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Penis Size Worries

February 13th, 2012

Dr Petra

Penis size. One of those topics that’s the source of many a joke, or shores up boasts around masculinity and sexual prowess. It’s integral to all those spam emails that clog your inbox. And it’s an issue that causes a great deal of distress to men and their partners. Only we rarely address the latter issue in any meaningful way.

Over the past decade of offering advice to men, the question I’ve been most commonly asked is ‘what’s the average penis size?’ (sometimes expressed as ‘is my penis big enough?’) . Underlying this seemingly simple question is a whole hot mess of anxiety about sexual performance, desirability, masculinity, sexuality, body image, personal identity, and relationship satisfaction.

So I’ve decided to put together a post to try and answer the many questions I’ve been asked on this topic and hopefully offers some reassurance and further information to men who are anxious about size, and perhaps are considering drastic solutions to their perceived ‘problem’.

What’s the average penis size?
Studies of penis size show the ‘average’ erect penis ranges from 5 to 6 inches (around 13 to 15 cms) with a girth of about 4 to 5 inches (around 10 cms). An average non-erect penis ranges between 2 to 4 inches (5 to 10 cms). Very few men have longer than average penises when erect (there’s more information about male genitals via The Kinsey Institute that you may find useful).

Research shows soft (flaccid) penises vary in size much more than erect ones do – and it isn’t possible to predict from a soft cock what it’ll look like when it’s hard. Some guys don’t change much between flaccid and erect, others do. Sometimes this is referred to as guys being ‘showers’ – they’re big when soft and don’t get much bigger; or ‘growers’ – they’re smaller when soft but then grow a fair bit as they get hard.

Those figures sound a bit low!
You may well have seen larger measurements or averages online. These are either based on flawed or outdated research, or are being used by people who want to make you feel anxious about your body so you’ll buy products from them (more on this later). If you see any website, book or other resource telling you the ‘average’ penis size is 7 or 8 inches and above, then be very wary of it. It’s a shame such sites don’t come with a built-in cock quackery klaxon, but in the absence of such a facility use the dodgy measurements to warn you off.

How do studies actually measure penis size?
Before you reach for the tape measure or ruler, it’s worth knowing that most sex researchers and therapists are skeptical about the whole concept of ‘average’ penis size.

The reason? They’re based on measurements from laboratory studies where men knew they were participating in research to see how their knobs measured up. This means guys who were worried about size were less likely to participate, whilst guys who thought they had big schlongs were more than happy to waggle them under researchers’ noses.

So most researchers, therapists and doctors suspect the ‘average’ penis size figures obtained in research (and widely quoted) are at least an inch larger than they should be. This is because research on penis size is skewed in favour of men who are happy to be measured.

That’s partly why you sometimes see a range of penis sizes given (as I’ve done above) rather than the mean size, which is unreliable. If you really want a mean measurement then probably 5 inches when erect is more likely than 6 or 7 inches.

The other problem with this area is studies differ in how they operationalize their measuring of penises. Some relied on lab based studies where men were measured by researchers, others based their work on self-reports from men (which, as you can guess, were likely to be very unreliable due to the sensitive nature of such research). Some studies were based on erect penis measurements; others relied on stretching a flaccid penis as far as it could be pulled and measuring that as an approximation of a hard-on. While some research didn’t directly measure penis size at all, but instead asked men to show on a ruler or with the span of their hands how big they thought their penis was. All of which provides a lot of variety in terms of how penises are measured, and introduces a lot of problems with establishing a reliable ‘average’ figure (more on the variability between erect and stretched flaccid penises can be found here).

Should I bother measuring at all?
Modern sexologists argue that we should look at what counts as ‘too small’ rather than being hung up about average sizes. They suggest this because men are often not reassured by learning their penis size is within the average range – because they want to be bigger than average.

Therapists report men who are worried about penis size underestimate their own size while overestimating the average penis size, which can add to their anxiety and warp their perceptions of their own bodies. Indeed some practitioners suggest asking men to indicate how they think they ‘measure up’ can help as part of sex education or therapy.

For adult cisgendered men anything under 7 cms when erect is considered clinically small for a penis – and is sometimes referred to as a ‘micro penis’. Some therapists and researchers suggest telling men to focus on this figure rather than the usual 5 to 6 inches ‘average’ can be reassuring. However, in my experience this has not always been well received by men asking about penis size worries as they are familiar with the ‘average’ measurements, want to know how their penis ‘measures up’ on that scale. They are not particularly interested in what is clinically ‘too small’ (which most of them are not). They are not necessarily comforted by hearing that they have to be fairly small when erect to be seen as having a clinical problem, but want to know if their (usually average) penis size is ‘enough’. For men who feel their penis is too large (particularly if it causing them to have problems getting or keeping an erection, or discomfort to their partner) knowing what is clinically too small doesn’t help deal with being ‘too big’.

This is an issue sex therapists, educators and researchers still need to address as it can mean men ignore advice given along these lines, and those who feel they aren’t big enough are persuaded by the more familiar messages about ‘average’ sizes and the promise of penis growth as advocated by cosmetic surgery and commercial websites selling grow it big products.

Telling men that most of them measure up just fine, or to focus on sexual techniques rather than fixating on penis size may reassure some men, but not all. For those who are not convinced psychosexual therapy or medical advice may be more appropriate (more on this later).

What’s the big deal about dick size?
The issue here isn’t really about size. For centuries, men have been led to believe a larger member makes them better in bed, more fertile, more masculine, or more attractive to a partner. None of these things are true.

Gay and straight partners of men have complained that longer penises are uncomfortable to accommodate and make some positions impossible. Straight women say they’re more interested in girth than length (although guys don’t always know this). Men with larger penises also are more likely to have problems getting and keeping erections. And you can’t rely on a big cock to get you by in the bedroom. Anecdotes abound that men with larger penises don’t try as hard to please their partners – leaving both parties dissatisfied.

The reason sex therapists or medics are unwilling to discuss penis size is because men are still often not satisfied to hear their penis falls within an average size range – they want to be bigger than average. And even If you tell guys they’re okay, often their body image worries means they’re still anxious. A recent study showed that men seeking penis enlargement consistently overestimate the average penis size of other men and drastically underestimate their own size.

Men get penis hang ups since they usually only see other penises in the changing rooms or toilets – where they view their dick downwards and everyone else’s front or side on making other guys seem bigger. Or they compare themselves with porn stars, where the actors are specifically chosen for their size – and filmed from flattering angles and with clever editing to emphasize length.

Mainstream media also doesn’t help men as it either tackles knobs in a jokey way, or overemphasises sexual positions and performance over communication, technique and exploration. Men’s magazines either don’t have problem pages or have pages that are not adequately equipped to answer penis size problems in any useful way. Online forums for men’s magazines increasingly focus on ‘banter’ and performances of hyper-masculinity that leave few safe spaces for men to ask for frank and supportive advice about penis size (this study provides an overview of what men can ask about when given a safe space to ask about psychosexual concerns, which is a stark contrast to what men’s media usually addresses).

It’s important to note that regardless of why men are anxious about their penis size, these worries are not insignificant and can cause considerable distress to men and their partners. It’s all too easy to pass this off as a joke, and in talking about this topic in mainstream media, education or science communication events I’ve frequently faced barriers in getting it treated in any way other than put downs and smutty innuendo. Men’s negative body image regarding their penis size and shape can have considerable impact on their sexual functioning (see here and here) and the quality of their relationships overall.

For most men, worries about penis size and shape are temporary. However for others their anxiety about penis size can lead to ‘small penis syndrome’ that can have devastating effects on their relationships, sexual encounters, and wider quality of life. It can also make men more prone to being exploited by quack remedies, untested herbal products or ineffective surgical interventions.

Do partners care?
Studies of partner attitude to penis size are not as numerous as studies about men’s attitudes regarding the penis. The studies that do exist tend to focus on cis gendered, heterosexual couples. However, despite these limitations these studies, perhaps predictably, tell us that men worry a lot more about penis size and shape than their partner’s do (an example of one such study can be found here). This can become a problem within a relationship if partners are not aware of a man’s penis anxieties, or (with the best intentions) dismiss his concerns. It can be that men are so ashamed of their penis size that they fear mentioning this to a partner in case they confirm a problem exists. Or that they may be laughed at. Some men avoid intimacy with their partner due to anxieties about penis size, or simply avoid relationships. Unsurprisingly penis size worries are often linked with premature ejaculation or erectile dysfunction.

Anecdotal evidence suggests partners can be upset if their loved one is anxious but fails to seek help about it, fails to vary their sexual techniques to incorporate activities other than penetrative penis and vagina/mouth/anal sex, or where their partner withholds non-sexual affection as they’re so withdrawn and unhappy about the size of their genitals so fear any physical contact could lead to unwanted intimacy.

There is also anecdotal evidence from partners when men have a larger penis length or girth where anal/vaginal penetration can be uncomfortable or difficult. While lubrication and sexual positions can help in part with this it may not necessarily be enough and this can lead to relationship distress when intimacy is desired. People in such situations may assume they cannot seek help from psychosexual therapists for fear of being viewed as time wasters. Help is available and couples should seek it (more information on this at the end of this post). However regardless of penis size, if sex is painful during or after penetration it’s important to seek medical attention as it could be the sign of an STI or other genital problem.

Are there any proven penis enlargement products or procedures?
You may be tempted to have penis enlargement surgery. There is currently no independent evidence that this is effective to either address men’s sexual performance or body image worries. Indeed if you are struggling with psychosexual problems or a lack of education about your body, surgery is not the answer. Surgery can make you look bigger when flaccid it won’t make you much larger when erect. Plus if there are complications you can end up impotent for life. It won’t make you a better lover, a more considerate partner, or give you the ability to last longer in bed or produce more ejaculate (all things men have wrongly been led to believe cosmetic penis surgery can provide).

In some countries (particularly the US) the area of cosmetic genital surgery is increasingly seen as a business opportunity. However, while unnecessary cosmetic genital surgery for well cis-women is increasingly meeting with protest and activism, challenges around the cosmetic genital surgery offered to health cis-men are virtually absent.

It is important to remember if you consult a cosmetic surgeon about penile enlargement surgery it is highly likely they will tell you that your penis does indeed need ‘work’. If you are considering this option always go via an independent practitioner and see a urologist and a psychosexual therapist before considering cosmetic/plastic surgery.

The Internet is full of websites promoting penis enlargement pills, potions and creams. Put it this way, if these products worked doctors all over the world would be recommending them to men. They’re not.

Flashy websites and glowing customer reviews can con us into thinking products are reliable, reputable and they work. But there’s only one way to be sure – if a pill, cream, patch, supplement or other product is effective at penis enlargement it would have been described as such in a research trial.

In a trial, a drug, product or pill will be compared with an existing and/ or a placebo product. Sometimes the participant won’t know what they’re testing (called a single blind trial) and occasionally the researcher won’t know either (called a double blind trial).

Over time the response to the product will be measured, perhaps with blood tests, self-report questionnaires or another measure. In this case, researchers would measure the penis before and after any intervention.

Companies often talk about ‘trials’ on their websites, or even include what looks like scientific reports or pictures of doctors. But this self-promotion isn’t anywhere near enough. Any product that’s effective should have been published in a reputable peer reviewed scientific journal. You can check this for yourself by searching PubMed. This will show if any research has been done and what the wider scientific community thinks about it. Moreover you’re not looking for a one-off paper based on a small sample that makes a claim for a product. You want a body of independent, peer-reviewed research that’s claiming a product works. Trust me, you won’t currently find this level of evidence for the range of pills and potions that supposedly grow dicks bigger. Go figure.

If you’re still not convinced, put this to a further test by contacting any companies promising guaranteed penis enlargement methods. Ask them to produce the research they’ve done on their product, where they’ve published, whether they have FDA approval, and what independent endorsements they have. You’ll most likely get no reply, or be fobbed off with some sales talk. Believe me, I’ve contacted enough of these companies to see them consistently sidestep reasonable requests to provide any evidence to support their products.

Some research suggests that herbal sex pills and potions can contain either products that won’t lead to any physical changes, or contain ingredients that could cause harm or interfere with other medication you may be on. Many of these products are untested, unlicensed and not approved by the FDA. At best they waste your money, at worst they could harm your health.

Another thing to consider is if products really do grow your penis – particularly claims made for creams that do this job – surely they should come with some warning about how to apply them? After all, if it’s going to grow your dick, presumably it’ll also grow your hands to massive proportions as you apply it? At the very least they ought to market them with gloves? Funny, yes, but thinking like this about claims made for products can highlight for you that you could be paying out for something that simply isn’t going to make a difference to your physiology, and certainly won’t do anything to help your confidence, technique or the quality of your relationship.

There is some evidence that penis-extending/stretching devices can increase length and girth to a moderate degree. However studies in this area remain limited by small numbers of participants and lack of independent evaluation. Most of the studies conducted in this area are run by the manufacturers of penis stretching devices and while a few have been published in peer review journals (for example) there needs to be wider independent trials conducted in this area that are tested against psychosexual therapy and basic sex education, rather than just testing devices alone.

Some men claim shaving their genitals can make them appear bigger, as can using coloured condoms that contrast with your skin tone. These are non-invasive approaches to make your penis look different. They won’t make a difference to your length/girth but it might make you feel better, which in turn might boost your sexual confidence. This is based on anecdotal evidence so not a reliable approach to tackling deeper psychosexual worries, but for men with low-level anxiety in this area it could be worth a try.

It is worth noting these products are aimed, in general, as cosmetic enhancements for men who have ‘average’ penis physiology. If your penis/erections have been affected by injury, cancer, STIs, Peyronie’s disease, Heart Disease, MS, Diabetes, Sickle Cell disease etc; or have pain in your genitals during or after sex; or have problems with your foreskin then you should seek medical advice from a healthcare professional (more information about this here).

So if you do not fit into this category, save your money, work out how much cosmetic genital surgery or a course of ‘grow it big’ products would amount to over the year and buy yourself a gift to the value of that amount. Or consider putting the money towards psychosexual therapy. Better you get something out of it, than the cowboys out there getting rich off your anxieties.

If you want to sort out your sex life, there are some surefire ways to do it – eat healthily, exercise regularly, cut down on alcohol and if you smoke, quit.

Also improve your communication skills so you can ask your partner what they want and make them feel confident enough to show or tell you.

All that will make a much bigger change in your sex life than a fake pill or potion that won’t help at all.

What happens to men with penis size worries?
Penis size worries do a lot of damage to many men. It can lead to relationship problems, avoiding sex or relationships, erectile dysfunction (not being able to get it up) or premature ejaculation (when you come too soon).

If you’re worried about your sexual performance, you can get help from The Sexual Advice Association. If your worries are severe, your GP can refer you to a psychosexual therapist who can unpack where your problems come from and reassure you you’re okay (there Is a waiting list for this service). Alternatively, you can self-refer via CORST (you will have to pay for this therapy but most practitioners offer a sliding scale and many are happy to treat GBT clients with penis concerns). Counselling can be effective, and while studies on its effectiveness are few, those that exist suggest it usually persuades men that previously desired surgical interventions are not necessary.

It’s common for men to have an occasional worry about their penis size – after seeing a bigger guy at the gym, following a negative comment from an ex-partner, or perhaps after reading somewhere you should have a bigger dick. Research indicates it’s more common for younger or sexually inexperienced men to have size worries and, with time, these worries reduce. However, for some men it continues to be a problem throughout life. Straight, gay and bi men all report having penis size concerns.

It strikes me that guys should start challenging a society that makes them feel they’re only a sexually attractive and functioning person if they have a slightly longer knob. However I’m fully aware of the many constraints around masculinity that prevent this from happening.

So the take home message is:
- Penis size worries are common, can be distressing, and may impact on men’s abilities to enjoy positive relationships.
- Men generally underestimate their own size while overestimating other men’s penis sizes.
- Studies of penis size vary in their methodological approaches and calculations of ‘average’ sizes. They are also biased by the kind of participants who volunteer to be measured.
- A range of factors contributes to men’s penis worries. Including mainstream media, a lack of sex education, porn, medicalization of men’s sexual functioning, quack sex products and few safe spaces to ask for unbiased advice.
- Herbal products, penis enlargement surgery, creams and lotions are not proven to make any difference to penis size.
- There is some, limited, evidence that stretching of the penis can make a moderate difference to penis size/shape.
- Believing you have a bigger than average penis can make you feel more confident as a lover, but may not mean you are sexually more competent
- Penises are only one body part that can be used to turn a partner on – oral sex and masturbation with a finger or sex toy can be equally or more pleasurable.
- Penis worries can lead to psychosexual dysfunction, relationship breakdown and anxieties in other areas of men’s lives.
- Learning basic information about penis size can be reassuring for men and reduce anxieties about their genitals and sex.
- In the UK your GP can refer you to a urologist if you are worried about penis size/performance. Or a psychosexual therapist. Both are available on the NHS.

More penis size FAQs and recommended reading can be found here.

Taking this forward
This post is based on a number of pieces I’ve written for men’s media outlets over the years and training I’ve delivered to healthcare practitioners specializing in men’s psychosexual functioning.

I’m hoping to keep this as an evolving resource for men and am aware there probably is more information needed for men with disabilities; men whose penises have been shortened during surgery (for example following radical prostatectomy); men who lack access to affordable healthcare (particularly in the Global South); Trans men; and BME men. Partners are implied within much research in this area (such that it is) but I’d be interested in hearing about resources to help them. Men who feel their penises are too wide/long are ignored in this area with its preoccupation on men’s anxieties about small penis size, but still require advice if it impacts on their relationship quality and psychosexual functioning. Practitioners (particularly those working in healthcare and therapy) also require more information in order to enable them to work effectively with clients, while academics working in this area probably are aware of studies I’ve missed. Reputable resources that aren’t pharmaceutically funded would therefore be appreciated. As would reputable, independent, sources of support in countries outside the UK. If you notice anything that needs adding or think you can help please email me (info@drpetra.co.uk) and I’ll keep updating this resource.

This post is created as a free resource for men and their partners, and those who work with men in psychosexual/genital healthcare and/or therapy. You are welcome to share this resource with acknowledgement (and if online, with a link back). Please note this is not designed for use on for profit sites, so if you see it being replicated anywhere that’s charging to read it – or it’s appearing alongside dodgy penis enlargement products let me know. For the record I don’t endorse penis enlargement products.

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