From birth, we speak of micropenis if the penis of a small boy is less than 1.9 centimeters long (after stretching and measured from the pubic bone to the tip of the glans) and if this small size is associated with no penile malformation .
The appearance of a micropenis is usually due to a hormonal problem. If a treatment is not set up, the micropenis can persist in adulthood, the man then having a penis of a length less than 7 centimeters in the flaccid state (at rest). Although small in size, the micropenis works normally sexually.
At the entrance to puberty, the limit for talking about micropenis is 4 centimeters, then less than 7 centimeters at puberty.
The penis begins to develop as early as the seventh week of pregnancy. Its growth depends on fetal hormones.
The penis contains spongy and cavernous bodies, the spongy bodies surrounding the urethra, which channel the urine to the outside. The penis develops over the years under the action of testosterone. Its development amplifies at the time of puberty.
In adulthood, the “average” size of a penis is between 7.5 and 12 centimeters at rest and between 12 and 17 centimeters during an erection.
The challenge for healthcare professionals to detect micropenis is that men often tend to find their sex too small. In a study of 90 men consulting for micropenis, 0% actually had micropenis after examination and measurement by the surgeon. In another recently published study, of the 65 patients referred by their doctor to a micropenis specialist, 20, about one-third, did not have micropenis. These men thought they had a penis too small but when a specialist took the measure after stretching it, he found normal measures.
Some obese men also complain of having a very short sex. In fact, it is often a ” buried penis “, the pubic portion of which is surrounded by pubic fat, making it look shorter than it actually is.
Penis size does not affect fertility or male pleasure during a sexual act. A penis, even small, allows to have a normal sex life. However, a man judging his sex too small can be complexed and have a sex life that does not satisfy him.
Diagnosis of micropenis
The diagnosis of micropenis involves the measurement of the penis. During this measurement, the doctor begins by stretching the penis 3 times, pulling gently on the glans. Then he releases her. The measurement is practiced with a rigid rule from the pubic bone, on the ventral side. If a micropenis is diagnosed, a hormonal assessment is carried out to find the cause of the micropenis and to treat it as well as possible.
Causes of micropenis
The causes of micropenis are variable. In a recently published study, of the 65 patients followed, 16 or nearly a quarter did not find the cause of their micropenis.
The causes of a micropenis can be hormonal (the most frequent case), linked to a chromosomal anomaly, to a congenital malformation, or idiopathic, that is to say without known cause, knowing that the environmental factors play probably a role. A study conducted in Brazil suggested an environmental cause for the appearance of a micropenis: exposure to insecticides during pregnancy could thus increase the risk of genital malformation.
Most cases of micropenis would ultimately be due to a hormonal deficiency related to fetal testosterone during pregnancy. In other cases, testosterone is properly produced but the tissues composing the penis do not react to the presence of this hormone. This is called insensitivity of the tissues to hormones.
Symptoms of micropenis, risks and prevention
A micropenis is a small penis, that is, less than 1.9 centimeters in the state of rest and after stretching at birth, or less than 7 centimeters in adulthood.
People at risk for Micropenis
People with Trisomy 21 or Klinefelter Syndrome (this syndrome corresponds to a chromosomal abnormality, the boy has 47 chromosomes including one Y and two X while the normal karyotype is 46, XY for a man) have a higher risk to suffer from a micropenis. The same is true for children whose mothers received anti-androgenic treatment during pregnancy (the androgen hormones, of which testosterone is a part, are responsible for male characteristics such as penis size, hair on the face, musculature, low voice …).
Children who have cases of micropenis in their family also have a greater risk of suffering micropenis in turn.
An undescended testes (testicles do not descend into scholarships) increases the risk of micropenis. Just like exposure to certain chemicals such as endocrine disruptors .
Prevention of micropenis
As exposure to various chemicals is suspected to increase the risk of genital malformations in little boys, some doctors advise eating “organic” as soon as you want to have a child and during the pregnancy.
The essential thing in micropenis remains screening . Micropenis should be detected at birth to provide the child with appropriate treatment.
Medical treatments of micropenis
In young children, in the event of a hormonal anomaly, the treatment may consist of testosteroneinjections , the dosage and regularity of which are fixed by the endocrinologist. This well-monitored treatment increases the size of the penis. When micropenis is caused by testosterone-insensitive penile tissues, this hormone treatment has no effect.
The sooner the micropenis is detected, the sooner the treatment is set up, the more effective it will be. Treatment may also be necessary at the time of puberty. After puberty, hormone therapy is no longer effective because tissues do not react in the same way.
Surgical treatment of micropenis
In adulthood, when the micropenis has not been treated or when the treatment has not been effective enough, surgery is possible. However, it does not present consistently convincing results.
The section of the suspensory ligament of the penis, which extends from the penis to the pubis, may be proposed. It does not change the penis but detaches it partially from the pubis, making it look longer. The observed gain is 1 to 2 cm in the flaccid state and 1.7 cm in erection. This lengthening is acquired at the price of an unstable erect penis, since it is less well attached to the pubis, which can make penetration less easy.
The injection of autologous fat is to inject the fat of the subject under the skin of his penis. It does not lengthen the penis, but makes it visually thicker. Only part of the fat put in place is not absorbed by the body over time (10 to 50% depending on the subject). The resorption may be unequal and result in a “rosary” aspect of the penis.
Since micropenis can have significant psychological repercussions, especially during adolescence, it is important that the person be helped and their doubts taken into account.