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Urology/Loss of size?


QUESTION: Is it possible to lose penis size? And if it is, what causes it? Can low testosterone levels lead to size loss and if so, how low they then should be?

ANSWER: James, yes, it is possible to lose penile size. In fact, as men age they gradually lose some of the length and girth of the penis (rarely more than one inch).  This is due to a varying degree of decreased blood flow (hardening of the arteries or atherosclerosis) and loss of elasticity of the collagen connective tissues.  This is not usually apparent to any degree until at least age 40-50.  Trauma to the penis or a condition called Peyronie's disease can also shorten the penis somewhat depending on the location of scar tissue produced.  If one's testosterone is very low, there may also be some loss of penile size.  This would be reversible in younger men with testosterone supplements.  There is no specific level of low testosterone that might cause this as there is great individual variation.  My best advise, if you are concerned, is to see a urologist in consultation.  As part of the evaluation, he may decide that a serum testosterone level is indicated to see if your hormone is normal or not.  Good luck.

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QUESTION: Okay thanks. I checked out my testosterone level last spring and it were 13 nmol/l. About 5 years ago maybe it was 21 or something. I stopped ssri-medicines 1,5 years ago and after that I think that the levels declined somehow. Is this 13nmol/l too low and how likely it is that this level has caused any size loss. I'm 25 years old.


James, the normal morning level of serum testosterone in men less than 40 ranges from 9-39 nmol/l.  Therefore, although in the lower range of normal, your serum testosterone is normal and I do not think this is a factor related to the "shrinkage" of your penis.  Generally, hormone replacement therapy is not indicated unless the level is in the 3-4 nmol/l range.  The variation you have noted in your level may be related to the time of day the blood was taken as it is normally higher in the morning and less later in the day.

If you are still concerned make an appointment to see a urologist and ask for both a total and free testosterone level.  Free testosterone accounts for only 1-2% of the total testosterone in your blood, the majority of testosterone being bound to protein (called protein binding globulin). The more important of the 2 tests is the free testosterone level as this is the fraction that exerts its influence on the body (the biologically active portion).  Blood for this test should be drawn in the morning as this is the time when the level it is highest & most consistent in the majority of  men.  Good luck.


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Arthur Goldstein, M.D.


Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.


I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

American Medical Association, American Urological Association, American College of Surgeons

College degree - BS Medical degree - MD Master of Science - MS

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