Testosterone Effects on Clit

by Benjamin Bunting BA(Hons) PGCert

Ben Bunting BA(Hons) PGCert Sports and Exercise Nutrition Level 2 Strength and Conditioning CoachWritten by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.

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The use of testosterone therapy or illicit steroids may see clitoral hood and labia growth - an effect known as bottom growth which is considered one of the positive side effects of testosterone treatment.

Testosterone Explained

Testosterone is a naturally-occurring steroid hormone with multiple functions in males. It plays a significant role in puberty (body hair growth, deeper voice, stronger muscles and penis growth) as well as helping build sperm for men.

Testosterone may also play a part in maintaining normal mood. Furthermore, women produce much smaller quantities through their ovaries which may contribute to maintaining it at an appropriate level for healthy functioning.

Studies have also revealed that testosterone imbalance can result in various health complications. If your hormones seem out of sync, seek advice from an experienced physician immediately if this is the case for you.

A total testosterone blood test measures the total amount of both bound and unbound testosterone present in the body.

Testosterone production occurs from Leydig cells found in men's testicles or by their ovaries, with most being bound by plasma proteins known as sex hormone-binding globulin (SHBG), then unavailable for other tissues to use. Only about 2-2% remains unbound which your doctor is testing for when reviewing your blood sample.

Binding of this hormone is integral to its function as it ensures it reaches all tissues requiring it. Some of it is converted by liver enzymes into dihydrotestosterone which has similar effects to unbound testosterone.

Testosterone and the Female Body

Contrary to popular belief, women also produce testosterone much although less.

Ovaries and adrenal glands produce most of it for females, and some is converted to the female sexual hormone oestrogen for conversion into female sex hormone oestrogen production.

Testosterone plays an integral part in many aspects of health including bone development, mood regulation and sexual desire in both sexes.

Effects of Low Testosterone in Women

Testosterone belongs to the androgen group of sex hormones, along with estrogen. Both hormones serve a number of important roles within the body, including healthy reproductive and bone functions.

Both men and women produce testosterone; premenopausal women see their levels diminish due to aging, surgery or certain drugs used. They may also decline due to chronic stress conditions, cancer or tumors.

Low testosterone in women often shows itself in reduced muscle mass. This can affect daily activities such as climbing stairs or lifting heavy weights, becoming especially evident for women who exercise frequently or work physically demanding jobs.

Studies have demonstrated that increasing testosterone levels through supplementation can reverse muscle atrophy and restore women's strength.

Low testosterone levels can have an adverse impact on sex drive and libido in women.

Unfortunately, such symptoms are often misdiagnosed as depression or perimenopause by healthcare providers resulting in unnecessary delays to receiving proper treatment.

Testosterone is essential in supporting sexual desire in female partners; reduced levels can result in reduced sexual desire as well as difficulties becoming aroused as well as poor vaginal lubrication and decreased sexual desire in relationships.

Lack of testosterone levels often manifests itself through difficulty focusing.

This may be exacerbated by anxiety or the presence of other health conditions like thyroid dysfunction which is sometimes misdiagnosed as depression.

Testosterone plays a vital role in brain health and memory function; low levels can impede its functionality.

According to Panay, the ovaries of young women produce three to four more testosterone daily than estrogen.

In 2002, Dimitrakakis et al. reported that testosterone was the most abundant gonadal hormone in females throughout their lifespan.

Unfortunately, because of a multitude of myths, there are no FDA-approved testosterone treatments for women, while men can choose from more than 30 testosterone therapies.

The use of testosterone could be used to treat many of the symptoms.

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What Is the Clitoris and Its Function?

The clitoris is the smallest component of female reproductive system and one of the key aspects for sexual pleasure.

The glans of clitoris is approximately pea-sized and contains erectile tissue which expands during sexual response for an intense sexual experience. It's covered by the clitoral hood which differs depending on individual size and coverage needs.

Medically speaking, the clitoris is a complex structure composed of regular and connective tissues that encase it.

Additionally, it's protected by ischiopubic ligament - an elastic band attached to pubic bone (ischial spine).

Finally, its protective clitoral hood safeguards underlying genital organs from coming in contact with urethra or labia minora.

Due to our culture's distaste for discussing sexual matters, women may feel embarrassed asking simple questions about their clitoris. Many people remain ignorant as to its location and function.

Good news is that numerous anatomical pioneers are helping to change this. Through microdissection on cadavers and magnetic resonance imaging techniques, they've revealed all aspects of the clitoral hood's anatomy.

Oregon Health & Science University researchers recently conducted a study which revealed that the clitoris has more than 10,000 nerve fibers compared with earlier estimates of 8,000.

This is good news since more nerves equals more pleasurable sensations during sexual contact - this explains why touching parts of your clitoris is essential when engaging in sexual intimacy.

History of Testosterone Treatment on Women

For over 80 years, women have been using testosterone to treat symptoms of perimenopause or menopause. Since more than 60 year, women in England and Australia have been able to use testosterone.

In the United States, hundreds of thousands women have their testosterone levels optimized. They report improvements in health and quality of life.

Despite this, there is controversy regarding the existence of androgen deficiency states as well as their clinical diagnosis and treatment.

Androgens are traditionally associated with masculinity and male sexual function. This has contributed to the lack of awareness of androgen effects on women.

Androgens play a crucial role in the development of female reproductive function, hormonal homeostasis 

The Effects of Testosterone Treatment on Women

The role of endogenous testosterone in women's health is critical, whether it be through its direct androgenic effect or the conversion to estrogens by the aromatase enzymatic enzyme.

Testosterone plays an important role in the reproductive and non-reproductive health of women.

The decline in testosterone occurs before the natural menopause. The most dramatic decline in testosterone levels occurs during late reproductive years.

When women with low sexual function present after menopause, testosterone is commonly prescribed.

The safety of testosterone therapy for women has been a major barrier to its approval.

In most countries, testosterone treatment for women is not approved by the FDA. Instead, it is prescribed as a formulation for men, with dose modifications, or as a compounded medication. 

If testosterone levels are kept within the range of female physiological requirements, adverse effects are rare.

Most common are excessive hair growth, acne, and weight gain. These are all reversible by reducing dosage or stopping the medication.

Alopecia, voice deepening and clitoral enlargement can be rare with testosterone replacement therapy.

Are there any benefits of testosterone therapy for women?

The topic of hormone replacement therapy is a controversial one in medicine. Certain narratives about safety concerns are not supported by peer-reviewed research.

The negative narratives about testosterone and women have led to the FDA not approving any testosterone treatments for women in the United States, while there are more than 30 FDA approved testosterone therapies available for men.

The use of testosterone could be used to treat the symptoms of menopause, perimenopause, and perimenopause in women who suffer in silence.

Growing evidence supports the use of physiologic testosterone doses for sexual function, bone health, brain protection and breast protection.

Since 1980, the safety of testosterone in women's use has been assessed.

Recent publication of a large cohort over a period of 7 years of subcutaneous hormonal-pellet therapy showed long-term safety.

Two large peer-reviewed long-term studies have shown a significant decrease in the incidences of invasive breast carcinoma in women who are on testosterone therapy.

Enlarged Clitoris 

Clitoromegaly is a medical condition in which the clitoris becomes abnormally large, either for children or adults.

This may occur as a result of too much androgen in the body or an imbalanced hormone balance; other possible causes could include tumors in pituitary gland or thyroid disorders.

Anabolic steroids have also been known to induce this condition when used during transition from female to male transition, although such growth should usually be considered desirable as part of that transition process.

Clitoromegaly can also be caused by various other conditions.

These include steroid-producing gonadal tumors, adrenal androgen-secreting carcinoma, Leydig cell tumour of the ovaries, Turner's Syndrome (TS), nevus lipomatous cutaneous superficialis and congenital generalized lipodystrophy - among others.

Clitoromegaly can also be caused by medications and diseases.

For instance, blood-thinning medicines may lead to blood clots; it could also occur as a side effect of anti-seizure drugs, chemotherapy therapies and certain hormone treatments; rare cavernous haemangiomas mimic clitoromegaly.

Does Testosterone Cause Clitoromegaly?

Exogenous or Endogenous Androgens may stimulate the clitoris and cause it to enlarge, leading to early virilization.

Topical testosterone gel has been approved as a treatment for hypoandrogenism among males. It is a convenient treatment, but there are concerns about the unintentional exposure of females and young children to the chemical through skin contact.

This study reports the case of a child who was referred to a pediatric clinic with clitoromegaly, which may have been caused by exogenous testosterone exposure.

That said, a report published in 2012 looked at the safety of testosterone therapy in women, and found that one of the possible androgenic side-effects is virilization, which includes a deeper voice, clitoris enlargement, masculization of the body and potential hair growth.

However, transdermal testosterone patches that contained 150ug - 300ug were considered safe with minimal complications.

Furthermore, a recommendation published in 2019 states that testosterone therapy for postmenopausal women does not cause an enlarged clitoris as long as the doses provided will bring testosterone levels up to concentrations that are similar to premenopausal levels.

A study published in 2022 outlines that testosterone levels of greater than 5 nmol/L are associated with virilization. As we know, virilization includes clitoris enlargement. 

The normal range of testosterone in females is often regarded as below 2.7 nmol/L according to infromation provided by the UK's National Health Service.

Therefore, it seems that if testosterone levels are raised to levels that are considered higher than a normal range, it may result in side effects including an enlarged clitoris.

This could be the result of a hormonal condition, or the use of testosterone drugs in doses that aren't considered safe.

Conclusion

The clitoral hood is the area of skin that covers the glans of clitoris along the upper edge of labia majora and protects them from overstimulation, such as clothing or underwear rubbing against them.

Although its size can vary, an overly large clitoral hood may cause friction, itching, and even genital tract abrasions; typically 5-25 mm diameter should suffice; any larger than this may indicate clitoromegaly (an overgrowth of skin covering).

An enlarged clitoral hood may be caused by many different factors. Sometimes it is due to an imbalance of hormones in your body.

This may occur as the result of certain health issues like polycystic ovarian syndrome (PCOS). When your ovaries produce excess androgens, this may result in an enlarged clitoral hood.

Transgender men and women undergoing testosterone replacement therapy (TRT) often develop an enlarged clitoral hood.

Testosterone, as an androgen hormone, causes their genitals to expand by stimulating testosterone receptors - this phenomenon is known as bottom growth and is one of the side effects associated with TRT use.

However, if testosterone is used in a medical context to raise testosterone levels within the clincially defined normal range, clitoris enlargement should not be a cause of concern.

Alternatively, if testosterone is used to raise levels above the normal range, then clitoris enlargement may be an effect.

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