Men’s Health: Penis Size and (Dys)function

If you’re a man, you’ve probably Googled some embarrassing questions: “why doesn’t alcohol freeze?”, “what happens if a woman takes viagra?” and, of course, the ever-famous “how big should my penis be?” These are not new questions, or at least not that last one. The search for the ideal penis size has gone on for millennia. In Ancient Greece, a small penis was considered handsome and a sign of wisdom. Today, it seems that large members have now taken over our cultural imagination! Whether you fantasize about them or worry about them, it’s only natural to wonder just how large a healthy penis should be.

Many myths surround penis size and its role in sex. What defines a larger-than-average penis is usually exaggerated: sexually charged media - including movies, TV, and pornography - can produce unrealistic expectations about how men should look or act to be sexually attractive. Sometimes these myths are considered immature, but they can have serious, long-lasting effects on men. Men with low genital confidence often struggle with feelings of inadequacy or depression. They might pursue potentially dangerous body modifications, like silicone injections or unnecessary surgery, while leaving their psychological pain unaddressed. Low sexual self-esteem can also intensify struggles with premature ejaculation or erectile dysfunction. Most importantly, men who feel ashamed of their bodies will feel unworthy of affection and may push their partner(s) away. Here are some essential facts and fictions about penis size and (dys)function for healthy male sexuality.

What Is the Average Penis Size? Does it Matter? Believe it or not, penis size is an important subject in academic research! One study, published in The British Journal of Urology International, compared data from up to 15,521 men and reported an average flaccid length of 3.5 inches and an average erect length of 5.1 inches. Unfortunately, men learn that this average size is small and that a small penis is sexually impotent (which is not true)! A survey by the company Health Bridge Limited found that men imagine the average penis length is around 5.5 inches, and image the ideal penis length is 6.5 inches! Meanwhile, in reality, 90% of men have a 4-to-6 inch penis. A penis above 7 inches is incredibly rare (about 2.27% of all men in the world). Long story short: most men are bigger than they think.

Not only are most men bigger than they imagine, but size alone is not that important for sexual enjoyment. Anxieties about penis size can make men feel less pleasure during sex and convince them that their lovers are unsatisfied. These fears misrepresent the relationship between penis size, the amount of sex a man will have, and the satisfaction a man can give their partner(s). One study found that 85% of women were satisfied with their male partner's penis size, while only 55% of men were satisfied with their own penis size. A study by King’s College London found that men who develop Body Dysmorphic Disorder (BDD) or small penis anxiety experience less sexual satisfaction but have just as much sex as men without BDD or anxiety. These conditions lead to constant obsession over body image and deep insecurity about penis size. Men with these conditions often develop unhealthy body images as early as 15 or 16. Both homosexual and heterosexual men struggle with these conditions.

Men who experience BDD or small penis anxiety are more likely to try and modify their bodies and might use dangerous “solutions” like pumping, stretching (jelqing), or enlargement surgery from untrustworthy sources. Excessive stretching or pumping can tear tissues or bruise your penis. Enlargement surgery is only recommended when medically necessary, which is very rare. Cosmetic surgery can cause infection or mutilation. “A simple search on Google will give hundreds of results for ‘solutions’ to increase penis size,” says David Veale, a researcher on the King’s College study, “Such ‘solutions’ are often risky, and clinicians should educate their patients to avoid any ‘solutions’ that have no evidence base and develop an effective psychological therapy for such men.” At the end of the day, sex is a deeply interpersonal act and focusing on your body as an object instead of a foundational means of connection with your partner(s) is important to take a closer look at.

Back to the Penis It is a myth a penis must be larger than average to pleasure someone, nor is it true that a penis under 5.5 inches is "small." Most men who worry about the size of their penis will have just as many sexual partners and sexual experiences as men who do not have anxiety. False expectations and unrealistic images make men feel uncertain about their sexual ability. While there are physical conditions that can inhibit sexual pleasure, inhibited pleasure from BPP or anxiety is psychological and not the result of penis size. In addition to emotional distress, fixation on penis size and sexual performance can cause physical problems like premature ejaculation and erectile dysfunction.

Premature Ejaculation and Erectile Dysfunction Many men report having trouble with penis sensitivity, premature ejaculation (PE), and erectile dysfunction (ED) at some point in their lives. These conditions can result from physical causes, but psychological factors can play an important role. Experiencing PE or ED can be mentally or emotionally distressing on their own.

Premature ejaculation is when ejaculation regularly occurs faster than you or your partner(s) would like, usually if it happens less than a minute after penetration. PE affects roughly 30% of all men.

Erectile Dysfunction describes difficulty acquiring or maintaining an erection, even when aroused. Erectile dysfunction is the most common sex problem that men report to their doctor; over 30 million men struggle with ED.

In addition to physical causes, PE and ED have psychological causes including:

  • Depression

  • Stress

  • Low self-esteem or body confidence

  • Experience of sexual abuse

  • Anxiety about sexual performance

Experiencing PE or ED can be difficult and emotional. While neither one is uncommon, men might feel like these conditions are abnormal because they don’t align with the social expectations of male virility. They can cause (or reinforce) feelings of sexual inadequacy, reduce self-confidence, and put stress on a relationship. Both physical and psychological factors play a role in these conditions. Treatment can include medication (ointments, blood flow stimulants, antidepressants) as well as therapy. Therapy can help you explore the stress and anxiety that may be causing the disconnect; it can give you space to reconsider your self-image and sexual needs without more care and kindness. If PE or ED is affecting your relationship, therapy can also provide a safe environment to talk with your partner(s). That conversation can be hard to do alone!

Men become concerned with penis size and sexual performance very early on, as early as high school. An abundance of sexually explicit material depicting masculine stereotypes (lean and muscular bodies, thick hair, sexual virility) produces unrealistic expectations that can cause emotional difficulty in men. These expectations and images are such a big part of our culture that it can be difficult for men to develop a healthy connection to their body or healthy sexual relationships with others. They can produce, or intensify, physical dysfunctions like PE and ED. Feelings of shame might discourage men from seeking help. Therapy is one option that can help men examine their sexual needs and self-image without judgment. It can help men embrace their sexuality and body on their own terms.

If you think that therapy could help you or your relationship, reach out today for a free 20-minute session. I look forward to talking with you!