Micropenis is a condition where the penis, though normal with respect to structure and function, is markedly small. While micropenis is very rare and only shows up in about 0.6 % of the entire male population, it is still considered one of the serious disorders associated with penis and male sex function.
Definition of micropenis
The strict definition of micropenis is one in which the stretched penile length is more than 2.5 SD below the mean for patient age.
Simply speaking, from a newborn to be classified as having micropenis the stretched penile length should be less than 1.9 cm. In other words, a man with a micropenis has an unusually small penis, of less than 2 cm at birth, and less than 7 cm in adulthood (many times smaller than the average penis size).
Hence, in the adult, an erect penis measuring less than 7 cm is considered to be micropenis and an erect penis measuring between 7 and 11 cm is considered to be small penis. This means that the term “micropenis” should not be confused with the term “short or small penis”. A man without micropenis can still have a “small or short penis”. To correctly determine size and configuration, the penis should be examined in both the erect and non-erect states.
Micropenis is a perfectly normal in shape and function, except it is much smaller in size than the “normal” penis.
What causes micropenis
There can be several causes of micropenis such as:
Hormonal imbalance: Hormonal deficiency is, perhaps, the most common cause of micropenis. In such cases, micropenis is believed to be caused by low levels of the needed male sex hormones (testosterone and dihydrotestosterone) that allow the normal development of the genitals, penis included.
This is due to abnormal testicular development (testicular dysgenesis, Klinefelter syndrome, Leydig cell hypoplasia), specific defects of testosterone or dihydrotestosterone synthesis (17, 20-lyase deficiency, 5-reductase deficiency), androgen insensitivity syndromes, inadequate pituitary stimulation (gonadotropin deficiency) or other forms of congenital hypogonadism.
It, sometimes, is also the result of congenital growth hormone deficiency (congenital hypopituitarism), which also induces lower height.
Genetics: Sometimes, the disorder runs in the family i.e. has hereditary basis and is a result of male sex chromosomal abnormality transferring from one generation to the next.
No known cause: In some cases, no hormonal abnormalities are recognized and the etiology is considered to be idiopathic (without a known cause).
Consequences of micropenis
Micropenis induces severe effects both mentally and physically for the patient. Micropenis can cause a severe self esteem and social-life problem, besides a physiological one. A man with a micropenis can father babies, but sexual pleasure is largely absent. In addition, urinating while standing is really a difficult task if you have a micropenis.
Treatment of micropenis
Once the diagnosis of micropenis is confirmed, consultation with a pediatric endocrinologist and urologist is warranted.
Surgery: Under the belief that one cannot grow up to be an emotionally adjusted healthy male without a “normal” size penis, surgeries have been performed on micropenis to make the child into girls (sex change operations). There are also penis enlargement surgeries (phalloplasties) but these are not recommended by most physicians, as they can induce risky secondary effects (impotence, swelling, scars, infections, curbed penis) and only add 1-2 inch (2.5-5 cm) at most.
Hormonal therapy: When micropenis is left intact and the patient is raised as a boy, he typically receives androgen to achieve masculinizing puberty. In some cases, successful testosterone administration can significantly alleviate the emotional distress felt by the families of boys with the condition. In fact, some studies recommend administration of intramuscular retard testosterone (50 mg) every 15 days for a total of 4 applications to all infants born with micropenis.
Exercises & extenders: There are also traction devices (penis stretchers and exercises) that are currently being explored for the treatment of micropenis. The main aim of these medical enhancement devices and techniques is to increase patients´ confidence and self-esteem regarding their sexual relations, not only to increase the size of the penis.
Therefore, many sexperts today believe that these penis extenders are useful for micropenis and short penis cases, but also for men who think that their sexual life would improve with this kind of medical devices. In fact, several scientific studies support the safety and efficacy of using some of these extenders in short penis cases as a feasible non-invasive treatment, hence making it the first-line treatment option in men seeking penile lengthening.