What is small penis
How penis Develops
Causes of small penis
Investigations in small penis
Why doctors donít take this problem seriously
Response of treatment
Side effects of treatment
What is small penis :- As we know average penile length is six inches (i.e. fifteen centimeter). When penis is somewhat smaller than this, is called small penis. And when it is too small than normal is called micropenis. This small penis size is found in approximately one percent of males .The small penis may occur as single disorder or in some persons it may be associated with Thin penis. In some persons penis is so thin that as in children. The urethral opening may be at the penile tip or it may open on the undersurface of penis. It makes them sexually unsure of himself and decreases there confidence. They feel inferiority complex in exposing themselves in public places as in swimming pools & sea beaches etc. Thus it must be consulted urgently, so that diagnosis and treatment can done by team of hormone specialist & micro vascular surgeon. For this you consult at our sex n hormone center for complete diagnosis & treatment. In majority cases proper diagnosis & hormone therapy of about one year duration leads to penis growth in size and normalization of penis in length & thickness. Thus you should go to center where doctor have experience of treating such problems. In very-2 rare cases surgical intervention is needed in which case by microsurgery technique the penis enlargement is achieved in length as well as in thickness (i.e. girth) if required.
Causes : The following are the major cause of small penis & Thin Penis
It may occur due to
Male Hormone Disorder: Hypogonadotropic hypogonadism (hypothalamic or pituitary deficiencies)Hypogonadism, Hypothyroidism, Testosterone deficiency, hyperprolactinemia,Hypogonadotropic states: Hypothalamic Ė pituitary deficiency: Idiopathic GnRH deficiency, Kallman syndrome, Prader-Willi syndrome, Laurence-Moon-Biedl syndrome , Hypothalmic deficiency, pituitary hypoplasia, Trauma, post surgical, postoradiation, Tumour (Adenoma, craniopharyngioma, other), Vascular (pituitary infraction, carotid aneurysm), Infiltrative (Sarcoidosis, histiocytosis, tuberculosis, fugal infection, hemochromatosis) Autoimmunehypophysitis,drug-induced hyperprolactinemia, Untreated endocrinopathies , Diabetes mellitus, Glucorticoid excess, Hypopituitarism, Cushing disease, Addison disease.
Isolated gonadotropin deficiency (non acquired) : Pituitary , Hypothalamic
Associated with multiple pituitary hormone deficiencies : Idiopathic pan hypo pituitarism (hypothalamic defects), Pituitary dysgenesis, Space-occupying lesions (craniopharyngiomas, Rathke pouch cycts, hypothalamic tumors, pituitary adenomas), Following surgery, Following cranial irradiation, Following CNS chemotherapy, Following inflammation, Infiltrative or destructive processes (autoimmune, hemosiderosis), Associated with syndromes involving hypthalamic function, Laurence-Moon-Beidl sundrome Prader-Willi syndrome , Frohlich syndromeGenetic Mutuations : KALI (kakallmann), Gonadotropin-releasing hormonereceptor(GnRHR), FSH3 isulated FSH deficiency, PROP1 (pituitary deficiency), HSEX1 (septo-optic dysplasia), DAX1 Isolated gonadotropic deficiency with or without anosmia, Fertile eunuch syndrone, Idiopathic hypopituitarism, CNS disorders : tumors, infections, pituitary agenesis or hypoplasia, hydrocephalus, Septooptic dysplasia, CNS radiation for leukemia or brain tumor, Prader-Willi and Laurence-Moon-Biedly Syndrome, Thalassemia major
Hyperogonadotropic hypogonadism: testicular failure, development defect, drugs, trauma, congenital defect, congenital adrenal hyperplasia, Chromosomal defect, testosterone hormone biosynthetic defect, Mumps orchitis leading to testicular atrophy,Primary testicular defect-disorders of testicular differentiation or inborn errors of testosterone synthesis, Klinefelter syndrome, Other X polysomies (i.e. XXXXY, XXXY)Rainbow syndrome,
Partial androgen insensitivity
Growth Hormone Deficiency
Thyroid hormone deficiency
Idiopathic small phallus: In many patients all the hormone growth factor & every thing else is normal ,still they have small genitalia. This occurs due to Decreased capacity of penile tissue to grow.This occurs due to defective morpho genesis of the penis in utero so that its growing capacity decreases later in life. This is also one of the common causes of slmall & thin penis.
Investigation & Diagnosis:
For diagnosis of cause of investigation following tests are required. These tests include
complete male hormone profile.
ultrasound of testis
Gowth Hormone analysis
other tests which may be required depending on likelihood of the any of above causes.
In biochemistry liver function or kidney function tests are done.
Dynamic test to judge functional capacity of testis whether testis has the capacity to function normally or not. In this test we inject single injection of gonadotropin as intramuscular injection then three day later the rise in concentration of male hormone is seen to asses whether testis has capacity to function normally or not.
Chromosomal analysis is done to see the genetic structure of testis, because there are many chromosome disorders, which lead to small penis.
Capacity of generation of active testosterone i.e. DHT is tested. This DHT generation test is abnormal in some cases of small penis / thin penis /underdeveloped penis.
Tests to locate testis as ultrasonography or C.T. Scan abdomen is needed if testis is not palpable.
MRI / CT SCAN head if suspecting hypogonadotropic hypogonadism.
Serum inhibin is tested which tells that whether testis is functioning or not.
Serum Iron, T.I.B.C. & ferritin concentration tested for hypogonadism due to hemochromatosis.
Combined Pituitary hormone tests are performed when suspecting pituitary disorder.
Molecular genetic studies done in some special cases.
Serum estrogen increased whenever testicular function is decreased.
Serum DHT is low in some conditions when generation of dihydrotestosterone is decreased.
Assessment of androgen receptor is done when needed, Dynamic tests as HCG test, response to antiestrogen & gonadotropin releasing hormone tests.
Interpretation of all above tests one need to be expert of hormone diseases with good experience. Based on above test result diagnosis of cause of small /or thin penis is made. Once the cause is found then treatment becomes very easy with good results.
Penis Enlargement Options: Before starting treatment for enlargement of penis all above causes are investigated and proper diagnosis is made. Once male hormone deficiency or other cause found treatment becomes easy. Various options of penis enlargement therapy are available for micropenis & small penis .
First We Test: Whether Penis Enlargement Is Possible Or Not.
For this hormone therapy given for three months in form of male hormone injection, skin patches, or oral tablets. If penis enlarges in size i.e. it grows in size by more than 1.25 cm in these three months, it means penis of that patient has potential for further growth. Once it is decided by above test that penis has potential for further growth, in such patient further courses of hormone therapy is given. By few courses of hormone treatment penis enlarges by three to four inches. By this therapy penis girth also increases besides increase in length. This penis lengthening treatment is very effective in those entire patientsís in whom initial penis increasing potential test shows that penis has capability for further penis growth. Thus all patients achieve fully normal penis i.e. good penis length & thick penis. As penis increases in size patientís confidence increases and feeling of well being is achieved.
Treatment:. Treatment can be either
Or Surgical therapy.
We start medical treatment only when above tests shows that penis has capacity to enlarge. It is given in the form replacement of male hormone testosterone & other hormone as growth hormone, DHT hormone & growth factor replacement. These hormones can be given in the form of oral tablets, skin patches, ointments, gel or injections.
As this treatment has no side effects, is economical and easy to take either as oral tablets, skin patches, or as gel or sometimes as injection of hormone.
Thread: Small Penis & Penis Enlargement
02-27-2005, 08:17 PM #1
Small Penis & Penis Enlargement
02-27-2005, 08:20 PM #2
The various Treatment options are :
1) Male hormone testosterne replacement : The replacement of male hormone testosterone is one of the common treatment for penis enlargement. The various preparation of testosterone is :
a) Oral preparation which is available in capsule form. It need to be given one to three capsule daily. These have no side effects.
b) Tran dermal Testosterone given as scrotal patch. It is very effective & has no side effects. It can be also given as Testosterone gel, which can be applied on any part of the skin.
c) Sublingual Testosterone cyclodextrin is now available which is very fast acting & very effective is fast & better sex organ secondary sexual character development.
d) Local application of D.H.T. gel is new preparation for male hormone replacement. It is very effective for increasing penile size, & in cases of cure of breast development in boys.
e) Injection Testosterone esters These includes Testosterone enanthate & testosterone cypionate given intramuscular injections every 10 to 14 days.
f) Long acting testosterone as testosterone bucilate given once in 4 months.
g) Testosterones implants are now available which once injected remain effective for up to six months.
h) New human androgen receptor modulators they increase the effect of male hormone over androgens.
2)Growth Hormone Therapy;is given when somatotropin deficiency is found.
3)IGF-1 therapy ; is given when somatomedin c is subnormal.
)DHT Therapy is given in many patients . It is very effective in most patients. This treatment is also effective in many patients when all above treatment has failed. The other good thing about this is that it is available as skin gel so taking this is simple & has no side effects. This treatment is very effective in those in whom male hormone is unable to work due to inability to generate the final end product for testosterone efficacy due to 5 alpha reductase defects. In such patient replacement of final target hormone is replaced leading to good penile growth. In such situation even male hormone can be used in higher than usual doses leading to achievement of good penile enlargement.
5) Gonadotropin therapy is also very effective in penis enlargement.
6) Gonadotropin Releasing hormone therapy is effective in many cases of underdevelop genitalia.
How this treatment works:
When we give above-mentioned hormone by any of the above-mentioned routes. The concentration of these hormones in blood circulation rises. This leads to binding of more hormones on androgen receptors of penis. After binding with receptors these hormones leads to certain changes in the penis tissue . This leads to multiplication of penile tissue leading to further growth. This continued multiplication of penile tissue leads to further penis growth. This continued multiplication of penis tissue under the effect of above mentioned hormone treatment continues till penis normalizes.
Response of treatment: When any of above treatment is started the response is very good & has no side effects. In one study when the above hormone started, penis size increases by 1.0 cm in first month & then 0.3 cm every month in later months. After few courses of above treatment penis enlarges by three to four inches in length & also in girth i.e. thickness. Thus the trial of treatment should be given to all adults with small penis before asking them to go for surgery.
But unluckily many doctors do not take the problem seriously leading to patient not given proper treatment. Thus many patients remain having small size of penis & associated lifelong inferiority complex.
Side Effects : It has no side effects if given in proper disease and in patientís when it is really indicated. This it is absolutely safe in young patients below 50 years.
Surgical Treatment :
Surgical Treatment is required when medicine are not effective then there are various surgical procedures are there which can lead to long & thick penis. At our centre our micro surgeon performs all penis enlarging or girth increasing surgery.
Penis lengthening surgeries are performed by specialist surgeon (microscopic surgery) when penis is significantly small medicines have failed. Sometimes it is performed to improve the performance & satisfaction of man.
Three types of surgeries are performed:
(i) Penis Lengthening Surgeries
(ii) Penis Girth increasing surgeries.
(iii) Chordee correction
02-27-2005, 08:22 PM #3
02-27-2005, 08:43 PM #4
02-27-2005, 08:46 PM #5
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02-27-2005, 08:47 PM #6
02-27-2005, 08:50 PM #7
02-27-2005, 08:52 PM #8
Wouldn't this sort of hormonal treatment only work during puberty. I thought there was only a small window of opportunity for hormonal therapy. For example for kids with dwarfism due to inadequate GH, GH injections are given throughout childhood. But at a certain age, GH injections will no longer create an increase in height. If this type of therapy worked, I'd go for it. Someone posted about jelqing. Now, I know the right techniques, I'm just skeptical. Have you guys really achieved decent results with it?
02-27-2005, 08:56 PM #9
01-04-2014, 03:01 PM #10
2. Apparently the reason Jelquing (ie manual stretching of the engorged penis) works, is because the cells in the Corpus Cavernosum break and new growth is required to repair thus elongating the penis (albeit VERY slowly). If DHT were applied topically during this "repair" phase would it not stand to reason there would be more growth?
3. Assuming the AR receptors are not unregulated, could a receptor agonist be developed to "restart" the growth process?
4. Finally I believe within my lifetime penis size will not be an issue, there are trials going on where penile tissue from rabbits has successfully been cloned and reattached. Of course this will first be used to help those who do not have a penis at all IE FTMs but eventually phylopasty will be as common as breast enlargement with stunning results (not just 1" but 3-4" minimum)