Penis Size: Concerns About Phimosis and Hormonal Impact

Penis size

Hello, Dr.
Hsu: This is a rather amusing yet somewhat lengthy question that dates back to my childhood.
I had severe phimosis since I was young, which prevented the glans from being exposed.
I’m not sure if this phimosis contributed to my smaller genital size.
It wasn't until I turned 20 and underwent a circumcision that I resolved the phimosis issue.
At that point, I became aware that my penis was smaller compared to others (which I was unaware of during childhood).
During my last follow-up appointment after the circumcision, I asked the doctor to measure my penis size.

Flaccid: Length 5 cm, circumference I forgot, diameter 2.3 cm.

Erect: Length 10.5 cm, circumference 10 cm, diameter 3.1 cm.

The doctor mentioned that this size is indeed somewhat small, but I didn’t inquire about ways to improve it.
Now, I’ve noticed that my secondary sexual characteristics are not very pronounced, and I have very sparse body hair.
The hair on my arms is almost as sparse as that of a female, and while I have some leg hair, it is also quite limited.
Additionally, I do not have an Adam's apple.
Since I was 22, I have been taking finasteride to treat male pattern baldness.

I would like to address the following three questions:
1.
Is it possible that low testosterone levels or the phimosis caused my smaller penis size?
2.
Now that I have passed puberty, are there any methods to increase size without considering surgical options? (e.g., hormone injections)
3.
Assuming that my penis still has the potential to grow at 24 years old, will taking finasteride affect its growth?
Thank you for your assistance.

Ke lian de nan zi, 20~29 year old female. Ask Date: 2012/07/26

Dr. Xu Weikai reply Urology

Dear Child,
1.
The size of the penis is related to factors such as constitution and genetics, as well as diet.
For example, frequent exposure to phthalates (found in plastic bowls, perfumes, beverages, and fragrances) may affect males.
2.
It is advisable to first check the levels of male hormones before considering supplementation.
Note: Most formulations of male hormones carry a risk of carcinogenicity.
3.
Boska may influence male virility.
If there are any unclear points, feel free to ask again for further discussion and research.
Responses found online should only serve as references; if necessary, it is important to seek medical attention at healthcare facilities.
Sincerely,
Director of Urology, Hsu Wei-Kai
Taitung Hospital, Department of Health, Executive Yuan

Reply Date: 2012/07/26

More Info

Understanding concerns about penis size, phimosis, and hormonal impacts involves a multifaceted approach that considers both physiological and psychological aspects. Your situation highlights several important points regarding the development of male genitalia, the effects of phimosis, and the role of hormones in sexual development.

1. Phimosis and Its Impact on Penis Size: Phimosis, which is the inability to retract the foreskin, can indeed affect the appearance and function of the penis. However, it is important to clarify that phimosis itself does not cause the penis to be smaller. The size of the penis is primarily determined by genetic factors and hormonal influences during puberty. In your case, the surgical intervention you underwent at 20 years old likely allowed for normal development and exposure of the glans, which may have contributed to your awareness of size relative to others.
2. Hormonal Influence: The development of secondary sexual characteristics, including body hair and the size of the penis, is largely influenced by testosterone levels. If you feel that your secondary sexual characteristics are underdeveloped, it may be worth discussing this with a healthcare provider. They can evaluate your hormone levels through blood tests to determine if there is an underlying hormonal imbalance. Low testosterone levels can indeed affect the development of male characteristics, including penis size and body hair distribution.

3. Possibility of Increasing Size Post-Puberty: After puberty, the potential for natural growth in penis size is significantly reduced. Most growth occurs during the teenage years due to the surge in testosterone. Non-surgical methods to increase penis size, such as hormonal injections, are not typically recommended due to potential side effects and the lack of evidence supporting their effectiveness. Hormonal treatments can have significant impacts on your body, including mood changes, increased risk of certain health conditions, and changes in sexual function.
4. Effects of Finasteride (Proscar): Finasteride, the medication you are taking for male pattern baldness, works by inhibiting the conversion of testosterone to dihydrotestosterone (DHT). While it is effective for hair loss, it can have side effects, including sexual dysfunction in some men. There is ongoing debate about whether finasteride can impact penis size or growth, but most studies suggest that any changes are typically reversible upon discontinuation of the medication. If you are concerned about the effects of finasteride on your sexual health, it is advisable to discuss this with your prescribing physician.

5. Psychological Considerations: It is also important to consider the psychological impact of perceived size and development. Many men experience anxiety regarding their genital size, which can affect self-esteem and body image. Counseling or therapy can be beneficial in addressing these feelings and helping you develop a healthier self-image.

In conclusion, while phimosis and hormonal levels can influence the development of the penis and secondary sexual characteristics, the potential for significant changes in size after puberty is limited. If you have concerns about your hormone levels or the effects of medications like finasteride, consulting with a healthcare provider who specializes in endocrinology or urology would be a prudent step. They can provide personalized advice and potential treatment options based on your specific situation.

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