Penis Size - More About Small Penis Syndrome
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Penile size and the "small penis syndrome"
There are a number of psychiatric conditions which may contribute to small penis syndrome. For example, anyone familiar with the effects of social phobia, obsessive-compulsive disorder, anxiety and depression or body dysmorphic disorder will know that extreme preoccupation with a real or imagined defect in the body is far from uncommon. Any small defect can become magnified into a major issue. Perhaps the borderline and narcissistic personality types are particularly susceptible to this kind of problem.
Other factors in small penis syndrome
As those who are overweight will know only too well, the perspective of the penis - i.e. how a man views his own penis, from above, and therefore fore-shortened - contributes to the perception of size. This is made much worse if the penis cannot be seen because of belly or suprapubic fat. Such a mass of fat makes the penis appear to be partly buried.
Advice for doctors faced with a man who believes his penis to be unusually small is to first establish whether the man believes his penis to be small when erect or when flaccid. Then again, for some men girth may be the biggest concern: therefore, the man's motivation and expectations from his visit to the doctor must be understood, and to assist in this process, a full medical, and psychological history should be undertaken. Of especial interest are any issues associated with concerns about appearance, body dysmorphic disorder and body image in general. How do the man's beliefs about penis size affect him? What is the source of his distress? Does he suffer from parauresis (an inability to urinate when others are around)? Is this some manifestation of social anxiety? Would he consider trying swimming or sports which might involve a public locker room? More important, perhaps, how is his social and sexual life affected by his perception of his penis size? Is he able to establish emotional relationships or intimate relationships which may lead to sex? Many men in this situation will go so far as to avoid certain professions. If the man is in a relationship, his partner's view is important.
All of these issues affect quality of life, self-esteem, self-confidence, social anxiety and the likelihood of forming relationships. Clearly, a physical examination needs to assess general physical condition as well as the state of the man's genitals: and factors such as cool temperatures must be taken into account in that assessment. In this respect the identification of any penile anomalies including but not limited to hypospadias, epispadias and Peyronie’s is important. Any suprapubic fat pad should be identified. Then careful measurements of non-erect length and girth are essential. Erect size can be measured after inducing an artificial erection with intracavernosal alprostadil. Finally, endocrine problems do in fact cause real micropenis, so an assessment of the man's secondary sexual characteristics is also helpful.
In almost every case, genuinely small penis size can lead to sexual dysfunction caused by a lack of confidence. Delayed ejaculation is a common problem (much more common than is generally believed, affecting one man in ten or twelve).
No mentally and physically fit man suffers erectile dysfunction through any other cause than emotions, provided his impotence is not traceable to any organic cause.
One manifestation of sexual dysfunction from emotional causes in a woman is in spasms of pain in the muscles of the vagina (vaginismus). In a man, a common dysfunction is immediate and premature ejaculation of seminal fluid usually due to over-anxiety causing a lack of control. Some women, refusing, in their subconscious mind, to 'grow up' and to accept the responsibilities of woman and wifehood, affect the weapon of frigidity to demonstrate their inability to perform the adult functions they seek to resist. Similarly, the man in refusing to assume manhood, refuses to become sexually a man in his attempt to show his unreadiness to be a responsible person. The man who does not want children becomes impotent, as the Woman with no maternal instinct becomes frigid. The frigid woman can, however, have a child in spite of her resistance, whereas the man cannot be successful if he is incapable of making a child.
Some men make themselves impotent by pretending to themselves that circumstances do not permit of sexual expression. They fear disease, feel too honest to trifle with a girl in the unmarried state, pride themselves on not easy becoming victims to sexual desire. Such a man is an escapist. So long as he cannot get an erection, he feels safe. Without a competent sexual organ he cannot be plagued with the responsibilities of manhood. The mind dictates the attitude that is to be, the body obeys. The man may be impotent, but not sterile. That is to say, he can produce seed, especially in premature ejaculation, and that seed can be living. Indeed, the frigid wife and the impotent man can have a child, and it can be born out of frustrated sex lacking in all joy and sensation. The man can ejaculate his semen prematurely. in order to' get the job done and perform his 'duty', satisfy his wife's demands for conjugal rights. He can lose his seed in this way as an expression of pent-up worry and anxiety. It can be a fleeting escape from care and responsibility.
The man may have an very easily. In the absence of organic disease, ability or inability to enjoy sex is a matter of mental approach. Men and women create the success or otherwise of their sexual lives. Their degree of passion is measured by their attitude to father, mother, brother, sister, career, wife, husband, children, social life. All is coloured, shaped, formed and influenced by what has gone before, in the early formative years.