Size Doesn’t Matter (And Your Penis Is Not Shrinking)

Urologists see it all the time: A patient makes an appointment. The chart says “enlarged prostate” or “kidney stone.” Then the doctor walks in, and the truth comes out. "I just used that as an excuse to see you, but here's the real issue: I'm concerned about the size of my penis."

It’s a worry that’s so acutely embarrassing many men can’t bring themselves to speak about it even with their doctor. But the good news is, outside of a few specific medical concerns, there really is no such thing as a shrinking penis.

Grade Inflation

The widespread idea that the penis can shrink with age is largely a misperception. Research shows that men tend to inflate the length and girth of their penises. (Worldwide, the average length of a flaccid penis is about 3 inches. An erect penis is about 5.1 to 5.4 inches.) Men also tend to compare themselves, unflatteringly, to what they see in the adult-film industry, which further drives insecurity.

While age or lack of use can over time account for a slight shortening — perhaps half an inch — the number one reason men believe their penis is shrinking is that they’ve reached the age of “the dad bod.” Abdominal weight gain obscures a man’s view of his lower extremities, hiding the penis’ full length below extra skin and tissue. Losing 10 pounds is the quickest and easiest way to regain that “missing” length.

Other Causes

There are a couple of conditions that can cause a penis to appear shorter or to actually lose length.

• Peyronie's Disease. This is a painful condition in which scar tissue within the penis causes an abnormal curve. The tangled scar tissue may not permit the penis to fully extend, or it may produce a curve so pronounced that it creates a loss of length.
• Surgery. When the prostate is completely removed — for example because of prostate cancer — part of the urethra is removed as well. That can cause the loss of about an inch, sometimes two.
• Lack of use. Just as morning stretches help make the body more flexible and mobile, regularly stretching the penis out helps to maintain length.

Ups and Downs of Intervention

There are procedures that make a penis appear longer or thicker; these are mostly cosmetic, and insurance may not cover them. There is a ligament attached to the pubic bone that holds the erect penis aloft. Releasing that ligament doesn’t really lead to more length, but it may give that perception because the erect penis becomes less vertical. (This procedure also can result in a greater change in direction than desired.) There also are aesthetic solutions called penile fillers, similar to fillers used on lips and eyebrows, but these are not all FDA-approved.

Don’t Forget Your Testicles

Testicles also can shrink — or grow. When a man takes testosterone, the testicles will shrink, because the “factory” inside no longer has a purpose. Shrinkage in testicles is no big deal medically — if they are growing in size, that can be a sign of testicular cancer. Just as women do monthly self-examinations of the breasts, men should also regularly examine their testicles, to know when there’s a change.

Don’t Worry, Be Happy

Sometimes the solution to concerns about penis size is not a procedure but a conversation with your doctor. For many men, once they realize what they’ve got naturally is pretty much what everybody else has, they feel less worried or dissatisfied.

Research studies have asked men to rate their performance and equipment, with majorities reporting that they felt inadequate or insufficient in length, girth or staying power. But when studies asked their sexual partners if they would prefer a longer penis or bigger girth, that majority was happy with their partners as they were, caring more about foreplay, intimacy, love and affection than anything to do with size.