In pregnant women who received norethisterone during pregnancy, masculinization of the fetus occurs, resulting in hypertrophy of the clitoris;[8] however, this is rarely seen nowadays due to use of safer progestogens.
[9] In acquired clitoromegaly, the main cause is endocrine hormonal imbalance affecting the adult person, including polycystic ovarian syndrome (PCOS)[10] and hyperthecosis.
[2] Female bodybuilders and athletes who use androgens, primarily to enhance muscular growth, strength and appearance, may also experience clearly evident enlargement of the clitoris and increases in libido.
[13][14] Women who use testosterone for therapeutic reasons (treating low libido, averting osteoporosis, as part of an anti-depressant regimen, etc.)
[19][20][21] In 2013, it was disclosed in a medical journal that four unnamed elite female athletes from developing countries were required to receive gonadectomies and partial clitoridectomies if they wanted to continue competing after testosterone testing revealed that they had an intersex condition.