and complete blood count. She had a negative pregnancy test, normal ACTH, cortisol levels and dexamethasone suppression test. Prior imaging included transvaginal ultrasound showing no uterine or ovarian pathology, CT with contrast that showed normal adrenals, and MRI of the sella turcica revealed a normal pituitary.

Physical examination revealed an obese female BMI She had moon facies with increased supraclavicular fat pads. She had dark coarse hairs encompassing the whole lower face down onto the neck, diffuse hairs present in the midline of the chest and abdomen, and striae on her abdomen and lower back. She was also noted to have male pattern escutcheon with dark hairs spreading onto the thighs, clitoromegaly and no discrete adnexal masses on pelvic examination.

A repeat transvaginal ultrasound revealed a low-level mass in the right ovary measuring 38 x 33 x 27 millimeters and two low-level densities in the left ovary measuring 8 x 8 x 7 and 7 x 7 x 7 millimeters. The rapid onset and progression of hirsutism and virilizing signs accompanied by a markedly elevated serum testosterone suggests the possibility of an androgen-producing ovarian neoplasm or severe hyperthecosis.

The patient was offered conservative approaches including a trial of a gonadotropin releasing hormone agonist to determine if androgen production was gonadotropin dependent and which is expected in hyperthecosis. Another conservative option explored with the patient included selective ovarian vein catheterization to determine which ovary was producing excess androgen, followed by unilateral oophorectomy of the affected ovary and removal of the mass on the contralateral ovary.

Hysterectomy with removal of both ovaries was discussed with the patient because of the presence of bilateral ovarian masses, which required diagnosis and treatment. After thorough discussion she elected to proceed with a laparoscopic assisted vaginal hysterectomy with bilateral salpingooopherectomy.

Pathology demonstrated a dermoid cyst of the right ovary and a steroid cell tumor, not otherwise specified, of the left ovary. The patient had a history of chronic mild hirsutism, but over the five months prior to presentation she had the rapid onset and progression of male-pattern hair affecting the face, neck, chest, abdomen and thighs.

She also had developed virilizing signs, with male-pattern hair loss, male escutcheon and clitoromegaly over the preceding five months. In addition, the patient also had amenorrhea of three years duration, central obesity, increased supraclavicular fat pads and moon facies, as well as abdominal striae. This case illustrates the importance of a high level of suspicion for ovarian or adrenal neoplasm when patients have the rapid onset and progression of hirsutism and virilizing signs so treatment is not delayed.

The markedly elevated testosterone with normal adrenal evaluation in our patient suggested that the ovaries were the source of pathology. The differential diagnosis in this case included hyperthecosis or an ovarian androgen-producing neoplasm. Hyperthecosis is a disorder of ovarian stroma that is most commonly seen in postmenopausal women but may blend with polycystic ovarian syndrome PCOS in younger women. The ovary undergoes uniform enlargement consisting of hypercellular stroma with luteinized theca cells scattered throughout the stroma.

Hyperthecosis may be resistant to suppression with oral contraception pills but will usually respond to gonadotropin-releasing hormone agonists GnRH -a like leuprolide. Androgen-producing neoplasms of the ovary are usually palpable on physical examination and typically the androgen levels are not suppressed by treatment with oral contraceptive pills or GnRH-a. After discussion of alternatives our patient elected to proceed with hysterectomy and bilateral oophorectomy due to the markedly elevated testosterone and rapid progression of her virilizing signs and symptoms.

The pathology demonstrated an androgen-producing neoplasm, not otherwise specified, of the ovary. The patient had rapid, significant improvement in her signs and symptoms. These androgen-producing tumors of the ovary may have malignant potential and thus the importance of their complete removal and pathologic evaluation. Hirsutism is a common problem that can be particularly distressing, causing significant psychological morbidity. Common causes of hirsutism include familial, idiopathic and PCOS.

Patients with hyperandrogenism will commonly have irregular menses. In fact, if the patient has regular menses, it points more to familial hirsutism. The evaluation of hirsutism entails a careful history exploring the onset and progression of hair growth, menstrual cycle history, assessment of fertility pregnancy history , medication use and family history.

A common method of assessing and documenting androgen-dependent hair growth is the semi-quantitative Ferriman-Gallwey scoring system. The nine body areas most sensitive to androgen upper lip, chin, chest, abdomen, pubic, arms, thighs, upper back and lower back are scored from 0 no hair to 4 frankly virile and then summed to provide a hirsutism score.

A score of 8 to 15 is classified as mild hirsutism, while moderate hirsutism is a score greater than This patient had severe hirsutism with virilizing signs. Therefore, it was not necessary to grade her level of hirsutism. Women with gradually progressing mild hirsutism, regular menses, family history of hirsutism and normal physical examination do not require laboratory evaluation. Women with sudden onset, rapidly progressive or moderate to severe hirsutism as well as when associated with menstrual irregularity, infertility , central obesity, acanthosis nigricans or clitoromegaly should be tested for elevated androgen levels.

If the total testosterone is normal in the presence of risk factors for hyperandrogenism or the presence of hirsutism that progresses in spite of therapy, measuring an early morning plasma total and free testosterone in a reliable specialty laboratory is indicated.

Free testosterone is a more sensitive, laboratory test for the detection of hyperandrogenism, but requires equilibrium dialysis for the best precision and accuracy. From a clinical standpoint a total testosterone is sufficient, since when it is elevated it correlates well with free testosterone and one is using this test to screen for testosterone producing tumors.

In patients with markedly elevated testosterone levels one is concerned about the possibility of an ovarian androgen-producing tumor. When androgen excess is discovered, the most common cause is PCOS, while only 0. Pelvic ultrasonography or adrenal protocol CT may be indicated in these patients. PCOS is the most common endocrinopathy, affecting 5 to 8 percent of reproductive-aged females, and they may present with moderate to severe hirsutism.

Diagnosis requires two of the following three criteria: oligoor anovulation , increased androgens either clinically or biochemically and polycystic ovaries on ultrasound evaluation. The diagnosis requires that other causes of irregular menstrual cycles and hyperandrogenism are excluded.

Hyperinsulinemia and other metabolic syndromes are also associated with PCOS. Treatment of hirsutism depends on the underlying cause. Referral may be indicated for suspected neoplasms, PCOS or adrenal pathology. For familial and idiopathic hirsutism in which cosmetic therapies are not adequate, pharmacologic treatment, along with direct hair removal methods, are recommended.

Oral contraceptives reduce hyperandrogenism by suppressing LH, stimulating production of sex hormone-binding globulin, slightly reducing adrenal androgen secretion and slightly blocking androgen receptors.

Drospirenone, which is also a weak antiandrogen, is a newer progestin used in several OCPs. Antiandrogens such as spironolactone, cyproterone acetate not available in the U. Spironolactone is an aldosterone antagonist that exhibits dose-dependent inhibition of the androgen receptor and inhibition of 5-alpha reductase. Finasteride inhibits 5-alpha reductase activity. Flutamide is not recomended as first-line therapy due to concern with hepatic toxicity. Pharmacologic therapies for hirsutism should include a six-month trial before making changes in dose or changing or adding medications.

Local cosmetic therapies include temporary methods such as plucking, waxing and shaving, as well as permanent methods such as electrolysis or laser destruction of the hair follicle. Local cosmetic therapies work best in combination with pharmacologic suppression of hair growth. It is important to remind the patient that hair growth is asynchronous, so control will require time and multiple applications of local cosmetic therapy to achieve the desired effect.

In cases of virilization with markedly elevated androgens, it is important to locate the cause of excess androgen production. In patients with an ovarian androgen producing tumor, removal of the tumor will usually restore androgen levels to normal female levels.

Once the levels are restored to normal then local destruction of the terminal hair follicles will help with the hirsutism. For patients with significant clitoromegaly, a clitoral recession will return the clitoris to a more normal size and maintain normal neurologic function. In patients with hyperthecosis, treatment can be aimed at suppressing ovarian function with oral contraceptive pills, progestins or gonadotropin releasing hormone agonists.

Patients with an androgen-producing adrenal adenoma or carcinoma will require surgical diagnosis and therapy, as well as chemotherapy in the case of adrenal carcinoma. In patients with congenital adrenal hyperplasia glucocorticoids and possibly mineralocorticoids, if salt-wasting, will suppress adrenal androgen production.

In patients with CAH, clitoromegaly, as well as labioscrotal fusion, require clitoroplasty and vaginal reconstructive surgery. Most cases of hirsutism result from benign conditions. The prompt and thorough evaluation of patients with hirsutism is important to determine the specific etiology causing this sign. This case reminds one of the importance of having a high level of suspicion for neoplasms of the ovary or adrenal when there is rapid onset or progression of hirsutism and virilizing signs.

Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study J. Androgen excess in women: experience with over consecutive patients. J Clin Endocrinol Metab. Familial hyperthecosis: Comparison of endocrinologic and histologic findings with polycystic ovarian disease. Am J Obstet Gynecol. Gynecol Oncol ; Psychological morbidity in women referred for treatment of hirsutism.

J Psychosom Res. Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline.

Since the dawn of time, men have been comparing penis sizes for sport and, cough, reminding themselves that size doesn't always matter. If a fungal or bacterial infection is behind your symptoms, your doctor will prescribe oral medication to help clear the infection. E-mail: moc. First of all, I'm not shy about requesting oral sex, as I refuse to set up unrealistic expectations that I will or should climax from intercourse which has happened, like, three times in my entire life. Think of it as the best prescription you'll ever receive from your doctor. Your doctor may also suggest reduction clitoroplasty, a surgical procedure used to remove volume from your clitoris.

Hirsutism make the clitoris larger

Hirsutism make the clitoris larger

Hirsutism make the clitoris larger. Introduction

Without that release, the throbbing and swelling of your genitals, including your clitoris, will subside more slowly. Certain conditions and infections can cause your vulva, which includes your clitoris and labia, to become temporarily inflamed. Vulva inflammation is also known as vulvitis or vulvovaginitis. It can happen because of:. An excess of androgen hormones, like testosterone , can cause your clitoris to grow in size.

High testosterone levels can occur naturally in your body or as a result of anabolic steroids. Women who have polycystic ovarian syndrome PCOS or other endocrine disorders often have elevated androgen levels, which can cause their clitoris to become enlarged. This is often seen in infants who are born with congenital adrenal hyperplasia CAH , as well.

This genetic disorder can cause an infant to produce too much androgen, which may cause an enlarged clitoris. Certain types of ovarian tumors , such as Sertoli-Leydig cell tumor and steroid cell tumor, can produce androgen. The increase in androgens can cause your clitoris to grow in size, among other symptoms. You should also see your doctor if you experience pain, discomfort, or bleeding. These symptoms may be a sign of a vaginal infection or another underlying medical condition.

Your options for treatment will depend on the underlying cause. In many cases, applying a medicated cream may be enough to relieve your symptoms. You may also need to use an over-the-counter OTC cortisone cream to reduce irritation and itching. Your doctor may also tell you to take a sitz bath and use a topical estrogen cream to ease your symptoms. If a fungal or bacterial infection is behind your symptoms, your doctor will prescribe oral medication to help clear the infection.

They may also recommend an OTC or prescription cream to help ease your symptoms. Your doctor may prescribe hormone therapy if you have high androgen levels caused by an endocrine disorder like PCOS. Your doctor may also suggest reduction clitoroplasty, a surgical procedure used to remove volume from your clitoris. Chemotherapy , hormone therapy , radiation therapy , and surgery are all options to treat an ovarian tumor and its symptoms.

Doctors have performed reduction clitoroplasty on babies born with CAH to decrease the size of the clitoris, though the practice is considered controversial. Children born with CAH, for example, grow up to live physically healthy lives. However, having an enlarged clitoris can cause some women distress or discomfort.

They can work with you to develop a symptom management plan that best suits your needs and connect you with resources for support in your area. An enlarged clitoris is usually nothing to worry about. Oftentimes, your clitoris will go back to its previous form on its own.

Many people think the clitoris is just a tiny button, but it's so much more than that. Learn how big the clitoris is and how to use it for pleasure. Most cases of swollen labia aren't serious. Here's what you need to know and when you should contact your doctor.

Vulvovaginitis is a common infection of the vulva and vagina. At the same time, other causes for hirsutism, including hormone abnormalities of the pituitary, thyroid and adrenal as well as rare tumors, can be excluded.

Hirsutism is often treated with a combination of approaches, including oral contraceptives with or without an antiandrogen, such as spironolactone, to lower levels or block actions of androgen on hair follicles. Oral contraceptives are often combined with antiandrogens to improve their clinical effect and to prevent pregnancy, since accidental exposure of the male fetus to antiantrogens can harm fetal development. A topical cream eflornithine hydrochloride also can be applied to treat facial hirsutism.

Medical therapy inhibits hair growth without eliminating hair already present. Therefore, medical therapy usually is combined with mechanical methods of hair removal, such as electrolysis or lasers.

Electrolysis refers to the insertion of an electrode to destroy individual hair follicles. It is ideal for removing small areas of sparse hair of any color. Laser hair removal is a common, safe and effective cosmetic procedure that also is performed for removal of unwanted facial and body hair.

Laser therapy is more expensive than electrolysis but is faster, less painful, and requires fewer sessions. Laser therapy destroys hair by targeting the pigment melanin in the hair follicle and is ideally suited for dark-haired, light-skinned individuals.

Longer-wavelength lasers with cooling devices can be used for individuals who have red, true blond, or white hair and for dark-skinned people. Most patients then require some degree of maintenance treatment, usually every months. Acne is usually treated with oral contraceptives and topical or antibiotic therapies.

Hair loss may require androgen suppression combined with antiandrogen therapy and topical means of stimulating hair regrowth. Follow-up visits are often necessary to review progress, assess side effects, and advise further management as necessary, thereby increasing long-term satisfaction.

What Is Hirsutism And Should I Care About It?

Clitoromegaly or macroclitoris [1] is an abnormal enlargement of the clitoris that is mostly congenital or acquired, though deliberately induced clitoris enlargement as a form of female genital body modification is achieved through various uses of anabolic steroids, including testosterone , and may also be referred to as clitoromegaly.

The different grade of genital ambiguity is commonly measured by the Prader classification , [6] which ranges, in ascending order of masculinisation, from 1 : female external genitalia with clitoromegaly through 5 : pseudo-phallus looking like normal male external genitalia. Clitoromegaly is a rare condition and can be either present by birth or acquired later in life.

If present at birth, congenital adrenal hyperplasia can be one of the causes, since in this condition the adrenal gland of the female fetus produces additional androgens and the newborn baby has ambiguous genitalia which are not clearly male or female. In pregnant women who received norethisterone during pregnancy, masculinization of the fetus occurs, resulting in hypertrophy of the clitoris; [8] however, this is rarely seen nowadays due to use of safer progestogens.

It can also be caused by the autosomal recessive congenital disorder known as Fraser syndrome. In acquired clitoromegaly, the main cause is endocrine hormonal imbalance affecting the adult woman, including polycystic ovarian syndrome PCOS [10] and hyperthecosis.

Acquired clitoromegaly may also be caused by pathologies affecting the ovaries and other endocrine glands. These pathologies may include virulent such as arrhenoblastoma and neurofibromatosic tumors. Female bodybuilders and athletes who use androgens , primarily to enhance muscular growth, strength and appearance see Use of performance-enhancing drugs in sport , may also experience clearly evident enlargement of the clitoris and increases in libido.

Pseudoclitoromegaly or pseudohypertrophy of the clitoris "has been reported in small girls due to masturbation: manipulations of the skin of prepuce leads to repeated mechanical trauma, which expands the prepuce and labia minora, thus imitating true clitoral enlargement".

Early surgical reduction of clitoromegaly via full or partial clitoridectomy is controversial, and intersex women exposed to such treatment have spoken of their loss of physical sensation, and loss of autonomy. In , it was disclosed in a medical journal that four unnamed elite female athletes from developing countries were subjected to gonadectomies and partial clitoridectomies after testosterone testing revealed that they had an intersex condition.

From Wikipedia, the free encyclopedia. For penis-like appendages in female non-human animals, see Pseudo-penis. For the pipefish genus, see Pseudophallus. Archived from the original on Retrieved Reproductive Health.

Therapeutic Advances in Urology. BJU International. Archives of Sexual Behavior. Morphologie, Hausfigkeit, Entwicklung und Vererbung der verschiedenen Genitalformen" [Genital findings in the female pseudo-hermaphroditism of the congenital adrenogenital syndrome; morphology, frequency, development and heredity of the different genital forms].

Helvetica Paediatrica Acta in German. Diagnosis and treatment". Annals of the New York Academy of Sciences. Obstetrics and Gynecology. Discovering Biological Psychology. Cengage Learning. Retrieved November 7, Drug Enforcement Administration.

Atlas of Human Sex Anatomy. Intersex Society of North America. Montreal Gazette. June April ICD - 10 : N Vaginal septum Vaginal hypoplasia Imperforate hymen Vaginal adenosis Cloacal exstrophy Vaginal atresia.

Clitoromegaly Progestin-induced virilization Pseudohermaphroditism True hermaphroditism. Categories : Congenital disorders of female genital organs Clitoris Intersex variations. Hidden categories: CS1 German-language sources de Wikipedia articles needing page number citations from April Namespaces Article Talk. Views Read Edit View history. In other projects Wikimedia Commons. By using this site, you agree to the Terms of Use and Privacy Policy.

Hirsutism make the clitoris larger