Many men are concerned about penile size whether or not they choose to bring it up with their doctors.

Size is often sensationalized in the media, online, and especially in pornography. Men are led to believe that a 8 inch penis is “average” but this is far from reality. In fact, the most reliable studies including almost 15,000 men have shown that the average flaccid length is 9 cm (3.6 inches) and the average erect length is 13 cm (5.2 inches). Less than 5% of men have penis that is bigger than 6 inches when fully erect! But if you ask any man, an overwhelming majority wish they had a bigger penis. This is despite the fact that 85% of women are satisfied with their partner’s penis size and 77% found penis size to be unimportant to them.

Regardless, men will go to great lengths to augment penile size, including spending lots of money on therapies that are not proven to work. So as a Urologist and Men’s Health expert I thought I would provide some reliable information on optimizing penile size with age.

It is well established that there are certain factors that can contribute to penile shortening with age. These factors include:

1.     Weight gain: I tell all my patients that nearly half of their penis is inside their body. With any weight gain for men, it tends to concentrate in the lower belly. This drapes over the base of the penis and can lead to perceived shortening of the penis.  

2.     Erectile Dysfunction (ED): This is one of the biggest risk factors for penile shortening. Getting frequent, reliable erections is a natural process even in men that are not sexually active (for example nighttime erections or morning wood). As we get older though, the number and quality of these erections go down. Many men also develop difficulties with getting and maintaining erections for sexual intercourse with the appropriate erogenous stimulation. Over time, this causes scarring and contracture of the erectile bodies so that length and girth can be significantly reduced because there is less space of the penis to fill with blood with an erection.  

3.     Peyronie’s Disease: Acquired penile curvature or other deformities (indentation or hourglass) can also cause reduced length and girth.    

4.     Prostate Cancer Surgery (Prostatectomy): This surgery can have irreversible changes in penile length and girth. Similar to the changes to the penis in men suffering with ED, men after prostate cancer surgery who had good erectile function before-hand typically, do have a period of time after surgery where the quality and frequency of erections is significantly reduced. Most men will regain erectile function after prostate cancer surgery, but many men report penile shortening after prostate cancer surgery.

What can I do to improve penile size?

1.     Weight Loss: This is one of the best ways to not only improve overall health but also improve perceived penile length if you are overweight. On average, 10 pounds of weight loss, translates to approximately 1 cm increase in penile length (or 30 pounds of weight loss for 1 inch increase in penile length). This will also improve your overall health, heart health, and stamina/vitality. Weight loss can also naturally improve testosterone levels.    

2.     Vacuum Erection Device: A vacuum device can be used to help increase penile length and girth. Think of it as an external tissue expander that allows the greatest filling of the penis with blood to allow the greatest expansion of the penis. Generally, most men will notice a 1-2 cm increase in penile size, but this needs to be used regularly to have true, sustained effect.

3.     Optimize erectile function: This is especially improvement in men that have had a progressive decline in their natural ability to get reliable and strong erections with stimulation. Pills and injections used prior to sexual activity can help optimize the blood flow, but will not be as helpful for penile size loss. Many men will consider an inflatable penile implant that essentially acts as an internal tissue expander. Not only will you be able to get reliable, strong erections on demand, the inflatable penile implant can increase length and girth after some time on the order of 1-3 cm.  

4.     Surgery: Surgery can be an option for some patients that have failed the above options. There are surgeries to help optimize the perceived length of the penis vs. penile augmentation surgery (True length of penis). Surgery to optimize perceived length are for men that have extra tissue either on the top or bottom size of the penis that creates a “buried” appearance. As noted above, half the penis is on the inside of the body and these procedures are designed to help improve the cosmetic appearance and perceived length. In some men a large pannus can drape over the penis on the top side that can be surgically removed (monsplasty). More commonly, men can develop peno-scrotal webbing, where a significant amount of redundant scrotal skin can tether the bottom side of the penis especially when erect. A scrotoplasty/ventral phalloplasty can be a good option to release this tethering. Surgery to improve the actual length/girth of the erectile bodies is performed less frequently because they have a unique set of complications. Typically, this surgery is completed concurrently with placement of an inflatable penile prosthesis. With one technique, a series of micro-incisions are made in the erectile bodies to allow additional expansion with length and girth (1-2 cm increase). For men with short pre-operative length (<8 cm), a modified sliding technique is performed with circumferential incision of both erectile bodies. Patients can expect 1-3 cm improvement with the sliding technique because the length of the dorsal nerve complex is the limiting factor. The risks associated with these procedures are relatively high, therefore I will only perform them in select patients.

If you are concerned regarding loss of penile size and erectile dysfunction/Peyronie’s Disease, it is extremely important to seek out a real expert. I have the experience and proven techniques to maximize penile size and function. Contact us to schedule a consultation.

-Dr. Patel