The clitoris is formed from the tubercle of the undifferentiated common tissue anlagen in the embryo. The clitoris is analogous to the penis as they arise from the same source as an embryo. The clitoris is capped externally with a glans about 20 – 30mm long with a similar diameter. The glans is covered by a clitoral hood formed in part by the fusion of the upper part of the two labia minora. The erectile tissue of the clitoral shaft consists of two parallel corpora cavernosa surrounded by a fibrous sheath (tunica albuginea). The size of the normal clitoris in the adult woman varies considerably.
Intersex children can be born with an enlarged clitoris, whether from chromosome abnormalities or from genetic hormonal maladies causing an over production of male hormones. An intersex child with an abnormally enlarged clitoris frequently undergoes corrective surgery as a child. However, it is not uncommon for these children to desire further reduction or reconstruction as adults.
The clitoris can also be relatively enlarged as a natural variant. However it can enlarge from too much male hormone in the body as a result of hormonal abnormalities or as a result of taking male hormones for body-building or for improving libido.
The woman may be self-conscious as to the size of the clitoris, especially when sexually aroused, since it can protrude significantly and simulate a small penis. If embarrassed, the woman may lose self-esteem and avoid intimacy. Enlargement can also cause discomfort in tight clothes.
The clitoris in the child or adult can be reduced by an outpatient procedure which removes the erectile spongy tissue of the shaft, sutures the clitoris closer to the pubic bone, and decreases the size of the glans or head of the clitoris. If properly performed, the risk of any change in sexual sensation is minimal or non-existent. However, this clitoral reduction procedure requires a very experienced surgeon with a clear understanding of anatomy. A labia minora reduction (inner lips) is often performed in conjunction with the clitoral reduction.