Penis
problems page 1 (this page) - click on the problem below for our answer
1
The retractile penis, and issues of size, width and length, too big and
too small
2
Foreskin problems, including the long foreskin, smegma and phimosis
3 Fordyce spots, pearly penile papules and genital warts
Penis problems page 2 - click below to go to page 2
4 My glans is over-sensitive
5 My glans is red, itchy and blotchy - I may have balanitis
6 I have webbed penis -the skin of the shaft joins onto my scrotum
7 I have skin bridges between my glans and foreskin
Penis problems page 3 - click below to go to page 3
8 My sexual organs didn't develop normally at puberty
Penis problems page 4 - click
below to go to page 4
9 I can't get an
erection as reliably as I used to
If
your problem is not
answered here, e mail it to: moreinfo "at" penis-website.com
Answers!
Q 1: I have a really small penis which goes
all the way into my body when I'm not erect. That is uncomfortable and
embarrassing in the locker/changing rooms. In addition, it's only about 4.5 inches
long when it's erect.
I have found that when having sex, it's difficult to keep my penis inside my
partner, especially when she gets on top - it keeps coming out and this gets
really frustrating for us both. I am also wondering if I can reach her G spot.
And what positions are best for sex for a man like me?
A: Between 1 and 3 % of men have a
retractile penis: in other words, one which retracts into the abdominal cavity
under nearly all conditions, except possibly when very warm and relaxed. These
men may appear to have almost no penis when they are not erect, with just the
glans showing, or even just a hole in the abdominal wall where the penile shaft
will emerge when it becomes erect. It's worse where there are large quantities
of fat around the abdomen, which obscure the base of the shaft, and when a man
is naturally anxious, which causes the cremaster muscle to pull the penile shaft back
in towards the body.
Not all these men will be small on
erection, and some have a normal-looking penis, though my research suggests it
is more common for such men to feature on the small side of the size
distribution in all conditions. The retractile penis may feel bunched up and
uncomfortable, and may need to be manually lengthened with the fingers before
urination.
There is no "cure", except possibly
surgery, which is never really to be recommended on the genitals unless
absolutely necessary. If surgery was the treatment of choice, it would entail
release of the suspensory (fundiform) ligament to allow the penis to drop down
and appear longer, and
possible release of the restricting bands of Scarpa's Fascia. Some surgeons
offer penile widening with alloderm grafts, but this is an unproven technique
and must be considered experimental. (Below the skin the superficial fascia is
divided into a superficial fatty layer, Camper's fascia, and a deeper fibrous
layer, Scarpa's fascia. The deep fascia lies on the muscles of the abdomen. This
deep fascia is composed of connective tissue with large numbers of elastic fibres, the whole structure being next to the linea alba and the symphysis
pubis, but also continuing down onto the top inner surface of the penis as the
fundiform ligament, the one cut during surgery to lengthen the penis.)
If you are in this position, it's
important to remember that the size and shape of your genitals is really no obstacle to
finding a
sexual partner. It's a superficial view of masculinity to judge it by the
size of your sexual organs, just as it would be a superficial judgement about
a woman to base her attractiveness or her femininity on her breast size. Try to
move out of the place where you have this logic in your head, and remember
that the qualities for which women are looking in a partner have nothing to do
with your penis. Lots of men who know (or think) they are less well-endowed don't have much
confidence about getting a partner. The truth, of course, is that penile size really
doesn't matter for most women, a fact most men find hard to believe.
When you are making love, keep your
penis in her body by using short thrusts and a position where your bodies are
closely aligned, such as missionary and rear entry (with you hugging her
close).
Photograph of the retractile penis
Q2: I'd appreciate some
advice. My penis is too long for sex. I know this may sound laughable but I assure
you it isn't. I have had women refuse me sex before now, and even when I do
have sex, I generally can't get more than two thirds of it into my partner's
vagina.
A: Having a penis as big as yours might
seem like every man's dream, but anything over 8 inches is far
too large for most women's vaginas to accommodate. Having such a large organ calls
for creativity in making love, using your imagination and finding positions where your penis does
not bang against your partner's cervix: this can be very
painful, especially if she is not especially aroused. Rear entry sex is good, provided
you do not thrust too hard or far. Side by side is also a position likely to
allow comfortable penetration. You may also want to simulate penetration by
rubbing your erect penis up and down her body
- perhaps over her vulva or between her buttocks, rather than in her vagina - to reach orgasm.
If your partner is willing, she can masturbate you with both hands while she
takes your glans into her mouth. If she wants vaginal penetration - and most
women do -
lots of lube, and a gentle approach (i.e. no hard thrusting) will be needed to ensure you only
enter her to the depth she is comfortable with. It's worth mentioning that the more aroused she
is, the deeper you will be able to penetrate her. In extreme arousal, woman can find the
joggling of their cervix and uterus caused by a longer-than-average penis thrusting into them
extremely satisfying, since it can induce a special type of "uterine" orgasm which is very
different from the usual clitoral orgasm. So, long foreplay and finding out exactly
what turns her on can be very helpful. In addition, you might like to get ideas
from other guys with the same problem. You can do that at the Large Men's Support Group.
(This special type of uterine orgasm is described in Deborah Sundahl's book, Female
Ejaculation And The G Spot.)
Q3: I am a 23 year old with a real problem. I
have met a new girl, who is a virgin, and we cannot have sex because my penis
is simply too thick for her vagina to accommodate it. I never thought of myself
well-endowed, and indeed all my other girlfriends have been able to take me,
but none of them were virgins. Also, I cannot use a normal condom
because although they are long enough, they are so tight around the base of my
shaft that I end up bruised and sore.
A: If you work up to
intercourse with extensive foreplay, reassure her that you won't hurt her, and use your fingers and tongue
to arouse her so she has plenty of natural lubrication, and give her control over
the depth or penetration and rhythm of sex (the woman on top position would be good for that) so
that she feels in
control, everything will be fine. I think Trojan Magnum XL,
a wider condom, might suit you, so check it out. By the way, the more aroused she is, the better her vagina will be able to accommodate
you, and the more she will want you in there. So by making your love a slow
affair, kissing and bringing her to orgasm with your mouth, lips and tongue,
before you penetrate her, you
may well find that she then wants your penis inside her, and that she is well lubricated and relaxed enough to accommodate you more easily.
Q4: Help please, I can't get
my foreskin back (see the picture I sent). What do I do? And does it need to
go back for sex?
A: It's natural for the foreskin to
move smoothly back and forth over the glans during sex or masturbation.
Obviously this can't happen when it remains stretched over the glans like the
one in the photo above. This condition is known as phimosis. It
happens when the opening of the foreskin (the preputial meatus) is too small
to allow the foreskin to slide back over the glans. This can be the result of
a fungal infection or it can be an anatomical issue. In the former case,
circumcision is called for; in the latter, there are several ways to open out
the foreskin so it can move more freely. These are discussed below.
There are two forms of phimosis -
congenital and acquired. The first definition refers to the fact that the
foreskin of young boys cannot be retracted: it is normal for it to adhere to
the glans for several years, and occasionally into a boy's teenage years. This
congenital phimosis will not normally cause urinary obstruction, hematuria, or
preputial pain and does not need attention; equally, it is important that
parents do not attempt to force the foreskin back over the glans in an attempt
to clean it. The foreskin continues to adhere to the glans until gradual
keratinisation of the epithelial layers between the glans and the inner
prepuce cause the foreskin and glans to separate.
A study conducted in Japan revealed that
by the age of three, only 40% of boys have a fully retractable foreskin; by
age eleven, 94% of foreskins are retractable; and by the age of twelve, only
3% of boys still have a congenital phimosis.
Acquired phimosis may be due to an
infection, chronic balanoposthitis, or forceful retraction of the normal
foreskin during childhood. It may develop during childhood or adulthood. There
is often fibrosis of the preputial opening which prevents the foreskin being
retracted. Signs of paraphimosis include edema, tenderness, and erythema of the glans,
flaccidity of the shaft of the penis proximal to the paraphimosis.
Paraphimosis is a medical emergency,
because constriction by the tight band of the foreskin can lead to edema and
venous engorgement of the foreskin and glans - in the ultimate case, this may
lead to necrosis of the penile tissues secondary to arterial occlusion.
But why bother to correct phimosis?
There are several reasons. First, when the foreskin doesn't move freely, sex
can be a little bit uncomfortable for both partners. For the man, the foreskin
becomes uncomfortably stretched, and for the woman, it can produce dryness and
abrasions in her vagina. This is because the thrusting movement of a rigid
penis with an inflexible foreskin, one which is stretched over the glans, is more likely to dispel her
lubrication than the natural movement of a "normal" penis back and forth in its
own sheath of foreskin.
Second, smegma, a natural product of dead skin
cells and oils from the glans and foreskin, can build up under the foreskin.
With a phimosis it cannot be washed out and may begin to present a hygiene
problem (it smells!). Smegma is made up of cholesterol, its esters, and
fatty acids, as well as dead skin cells. There has been much debate as to its
purpose, but it seems to be essentially a lubricant which enables the foreskin
to glide back and forth over the glans during intercourse. Natural, fresh smegma
does not smell and is replaced quickly after being washed off.
Third, some men with a tight phimosis have
suggested to me that their penises have become bent from years of trying to
get fully erect under a foreskin that is so tight it prevents the erection
reaching its full size.
And fourth, it can be very uncomfortable when
a man gets an erection or tries to engage in intercourse!
By the way, in uncircumcised boys and men, it's
natural for the foreskin to swell up (balloon) when you're peeing. This does not necessarily mean the foreskin is
tight - it's a natural process. The only test of a tight foreskin is whether it
will go back when your penis is erect.
If you have a tight foreskin, it's best not to
force it back over the glans in case it gets stuck there! This can be a medical
emergency, because a tight foreskin stuck behind the coronal rim of the glans
can restrict the blood supply to the head of the penis. If this ever happens, there
is a procedure for dealing with the situation. This technique
is described here.
The last observations worth making are that
phimosis is reasonably common - some reports suggest up to 10% of adolescent boys'
foreskins will be tight. In most cases gentle stretching is all that is needed to
render it freely moving. But sometimes the foreskin is stuck to the glans -
these adhesions are normal in small boys, though they usually separate naturally
by about ten to fifteen years of age. They should certainly have separated by puberty.
In the cases where a foreskin won't retract simply because it remains attached
to the glans, a simple steroid cream (Betamethasone 0.1%) can loosen the adhesions and free it off - circumcision
is generally not necessary.
Cures for phimosis have included
circumcision, which unfortunately many doctors still recommend. This may be
needed in some cases, but in others a gentle stretching routine using a steroid
cream can be effective. Betamethasone 0.1% cream applied once or twice a
day to the outside for my foreskin from the opening to about mid-glans, together
with a daily stretching routine has cured the problem for many people, although
it is necessary to either move the foreskin back and forth, or stretch the
opening wider with one or two fingers. Some men find that this is needed on an
ongoing basis, others claim a permanent cure.
My foreskin is too long
Q5: I'd appreciate some
advice. My foreskin
is long - too long. In fact, I think it's pretty ugly. I was laughed at by all
the other boys in the showers at school, and frankly, I can see why. Here's a
picture:
Is there anything I can do?
A: According to the medical experts, the
"normal" male foreskin is one that covers the glans of the penis.
However, when you've done as much research as the team here at Penis Size
Myths And Facts, you realize that a foreskin which completely covers the glans
and protrudes like the one in the photo above is actually not "normal"
at all! Foreskins such as that are found on about one in a hundred penises. Something
like the foreskin shown below is much more common:
So, does it matter that you have such a long
foreskin? If you search on Google, you find a variety of responses from women
in the forums where such issues are discussed. Here's an interesting one: "I'm
much more interested in people than penises." The consensus is this: some women think a
circumcised penis looks neater, but this is probably because they have never
seen an uncircumcised one. As fashions change, and circumcision becomes less
common, younger women will grow up with an expectation of seeing men with a
normal, uncut penis, and will come to see that as more attractive, more
sexually exciting, and more enjoyable for intercourse.
None of which helps you right now! The answer
of course, is that it doesn't matter unless it matters to you. If it's a
purely personal issue, in that you find a very long foreskin unattractive and
unaesthetic, then you could have a partial circumcision, where just the tip of
the foreskin is removed. However, many people think this is the part that is most
sexually sensitive. If, however, it's a matter of what women might think, then
to do anything about it would be a serious mistake. You're just as likely to
find a sexual partner who loves the appearance of your penis as one who doesn't
- and even if she doesn't like it at first sight, experience may change her
mind: she may find that your penis is much nicer to have in her vagina when
you're making love than a circumcised one. Why? See the sidebar for more
information on this!
I get lots of smegma under
my foreskin
Q6: I can't seem to keep my
foreskin clean - I get loads of smegma accumulating under my foreskin, even
if I wash it every day. This may be paranoid, but I can't help thinking that
no woman is going to want to go to bed with a man whose penis smells like a
cheese factory! Please help.
A: Smegma can be
unpleasant. It's a whitish, flaky deposit that forms under the foreskin, and
it's made up of dead skin cells and natural secretions from the sebaceous
glands of the penis skin, together with some secretions from the urethral glands
and Cowper's glands (a part of a man's reproductive system). But the fact that
it can smell unpleasant if left unwashed for a while does not mean that smegma
is a useless secretion which just represents a hygiene problem! In the young
male infant, smegma protects the surface of the glans from urine, which can be
intensely irritating to the penile skin if left in contact with it for any length
of time. Some experts on the penis also claim that the separation of glans and
foreskin that takes place between five and fifteen years of age depends on the
mechanism of smegma formation (the sloughing of epithelial cells, in fact).
In an adult male penis,
where the foreskin has usually completely separated from the glans, smegma is
both a protective and lubricating substance, keeping the glans moist
and defended against infection and allowing it to move freely over the head of
the penis. There are some eloquent explanations of why smegma is a good thing
for a penis on the Foreskin.org pages, which you can see by following
this link. You'll note that many experts have now completely discredited
the idea that having an uncut penis (i.e., an uncircumcised penis)
is likely to lead to an increased chance of getting penile cancer and cervical
cancer. This
is in fact one of the greatest myths ever presented as justification for a
medial procedure - circumcision.
Assuming, therefore, that you
are convinced of the need for smegma as part of a healthy penis, the question
is what you can do to keep it under control. Simple hygiene should normally be
enough, which means washing under the foreskin with a pH balanced soap (one
that is the same level of acidy and alkalinity as the skin) with no fragrances
or colors is best. Run your finger around the innermost bits of your foreskin
to get all the accumulated smegma out. After washing, you need to rinse your
penis well with warm water to ensure there is no soap left on your glans. And
if you still have a problem with a smell, you can always wash just before sex.
Q7: I am writing to you for some advice as
basically my scrotum and penis are covered in little white, cream and yellow
spots, and it's not
very pretty to look at. I have had these at least since I was 8 or 10 years of
age, and I always thought they were sweat glands and would disappear as time went
by, but they are still there and I am now too embarrassed to have sex. I do
have a girlfriend, and although she isn't pushing me to have sex, I know the subject
is going to come up soon - we've been living together for a year. I'm pretty
confident generally, but when it comes to sex, these spots - which I consider
a gross disfigurement - have made me shy with my girlfriend. She's never actually physically touched my penis or visibly seen it.
The real problem is that my self-consciousness means she can walk about naked
and I can touch and look at her, but I refuse to do the same thing. The spots
are pretty bad, and I just realized I had
some on the rim of my penis as well. Can anything be done about them?
A: The spots you describe are probably Fordyce spots.
They are little white bumps or
spots formed from modified sebaceous glands found only on the skin of the
genitals and the lips, in both men and women, though they do seem to be more common in men.
They are completely normal and occur on the skin of almost all men's
penises or scrota. However, some men do have more than others, and they can cover
large areas of the skin surface. In some cases they become very obvious, and
it's easy to see why a guy with a penis or scrotum covered with Fordyce spots is somewhat
self-conscious.
Generally doctors do not advice
treatment, although recently some dermatologists have had success in reducing
their prevalence with the use of the superpulsed CO2 laser. Another approach
is to work on the self-consciousness you may feel about them.
The secret of a good sexual relationship is
communication. After all, if two people love and respect each
other, there should be support and understanding when one partner tells the
other something that is bothering them. You could work round to the subject
next time you are getting intimate by saying that there is something bothering
you that you would like to talk about. She will be delighted that you are taking her
into your confidence, and once you have explained the source of your embarrassment,
it's highly likely that she will respond by telling you it doesn't matter. As you get more physically close and intimate your fears about your
problems will diminish and fade away. I assume you have not told her because
you fear rejection. But even if she doesn't accept you once you have told her
this, isn't that a more honest situation, and one which offers you the chance
to either move onto a new relationship or work things out in this one? I have,
by the way, never heard of anyone losing a relationship because of these
spots. I have, however, heard many stories of relief from men who were
extremely relieved when they discovered that their girlfriends didn't think the
issue was of any importance whatsoever!
I have seen the observation on a medical
information site that Fordyce spots are ectopic sebaceous glands (formed of
small yellow papules), whose importance is simply that they may be confused
with genital warts or candidosis. That's an extraordinarily badly informed comment
from someone who obviously has never dealt with the embarrassment of a man
whose penis is covered in them. If you have them, and would like to do explore
the possibility of doing something about them, see a dermatologist.
Picture of Fordyce spots
It's also an extraordinary observation
to imply they could be confused with pearly penile papules or warts by anyone
with a medical qualification.
Warts are caused by the human
papillomavirus or HPV. Other names are venereal warts and condyloma acuminatum.
Some evidence exists that they can be transmitted through non-sexual contact
(towels, toilet seats, etc), so their occurrence in an established couple is
not evidence of infidelity. (Reference
here.) There are about 70 varieties of HPV, though the finger of suspicion
for genital warts tends to be pointed at HPV-6 and HPV-11. Once you're
infected, it is a permanent infection which never goes away - and an infected
mother can pass the virus on to her child at birth, and the effects of this
may not show up for years. Though there are effective treatments for genital
warts, the problem is not so much in the cosmetic issues of having warts as in
the potential long-term effects of the virus. HPV-16, 18, 31, 33 and 35 are
linked to cervical cancer and, in very rare cases, cancer of the penis. In ninety
percent of cases of cancer of the cervix, you can detect HPV within
them.
HPV is highly contagious. About a quarter of people exposed to an infected
person will develop the infection after one sexual experience. And it's no use
thinking that practicing safe sex will prevent you from catching HPV, as
condoms are not a completely effective method of protection against HPV. The
infection will show up after an incubation period which can range from one to
six months. But, to reiterate the point, not everyone who has the virus will
develop warts, and many sexually active people with no sign of warts will be
carrying the virus. If you do have warts, around your anus, penis, scrotum,
labia or vulva, it's important to get medical advice.
Treatment of genital warts is not difficult, but the method selected will
depnd on individual circumstances. Chemical agents are often used, for
example, Imiquimod, (Aldaraź), podophyllin, podofilox solution, 5%
5-fluorouracil (5-FU) cream, Trichloroacetic acid (TCA); other methods of
treatment include pulsed dye laser, liquid nitrogen cryosurgery, electric or laser
cauterization.
Picture of genital warts - penis and vulvar
Pearly penile papules are quite
distinctive. They are illustrated in the photograph below.
They are a normal anatomical variant,
though men often seek help because they think that the growths are cancerous
or that they may be genital warts. For men who develop them, the two most
important questions are: what are they, and can they be removed? The answer to
the first question is that they are not associated with infection, sexual activity,
masturbation or poor personal hygiene. In fact they when analyzed, histological
examination reveals thin-walled ectatic vessels in the underlying layer of the
skin, the dermis, together with a collection of fibroblast cells. Concentric
fibrosis surrounding adnexal structures is another defining characteristic.
Although other tissue outgrowths have similar histopathology, the location of
the penile papules is clearly characteristic. Fortunately the papules can be removed
with laser treatment or by electro-cauterization. A competent dermatologist
will be able to advise on the best method of removing them.
Picture of pearly penile papules
(papulosquamous eruptions)
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More information on Peyronie's disease
Donald R. Taves has written about
the intromission function of the foreskin.
The question is, is intromission (insertion of the penis into the
vagina) easier with or without a foreskin? Research has shown that
provided the foreskin initially covers the glans during intromission, the
unrolling effect of the foreskin reduces the amount of force needed to
penetrate the vagina by about ten times! It's easy to make generalized statements about the
function of the foreskin, based on common sense assumptions: such as, it physically, physiologically and
immunologically protects the glans and urethral
meatus. But such statements are not proof!
Accordingly,
Donald Taves made a
pseudo-vagina with which he measured the force needed to introduce a penis
(he doesn't say whose it was!). He found that there was a ten-fold reduction in the force needed to
gain entry when the glans penis was initially covered by foreskin. This
appeared to be much more comfortable for the man and, by implication, the
woman. MEDICAL HYPOTHESES, Volume 59,
Number 2: Page 180-182, August 2002.
He
observes that the unretracted foreskin is a thin dermis, folded back on
itself with only a little friction between the layers. As the penis makes
its way into the vagina, the foreskin unrolls so that it is very extended
before there is any friction. In general, few men pull back their
foreskins before sex, and the exposure of the glans usually only occurs
during sexual intercourse.
Smegma
was studied by Thomas Ritter, who observes: "The
animal kingdom would probably cease to exist without smegma.'"
Infant
skin cells appear at the end of the glans as a whitish substance - this is
part of the epithelial sloughing which serves to separate the glans and
foreskin. By contrast, adult smegma is protective and lubricating. In 1942,
experiments by the National Cancer Institute showed beyond doubt that
smegma was not in any way carcinogenic. In fact, the substance we know as smegma is a mucosal lubricant and may even contain sexual
pheromones. The smegma is produced in sebaceous glands found over the
whole of the inner surface of the foreskin.
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