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Micropenis

What is a Micropenis?

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Micropenis is a clinical term used to describe a very small penis. In an ideal world (where we didn’t assume that being too far from a norm is automatically cause for concern) being born with a very small penis would not be considered a medical problem unless the penis was causing pain, or not functioning the way a newborn penis should. However, because we do associate health at birth with a variety of norms, infants born with very small penises can be labeled as in need of medical attention.

People born with micropenises that either received no treatment, or received treatment that had no effect, can go through puberty and move into adulthood and still have a micropenis. The generally accepted definition of a micropenis is a penis that is “more than 2.5 standard deviations” below the average penis length for the age of the individual. This is just a statistical term that means a certain length away from average, based on the average penis size in the population.

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Despite the fact that researchers disagree on what constitutes and average penis size, a micropenis is considered in newborns to be around 3 /4 of an inch (1.9 centimeters) in length, and in adults to be less than 2.8 inches (7 centimeters) in length when flaccid and stretched.

Why do some people have Micropenises?

Micropenises are the result of a difference in fetal development. Most often the cause of a micropenis is chromosomal and hormonal, and results from some problem in either the making of, or body’s response to, androgen. Research on fetal development suggests that there are two stages of penile development in fetuses. The first happens early in fetal development is when androgen triggers the development of the penis and scrotum from its undifferentiated state. The second, which happens later on in fetal development, occurs when androgen influences the further growth of the penis. It is thought that a micropenis is the result of the first stage happening but not the second (so the penis looks like most penises, but it is much smaller).

Because the term micropenis is really just a descriptive one, there could be many reasons someone is born with a micropenis. As many as a third of people born with a micropenis don’t fit into an easily identifiable category to explain the cause of it.

Many adult men who think they have a micropenis would not fit the clinical diagnosis. If you are concerned that you may have a micropenis the easiest first step would be to talk with your doctor.

Can you have sex with a Micropenis?

You can absolutely have sex with a micropenis. For adult men who have true micropenises this may be a huge concern. The first thing to point out is that if you want, you can have great sex without a penis at all. So regardless of size, sex is still out there.

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In terms of the sexual functioning and response of the micropenis itself, reports vary. Certainly many men who have micropenises report having satisfying sexual intercourse as well. There haven’t been many studies, but one reported that 75% of men with micropenises reported satisfying sexual intercourse. Yet another recent study which examined the nighttime erections of men with micropensises found them to be different from men without micropenises. Again, I would suggest that sexual satisfaction and functioning are not categories to be left to “researchers” alone, and how you feel about it is more important than what laboratory research can tell us.

Is there treatment for a Micropenis?

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Given the society we live in, where a man’s worth is measured by the size of everything from his car to his income to his penis, it’s not surprising that many men think a small penis is, by definition, a broken penis. But this isn’t the case. If you are an adult with a micropenis the “treatment” may be more about accepting that your body is okay, and can give you the same amount of pleasure as other bodies than any more significant intervention.

Definition of Micro penis- A very small penis 

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Micropenis, also known as microphallus, is a penis that is 2.5 standard deviations below the mean (average) for the age and race of the child. This definition translates to a stretched penis length of less than 1.9cm (3/4 inch) long at birth and can be described as a micropenis. Statistically, micropenis occurs in 0.6% of the population.

Lack of development of sexual organs and penis size       

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There are many reasons why the penis may not develop. Very early in the development of the human male or female fetus differences in the genitalia cannot be detected, even though the sex chromosomes XX (in most females) and XY (in most males) have put down the basic building blocks. It is hormones produced by the gonads determined by the sex chromosomes that then determine which organs develop and which ones disappear. The same tissue that forms the clitoris in the female forms into a penis in males, the tissue that makes the scrotum in the male makes the labia in the female. Because of the complexity of fetal development things can and do go wrong. Therefore it should be no surprise that things can go wrong in the development of the sex organs.

Getting the best advice about Micropenis

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As a parent, advice and treatment options should be discussed with a specialist medical team made up of pediatricians, urologists, endocrinologists, geneticists and radiologists very soon after the birth of the child. Tests will need to be carried out to see if the gender of the baby can be determined. Treatment and management options need to be discussed that result in the best possible outcome for the child. The family need to be supported and informed. Changes in the way micropenis is treated by the medical expert’s means that it is worth getting more that one opinion to make sure all avenues have been explored if the treatment is complex or has lasting implications for the infant.

Causes of micropenis- Very small penis

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The central role here is chromosomes and hormones as the deciding factors of the male or femaleness of the fetus and baby. Micropenis occurs when these systems fail to work properly. There are many different possible causes and problems with penis growth can start the after 14 weeks of fetal growth.

Micropenis is often due to inadequate testosterone in 2nd and 3rd trimester of fetal growth. There may be a genetic cause. Although there is no gene per se that causes micro penis, there are a number of associated syndromes. An example is androgen insensitivity, where the fetus started as a male but was insensitive to testosterone (the male hormone), or syndromes caused by chromosomal abnormalities such as Klinefelter’s Syndrome, Turner’s Syndrome or Down’s Syndrome.The medical team can investigate the many possible causes and carry out tests that will inform future management and treatment.

Cultural & social issues of maleness & the penis             

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The range of things that can go wrong in the external genitalia and the way the penis may look and function, is an area bound up with images of maleness (or femaleness). The penis is so central to sexuality and sexual satisfaction that it has even influenced medical treatment. Since the mid 1950s and until quite recently, a child with a micropenis would be surgically realigned to a female and hormones given to enhance that change.

Many would argue that the decision was underpinned by the idea that was essentially, culturally and socially led, that a man must have a ‘normal’ penis size to be a man. Size really did seem to matter.

The medical establishment has responded to the changing attitudes on gender and sex, social and cultural issues, increased genetic information and medical advances, research and from information from relevant pressure and support groups. Treatment options are no longer as straight forward as they used to be. Society does expect male or female. If a child waits until it is old enough to make a decision there is obviously the potential for confusion, upset, teasing and bullying. A great deal of thoughtful and emotional support will be required

What are the symptoms of Micropenis?

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While each child may experience symptoms differently, the most common finding with micropenis is an infant penis size that is less than 1.9 centimeters when stretched gently. In some cases, low sperm count, resulting in infertile                                          

How is Micropenis Diagnosed?

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Diagnosis is usually made by physical examination. Your child may then be referred to several specialists including a pediatric urologist (a physician who specializes in the in disorders and care of the urinary tract and the male genital tract) and a pediatric endocrinologist (a physician who specializes in hormones).

Research & Micro Penis 

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Although research in this complex area is relatively lacking, there have been a few long term studies that have found that most boys raised as boys have strong male identity. Most end up as sexually active and enjoy sex and satisfy their partners. More comprehensive research is needed to give a clearer picture of people’s lives who have micropenis, or who have had treatment decided for them, been assigned gender with or without surgery.

Treatment

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