Penis problems & solutions 

We get a lot of emails asking for help. And with the assistance of our sexual therapist we do our best to answer them all. If you would like to send in your problem feel free to do so. You'll get a personal reply and the question and answer may also be posted here (anonymously, of course) to help anyone else in similar straits. Send your problem to: moreinfo "at" penis-website.

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" www.penis-website.com


Answers!

1 The retractile penis and other issues of size

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. 


2 Foreskin problems, including the long foreskin, smegma and phimosis

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.


3 Spots - white or yellow Fordyce spots, pearly penile papules and genital warts

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. 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, (Aldara®), 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)

Main pages on this site

Worried about your size? Think you don't measure up? Get the real deal on size here. (Home page)
Penis Size and Sex Find out how your size can affect sex.
All there is to know about your most precious asset.
Got A Penile Problem? Check out our problem page for the answer! (This page)

Other pages of penile problems

Problems with the glans
Penile warts, papules & spots
Penis and sex problems
Erection problems
My ejaculation is weak
Retractile testicles
More on Peyronie's disease
Pro-circumcision
Premature ejaculation
On premature ejaculation

 

 

 

 

 

 

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.