Micropenis ➤ Treatment Options

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What is a micropenis?

The micropenis – medical Microphallus or hypogeniatlism called – is a congenital malformation of the penis, which makes it unusually small. The function of the penis is basically not affected – those affected are just as capable of erection and ejaculation as men with a normal-sized penis.

When does one speak of a micropenis?

The micropenis can already be diagnosed in the womb by ultrasound. Normally, however, a micropenis is only detected after birth. A deviation from the norm is assumed for diagnosis in childhood and adolescence: If the penis length is more than two and a half standard deviations below the average penis length in the corresponding age group, a microphallus is diagnosed. The length of the penis is measured on the back of the penis, i.e. from the pubic symphysis to the tip of the penis.In addition to the age group, ethical peculiarities are also considered for the diagnosis of a micropenis, since the average penis length varies greatly depending on ethnicity. For example, the average penis length in United Kingdom is 15 cm, while in South Korea it is only 9.7 cm.When diagnosing the micropenis, it is important to distinguish it from so-called pseudo-micropenis. These include, for example, the “buried penis”. This is often seen in overweight people, in whom the penis appears very small due to the high percentage of abdominal fat, but does not meet the medical criteria for a microphallus.

Digression: Measure the penis correctly

  • Measure length of penis: Measure the distance from the base of the penis to the pubic bone and the tip of the glans. It is best to use a flexible tape measure for this.
  • Measure the circumference of the penis: Using a flexible tape measure, measure the circumference of the thickest part of your penis. This is usually the base of the penis directly on the pubic bone.

How common is a micropenis?

Little statistical data is available on the incidence of micropenis. However, it is estimated that less than 2% of the male population has a medical micropenis. In a study from Colombia, it appeared even less frequently – only about 0.02% showed a microphallus here. The frequency of micropenis can therefore vary regionally.Some studies show that the diagnosis of micropenis in newborns has increased in recent years. The reasons for this are said to be exogenous active ingredients – such as plasticizers, pesticides, medicines or cosmetics – which damage the hormone system.

What are the causes of a micropenis?

There are many reasons for a micropenis. However, the background is always one developmental disorder of sexwhich is usually caused by reduced testosterone production.The most common cause of a micropenis is one Hypothalamic hypofunction or the pituitary gland, which can cause insufficient testosterone production and thus inhibited development of the sex organs. A direct hypofunction of the testicles has the same effect, but usually only becomes noticeable during puberty in the form of a lack of further development of the penis.Another possible cause of a micropenis is partial androgen resistance: Although testosterone production works here, the receptors for testosterone are missing. As a result, the hormone has no effect. This resistance already exists before birth and usually has an impact on the height of the child.The microphallus can be one of many symptoms of a condition that directly or indirectly affects the body’s testosterone or growth hormone production. Exogenous active ingredients and hormones – such as plasticizers or cosmetics – can also affect testosterone production in the body.In about 10% of those affected, no medical cause is found for the micropenis – they suffer from it idiopathic micropenis.

Is the micropenis experienced as an impairment?

A micropenis can be a big one psychological burden for those affected. As early as childhood and adolescence, people with a micropenis often have to deal with teasing and constant comparison with their peers. The consequences are usually inferiority complexes, which also persist in adulthood. Those affected often feel inhibited about entering into intimate relationships and showing themselves naked to others. Activities that might involve the micropenis are often avoided altogether, and social withdrawal, depression, and anxiety disorders can result.The micropenis itself is usually not restricted – it only differs in size from a normal-sized penis. The ability to have an erection and ejaculation as well as the fertility are normally without impairment.Only during sexual intercourse can there be restrictions due to the size of the penis: the micropenis is often not big enough to stimulate the vagina sufficiently. This can be very stressful for both the person concerned and their partner. That’s why it’s very important to talk openly about your own needs and to experiment with which techniques and positions work for both partners. A fulfilling sex life for both partners is also possible with a micropenis!

The best positions for sex with a very small penis

How should the partner deal with a penis that is too small?

Since the micropenis is often a great burden for those affected, it is important as a partner to approach the topic sensitively and openly:
  • Refrain from comments and jokes about his penis! Sayings like “Is it in yet?” are mean, hurtful and totally counterproductive. If you’re dying to let him know that you’re unhappy with his cock, you should do so in a respectful manner.
  • Be open to experimenting! Suggest your partner to try new sex positions. You can find the best positions for sex with a small penis here here. If you still miss the feeling of the penetrating penis, including sex toys – for example a strap-on dildo – can be very helpful and exciting.
  • See the positive! Many men with small penises make the best of the situation by acquiring excellent oral and manual skills over time. Just let yourself be surprised by what your opponent can do!

The right condoms for a micropenis

Many sufferers find it embarrassing to buy condoms for small penises. However, this is absolutely not justified, especially since it is much more uncomfortable if the condom does not fit properly and – in the worst case – suddenly disappears during sex. In addition, a condom that is too large does not offer sufficient protection against sexually transmitted diseases or unwanted pregnancy.When choosing the right condom, the length of the penis is less important than the width. It is best to measure the length and circumference of your penis and buy a condom that suits you. There is now a Parisian for every size and width on the market – from XXS to XXL.

Enlarging a penis that is too small: can a micropenis be treated?

If the micropenis is diagnosed in childhood or adolescence, it can usually be treated with hormone therapy. After puberty, however, it is too late for this and other therapeutic measures must be considered – such as surgery or the use of a penis pump.

Hormonal treatment of the micropenis

In most cases, a micropenis can be diagnosed quite early and treated accordingly. If too little testosterone production is detected in the womb, the growth of the penis can be stimulated with the help of hormone injections. Even in childhood, the micropenis can be treated with hormone therapy. The injection of testosterone into the penile muscles enables normal development of the penis. The dosage of the hormone injections is adjusted to the stage of development and the age of the patient. After puberty, i.e. after the sexual organs have developed, such hormonal therapy is no longer possible.

Surgery: Elongate and thicken the micropenis

During penis enlargement surgery, the front part of the penis shaft is detached from the pubic bone and part of the inner shaft of the penis is shifted outwards so that the penis looks longer and wider. Additional tissue from the thigh or abdomen may also be inserted into the penis. The extended penis can then be embedded in plastic to preserve the excitable tissue. With this method, a penis thickening and lengthening of 2 – 3 cm is possible. However, the risk of the procedure is very high and should be carefully considered.

The penis pump for the micropenis

According to some sources, training with a penis pump or vacuum pump should help to lengthen the penis permanently. The idea behind it is that the negative pressure of the penis pump should stimulate the build-up of the erectile tissue and the growth of tissue in the penis. Especially after the surgical penis enlargement, this training should lead to optimal results. However, the effectiveness of the penis pump for enlarging the micropenis has not been scientifically proven.Another, also controversial and not scientifically proven method of lengthening the penis is the use of a so-called penis stretcher. Here the penis should be stretched by pulling force.
The explanations and lists of possible treatment options are purely informative and do not replace consultation with your doctor or the explanations about the intake, mode of action and side effects from the product-specific leaflet.
Isabel D White

Isabel D White

Isabel led the Royal Marsden Hospital (London) psychosexual therapy service until 2019. She works in partnership with individuals & couples to explore physical, emotional & relationship factors that contribute to sexual difficulties after cancer. These include: low desire, erection, arousal or orgasmic difficulties, sexual pain & sexual avoidance. She adopts an integrative approach to personalized therapy using psychosexual therapy (sensate focus framework), biomedical management (erectile dysfunction medication & devices, menopause & vaginal health strategies, sexual aids) & psychoeducation.

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