Many men worry about the size of their penis; however, not many realise that there is an actual medical condition where the size of the penis is referred to as a “Micropenis”.
The condition is usually recognized shortly after birth. The term is most often used medically when the rest of the penis, scrotum, and perineum are normally developed and only penis is small.
The condition refers to any penis which when stretched, is 2.5 standard deviations below the mean size for the age of the patient.
In adults, the condition refers to any penis smaller than 2.8 inches in length. In infants, a Micropenis is classified as any penis that is less than 0.75 inches in length. This is considered significantly smaller than a “normal” male newborn’s penis, which is between 1.1 and 1.6 inches in length when stretched gently.
Having a micro-penis can cause several problems including difficulty urinating and having sexual intercourse. Fertility can also be affected. Some people with Micropenis have a low sperm count which results in infertility or decreased fertility. The condition can also have a major impact psychologically. Many men with the condition have very low self-esteem and some even suffer from depression.
Micropenis is caused by the male baby’s penis failing to elongate after the first trimester of pregnancy.The cause of this is thought to be a hormonal problem. Specifically, it is thought to be due to insufficient levels of testosterone, a male sex hormone.
The inadequate levels of testosterone may come as a result of inadequate production of testosterone during the second and third trimesters of pregnancy or as a result of the unborn child not responding to the produced testosterone.
Research carried out has shown that genetic mutations of the SRD5A2 gene that is the gene, which codes for enzyme 5-alpha reductase, which in turn processes testosterone.
Researchers have also found that there may be a genetic condition, which makes boys more susceptible to the development of Micropenis triggered by factors in the environment namely dioxins and pesticides.
Incidence of Micropenis
Despite not being commonly discussed, the condition is thought to affect 1 in 200 males that are born. Not every small penis could be classified as a Micropenis. Some may be concealment of the penis in the supra-pubic fat (extra fat around the mons pubis), a large body and frame for which a pre-pubertal penis simply appears too small or delayed puberty with every reason to expect good future growth.
Early diagnosis of “true Micropenis” is important because it allows for various treatment options to be utilized early. The first step in the diagnosis of Micropenis is the physical examination of the patient’s external genitalia. Historically, people considered changing sex of the child from male to female if there was a Micropenis.
Nowadays, according to the UK Intersex Association (UKIA), cosmetic surgery of the genitals to reassign an infant’s gender from male to female, solely due to the child having a small penis, is same as “child abuse”. Instead, they advocate hormone therapy called testosterone replacement. This can produce a penile length within the “normal range”.
Micropenis can also be treated with surgery called phalloplasty which often involves using skin from the patient’s forearm. This skin is wrapped around the native penis and sometimes an inflatable penile prosthesis is inserted to provide an erection. Researchers have found that this procedure produced a penis which could be used for sexual intercourse on a regular basis and that remained stable for the long-term.