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PubMed1977

Effects on hamster vaginal development of a single dose of testosterone or estradiol given neonatally.

Postnatal injections of a single dose of testosterone propionate or estradiol benzoate to newborn female hamsters produce a precocious vaginal opening at 5 days of age. Vaginal postnatal development, histologically, has shown that in testosterone-propionate-injected animals sinusal vagina is absent. The Müllerian vagina presented a stimulated epithelium at early ages. After 40 days, the Müllerian epithelium was stratified keratinized, with zones of stratified cuboidal epithelium. In estradiol-benzoate-treated animals, the Müllerian epithelium rapidly changes to stratified keratinized epithelium (10 days), with zones of stratified cuboidal after 20 days of life. The sinusal epithelium was stratified squamous at 10 days, and after 40 days changes to stratified keratinized epithelium were seen. Probably, early changes are due to a direct effect of steroid action. Later effects are due to ovarian secretion. Histologically, no significant changes were observed in the preputial and urethral glands. The clitoris showed malformations.

Age Factors↗
PubMed1969

The conversion of testosterone to 5 alpha-androstan-17 beta-ol-3-one (dihydrotestosterone) by skin slices of man.

The conversion of testosterone-1,2-(3)H to dihydrotestosterone by slices of human skin obtained from various anatomical sites in 112 normal subjects and three individuals with the syndrome of testicular feminization has been measured under standardized conditions. Very low rates of dihydrotestosterone formation were observed in sites obtained from the mons or from miscellaneous areas of the trunk and limbs of the control subjects. The mean rates of conversion were very high, however, in slices of skin obtained from several perineal sites (labia majora, scrotum, prepuce, and clitoris). Furthermore, as measured here, the rate of dihydrotestosterone formation by prepuce rises during the 3 months after birth and then falls progressively thereafter, reaching a level in the adult that is almost as low as that observed in the slices of nonperineal skin from all ages. In the patients with testicular feminization dihydrotestosterone formation by slices of skin obtained from the mons was within the normal range, whereas the rates observed in labia majora were lower than the average values obtained in the normal subjects.

Adolescent↗
PubMed1983

Female child circumcision in Ilesha, Nigeria. The present and the future.

In February 1981, the external genitalia of 578 female children were examined at the child welfare clinic, Wesley Guild Hospital, Ilesha, Nigeria. Of these children 96.5 per cent were under five years of age, and 66.3 per cent were circumcised. Of the circumcisions, 75.5 per cent had been done in the first month of life. "Traditional" surgeons performed 68.7 per cent of the circumcisions, and private clinic personnel, 21.1 per cent. In 49.6 per cent, circumcision had been done to prevent the head of any future baby from touching the clitoris at parturition, an event believed to result in early death of the neonate. In 48 per cent, circumcision had been done just to conform with custom. Of 175 mothers questioned, 82 per cent believed that an uncircumcised lady was more likely to be promiscuous than a circumcised lady.

Child, Preschool↗
PubMed1994

Human female phenotypic development: role of fetal ovaries.

Morphogenesis of external genitalia was studied in human fetuses obtained from cases of medical termination of pregnancies and cases of spontaneous abortions. Eighty-two fetuses, 16 mm crown rump (CR) length (6 weeks gestation) to 240 mm CR length (26 weeks gestation), were studied. Fetal sex was determined with the help of chorionic villus of fetal skin biopsies in cases of fetuses less than 70 mm CR length. Growth and differentiation up to 50 mm CR length (9 weeks gestation) was identical for both sexes. After this there was rapid growth and differentiation in males. But in females subsequent growth until 180-200 mm CR-length stage (20 weeks gestation), was restricted to growth of labia majora. After this there was rapid ventral outgrowth of the region of perineum between the clitoris and anus, which brought the urethral and vaginal orifices to the surface. There was also further growth of labia. This process of feminization of external genitalia was completed by the 26th week of gestation. Histology revealed that ovary and testes could be clearly identified at 60 mm CR length stage. Maturation of fetal testes progressed rapidly, but there was little change in the histological appearance of ovaries until 160-180 mm CR-length stage (18-20 weeks of gestation). Follicular growth started after this. Feminization of urogenital sinus started after follicular growth started in the fetal ovaries. So from the temporal profile of events, it appears that it may be initiated by fetal ovarian steroids.

Abortion, Induced↗
PubMedDate not supplied

Genital surgery among females with congenital adrenal hyperplasia: changes over the past five decades.

The treatment of intersex patients, including any patient born with genital ambiguity, is being reassessed. The re-evaluation is primarily focused upon the indications for and age of genital surgery, the impact of prenatal androgen levels upon gender development, and the potential for maximum sexual responsiveness as an adult. As a background to document changes in genital surgery for females with 21-hydroxylase congenital adrenal hyperplasia, this report is a review of surgical treatment of this most common form of genital ambiguity. Results document changes in the 1960s from clitorectomy to clitoroplasty using more refined techniques, but more interestingly a choice by parents against any surgery during childhood. This shift preceded the current impetus from intersex support groups. It appears to result from an appreciation by parents of variation in female genital configurations plus a realization that the clitoris will regress with the withdrawal of excessive androgens with relative size diminishing as growth proceeds. The primary impetus for this shift apparently has not been to preserve the vascular and neural supply to enhance sexual responsiveness, since parents in the past assumed that such could be preserved with appropriate surgical techniques.

Adrenal Hyperplasia, Congenital↗
PubMed1984

Effects of neonatal medroxyprogesterone acetate on postnatal sexual differentiation of female rats.

Medroxyprogesterone acetate (MPA), 5 micrograms/g body wt, was given to lactating female rats 1 day after parturition. Group 1 females suckled 10-12 young, with equal numbers of males and females, while Group 2 females each suckled 10 female young. The young were weaned at 21 days of age. Exposure to MPA advanced the day of vaginal opening by 1 day, and increased anogenital distance in Group 2 young. At autopsy between 80 and 100 days of age, the clitoris of Group 2 females was significantly greater than in controls, and ovarian and adrenal weights were reduced.

Adrenal Glands↗
PubMed1992

Hormonal correlates of 'masculinization' in female spotted hyaenas (Crocuta crocuta). 1. Infancy to sexual maturity.

This report is concerned with hormone concentrations accompanying sexual maturation in a highly 'masculinized' female mammal, the spotted hyaena, Crocuta crocuta. Plasma concentrations of testosterone, androstenedione and oestrogen were determined by radioimmunoassay in a longitudinal study of 12 female and eight male hyaenas 2.5-62.5 months old. Concentrations of testosterone were significantly higher in males than in females after 26.5 months of age, but earlier measurements did not differ between sexes. Mean testosterone concentrations in adult female hyaenas (0.4-0.5 ng ml-1) were similar to those in several other female mammals that do not display a 'masculine' profile, but mean concentrations of androstenedione (2.5-5.5 ng ml-1) in female hyaenas were significantly higher than in males (1.0-2.0 ng ml-1), at most ages. Oestrogen could not be detected (less than 0.03 ng ml-1) in females until about 14 months of age and then increased (to approximately 0.13 ng ml-1) between 18 and 30 months; oestrogen remained undetectable in males. This rise in oestrogen in females corresponded to nipple enlargement and to changes in the size and elasticity of the urogenital meatus, permitting copulation and parturition through the clitoris. Gonadectomy (two males and four females) at 4-7 months resulted in nondetectable concentrations of testosterone and oestrogen and a marked attenuation in androstenedione (to approximately 0.39 ng ml-1), indicating that the gonads are the major source of these three steroids. Gonadectomy also eliminated sex differences in weight, nipple development and elasticity of the urogenital meatus.

Aging↗
PubMedDate not supplied

Female counterpart of shawl scrotum in Aarskog-Scott syndrome.

Aarskog-Scott syndrome (ASS) is an X-linked disorder characterized by facial, skeletal and genital anomalies, including penoscrotal transposition in males. We report on a girl from a family with ASS who exhibits a transposition of the clitoris.

Abnormalities, Multiple↗
PubMed1992

Primary vulvar lymphoma presenting as a clitoral tumor.

We report a case of malignant large cleaved cell vulvar lymphoma predominantly affecting the clitoris, in a 60 year-old woman. In a review of the literature, female genital tract lymphomas of vulvar location are exceptional. Histologically, these tumors must be differentiated from pseudolymphomatous lesions. In the present case (Stage IE), response to chemotherapy was good and the patient remains asymptomatic after three years of follow-up.

Clitoris↗
PubMed1997

Sry gene detection in gonads of intersex patients using FISH.

A candidate gene for sex determination was localized within a 35 kb region of the Y chromosome immediately adjacent to the pseudoautosomal boundary. Here, we describe a study of Sry detection in the gonads of intersex patients including 5 male pseudohermaphrodite (MPH), 4 XX true hermaphrodite (TH) and each 1 mixed gonadal dysgenesis (MGD) and XX sex reversal, and in the clitoris of 3 female pseudohermaphrodite (FPH) by fluorescent in situ hybridization (FISH). Sry gene was observed in all cases of MPH and each case of MGD and sex reversal in contrast to bare expression in all cases of FPH and most of TH. To our knowledge, the Sry gene itself functions testicular determination in almost all intersex cases except true hermaphrodite, a distinguished type of intersex in a different pathogenesis. In addition, FISH might be useful to detect the translocated Sry gene and localize the signal with ease.

Adolescent↗
PubMed1999

A case of trisomy 22 in a live hereford calf.

A case of the rare genetic trisomy 22 in a live calf is described. The calf had low blood thyroxine level and low growth rate. It had several defects including brachygnathia superior, strabismus convergence, aortal cusp insufficiency and hypertrophy of clitoris. Chromosome analysis was performed on cultured blood lymphocytes and fibroblast cells. In all counted metaphases 61 chromosomes were present. The extra chromosome was identified as a chromosome 22 by R-banding. The defects of the calf have similarities with cases of partial trisomy 3p25-pter in human. This section of the human chromosome 3 corresponds to sections of cattle chromosome 22.

Animals↗
PubMed1999

[Knowledge of the "Gräfenberg zone" and female ejaculation in ancient Indian sexual science. A medical history contribution].

Ancient Indian texts in sexology (kamaśastra) from the 11th century onwards prove that their authors knew about the area later termed the "Gräfenberg zone" in Europe, as well as about the female ejaculation connected with the stimulation of this area. The Gräfenberg zone is a sexually arousable zone in the front part of the vagina, stimulation of which can lead to the discharge of liquid from the urethra, a phenomenon which is described as female ejaculation. The german gynaecologist Ernst Gräfenberg, who worked in America, described this zone, situated beneath the clitoris, for the first time (at least in this century) in Western medicine in an article published in 1950. (There are, however, evidences, that the 17th-century anatomist Regnier de Graaf had knowledge about the mentioned erogenous zone as well as female ejaculation.) Since the 1980s the so-called Gräfenberg zone, popularly termed "G-spot", and female ejaculation have been controversially discussed medically as well as in popular science, first in the United States, then in Europe; both phenomena have meanwhile been accepted as facts in medical manuals and reference books (e.g. the "Pschyrembel"). Whereas the oldest and most well-known sexological-erotological work of Ancient India, the Kamasutra, dating probably from the third century A.D., apparently did not know the Gräfenberg zone and female ejaculation, texts such as the Pañcasayaka (11th century), Jayamangala (Yaśodhara's commentary on the Kamasutra from the 13th century), the Ratirahasya (13th century), as well as the late kamaśastra-works Smaradipika and Anangaranga (16th century?) demonstrably describe both, the Gräfenberg zone and female ejaculation, in great detail. The female ejaculation is described already in the 7th century in a non-kamaśastra-text, in a work of the poet Amaru called the Amaruśataka.

Clitoris↗
PubMed2000

Renin angiotensin system of rabbit clitoral cavernosum: interaction with nitric oxide.

PURPOSE: Angiotensin (ANG) II has been known to be a potent modulator for the maintenance of smooth muscle tone of the penile cavernosum. However, its role in clitoral cavernosum is unknown. The clitoris is the homologue of the penis arising from the embryological genital tubercle. We investigated the presence of ANG II receptors, the function of ANG II, and its interaction with nitric oxide (NO) in rabbit clitoral cavernosum. MATERIALS AND METHODS: The isometric tension was measured in the strips of clitoral cavernosum. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to evaluate expression of AT1a and AT1b ANG II receptor subtype mRNAs. In vitro autoradiography was used to localize ANG II receptors in the clitoral cavernosum. RESULTS: The clitoral cavernosum was contracted dose-dependently by the addition of ANG II. Dup 753 (ANG II type 1 receptor antagonist) inhibited significantly ANG II induced contraction. PD 123,319 (ANG II type 2 receptor antagonist) did not affect the ANG II response. Pretreatment with NG-nitro-L-arginine methyl ester (NO synthase inhibitor) accentuated contractions induced by ANG II. Specific binding sites for 125I-ANG II were found in the clitoral cavernosum. The dissociation constant (Kd) was 0.58 + or - 0.05 nM. Specific binding of 125I-ANG II was displaced by Dup 753 (10-5 M) but not by PD 123,319 (10-5 M). The inhibitory constant (Ki) for Dup 753 was 23. 4 + or - 9.73 nM and mRNAs for AT1a and AT1b receptor subtypes were detected by RT-PCR. CONCLUSION: The present study shows that ANG II is involved in the regulation of clitoral cavernosum smooth muscle tone via ANG II receptor subtype AT1, and that ANG II has cross-talk with NO.

Angiotensin I↗
PubMed1975

Relation of lichen sclerosus et atrophicus of the vulva to development of carcinoma.

One hundred and seven patients with lichen sclerosus et atrophicus (LS&A) of the vulva were studies to determine the malignant potential of the LS&A. Five patients had coexisting invasive carcinoma of the vulva or perineum with the LS&A, and 1 patient had coexisting intraepithelial vulvar carcinoma on the clitoris. None of these, however, was known to have LS&A prior to the biopsy for carcinoma of the vulva. The high association of carcinoma and LS*A is probably a result of selection of 2 unusual lesions sent for consultation and evaluation. Squamous hyperplasia in the vulva occurred in association with LS&A in 37 (35%) patients, but only 6 patients had areas of dysplasia coexisting with LS&A. These areas of dysplasia, like the 5 invasive carcinomas, occurred in an area of the vulva where the LS&A was minimal or absent. Follow-up data were obtained on 92 patients with LS&A. Only 1 developed carcinoma of the vulva, which occurred 12 years after identification of the LS&A. When carcinoma arises in the vulva in a patient with vulvar LS&A, it tends to arise in areas of minomal LS&A or isolated areas of relatively normal vulvar skin. This study did not provide evidence of carcinoma arising from LS&A. Five of the 92 patients developed 6 malignant neoplasms in other sites, including carcinoma of the endometrium (3 patients), lung (1 patient), and simultaneous carcinomas of the colon and cervix (1 patient).

Adolescent↗
PubMed1975

[Epispadia without bladder extrophy in a female (author's transl)].

A very rare case of female epispadia without bladder extrophy is presented. The main symptoms with this malformation is incontinence and the presence of a bifid clitoris. The therapy of choice is the operative reconstruction of the urethra and reforming the bladder neck. This should not be carried out before the age of three years since the post operative bladder continence training is important for the success. Lasting urinary continence can only be expected in less than 50% of the cases.

Bladder Exstrophy↗
PubMed2003

Functional anatomy of the human vagina.

Anatomy studies normally precede physiology. While the anatomy of the penis and the biochemical and molecular regulation of erection are largely known, the exact anatomical description of the human clitoris was produced in 1998, the taxonomy of female sexual dysfunctions classified in 1999, and biochemistry of female excitation described only in 2002. There are various reasons for this. Female sexual physiology is much more complex than that of the male, and cultural and religious considerations have discouraged the scientific study of female sexuality. However, it is now apparent that modern sexology cannot be truly 'medical' if female sexual anatomy and the physiology of female sexual response are unknown.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed2003

Clitoromegaly in type 2 neurofibromatosis: a case report and review of the literature.

OBJECTIVE: Genitourinary neurofibromatosis (NF) is a rare disorder and clitoral involvement has been reported infrequently. In the English literature there are only 26 reported cases with clitoral involvement in NF. CASE: A 28-year-old female with clitoral enlargement, previously diagnosed with NF 2, was successfully treated by removal of the clitoral mass that increased in size during the previous two years. Clitoroplasty was performed while preserving the glans of clitoris. Histopathologic examination revealed plexiform neurofibroma. CONCLUSION: To the best of our knowledge the patient is the 27th reported clitoromegaly case with NF, but the first case reported with NF 2 or central NF in the English literature.

Adult↗
PubMed2004

[Biological characteristics of female rabbit clitoral smooth muscle cell culture in vitro].

OBJECTIVE: To investigate the method of culturing rabbit clitoral smooth muscle cells(SMC) in vitro and their biological characteristics. METHODS: Rabbit clitoral SMCs were cultured in vitro by enzymatically dispersed method, and morphological observation, cell counting and immunohistochemical staining were employed to study their biological characteristics. RESULTS: Rabbit clitoral SMCs were spindle-shaped and parallelled along their longitudinal axis, and the attachment and proliferation in vitro were rapid. CONCLUSION: Rabbit clitoral SMCs cultured in vitro can grow and maintain their steady characteristics when provided with appropriate culture condition. Clitoral SMCs cultured in vitro can serve as a cell material for researches of clitoris.

Animals↗