Small Penis Syndrome

Small Penis Syndrome (SPS) is a type of psychological disorder where the male affected has excessive concern and a preoccupation that his penis is small when actually they have a medically normal, average sized penis. SPS isn’t the official term used in the DSM-V that is used to diagnose psychiatric/psychological illnesses of this sort, it is a term more commonly used on the internet. Body Dysmorphic Disorder (BDD) is the proper term, but has a much broader definition that includes actual body defects rather than just perceived ones, which is the case in Small Penis Syndrome.

You could say that men with real small penises (under 4″ erect length) often suffer BDD as well as men who are average sized but think they’re small. However, for the purposes of this article we won’t be discussing small penis men with BDD, but average sized men with SPS.

Small Penis Syndrome can cause psychological distress, impairs occupational or social functioning, emotional depression, severe anxiety, and social withdrawal or isolation. That’s why men who suffer from it need to seek proper medical treatment.

The media equate a man’s penis size with his power and masculinity. Views about penis size were assessed in an Internet survey of 52,031 heterosexual men and women. Most men (66%) rated their penis as average, 22% as large, and 12% as small. Self-reported penis size was correlated positively with height and negatively with body fat level. Whereas 85% of women were satisfied with their partner’s penis size, only 55% of men were satisfied with their penis size, 45% wanted to be larger, and 0.2% wanted to be smaller. Satisfaction did not vary across age groups from 18 to 65.

Despite 85% of female partners reported being perfectly happy with their husbands/partners penis size, men still grapple with feelings of inadequacy. Of the 15% of women who reported they weren’t happy with their partners penis size they said it was because the penis in question was either too big (it hurt) or a micropenis (less than 3″ erect). Proving that a lot of penis related anxiety is purely psychological.

Risk Factors for men developing SPS:

  • A history of past emotional and physical abuse
  • A significantly smaller flaccid penis compared to others, even though erect length is average
  • A history of genitalia teasing from prepubescent age onwards. Overall, a poor attachment as a child, general teasing, and specific teasing about penis size can combine to make “a perfect storm” of risk factors for SPS.
  • Initial sexual experiences are negative.
  • Men on the lower side of average erect length have a higher vulnerability to developing SPS.
  • Comparing flaccid penis (especially as a teen) to fathers and older brothers/peers.
  • Being a late bloomer (meaning puberty starts at a later age) so his penis seems smaller than his peers during an impressionable age.
  • Poor sex education
  • Unrealistic examples of penises and sex represented in pornography.
  • Someone deliberately being mean about penis size to a man who’s vulnerable to having SPS.


The greatest cause of Small Penis Syndrome is males (especially when teens) comparing themselves to other males. Flaccid penis size varies greatly and some men can have smallish flaccid penises that grow to average size or bigger when erect. Other males can have large flaccid penises that will grow very little when erect, they just get hard but change very little. The correct way to measure and/or compare penis size is while erect (hard). That’s because a big flaccid penis don’t necessarily mean a huge erect penis.

However, the best advice for those suffering from small penis syndrome is to measure themselves correctly and look at the data for themselves. If your erect penis is average size (according to accepted data) then you don’t have a small penis. There’s no reason to believe you cannot satisfy a woman. The tape measure never lies, people do. If that cannot break through the anxiety you experience then see your Doctor. Some men require psychological counselling in order to overcome Small Penis Syndrome. Even though they know ‘intellectually’ that their penis isn’t small, they still have the emotional and psychological problems associated with Small Penis Syndrome. These men need counselling.

Plainly, if a man suffers acutely from Small Penis Syndrome they can have severe anxiety and depression. They may need anti-depression medications to help them, and psychological counselling to discover the root of the issues and move towards resolution. Severe depression, no matter the cause, is a serious health risk both mentally and physically and can lead to suicide. That’s why it’s important to have it treated.

Many countries have organisations that can help you with depression so check your local phone books or do an online search. Often the best place to start is with your local Doctor and get a proper physical check up. They then can refer you to other specialists who can help you find a resolution to your fears about your penis.

The biggest fear of men in regards to penis size is that they will fail at sex because of it, or that potential sexual partners will not be attracted to them. As we have pointed out on our Sex Education page, that most men can be good lovers regardless of their size.

Self Help Tips for SPS

By Mark Dombeck, Ph.D.

There is no medical procedure that we know of that can reliably and safely enlarge a small penis. So the question becomes: Given that I have this problem that cannot be fixed, what can I do to reduce its impact on myself so that I can live a happier life? Our thoughts about how to answer this question follow. While these suggestions are intended as useful aids to all men, they might be especially helpful to the men who are extremely angry, hopeless and depressed because they are convinced that they are not well enough endowed.


Identify and Correct Cognitive Distortions

Cognitive therapy and appraisal theory have taught us that how we think about and judge situations causes and shapes our emotional reactions to those situations. We do not become anxious about a situation unless that situation feels threatening to us. Not all situations that feel threatening actually are, however. And not all threats are actually all that dangerous either. In the case of Small Penis Syndrome, it seems to us that there are common habits of thought and common beliefs frequently present that are not necessary and which make the situation more difficult and painful than it has to be. By identifying what those thought habits and beliefs are and taking steps to correct them, a fair amount of the pain and difficulty of this issue can likely be avoided.

The most important thought habits to watch out for are rigidity, over-certainty, and a tendency to over-generalise. As we’ve pointed out, men with Small Penis Syndrome tend to fixate on the idea that they are hopelessly inadequate, that all women will reject them, that all women are lying if they don’t reject them, etc. There is no room to move from this position, and yet these beliefs, in their rigid over-certainty simply cannot be true in all cases. No real work on cognitive biases and faulty beliefs can occur until these men become aware and accept that they might just be wrong in some cases.

It is important for men bothered by the size of their penis to identify and correct any distorted beliefs they may have regarding their small penis. An important first step is simply identifying whether one’s penis is actually small in the first place. Answering that question gets directly to the concept of reference points; that which you are comparing your penis against. There are two kinds of reference points that matter here; those that reflect the average penis size in the community (e.g., sampling distributions), and the honest acceptance of a person’s body by that person’s lover. In our estimation, the latter is far more important than the former. If someone cares for you and accepts you as you are, with all the imperfections that plague most human bodies, then it doesn’t matter so much how you stack up against other people.


Reference Points: Testimony versus Statistics:

In using reference points in deciding that one’s penis is small, there are at least two types of data you can compare yourself against. One is testimony from sexual partners, and the other is statistical data (sampling distributions) derived from various research studies on this topic. By women’s testimony we mean stories and articles published by women in magazines and on the Internet and the like. We also mean women’s behaviour (particularly rejecting behaviour) that men may have encountered directly in the course of their lives. In the case of one example blog that was pointed out to us, a woman gushed about how much she enjoyed intercourse with men who have large penises and wrote about this pleasure in such a manner as to suggest that normally she lies about this to her partners and does not tell them the truth about her preferences.

When trying to decide whether to compare one’s self against a sampling distribution or against the negative testimony of a few women, it is almost always a better idea to prefer the sampling distribution. There are a number of reasons why this is the case. Two prominent reasons are that that many more people’s information is typically represented in a sampling distribution than in the testimony of a few women, and that typically sampling distributions are more representative of the true nature of the population than are the opinions or observations of a few women.

A third reason to avoid testimony when possible is that it is so often used to manipulate people for commercial reasons. For example, stories appearing in magazines and blogs can be distorted and sensationalised simply because doing so will tend to attract more attention and thus more advertising dollars. Commercial testimonies, such as found in popular magazine stories and on blogs, and in email spam pitches for “penis patches” are not always representative of the true nature of the population because they are conceived with the idea of selling stuff.

This is not a perfect rule (to trust sampling distributions and to avoid reacting to testimony); sampling distributions can be badly constructed and contain bias themselves. However, if a sampling distribution has been well constructed (in the course of a scientific study) it will have been created using methods that try to reduce the possibilities for bias such as random sampling techniques, and it will contain a lot of people’s information, which tends to dilute the influence of a few people with strong opinions one way or another who would otherwise stand out like sore thumbs in a tiny sample. The worst thing you can do is to feel inadequate after reading a cruel blog entry, as the opinion of one woman is never representative of what all women believe.


The Need for Statistical Education

The men who have written us about their small penises who have compared themselves against statistical data have not always been careful about which data sets they have chosen to compare themselves against, and in some cases have made statistical errors such as failing to take into account the “cloudy” or probabilistic nature of sampling distributions as they came to their conclusions. It is possible that this tendency towards misinterpretation is due to a lack of knowledge about statistics and/or proper research design techniques, neither of which are widely taught subjects.


The Need for Real World Experience

In light of the fact that many of the men discussed in this essay report few sexual encounters with women, it is important to recognise the need for real world experiences in the area of sexuality and relating to women. In other words, these men need to get out and date; to talk to women and listen to what they have to say. Men need to be careful to avoid dismissing what they are hearing from the women they spend time with when what they hear disagrees with their preconceived notions. Finally, a variety of experiences with different women might help these men better appreciate the variety and types of women who are actually out there. In essence, we are recommending a form of exposure therapy. Only through direct experience will these men be able to learn that women are not all castrating and hostile, or dominantly focused on penis size when it comes to sexuality.

We do not mean to be flip about making this recommendation. We understand that there is a tremendous fear of rejection, and that actual social phobia may be present. We understand that a lot of anxiety is likely to be present which will interfere with the process of dating or just talking. Nevertheless, getting out there is going to be an absolutely vital part of working this issue through. You cannot appreciate that you’ve made a mistake by avoiding all women until you’ve taken the risk to talk to many women and have experienced first hand that many of them will not reject you. As this process of dating can be difficult for people who are very anxious about it, we recommend that professional help be sought. The best type of therapy for social anxiety is Cognitive Behavioural Therapy (CBT). Cognitive Behavioural Therapy helps people to identify and correct thought distortions and biases, teaches self-assertion (to help men better persevere in the dating process) and assists socially anxious men in coping with those rejections which will inevitably occur (regardless of penis size), among other helpful outcomes.


Put Pornography in Perspective

Our hunch is that some of the distorted ways of thinking about male and female sexuality that manifest in Small Penis Syndrome may stem from the fact that many of the men who have this problem have exposed themselves to a lot of pornography. One of the many problems related to pornography is that it misrepresent what human sexuality is about; replacing intimacy and love with simple and raw sex. It also tends to be populated by male actors with larger than average genitalia who aren’t shy about using enhancement drugs to prolong the size and duration of their erections. There are a lot of sexual behaviours (such as anal sex) that are far more common in pornography than in the regular world. It is certainly the dominant attitude within pornography that when it comes to penis size, bigger is always better. That is not necessarily always the case in the regular world. Without condemning pornography, which seems to have its firmly fixed place in society, we want to make clear to men with Small Penis Syndrome that it is vital to recognise that these biases and distortions exist in pornography, and that it is not wise to apply the standards of beauty and performance and the value systems present pornography to your own life. Anyone who tries to do so will likely feel incompetent.

Because porn is unable or unwilling to film lovemaking (intimate sex), men who get most of their sexual education from porn fail to realize that for many many men and women, the actual act of sexuality is ultimately valued less for its capacity to create an orgasm, and more for the intimacy to be found therein. This becomes more the case, we suspect, as people get older, but it is true for a great many young people as well. We recommend that men who watch a lot of porn and who suspect that they may be suffering in part because of this take an adult sex education class so as to help them gain a better perspective on what normal sexuality is actually about.


Explore Acceptance and Detachment Coping Strategies to Gain Better Peace of Mind

When rigidity of thought is high, as seems to be the case with some frequency with regard to Small Penis Syndrome, it is very difficult for people to seriously entertain the possibility that they may be contributing to their own problems through cognitive biases and honest mistakes regarding statistics and the like. It seems all too clear to such people that they are doomed; that they can never be an acceptable man to any acceptable woman, and that because of this, they might just as well commit suicide. To such people we say, don’t bother with the advice we’ve given above. What you need to do is to work on what we might term self-acceptance and detachment coping strategies. You are so embedded in the problem that you have no perspective on it from which to constructively criticise it. What is needed for you is to help you pry yourself out of the problem enough to give you that room to maneuver

Mindfulness meditation is one of the most powerful and safest techniques available to help people disembed themselves from cognitive prison (in the 1960s authors like Leary and Huxley recommended LSD for this same purpose, but we are far more sober now). In mindfulness meditation you learn to simply become aware of the continual stream of thoughts, perception and judgements that flow through your mind, and you learn that you are are not the same thing as the content of those thoughts, but rather that which has the thoughts. This is sometimes called the “witness” consciousness. It is a non-judgmental mental space that can be cultivated by anyone. In the embedded state, the thought-haver and the thought are fused, but mindfulness meditation helps open a space between the haver and the thought. Mindfulness meditation is originally part of an ancient religious tradition originated by Buddhists and going back thousands of years. Today it is being incorporated into western mainstream psychotherapy as an effective coping strategy for helping people cope with life stress and extreme emotional mood swings. As you learn to detach yourself and take up the witness consciousness, you become able to view your thoughts more objectively and ultimately gain a better ability to critically examine them.



Risk Factors Identified for ‘Penile Dysmorphic Disorder’

Is My Penis Too Small?

Small Penis Syndrome: Characteristics and Self-Help Treatment Suggestions

Human penis size

Body Dysmorphic Disorder Symptoms

Body dysmorphic disorder: recognizing and treating imagined ugliness

Does size matter? Men’s and women’s views on penis size across the lifespan. Lever, Janet; Frederick, David A.; Peplau, Letitia Anne. Psychology of Men & Masculinity, Vol 7(3), Jul 2006, 129-143.

Penile size and the ‘small penis syndrome’