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Penile Atrophy (Penis Shrinkage): Causes, Treatment And Prevention

Penile atrophy or penis shrinkage is the decrease in the size of the male genitalia. The length of one's penis can decrease by up to an inch or so due to various reasons. Basically, it is the decrease in the length or girth of the penis caused by extensive loss of penile tissue.

The shrinkage is mostly temporary, however, can be permanent in some cases. According to various urologists, this shrinkage is commonly reported globally. The size of the male genitalia varies according to the genetic and hereditary factors. And the flaccid length of a penis is not necessarily the same as that of the erect length.[1]

According to a study published on assessing the phallic sizes, it was pointed out that an average flaccid length is 8.8 cm (3.5 inches), average erect length is between 12.9 and 15 cm (5-6 inches) and the average circumference of the erect penis is 12.3 cm (4.75 inches).

The size of the penis varies, depending on the penile blood circulation. With more blood flow comes more tumescence and vice versa in case of limited blood flow. Shrinkage is mainly caused due to exposure to cold, being anxious or nervous, and participation in sports activities, which are all linked with blood flow.[2] [3]

Types Of Penile Atrophy

The shrinkage can be characterised into two types.[4]

Acute shrinkage: It is the type of shrinkage that affects the male genitalia for a short period of time, that is, it is temporary.

Chronic shrinkage: This type of shrinkage persists for a longer period of time and can become permanent.

Causes Of Penile Atrophy

The causes of the condition can be distinguished in accordance with the types .[5] [6] [7]

1. Acute shrinkage

Mental state: When an individual becomes nervous or anxious, the fight-or-flight hormone adrenaline releases from the body. The hormone functions as a vasoconstrictor, which causes a flaccid penis.

Temperature: It is described as being one of the major causes of penis shrinkage. When you are exposed to cold temperatures, it causes the narrowing of arterial flow in body's peripheral parts so as to maintain the blood flow and body temperature. The cold reduces any swelling and inflammation, thereby causing the penis to shrink.

Exercise: Excessively working out on a regular basis can significantly impact the blood flow in the penis. The excessive need for oxygen to be burnt during the workout sessions reduces blood flow in the penile region and increases flow in the pulmonary region, therefore causing it to shrink.

2. Chronic shrinkage

Irregular sexual activity: Any part of your body, be it your heart or your sexual organs are required to be working on a regular basis in order to maintain your overall health. A lack of regular sexual activity can cause the penis to shrink, that is, the smooth muscle, elastin, and other tissues within the penis may be affected. This can result in the loss of penile length and girth and an inability to achieve an erection.[7]

Diseases and treatments: Some diseases and treatments can also cause shrinkage. Radical prostatectomy (a treatment for prostate cancer) requires the surgical removal of the prostate, resulting in disuse atrophy. Studies have revealed that about 70 per cent of men experience mild to moderate shortening of their penis in the event of prostate surgery. That is, the abnormal muscle contractions can pull the penis further into the body.

One of the other causes is Peyronie's disease, in which the penis develops an extreme curvature which can make involving in sexual activities difficult. The disease can reduce the length and girth of the penis .[8]

The other major causes of penile shrinkage are ageing and obesity. As one gets older, the penis and testicles can get smaller in size. The build-up of fatty deposits in your arteries reduces the blood flow to your penis, causing damage to the muscle cells in the spongy tubes of erectile tissue (inside the male genitalia).[9]

Apart from this, obesity is also a major reason for penis shrinkage. Gaining weight around the lower abdomen can result in the penis looking smaller. The thick fat deposits around the abdomen begin to envelop the shaft of the penis, enclosing most of it .[10]

Also, some medications that include amphetamine & dextroamphetamine mixed salts, some antidepressants and antipsychotics, and some drugs prescribed to treat an enlarged prostate can cause penis shrinkage.[11]

One can experience penis shrinkage as a side effect of continuous smoking. Chemicals from the cigarette can injure the blood vessels in the penis and prevent the penis from filling with blood and stretching .[12]

When To See A Doctor

If you begin to notice a curvature developing on your penis, along with swelling and pain - go to the doctor immediately. This could be a symptom of Peyronie's disease.[13]

Treatment For Penile Atrophy

1. Platelet Rich Plasma (PRP) therapy

It is regarded as being one of the safest and most effective methods to rejuvenate and rebuild body tissues. The therapy does not involve any surgery and scarring, is organic, and a quick procedure. It has been advised for many professional athletes, as their lifestyle involves long hours of exercise that may cause penis shrinkage.[14]

2. Surgery

For men diagnosed with Peyronie's Disease, the surgery can help improve the blood flow. The surgical and ultrasound technology options help remove the scar tissue but the length will remain short. However, it aids in improving one's sexual performance.[15]

Prevention Of Penile Atrophy

The first step to be adopted is lifestyle changes. One can prevent the onset of the condition by avoiding smoking and eating healthy.[16] [17]

• Remain physically active

• Consume a nutritious diet

• Quit smoking

• Avoid the consumption of excessive amounts of alcohol

• Understand that cold, stress, and athletics can cause a temporary shrinkage

• Do pelvic floor exercises such as Kegel exercises

• Try to remain sexually active and practice safe sex.

View Article References
  1. [1] User, H. M., Hairston, J. H., Zelner, D. J., McKENNA, K. E., & McVARY, K. T. (2003). Penile weight and cell subtype specific changes in a post-radical prostatectomy model of erectile dysfunction. The Journal of urology, 169(3), 1175-1179.
  2. [2] Lin, H. C., Yang, W. L., Zhang, J. L., Dai, Y. T., & Wang, R. (2013). Penile rehabilitation with a vacuum erectile device in an animal model is related to an antihypoxic mechanism: blood gas evidence. Asian journal of andrology, 15(3), 387.
  3. [3] Ciancio, S. J., & Kim, E. D. (2000). Penile fibrotic changes after radical retropubic prostatectomy. BJU international, 85(1), 101-106.
  4. [4] McCullough, A. (2008). Penile change following radical prostatectomy: size, smooth muscle atrophy, and curve. Current urology reports, 9(6), 492-499.
  5. [5] Pahlajani, G., Raina, R., Jones, S., Ali, M., & Zippe, C. (2012). Vacuum erection devices revisited: its emerging role in the treatment of erectile dysfunction and early penile rehabilitation following prostate cancer therapy. The journal of sexual medicine, 9(4), 1182-1189.
  6. [6] Wespes, E. (2002). Smooth muscle pathology and erectile dysfunction. International journal of impotence research, 14(S1), S17.
  7. [7] Zippe, C. D., & Pahlajani, G. (2008). Vacuum erection devices to treat erectile dysfunction and early penile rehabilitation following radical prostatectomy. Current urology reports, 9(6), 506-513.
  8. [8] Haneke, E. (1982). Skin diseases and tumors of the penis. Urologia internationalis, 37(3), 172-182.
  9. [9] Kingsberg, S. A., Kellogg, S., & Krychman, M. (2009). Treating dyspareunia caused by vaginal atrophy: a review of treatment options using vaginal estrogen therapy. International journal of women's health, 1, 105.
  10. [10] Zhou, M., Netto, G. J., & Epstein, J. I. (2012). Uropathology. Elsevier Health Sciences.
  11. [11] Sachs, B. D. (1983). Potency and fertility: Hormonal and mechanical causes and effects of penile actions in rats. In Hormones and behaviour in higher vertebrates (pp. 86-110). Springer, Berlin, Heidelberg.
  12. [12] Tourchi, A., Shabaninia, M., Stewart, M., Miyamoto, H., Di Carlo, H., & Gearhart, J. P. (2018). Complete penile disassembly for repair of epispadias causes erectile tissue alteration through transforming growth factor beta 1 overexpression in a rabbit model. Urology, 111, 151-156.
  13. [13] Kilic, S., Kolukcu, E., Erdemir, F., Benli, I., & Arici, A. (2019). The Effects of Oral 5-alpha Reductase Inhibitors on Penile Intracavernosal Pressures and Penile Morphology in Rat Model. Urology journal.
  14. [14] Xu, Y., Xin, H., Wu, Y., Guan, R., Lei, H., Fu, X., ... & Yang, Y. (2017). Effect of icariin in combination with daily sildenafil on penile atrophy and erectile dysfunction in a rat model of bilateral cavernous nerves injury. Andrology, 5(3), 598-605.
  15. [15] Wallen, J. J., Madiraju, S. K., Wang, R., & Henry, G. D. (2019). Implementation of length expanding inflatable penile prosthesis is not sufficient to prevent postsurgical penile shortening. Asian journal of andrology, 21(1), 98.
  16. [16] Ottenhof, S. R., Bleeker, M. C., Heideman, D. A., Snijders, P. J., Meijer, C. J., & Horenblas, S. (2016). Etiology of Penile Cancer. In Textbook of Penile Cancer (pp. 11-15). Springer, Cham.
  17. [17] 17. Clavell-Hernández, J., & Wang, R. (2018). Penile Size Restoration With Nondegloving Approach for Peyronie’s Disease: Initial Experience. The journal of sexual medicine, 15(10), 1506-1513.

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