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 paruresis (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 artifical 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.