What is Clitoromegaly Size?
Clitoromegaly is called as macroclitoris. It is basically enlargement of the clitoris, may be acquired or congenital. Clitoromegaly in newborn, this feature is recognizable in girls. Easily detectable at birth. Neonatal Clitoromegaly is usually due to androgen stimulation or in utero androgen stimulation. The initial diagnosis in neonates is based upon clinical investigation. This Clinical investigation can lead to overdiagnosis and stress for parents. The clitoris is a part of external genitalia. External genitalia abnormalities in the first 2 days of neonate's life considered as an endocrine or genetic disorder.
Fetal clitoromegaly is usually due to maternal or fetal hormonal imbalance or due to treatment. If the fetus still shows clitoromegaly in prenatal sonographic finding, then most probably there will be clitoromegaly chances in the neonate.
The mechanism of clitoromegaly is exactly not known. Still, some theories are there that somehow relate the clitoromegaly, one theory is that vulva fat is not present that makes the clitoris appearance large, second theory is that high levels of androgen's lead to clitoromegaly. High androgen levels may be due to high luteinizing hormone and re-programming of the ovary. One more reason for the high androgens level is prolonging synthesis and release of kisspeptin from the brain or placenta contribute to increasing gonadotropin hormone. But in childhood, if clitoromegaly continues, these theories do not explain the reason.
In neonates, clitoris measurement is performed by using a digital campus having a measurement sensitivity of 0.01cm. Firstly the genital part is measured that either the clitoris is covered by labia majora or not. Then the baby is placed into the frog-leg position, and the length of the clitoris was measured. During the measurement procedure, the legs are secured by the assisting nurse, physician separated the labia majora by using the thumb and second finger of the left hand and then take the measurement.
Clitoris is known to be prominent in the newborn. Studies show that the clitoris length should be less than 5 mm when it appeared to be covered by the labia majora. Clitoromegaly is clearly diagnosed when clitoris length is more than 1cm even if it is covered by labia majora. Newer studies showed that if the clitoris length is more than 8mm, then it should be carefully monitored, and if the clitoris length is more than 10mm, then we considered it as a pathological condition.
Fetal clitoromegaly is usually due to maternal or fetal hormonal imbalance or due to treatment. If the fetus still shows clitoromegaly in prenatal sonographic finding, then most probably there will be clitoromegaly chances in the neonate.
The mechanism of clitoromegaly is exactly not known. Still, some theories are there that somehow relate the clitoromegaly, one theory is that vulva fat is not present that makes the clitoris appearance large, second theory is that high levels of androgen's lead to clitoromegaly. High androgen levels may be due to high luteinizing hormone and re-programming of the ovary. One more reason for the high androgens level is prolonging synthesis and release of kisspeptin from the brain or placenta contribute to increasing gonadotropin hormone. But in childhood, if clitoromegaly continues, these theories do not explain the reason.
In neonates, clitoris measurement is performed by using a digital campus having a measurement sensitivity of 0.01cm. Firstly the genital part is measured that either the clitoris is covered by labia majora or not. Then the baby is placed into the frog-leg position, and the length of the clitoris was measured. During the measurement procedure, the legs are secured by the assisting nurse, physician separated the labia majora by using the thumb and second finger of the left hand and then take the measurement.
Clitoris is known to be prominent in the newborn. Studies show that the clitoris length should be less than 5 mm when it appeared to be covered by the labia majora. Clitoromegaly is clearly diagnosed when clitoris length is more than 1cm even if it is covered by labia majora. Newer studies showed that if the clitoris length is more than 8mm, then it should be carefully monitored, and if the clitoris length is more than 10mm, then we considered it as a pathological condition.
The study shows that the serum steroid profile should be done during the clitoromegaly period. 16-hydroxysteroid and 3β-hydroxy-5-one steroid metabolites levels are increased. These changes may be due to immaturity in the adrenal gland of the neonate. Sudden changes in the fetal clitoris may be parallel to the hormonal changes in the immature adrenal gland. An association is shown between clitoromegaly and cloacal anomaly in many cases. Some cases of clitoromegaly were shown in 15 to 16 weeks of the gestation period, but clitoromegaly was disappeared at 22 to 26 weeks of gestation period.
Treatment is the surgical removal of the unnecessary part of the clitoris or to wait till the adrenal gland matures in the neonate.
What is Clitoromegaly Size?
Reviewed by Simon Albert
on
February 05, 2020
Rating:
Reviewed by Simon Albert
on
February 05, 2020
Rating:
