Penile Atrophy: Penis Shrinkage Causes and Treatment

When you think of your penis shrinking, you might think of what happens after you’ve taken a cold shower or bath.

A shrunken penis is typically a temporary, sometimes embarrassing situation that can be fixed when you warm up, or if you get aroused and increase flow to the blood vessels in the penis.

But for some men, penis shrinkage can be a permanent issue that keeps their members at a reduced size. Penis shrinkage, also known as penile atrophy, is often tied to aging but can occur for other reasons.

We’ll dive into what causes penis shrinkage and the available treatment options to help you manage this condition.

Causes of Penis Shrinking (Penile Atrophy)

Before diving into the world of penis shrinkage, let’s discuss why penis size is such a popular topic among men. 

According to a review of studies, many men feel that their penis is not large enough or that they have a small penis compared to other men. In addition, the review found that 45 to 68.3 percent of men wished they had a larger penis.

But is it actually true that all these men have penises that are “too small?” Most are probably pretty average, but some people may actually have penile shrinkage.

There are limited studies on why penis shrinkage or atrophy occurs — especially compared to other men’s health issues like erectile dysfunction (ED) and premature ejaculation. 

From the evidence available, there are a few reasons why penis shrinkage or atrophy occurs — some of which are preventable or reversible, and some are of which are not. We’ll go through each risk factor one by one. 

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A common question is “Do penises shrink with age?” According to research, there may be a connection. 

As you age, you can expect your body to undergo different changes. You stop growing, your hair turns gray — and your penis may get smaller. 

According to a review, atherosclerosis of the penis, an age-related condition that causes the thickening or hardening of arteries, can also cause changes in penile collagen. This can make it difficult to get erect, possibly contributing to penis shrinkage. 

Have you ever heard the terms “grower” and “shower?” Growers are men whose penis length significantly grows in length when they go from flaccid to erect, while showers do not have this increase in length between the two states.

In a review of studies involving 274 patients who had a penile duplex Doppler ultrasound (PDDU) to treat erectile dysfunction, the majority of younger men were more likely to be growers, while older men were more often showers. This may lead to the perception of penile shrinkage.

Another reason for penile atrophy as you age? Research shows that as you age, you experience an increase in visceral fat and the risk of chronic diseases such as heart disease, type 2 diabetes and certain cancers.

Visceral fat is the fat stored deep in your abdomen. An increase in visceral fat can negatively impact erectile function, potentially leading to erectile dysfunction and other health problems.

Along with how much fat you have, your levels of testosterone, a hormone that gives you all your masculine characteristics, can change as you age. And when your testosterone levels are out of whack, you may face sexual dysfunction. 

A study involving 47 older patients with ED revealed that testosterone deficiency can cause penile fibrosis, which is any fibrotic disorder that affects the functioning of your penis. 

It can also cause organic erectile dysfunction, which is the inability to get an erection for penetrative sex or sustain an erection until the deed is done, specifically due to physical causes like vascular issues, Peyronie’s disease and side effects from medication. 

The study also shows that there’s a strong association between age and testosterone deficiency, reaffirming that aging is a significant risk factor for penile atrophy.

Because of these conditions, penis shrinkage can become a multifactorial issue for older adults, meaning it can arise from the many health problems that develop as you age. 

Weight Gain

As we briefly covered in the last section, having a lot of fat can lead to sexual dysfunction problems. 

So, if you’re overweight or obese, you increase your chances of erectile function issues like penis atrophy. Weight and ED go hand-in-hand, as the more obese or overweight you are, the more likely you are to deal with impotence.

One study found that a high body mass index (BMI) is closely related to a reduction in erect penis size, and weight gain can shorten the length of a limp or flaccid penis.

Prostate Surgery

Radical prostatectomy, a surgery that removes the prostate and is used as a treatment for an enlarged prostate gland or cancer, can cause complications that affect a man’s sexual performance. 

Research involving 105 patients who were treated for prostate cancer with radical prostatectomy showed that their penises shrunk an average of one centimeter for at least 12 months post-surgery. 

Another study found that all penile dimensions (penile length and girth) decreased after nerve-sparing radical retropubic prostatectomy.

The most substantial changes occurred between four and eight months after surgery. 

The amount of change? About 20 percent.

Yeah. Yikes.

ED after prostate surgery is also possible, alongside other complications affecting a man’s penis like urinary incontinence.

Diseases and Congenital Causes

Penile shrinkage may also arise due to congenital issues, or conditions that one has since birth.

Peyronie’s disease, or penile curvature, is a disorder where scar tissue forms under the penis’s skin. This tissue, also known as plaque buildup, causes the penis to curve or bend during an erection.

Peyronie’s disease can make sexual intercourse painful, challenging or downright impossible. 

While this disorder is commonly found among older men, a study revealed that 8.2 percent of men under the age of 40 have Peyronie’s disease.

According to one study, penile shortening is associated with medical conditions like Peyronie’s disease and congenital anomalies.

Erectile Dysfunction

While it has not been confirmed that erectile dysfunction is directly tied to penile atrophy, there are some potential connections that you should make a note of — especially if you have ED caused by radical prostatectomy.

Research suggests that this sexual dysfunction problem may be an independent risk factor for penile shrinkage and atrophy. 

Another study involving both potent and impotent men revealed that those with erectile dysfunction tend to have shorter penises.

Radiation and Hormone Suppression

Certain cancer treatments, as well as hormone replacement therapies (HRTs), are linked to a change in penis size. 

While we previously covered prostate cancer surgery, there’s research that indicates radiation therapy for prostate cancer may also contribute to penile atrophy.

According to a study of 948 men, 2.63 percent of them complained of reduced penis size after receiving prostatectomy or radiotherapy consisting of external beam RT or brachytherapy with or without androgen deprivation therapy. 

The study also mentions that these men felt that their shorter penis contributed to problems in their relationships and led to treatment regret.

In addition to radiation treatments, certain hormone therapies have been associated with penile atrophy.

Androgen deprivation therapy, or ADT, is a therapy that decreases androgen levels to stop the growth of prostate cancers.

As we discussed previously, weight gain is associated with penile shrinkage — and ADT can cause you to gain a few pounds.

A study of 118 men with nonmetastatic prostate cancer who’d been treated with ADT for at least six months had significant weight gain. A patient’s age and BMI were independently associated with weight gain one year after ADT, all of which means this treatment can lead to some shrinkage.

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Penile Atrophy Treatment Options

Okay, so now that you know what can cause penis shrinkage, you’re probably wondering how to fix it. 

First, it’s important to keep in mind that there isn’t a ton of evidence to determine if a man’s penis size is associated with his ability to get hard and his sexual activity. So, while you probably want to address any underlying condition, your penis size may not really affect your sex life at all.

But that doesn’t mean it won’t affect things like your self-confidence or your libido, both of which are worth addressing.

The good news is there are plenty of options to combat the causes of penis shrinkage, increase penis length, bolster your confidence and improve sexual health.

Let’s look at what treatment options are available to treat or manage penile shortening and increase penile size.

Vacuum Erection Devices

Vacuum erection devices (VEDs) are devices with a closed-ended clear plastic cylinder and a vacuum pump. The device uses negative pressure to increase blood flow to the penis to help with erectile dysfunction. VEDs can be manual or battery-operated.

According to a review, these devices are becoming the first-line treatment for erectile dysfunction and rehabilitation of erectile functioning following prostate cancer treatments. The review showed that vacuum erection devices are effective in combination with penile injections and oral medications. 

In addition, one of the studies in the review revealed that using VEDs for 20 minutes twice a day for three months after getting saphenous graft surgery for Peyronie’s disease lengthened erected penises for 13 out of 16 patients. 

Another review of studies involving men who’ve received radical prostatectomy found that the use of VEDs may be effective for preserving penis size, but further research is necessary to confirm.

Oral Medications

There are prescription medications that can help you manage erectile dysfunction, which, as we’ve mentioned, may cause penile shortening.

PDE5 inhibitors (PDE5is) are first-line drugs to treat erectile dysfunction. They work by stopping the action of the PDE5 enzyme, increasing the blood flow to your penis. PDE5 inhibitors can help you obtain and sustain an erection in the bedroom.

Here are the PDE5 inhibitor medications available on the market:

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Penile Implants

A penile implant or prosthesis is another option for treating penile atrophy. These devices are approved by the Food and Drug Administration for erectile dysfunction. They help improve sexual function with cylinders implanted into the erectile tissues of the penis, which can increase your erectile rigidity.

Other conditions where penile implants can be helpful include Peyronie’s disease, penile fibrosis, post-priapism spongiofibrosis and psychological impotence.

Out of all the erectile dysfunction treatments, penile implants have the highest satisfaction rate and deliver predictable and reliable results.

But surgery under anesthesia is required to insert the penile implant, and because a penile prosthesis is one of the most invasive treatments for erectile dysfunction, it’s the least popular. It also can come with many complications, such as device failure, improper device insertion or infection.

While research claims that penile implants don’t lengthen your penis, there’s one FDA-approved implantation device called a Penuma implant that has been proven to aid in increasing penis size.

Speak with your healthcare provider or urologist to discuss the best treatment for erectile dysfunction and penile atrophy.

Lifestyle Changes

Lifestyle habits may cause ED, which could contribute to penis shrinkage. Weight gain, for example, could be a contributing factor to ED.

If you have obesity, it could help to lose weight through diet and exercise. You may also want to stop cigarette smoking, if you’re a smoker, as there is a relationship between smoking and ED.

If you want to make lifestyle changes, make sure to get medical advice from a healthcare provider first.

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The Bottom Line on Penis Shrinking

So, can a penis shrink? Absolutely.

From aging to prostate cancer surgery, there are many reasons why you may lose a few inches of your penis. But don’t fret — solutions are available to lengthen your penis, increase sexual performance and boost your self-confidence in the bedroom.

  • The main reasons you may notice some penile shrinkage are aging, weight gain, prostate surgery, certain conditions like Peyronie’s disease, erectile dysfunction or hormonal suppression treatment. 

  • There is a significant crossover between many of the risk factors for penile shrinkage, which makes it difficult to pinpoint one cause — it’s likely more than one issue could be contributing to a smaller-than-average penis size.

  • For example, men are more likely to develop ED as they age, and ED is associated with shrinkage. Similarly, aging itself can also result in some shrinkage. 

  • Depending on your individual situation, some treatment options are available, such as erectile dysfunction treatments, penile implants and vacuum devices. Additionally, maintaining an overall healthy lifestyle can help improve your penile health. 

You can never learn too much about your penis, so check out our blog on penis facts, which briefly covers penis shrinking, and learn about what jelqing is.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment or medication.

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