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What Is Penile Atrophy?

Mary McMahon
Updated Mar 06, 2024
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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.

Peyronie’s Disease

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.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon996641 — On Sep 21, 2016

What would cause a 'pinch-like' feeling in the upper shaft region of the penis, particularly during arousal? Is this a symptom of penile atrophy or urinary-tract cystitis? There is no discharge and tests confirm no STD infection.

By Achiever — On Jun 06, 2016

Would a vacuum pump help with penis atrophy? If so what is a good model? Sex stores sell them--are they useful or should you consult a urologist and get a prescription for an expensive model? My sexual prowess was obliterated because of prostate cancer. Cryosurgery took care of the cancer but desimated my stellar sexual skill. Alas, my marvelous sex organ is now a simple water pipe. I'm 87.

By TheStranger — On Mar 23, 2016

My experience is similar to Pharoah's. I was diagnosed with aggressive but early stage prostate cancer back in 2013. The oncology team assigned to my case recommended a three-legged stool treatment approach consisting of radiation, chemo and hormone therapy because I didn't want the surgery option.

My wife and I sat with this team for an entire day listening to what they said we were in for and asking every question we could think of. Afterward I decided to look up the drugs they were using and that's when I first heard of testicular atrophy; it was a side effect of the Lupron hormone therapy drug. The article said that Lupron was developed for use as a chemical castration agent used on sexual predators and cattle!

I was outraged. They talked me into castrating my own self without any discussion of my 44-year marriage! They did tell me that my testosterone had to be shut off because it fed the tumor in my prostate, but nothing on what the estrogen they didn't shut off does to the male body that I should be ready for, like growing boobs, no erections or ejaculation.

And it wasn't until today that I find out that in addition to the possible loss of all testicle function, I'm also in the process of having my penis dissolve right before my eyes!! It's crushing as a prospect no doctor or anyone else has ever mentioned in my hearing! My head is still spinning in disbelief.

I did receive one clue that my penis was acting weird when the catheter urinal I wore during treatment just started falling off by itself, followed by not being able to get the darn thing on at all because my penis had, for unknown reasons, until now receded back into the foreskin.

I'm in a state of shock at the moment, but I am glad that there are some fellas around whom I can blow off some of this shock and awe to without being fitted for a strait jacket and tossed into a rubber room! Thanks for listening guys and I'd really appreciate any helpful comments or experiences any of you might care to offer! I feel like I'm flat up against the five stages of grief right now! Testicles and penis, possible casualties of war! How the mighty have fallen.

By SeanH — On Mar 18, 2016

The healthier the penis, the less likely that things like atrophy or ED will occur. Most medical professionals recommend that guys use a penis health creme called Man1 Man Oil. This creme is loaded with vitamins, nutrients and antioxidants that will keep this organ working properly and looking good well into the future. It's a very helpful product. Check it out.

By okie — On Jul 22, 2015

I think our best hope in discovering how to prevent the telomerase that keeps our chromosomes bundled up from shortening and causing the chromosomes to reproduce less perfect copies of the cells kind of like a camera picture fades over time or gets wrinkled.

Another cure is perfecting stem cell infusion. Plus, they are developing in the lab penises so may we could get designer size and restored testes through the first two protocols I mentioned. Wake Forest University is doing the penis research. Oh, by the way, it is estimated two to five years for FDA on the shelf treatments for restoring telomerase, and in the process your body becomes younger, you are healthy and strong again and with the companion research, get a designer body. What is the definition of success? 10 percent inspiration and 90 percent work.

By anon341336 — On Jul 10, 2013

I have never been longer than 5 1/2 inches. I have fathered two children. I have been the same size as in all my 67 years. I am having trouble with morning erections. My wife is ill with RA and other diseases and had not allowed closeness in fifteen years. I feel the need to self care for the emptying of my prostate, not often, but it helps. I will not cheat on her.

By anon283060 — On Aug 02, 2012

I was diagnosed in my early 30s with a very low testosterone level, which may have been due to an accidental impact to my groin at age 15. At 16, I begin to notice the rapidly spreading hair up my stomach suddenly stopped and around 28 I began losing hair under my arms.

I didn't really become seriously bothered by my 5" penis, which also seems small in diameter, until my urologist put me on 5mg/ day of transdermal testosterone. My testicles also shrank by 70 percent or more, which contributes to my distress over my ppareent size.

I've been told that I'm about average in size by my urologist, but it just doesn't seem right. I recall being very satisfied in my youth and wish I could somehow regain this confidence. It's seriously affected my self image, desire for intimate involvement and sex life.

By anon280446 — On Jul 17, 2012

I'm a 30 year old guy. At about the age of 16, I developed a varicocele adjoining my left testicle, had a kidney infection, plus appendicitis in a period of about 12 months. My penis and testicles underwent a huge change, where they became harder, less sensitive and greatly shrunken. My penis size dropped about two inches, and my libido has never recovered.

It is still to this day a huge problem for me. Sadly, GPs seem reluctant to recognize any problem and tend to recommend counseling and anti-depressants rather than any real treatment.

If anyone has any info that could help, it would be greatly appreciated. I really think this is a grossly under-diagnosed problem for a lot of men.

By JaneAir — On Jul 13, 2012

You know, I hope that anyone dealing with this issue ends up with a doctor with a nice bedside manner. Because as the article said, penile atrophy isn't actually medically dangerous. So there's really no reason to treat it, except for psychological and quality of life reasons.

I can imagine a doctor who was lacking in empathy being reluctant to spend time on this condition. Especially if the hormone therapy that treats this condition causes unpleasant side effects. I know some doctors like to weight the benefits of taking medications with their positive effects.

By JessicaLynn — On Jul 12, 2012

@Pharoah - Actually, I think that most health issues concerning the reproductive system aren't that well publicized. There are a lot of conditions of the female reproductive system that aren't very well known either. I think people in general are uncomfortable dealing with problems in that area of the body.

Anyway, it sounds like all men are at risk for developing penile atrophy, which is kind of disturbing. I mean, getting old sounds bad enough as it is, but that sounds really rough.

By Pharoah — On Jul 11, 2012

I've never heard of penile or testicular atrophy before, which actually isn't that surprising. I feel like men's health issues (besides erectile dysfunction, of course) aren't that well publicized.

I think a lot of this has to do with the embarrassment men feel about these problems. A lot of men consider their penis as a direct representation of their virility and worth as a man. To admit that there is something wrong "down there" would probably be really hard for a lot of men. So I imagine this is why this issue isn't more publicized.

By ZipLine — On Jul 10, 2012

@MikeMason-- Did you have any injury where you received a blow to the penis and testicles? Because that could be another reason for atrophy.

It happened to me when I was in high school. I got a blow to the area while playing soccer which damaged a vein that carries blood to the penis and testicles. Until the vein recovered, I had atrophy in my penis.

I also had a friend who experienced the same because of hormones. The interesting part was that he had enough testosterone, but his estrogen was too high. So he took medications to lower his estrogen and everything went back to normal.

It seems like there are so many different reasons as to why this could happen.

By ddljohn — On Jul 10, 2012

@MikeMason-- Yea, penile atrophy can happen to young men too. You cannot know what is causing it without going to the doctor for an examination and having tests done. Please don't be afraid to see a doctor about this. There is nothing to be ashamed of, many men experience this sometime in their lifetime.

As far as I know, penile atrophy usually happens to young men in their thirties, especially if they've gained weight recently and have become less active. Hormonal imbalance and underproduction of testosterone is of course another major cause like the article mentioned. A simple blood test can tell if your testosterone levels are abnormal.

Since you said that you are underweight, I'm sure that malnutrition could be a factor too. Like I said, see a doctor so that whatever the underlying cause is, it can be treated. Waiting might make things worse.

By stoneMason — On Jul 09, 2012

Just curious, can penis atrophy happen to someone who is young? And if so, what might be the cause of it? Hormones?

I'm in my twenties, and for the last couple of years, my penis and testicles appear smaller than they used to. I think there is some decrease in erectile function too.

To be honest, I've been avoiding going to the doctor because I don't think that I could be having penis atrophy at this age. I'm generally health, a little bit underweight, but that's all. I'm also not comfortable with discussing this with someone face to face.

If anyone has any information about penile atrophy in the young, I would appreciate it if you could share it with me here.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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