Does size matter? Men feel better if they are well-endowed but women don't always agree that bigger is better. Men with average-sized penises are much more likely to suffer from small penis syndrome. And some even use weights or encourage snakes to bite them to make themselves bigger, according to a research review spanning more than 60 years.
Women are much more interested in a man's personality and looks than the size of his penis, but men can experience real anxiety even if they are average sized, according to a research review published in the June issue of the urology journal BJU International.
Dr Kevan Wylie from the Porterbrook Clinic and Royal Hallamshire Hospital, Sheffield, UK, reports that while men often have a better body image, genital image and sexual confidence if they have a large penis, women don't necessarily feel that bigger is better.
He teamed up with Mr Ian Eardley from St James' Hospital in Leeds to bring together the findings of more than 50 international research projects into penile size and small penis syndrome carried out since 1942.
By drawing together the results of 12 studies that measured the penises of 11,531 men, they discovered that average erect penises ranged from 14-16cms (5.5 to 6.2 inches) in length and 12-13cm (4.7 to 5.1 inches) in girth.
Wylie and Eardley also looked at the bizarre practices used by men worldwide to enhance the size of their penis, including the Topinama of Brazil, who encourage poisonous snakes to bite their penises to enlarge them for six months!
They report that Indian Sadhus men are known to use weights to increase the length of their penis and Dayak men in Borneo pierce the glans of their penis and insert items into the holes to stimulate their partner.
Other key findings of the review include:
"It is very common for men to worry about the size of their penis and it is important that these concerns aren't dismissed as this can heighten concerns and anxieties" says Dr Wylie.
"It is helpful to normalise the situation and provide as much accurate information as possible, as many men either lack any information or have been misinformed.
"This extensive review aims to provide clinicians with an overarching summary of the many research projects that have been carried out into penile size and small penis syndrome."
Clinicians who are presented with a man with small penis syndrome need to consider a number of treatment approaches.
"The initial approach should be a thorough urological, psychosexual, psychological and psychiatric assessment, possibly with more than one clinician involved" say the authors.
"Conservative approaches to therapy, based on education and self-awareness, as well as short-term structured psychotherapies, are often successful."
They authors are, however, very cautious when it comes to treating a psychological condition like small penis syndrome with gadgets or surgery.
"There is poorly documented evidence to support the use of penile extenders, and while information is starting to emerge on the success of some surgical techniques, this is not backed up by data on patients' satisfaction with such procedures" stresses Dr Wylie.
Reference: 'Penile size and the 'small penis syndrome'. Wylie K R, Eardley I. BJU International. 99, pages 1449-1455. (June 2007).
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