Penis size concerns (Penile Dysmorphic Disorder: PDD)

Many males in our society are influenced by the stereotypes that determine the pre-requisites of what it is to be a man.  In reality, a very small percentage of men meet with all of these prerequisites.

Of course there are diversities among all communities of men, but most of the messages that men receive pressure men to aspire to be muscular, large bone structure, ruggedly handsome, tall, body hair and be masculine in behaviour and persona.  If the pre-requisite of being a male was based on penis size then more slender men with smaller frames would be viewed as the most masculine.  In reality, meeting this stereotype does not usually translate to being well endowed.  For example; some of the largest physically built nationalities of men, are among the smallest average penis size and nationalities where the average builds are often slender in stature, their average size of penis is at the middle to upper end of the measurement scale.

In reality, any stereotypes that ‘pigeon-hole’ a person are only going to result in causing discrimination, persecution and as a result, a low self-acceptance and difficulties across all areas of life.

A person can work on their physique to change to what they find more acceptable, whether it is gaining weight, losing weight, gaining muscle, having plastic surgery, changes can be successful, however when the desired change involves the penis, there is very little that can be done to change what you have physically, but in reality, there is much that can be done psychologically.

“People with small penis syndrome do not have a physical condition but experience persistent anxiety about the size of their penis. These individuals worry that their penis is too small or that others will judge them for its size.” https://www.medicalnewstoday.com/articles/324569

Having a small penis is not a medical diagnosis. Very rarely, a person’s penis is small enough to interfere with sexual functioning, and where it does doctors will refer to it as a “micropenis”.  A “micropenis” can be caused by a variety of factors including structural or hormonal defects of the hypothalamic-pituitary-gonadal axis. It can also be a component of a number of congenital syndromes. For the etiological evaluation, endocrinologic tests are essential. (J Clin Res Pediatr Endocrinol. 2013 Dec; 5(4): 217–223.  Published online 2013 Dec 12.)  In the Unites Stated of America (USA), the incidence of micropenis was reported as 1.5 in 10 000 male children born between 1997 and 2000 (Schonfeld WA, Beebe GW. Normal growth and variation in the male genitalia from birth to maturity. J Urol. 1942; 48:759–777.)

PDD (Penile Dysmorphic Disorder) is a type of BDD (Body Dysmorphic Disorder), which is a disorder that distorts a person’s perception of their body. BDD can trigger immense anxiety in a person about their appearance.  People with PDD feel shame and anxiety about penis size. They may mistakenly believe that they have a micropenis, even when their penis size is normal.  Research has sought to quantify what counts as a micropenis and in a 2014 study (https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/bju.13010) a micropenis is defined as a penis that is less than 7 cm (about 2.75 in) in length when flaccid and stretched.

For those outside of this rare condition, estimates on average penis size vary.  Many people believe that a typical penis is 6 inches long, but this is false and misleading, potentially triggering anxiety in those who worry about having a small penis.  Data from the same study on 15,521 men discovered the following about penis size:

  • The average non-erect penis is 9.16 centimeters (cm), or 3.61 inches long.
  • The average erect penis is 13.12 cm (5.17 inches) long.
  • Penises longer than 6 inches when erect are rare, with this length of penis falling in the 90th percentile.

It is common for people to occasionally worry that their penis might not be large enough, especially when they feel pressure from the media and from seeing larger male genitals in pornography, regardless, people with small penis syndrome obsessively worry about penis size.

Some symptoms of small penis syndrome or PDD include:

  • Constantly comparing their penis size to that of others, including those in the media
  • A belief that the penis is unusually small, in spite of evidence to the contrary
  • Distorted perceptions of penis size
  • Placing an unusually high value on penis size
  • Feeling ashamed or embarrassed about penis size
  • Difficulty having sex with a partner because of anxiety about penis size
  • Reduced sexual function, including getting an erection or having an orgasm

Some people with small penis syndrome have other symptoms of BDD. These might include:

  • Obsessive preoccupation with appearance
  • Repetitive or compulsive behavior relating to appearance, such as grooming or buying clothes
  • Chronic distress about appearance
  • Depression or anxiety about appearance

Although small penis syndrome and BDD might appear to be the same condition, there are essential differences. Small penis syndrome is not a medical diagnosis, whereas doctors can diagnose a person as having BDD. Adapted from:  https://www.medicalnewstoday.com/articles/324569

There are a number of products being marketed to extend the length of your penis.  Penile pumps can extend your penis ever-so-slightly after regular multiple times daily use, and surgery may be successful to extend your penis by 1 ½ – 2 inches however the procedure can be extremely invasive.  Some procedures and over-use of penile pumps can damage the nerves in the penis and negatively affect its sensitivity and ability to form an erection.

Many people who suffer from BDD believe that the only way to cure their obsessive worry about their particular areas of image insecurity is to change it physically.  Dave Wells believes that when people do manage to make positive changes to their physical area that causes BDD/PDD, they are still looking at themselves through the same eyes and with the same perceptions, and it won’t be long before they find other faults which will cause the same levels of stress.  This is a reason that many people who use steroids take them longer than they should.

In most cases, our insecurities come from poor treatment, bullying, discrimination and rejection, and especially when these are experienced in our childhood and the sexual-developmental years as teenagers, we often develop an avoidance approach to dealing with our concerns.  For example, in the situation of PDD, men might avoid wearing certain items of clothing such as bathers, avoid situations where you get undressed in front of others, going on school camps, and/or sexual relations, etc.

The course of action that Dave Wells takes when supporting a person with PDD or BBD, is exploring where and how the person has received their negative messaging in regards to their insecurity, and he works to change a person’s cognitive thoughts and behaviours that attribute to the barriers constructed in the aim of self-protection.  Unfortunately, we have constructed these barriers to protect us from others, however at the same time they restrict us from living a fulfilled life.

It is also essential to mention that certain cultural groups, e.g. Gay men, often have added pressures perpetrated by other men for their penis to be generous in length.  This is not related only to gay men, as straight men often communicate preferences for large breasts, which places similar insecurities on women with small to average size breasts.  These type of shallow judgements made on a person anatomy are related more to individuals who enforce these preferences, then it is to the sexual-orientation of the person.  All-the-same, when a person is pre-judged or rejected due to their penis size, shape, or whether it is circumcised or uncircumcised, it can have debilitating outcomes for the individual.  Furthermore, research on more than 52,000 heterosexual men and woman found that 85 percent of women were satisfied with the size of their partner’s penis. In comparison, only 55 percent of men were satisfied with their penis size https://www.medicalnewstoday.com/articles/324569.

It important to remember that having a large penis does not make a good lover. A good lover is more-likely to be someone who is comfortable and accepts themselves, who is considerate of how others feel, can communicate openly and interpret the non-verbal language of their partners, and has a confidence to explore another person sexually for their own personal pleasure, rather than always focusing on trying to satisfy the other partner.  By subconsciously incorporating negative feelings about yourself in a sexual engagement, whether verbally or non-verbally will only result in dampening the stimulation for the partner/s and yourself.

For many men, sex is focused on penetration and yet a sexual engagement may include; physical touch, intimacy, fantasy, being made to feel attractive and desired, are the areas that will often be long-lasting, penetration can also be an important activity towards fulfilling sex, and if you educate yourself where a woman clitoris is, or in relation to same sex penetration, where the prostate is located, as well as other erogenous zones that the person enjoys, then you can successfully stimulate a person with 3 to 4 inches if positioned correctly.  If you have ever heard the saying “positives attract positives and negatives attract negatives, a person’s level of self-comfort becomes more important than the size of their penis.

It is not the size of the penis, it’s all about the attitude.

For many men it may feel impossible to over-come their insecurities about their penis size, but there can be many areas of judgement such as age, body-types, nationality, persona, etc., and when we feel uncomfortable or incompatible in sex we usually blame it on our areas that we have paranoia and deem as a flaw, regardless of what it is, in reality if a person is uncomfortable with us sexually for whatever reason it is more-likely an indication of incompatibility.

Traditionally men do not discuss sexual insecurities with other men, which leaves them alone to find the answers and even the realisation that many men experience similar difficulties.  Speaking to a sexologist is like having a personal sexual life-coach to listen to about your experiences, fears and insecurities without judgment or breaches of confidentiality, and with the knowledge of strategies that can assist you with becoming a confident lover regardless of your anatomical makeup.