Clitoral enlargement methods are forms of body modification that have the potential to increase the size of the clitoris and enhance sexual pleasure. Clitoral enlargement can be accomplished through a variety of means, each potentially having certain side effects and risks.[1][2][3][4]
The congenital or acquired medical condition known as clitoromegaly or macroclitoris contrasts intentional enlargement of the clitoris, though any abnormal enlargement of the clitoris is sometimes referred to as clitoromegaly.[1][5]
There are multiple reasons someone might want to enlarge their clitoris. For some, it is a personal aesthetic choice. People who believe that the size of their clitoris prevents adequate stimulation from sexual acts that can directly stimulate the clitoris, such as the coital alignment technique, may choose to enlarge the clitoris in the hope it will be easier to stimulate.
The most common methods of clitoris enlargement are:
There is disagreement on the best approach; many claim size increases from pumping while others say testosterone is the only way to obtain significant results. Both methods involve some risk. If pumping is done incorrectly, it can cause damage to the erectile tissue and blood vessels. The use of any steroid such as testosterone incurs risk as these compounds can have systemic effects.
While the systemic effects of testosterone are both expected and desired in both trans men and non-binary people using it, cisgender women generally do not want the other masculinizing effects of systemic testosterone. Applying cream or gel containing testosterone directly to the clitoris, rather than injecting it (the usual route of administration for transgender hormone therapy), lessens systemic absorption, and may be sufficient for those looking only to have a larger clitoris and avoid other unwanted virilizing effects. Anecdotal evidence suggests that DHT (dihydrotestosterone), a very potent androgen, can effectively be used for this purpose with minimal side effects. No scientific studies have confirmed this effect in female anatomy, but research targeting the treatment of micropenis has found that local application of DHT is very effective at stimulating penile growth in microphalli.[6] Due to the biological similarity between penile and clitoral tissue, significant growth of the clitoris is likely. Unlike testosterone, DHT cannot be converted into the estrogen estradiol and is thus ideal for generating purely androgenic effects. However, DHT is not available in some countries, including the United States.
Clitoral pumping is another applied method of clitoris enlargement. Evidence proving its effectiveness is still lacking but it continues to be a popular activity. The potential dangers of vacuum pumping are well known to those familiar with penis pumping. If the applied vacuum pressure is too great it can cause bursting of blood vessels, bruising, blistering, damage to erectile tissue, and other types of trauma. Safe pressures are generally considered to be less than 5 in-Hg of vacuum or 0.17 atm (16 kPa).
A less common approach to clitoral enlargement is saline injection.[7]