Penile atrophy is a reduction in the size of the penis that may be the result of aging or disease. This particular organ naturally grows and shrinks in size, depending on situational factors like arousal and extreme cold. Atrophy, however, represents a long-term change in the size or shape of the penis, or of structures like the foreskin. A patient who notices such changes can discuss them with a urologist, who can perform an evaluation to learn more about the cause and provide some treatment recommendations.
As men age, shifting deposits of body fat may cause the penis to appear smaller, although this is not actually the case. Older men do eventually start to develop penile atrophy, usually after around age 60, as a result of reduced bloodflow to the organ. People with conditions like atherosclerosis are more likely to experience this, because plaques in the arteries obstruct the flow of blood and the tissues in the penis start to shrink as a result. Erections also tend to be smaller, because they rely on an ample supply of blood.
Another potential cause of atrophy of the penis is a drop in testosterone levels. This often occurs as part of systemic disease or in the course of treatment for a condition like prostate cancer. Men will also notice other symptoms, like shrinking testicles. An endocrinologist can run a blood test to see if testosterone levels are normal and determine if hormone therapy would be appropriate for the patient. Taking testosterone can expose people to the risk of side effects and they need to weigh the pros and cons before moving forward with therapy.
Connective tissue diseases involving the penis can also contribute to this condition. Patients may notice other symptoms, like a change in the curvature of the penis, difficulty getting and maintaining an erection, and changes in the texture or color of the skin. A medical professional should examine the patient and conduct an interview, and it may be necessary to run some tests to determine the origins of the disease and develop an effective treatment plan.
Penile atrophy can make men feel uncomfortable. Patients in treatment should make sure to discuss their concerns with a medical professional. Most healthcare professional understand that, while it may not be medically necessary to address changes in penis shape or size because they may not be dangerous, it may be beneficial for a patient's mental health to explore some options for correcting the problem. In cases where atrophy is accompanied by erectile dysfunction, treating it can make a significant difference in a patient's quality of life.
While some causes of penile atrophy are unpreventable, knowing what can potentially lead to it can make the patient aware of the signs so they can seek a diagnosis and treatment sooner.
As discussed above, prostate cancer treatment can lower testosterone levels leading to atrophy or erectile dysfunction (ED). Peyronie’s disease is another occurrence where complications in the penis can cause shrinkage or ED.
The link between penile atrophy and mental health should also be kept in mind. While cases of Koro syndrome are rare and extreme, anxiety and depression around bodily change are important to keep note of.
Lower Testosterone Caused by Prostate Cancer Treatment
The prostate gland’s primary function is to produce fluid that mixes with sperm to create semen. It also helps with hormone regulation and ejaculation during orgasm. Cancer affecting the prostate can interfere with these functions causing symptoms that can lead to atrophy with reduced testosterone levels.
However, treatments can cause damage to the nerves and muscles around the area. Hormone therapy for this cancer lowers testosterone levels, affecting sex drive and erectile function. During recovery, discuss considerations for atrophy and ED treatments.
According to John Hopkins Medicine (JHM), most men experience ED for a few months after the treatment. The severity and time for recovery vary based on the type of treatment. While ED and atrophy are not guaranteed to happen or last post-cancer treatment, prolonged disuse or nerve damage can cause lasting effects.
Treatments can include medicine, surgery, and devices to assist with blood flow to the penis. Though still under study with little evidence, penile rehabilitation can also be considered.
Nerve-sparing surgeries can have positive results in returning to normal erection function and health. Though it ultimately depends on the procedure the surgeon was able to do to assist in recovery, this can be a preferred method to radiation if available.
Different kinds of radiation yield different results and recovery times. Because the radiation damages the nerves, recovery to pre-treatment erection function can be difficult to achieve or may take years.
Though the cause for Peyronie’s is still unsure, cases range from repeated injury to the penis to a potentially hereditary cause. The disease is defined by the Mayo Clinic as “A noncancerous condition resulting from fibrous scar tissue that develops on the penis and causes curved, painful erections.”
About four out of every 100 men between the ages of 40-70 develop Peyronie’s Disease, though cases in younger men are possible. There are concerns about a lack of awareness and underreporting despite the disease’s commonality.
Peyronie’s can develop over time or seem to happen suddenly. Unfortunately, it’s unlikely to go away, making it imperative to see a doctor as soon as any concerns arise. Prolonged symptoms can include pain in the penis regardless of erection, shrinkage of the penis, ED, and other penile deformities along with the bend and scar tissue.
With Peyronie’s, the scar tissue that develops along the penis makes having an erection painful as the tissue doesn’t allow for stretching or easy blood flow while maintaining the erection. It can cause difficulties with intercourse and lead to stress and anxiety about related matters.
Medicine has been deemed ineffective except for anti-inflammatories, leaving surgery as the primary option. And in some rare cases, post-surgical therapy gives rise to reduced penis size.
What is Koro Syndrome?
Koro syndrome is a rare psychiatric disorder that exemplifies how penile health can affect mental health. Though originally thought to be a culture-based epidemic in Asia, there have been global occurrences. Koro syndrome is the fear caused by the belief that one’s penis will shrink to the point of retracting into the abdomen and causing death.
While no such thing has happened, the depression and anxiety caused by this belief are real problems.
Other mental health concerns in regards to penile atrophy are also real issues. This condition is closely related to ED, and can cause undue stress on a relationship, give complications with conceiving children and affect self-esteem and body image.
Patients concerned about penile atrophy and looking to take preventative measures can speak to their medical care physician about these different causes and some of the best ways to maintain a healthy penis.
A simple way to start would be to avoid cigarettes and excess consumption of alcohol, as these can affect testosterone levels. Doctor-recommended diets and exercises to help increase blood flow can also help.