Micropenis is a male limb that is shorter than seven centimeters when erect. It is an underdevelopment of the sexual organ, which can be treated well in early childhood with the administration of male sex hormones.
What is micropenis?
Micropenis, also called microphallus, is a condition in which the penis is particularly small. Micropenis is a subset of hypogenitalism, the main symptom of which is underdeveloped sexual organs. Not every small penis is a micropenis. Generally, micropenis is present when an adult male’s member is less than seven centimeters long when erect. During development, a disorder of sex development can often be difficult to determine objectively. Most often, physicians make do by comparison with peers. Penis length is measured from the back of the penis to the tip. Although many men feel they have a member that is too small, this is usually not the case. The exact incidence of this disorder is not known, but is likely to be less than two percent. When diagnosing micropenis, the ethnic background of the affected person must be considered, as there are differences.
Causes
There are a wide variety of causes for a micropenis. Sometimes it is not possible to determine the cause during the diagnostic process; in this case, the condition is referred to as idiopathic micropenis. A common form of this developmental disorder of the sex organs is the so-called hypogonadotropic hypogonadism. This disorder results in insufficient secretion of sex hormones by the hypothalamus or the pituitary gland. In androgen resistance, there is a sufficient amount of sex hormones in the body. However, the cells on which the hormones act are partially or completely resistant to their action. If too little testosterone is produced in the testes, micropenis may develop. The most common cause is hypogonadotropic hypogonadism; almost half of all affected individuals suffer from it. Furthermore, there is an increased risk of developing a micropenis if male babies experience androgen deficiency during development in the womb. Another possible cause is a deficiency of growth hormones. In these cases, not only the penis but also the body size is affected. In addition to the above causes of microphallus, there are a wide variety of genetic diseases that have micropenis as a symptom. These hereditary diseases include Robinow syndrome and MORM syndrome.
Symptoms, complaints and signs
The main physical symptom of micropenis is the presence of a very small member in boys and men. Erectile function and ejaculatory ability are basically unaffected in this disorder. Particularly those affected in adolescence often suffer greatly from the psychological consequences. They feel shame and isolate themselves from peers. Problems with self-esteem make it difficult to deal with the opposite sex. Men with micropenis may develop psychological disorders such as depression or anxiety disorders. However, even with a micropenis, a fulfilling sex life is possible for both partners. For this, certain adjustments regarding position and method are necessary. The procreative power of a man with micropenis is not limited.
Diagnosis and course of the disease
Diagnosis of micropenis usually occurs shortly after birth or prenatally. Before birth, micropenis can be diagnosed by ultrasound examination. In most cases, the underdevelopment of the sexual organ is not noticed until after birth. Before diagnosing micropenis, the attending specialist must consider other possible disorders. Since various genetic disorders are associated with underdevelopment of the male sex organs, a geneticist is often consulted for diagnosis. Basically, true micropenis must be distinguished from pseudo-micropenis. The pseudo-micropenis looks very small at first glance, but on closer examination it turns out to be of normal length. This is the case, among other things, when the limb lies under a layer of fat. In overweight men, a “buried penis” sometimes leads to the erroneous assumption of a microphallus. In rare cases, a greatly enlarged clitoris may be mistaken for a micropenis.The examination is performed by a pediatrician and includes visual inspection and palpatory examination of the penis. Since a hormonal imbalance may be responsible for the disorder, an endocrinologist is often consulted for diagnosis. The further course depends on the chosen therapy.
Complications
As a rule, micropenis does not cause any particular health limitations in the patient. The complaint itself is not a dangerous symptom and therefore does not need to be treated or examined by a physician. However, most of those affected suffer from psychological discomfort and depression due to the micropenis. It is not uncommon to experience feelings of shame or inferiority complexes. A reduced self-esteem can also develop and significantly affect the quality of life. Children in particular may experience teasing or bullying as a result of their symptoms. They may develop anxiety disorders or aggressive behavior. Furthermore, the sexual intercourse of those affected is also significantly restricted, resulting in discomfort with the partner. However, a micropenis does not lead to an inability to procreate and does not have a negative effect on the potency or erection of the man. As a rule, a micropenis can be treated relatively well with the help of hormones. This does not lead to further complications. However, in some cases, psychological treatment is also necessary in case of psychological discomfort. Micropenis does not affect the life expectancy of the patient.
When should one go to the doctor?
In many cases, the diagnosis is made by the pediatrician during pregnancy or shortly after birth. However, if parents still suspect that their infant or toddler has a micropenis, it is recommended to see the pediatrician or a specialist. If micropenis is not detected until childhood or adolescence, it is important to act as quickly as possible. The earlier the diagnosis is made, the greater the chances of successful treatment. In the case of micropenis, hormone therapies are usually used. It is important to start these before the onset of puberty in childhood. In this phase, the chances of a largely complete cure and normal further development are highest. If the affected men have already reached adulthood, it is usually too late for hormonal treatment and they have to undergo complex surgical procedures. The chances of success of these operations are much lower than those of hormone therapies. Therefore, in case of uncertainty or a suspicion of micropenis, a doctor should be consulted promptly.
Treatment and therapy
If diagnosed in a timely manner, hormone therapy is extremely promising and is the treatment of choice in the majority of cases. The child is administered male sex hormones such as testosterone during this therapy. Good results have been demonstrated in various studies. Affected individuals who had undergone hormone therapy to treat their micropenis often showed normal development of the sexual organ. Although the penis was still rather small even in adulthood, the length was largely within the norm. In exceptional cases, treatment is by sex-correcting surgery. This involves phalloplasty, in which a larger penis is created from the existing tissue. However, this procedure is associated with many risks. Studies have not shown that those affected were happier with their sex organ after the procedure. For this reason, hormonal therapy should be preferred to surgery whenever possible. A somewhat unconventional measure is the use of dilators, which affected men must use for several hours each day for several months. With this procedure, an increase of about two centimeters can be achieved. In addition to physical treatment, psychotherapy or behavioral therapy is recommended for older affected individuals. The therapy is used to develop a positive body image and boost self-confidence.
Outlook and prognosis
Due to the fact that micropenis results from a developmental disorder of the male sex organ, there is no prospect of spontaneous improvement in any case. Hormonal therapy options also have a chance of success only if they begin before puberty.Otherwise, the development of the sexual organ is complete and cannot be hormonally corrected even afterwards. Surgical procedures have a very good prognosis in terms of healing of any scars and injuries. Complications resulting from surgery for micropenis are rare. However, the subjectively perceived success due to surgery is very dependent on the affected individual. However, in the vast majority of cases, the surgical procedures can bring about an improvement in self-esteem and greater satisfaction with one’s own member. The further prognosis in case of micropenis also depends very much on the affected man. In some cases, the visual and sexual restriction caused by this is a lifelong problem, which is countered with therapies, among other things. The lowered self-esteem and the subjective feeling of not being masculine enough can also promote severe psychological problems. Depression and the like occur in this context. On the other hand, there are all those men with micropenis who have come to terms with their condition and lead ordinary lives. Important factors here are general satisfaction, a fulfilling partnership and their own resilience.
Prevention
Micropenis cannot be prevented with specific measures, as it is a complex developmental disorder of the sexual organs. In general, if a disorder is suspected, it is recommended that a specialist be consulted during infancy. The best time to make a diagnosis is immediately after birth. In this way, therapy can be started as early as possible.
Aftercare
In most cases, micropenis does not cause any special or serious complications, so the affected person can lead an ordinary life despite the condition. A doctor should still be contacted to prevent further worsening of the condition. The disease itself can usually also be treated relatively well, so that there is also no reduced life expectancy of the affected person. In the case of micropenis, these suffer from a very small penis. This leads to disturbances of the erection and thus also to very strong disturbances during sexual intercourse. In many cases, those affected therefore also suffer from depression or other psychological upsets, and bullying or even teasing can occur, especially in children or in adolescents. As a rule, a micropenis also results in reduced self-esteem, which can have a negative effect on the quality of life of the affected person. Most patients are afraid to tell other people about the condition and are ashamed of it. However, it can be relatively well alleviated by surgical intervention.
Here’s what you can do yourself
Men with micropenis cannot make any independent changes to their physical appearance besides medical care or cosmetic surgery. The physical features can only be adjusted through the use of a medical professional. The self-help here lies in building the emotional strength and stability. Self-esteem and also self-confidence should be powerful so that feelings of shame or inferiority do not occur. Talking to therapists or men who were also born with a micropenis is helpful. In addition, if available, communicative exchange with the partner should take place. In many cases, the size of the penis is an emotional problem only for the affected person, which can be clarified in a conversation. In sexual activities, there is the possibility of jointly finding techniques of satisfaction in which the size of the penis does not play a central role. Additionally, a change of perspective and cognitive patterns are helpful. The center of life and thus the general well-being or life satisfaction should not depend on the appearance of a sexual part. As soon as the focus is placed on other areas, skills and talents of the affected person in which he or she experiences fame and recognition, there is a possibility that the micropenis will no longer be perceived as a burden.
