Penis Enlargement

Introduction

Many males are concerned with the size of their penis. Masculinity and power have been associated with the size of a man’s penis for thousands of years.3 In Ancient Egypt, Min, the god of virility (manliness) was represented as a man with a large, erect penis. Priapus, the Ancient Greek fertility god, was depicted in paintings and literature with an oversized penis that was permanently erect. Imagery of large penises​representing masculinity throughout religion, literature, and art has created a lasting influence on men. For example, there is historical evidence of men trying to enlarge their penis as a result of these influences. In Southeast Asia, the Dayak tribe put holes in their penises and inserted “decorative items” to help pleasure their partner and maintain an erection. During the 16th century in Brazil, Topinama Indians allowed poisonous snakes to bite their penis in order to enlarge it. The excruciating pain would last for at least six months! Both of these methods led to severe pain, infection, and sometimes even amputation of the penis.3

 

 Unfortunately, men today continue to feel pressure from society to have larger penises. This pressure can lead to stress, embarrassment, and shame. It can also influence men with an average penis size to believe that they need to enlarge their penis. The countless magazine advertisements, commercials on television, and Internet specials that advertise various ways of enlarging a male's penis can make men feel insecure. These methods include surgery, drugs, supplements, pumps, and exercises. It is difficult to find accurate scientific data concerning the validity of these claims and their possible side effects. This is partly because much of the science is so recent that long-term studies have not yet produced clear results. Additionally, the companies that sell penis enlargement products hire many of the scientists who publish studies on the topic, leading to significantly biased research and it is therefore unreliable.

 

The authoritative source on the subject of penis enlargement is the Food and Drug Administration (FDA). The FDA has not yet approved any method of penis enlargement. Some websites attempt to omit this by advertising their products as "FDA approved," when in fact they are only FDA approved for other applications. For example, there are penis pumps on the market that are FDA approved only for the treatment of impotence, but they are advertised for penis enlargement. Some websites use ambiguous wording to trick consumers into buying a product for the wrong reasons. For example, one website states: "We offer an FDA-approved product to assist with impotence and the user may gain up to 3 inches or more!" Websites offering pills and creams tend to not address the FDA-approval issue, which should be evidence enough that they are not FDA approved. 9

In this article we will discuss penis size, the psychological perspective surrounding the subject, and treatments for penis enlargement.

 

Penis Size  

Penis size can be measured in many different ways. People may either measure the length or the girth of their penis, or both. Below, we will define: girth and length, length of a micropenis, and the average length of a penis.

Girth and Length 

When men assess their penis size, they mainly focus on the length of their penis rather than the circumference (girth). However, 45 out of 50 surveyed women reported that the girth of a penis affected their pleasure level more than length.2  Therefore, when discussing penis size, both length and circumference should be taken into account. A study conducted in London measured the penis size of 15,000 men. The average flaccid penis for this specific study was 9.16 cm and the average erect length was 13.12 centimeters. The average flaccid circumference was 9.31 centimeters and the average erect circumference was 11.66 centimeters.10 It is important to keep in mind that the average size varies depending on race and age.

Micropenis

The definition of a micropenis is a penis that has stretched penile length (SPL) that is two standard deviations below the average length for the male’s age and race.1 Micropenises are often a result of a congenital abnormality. A micropenis “most commonly suggests a defect in the hypothalamic-pituary-gonadal axis during fetal development.” 5 Therefore, a micropenis is typically a result of hormonal imbalance during fetal development. 1 Later, we will describe the treatment for micropenises.

 

Psychological Perspective                                                                    

Men who have insecurities about their penis size are more likely to have poor self-esteem about their body, face, height, and overall physical attractiveness.8 Both men with small penises and men with average penises suffer from these insecurities. 8 Men who underestimate their penis size often suffer from “locker room syndrome.” Locker room syndrome is the anxiety and fear that men feel when they compare their flaccid penis to those of other men. Locker room syndrome is also called small penis anxiety (SPA).        

Significant SPA can turn into penile dysmorphic disorder (PDD). 7 PDD is a diagnosable condition that involves a male obsessively checking the size of his penis and comparing his penis to others.  Men with PDD who have an average or slightly below average will perceive their penis as small. This disorder lies under the umbrella of body dysmorphic disorder (BDD). PDD can create harmful effects such as significant distress, depressed mood, general anxiety and/or suicidal ideations. 7                                                     

Can surgery help a man with his self-esteem issues? Unfortunately, a male with PDD may continue to have self-esteem issues even if his penis grows in size.8 Most self-esteem issues stem from deeper psychological issues. Therapy may be more useful than surgery to help men with penile dysmorphic disorder.   Surgeons should be hesitant to perform a penile enlargement surgery if it is not going to increase the patient’s well being. The patient should be psychologically evaluated prior to surgery to ensure that the man has realistic expectations and has the right mindset. 8

According to an online survey of 52,031 heterosexual men and women, 45% of the men reported dissatisfaction with their penis size. Despite men’s dissatisfaction with their penis size, 84% of the women reported no dissatisfaction with their patners’ penis size.4 These studies prove how a significant amount of men tend to underestimate their penis size, despite the fact that the overwhelming majority of women report no dissatisfaction.

As shown by the studies above, most men have no reason to worry about their penis size. It is important for males to communicate with their partners about whether or not they are satisfying them. If both partners are sexually satisfied, then the size of the penis does not matter.  To please their partner, males should focus on different sexual positions, foreplay, cunninglingus, fellatio, or anything else that helps their partner achieve sexual satisfaction.  

 

Treatment                                             

Treatments for penile-elongation have been a controversial topic for doctors. Academic urologists do not perform these treatments, making treatment a market of the private sector. The sections below examine the two different methods for penis enlargement: nonsurgical methods and surgical methods. It is important to note that none of the methods below are FDA approved, meaning they are not government-approved.

Non-surgical methods

Doctors first recommend conservative, non-surgical methods for men seeking penis enlargement. The non-surgical methods are safer than the surgical methods for penis enlargement. 

Testosterone

Doctors can use topical or injections of exogenous (originating from another organism) testosterone on children who have micropenises as a result of unbalanced hormones during fetal development.1  A study of children with micropenises exposed to exogenous testosterone resulted in a significant increase in stretched penis length.6 Although these treatments help increase length during childhood, there are no studies that demonstrate there are any long-term effects into adulthood. 1

Jelqing

While many males have reported through online forums and videos that jelqing is an effective means of increasing penis size, no scientific study has ever concluded that this method works. Proponents of the technique claim that routinely pulling and stretching the penis will cause the tissue to fill with blood and permanently swell. However, the basic anatomy of the penis contradicts this theory. The penis itself is not a muscle that can be strengthened or altered with exercise. The size of an erect penis is genetically predetermined by the length of the corpora cavernosa tubes. If the tubes were able to be stretched, erections would never be fully firm. Jelqing supposedly works by forcing blood to flow into the penis, causing it to swell and creating pressure that promotes the expansion and growth of penile tissue. The process may be able to increase blood flow, but most urology experts assert that this technique cannot permanently enlarge the penis.

There are also devices on the market that claim to provide the same “traction” technique as jelqing. For example, a penis pump also creates pressure within the penis due to blood rushing in. The penis pump is a vacuum that draws blood into the genitals. While the blood flow caused by penis pumps may provide temporary penis enlargement or offer therapy for men with erectile dysfunction, permanent growth has never been recorded. However, permanent damage is possible. If you are interested in learning more, read our Jelqing article

Surgical Methods

The surgical methods of penis enlargement are a more invasive and risky approach compared to that of the non-surgical methods. It is important to note that there is no optimal surgical method and each one has multiple risks.

Penile Augmentation

One of the most common, less invasive methods for penis enlargement is injecting liquid silicon, polyacrylamide, hyaluronic acid, or mineral oil into the penis.1 However, studies have shown that injecting these foreign materials into the penis results in swelling, penile distortion, granulomas (inflammation of tissue) and need for removal. Instead of using foreign bodies, constructing a fat graft from the patient’s body has been used for injection. Doctor Sydney R. Coleman, a famous American plastic surgeon, has refined the fat graft technique. Studies have shown that fat injections can increase length and circumference, but due to resorption of the fat graft, the effects are not long lasting. Within the first year of the injection, the graft loses 20%-80% of its volume, thus men often do more than one injection.1

Other Surgeries

There are other, more invasive surgeries, such as Suspensory Ligament Release, V-Y Advancement, and Flap Reconstruction.1 With these more intrusive surgeries come dangers and more risk of complications. Overall, these surgeries are not supported by any scientific research. They are not the optimal choice for penis enlargement. To learn more about these surgeries, visit this article. Penis enlargement is a fairly new industry, so it is difficult to determine the actual results and possible side effects of any methods at this point in time. More research and scientific work in this field is required to find the best treatment with the lowest risks and highest results.1

A Final Note 

Unless a person has a micropenis, it is not necessary to seek treatment for penis size. Effective communication with your partner and therapy could help treat any feelings of dissatisfaction with penis size. If you are concerned that your penis is too small or have any other questions regarding penis enlargement ask the Sexperts here!                                                           

 

References:                                                                                                                                                  

 1. Campbell, Jeffrey, and Joshua Gillis. “A Review of Penile Elongation Surgery.” Translational Andrology and Urology 6.1 (2017): 69–78. PMC. Web. 27 Feb. 2017.

2. Eisenman, Russell. "Penis size: Survey of female perceptions of sexual satisfaction." BMC women's health 1.1 (2001): 1.

3. Kim, Won Whe. "History and Cultural Perspective." Penile Augmentation. Springer Berlin Heidelberg, 2016. 11-25.

4. Lever J, Frederick D, Peplau L. Does size matter? Men’s and women’s views on penis size across the lifespan. Psychol Men Masc. 2006;7(3):129–43.

5. Minhas, Suks, and John Mulhall, eds. Male Sexual Dysfunction: A Clinical Guide. John Wiley & Sons, 2016. 236.

6. Nerli, Rajendra B., et al. "Penile growth in response to hormone treatment in children with micropenis." Indian journal of urology: IJU: journal of the Urological Society of India 29.4 (2013): 288.

7. Veale, David et al. “Sexual Functioning and Behavior of Men with Body Dysmorphic   Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study.” Sexual Medicine 3.3 (2015): 147–155. PMC. Web. 27 Feb. 2017.

8. Youn, Gahyun. "Psychosocial Perspectives on Penile Size." Penile Augmentation. Springer Berlin Heidelberg, 2016. 41-46.

9. LeVay, Simon, Janice I. Baldwin, and John D. Baldwin. Discovering Human Sexuality. Sunderland, MA: Sinauer Associates, 2009. Print.

10. Wise, Jacqui. "Average length of a flaccid and erect penis is published to help   counsellors." BMJ: British Medical Journal 350 (2015).

 

Last Updated: 15 March 2017.

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