Many men worry about penis size, particularly if their penis appears to become smaller over time. The reality is that flaccid penis size may have little or nothing to do with erect penis size and, of course, penis size has absolutely nothing to do with masculinity. Nevertheless, it’s true that your penis may change length, usually for completely benign reasons.

Obesity

If you gain weight, particularly around your lower abdomen, your penis may start to look shorter. That’s because the thick pad of fat starts to envelop the shaft of your penis. When you look down at it, your penis may seem to have gotten smaller. In extremely obese men, fat can enclose most of the penis.

Smoking

Chemicals in cigarettes can narrow or damage arteries that allow blood flow into the penis. Healthy blood flow is essential to penile health. It allows for penile tumescence (hardening) and erection. Quitting smoking can improve blood flow along with a man’s overall health.

Medications

Some drugs, including Adderall, dutasteride, finasteride and some antidepressants and antipsychotics have been linked to penis shrinkage. Men who are concerned about this side effect should talk to their doctor. Men should not discontinue current treatment before discussing the possibility of replacement with a health care provider.

Aging

Because of decreased testosterone levels and poorer blood flow, a man’s penis may get smaller as he gets older. However, the change is gradual and not always noticeable. In cases of documented low testosterone levels, treatments are available.

Prostatectomy

Prostatectomy is the surgical removal of the prostate gland and a common treatment for prostate cancer. Men who undergo this surgery might have penile shortening afterward, at least temporarily.

Peyronie’s Disease

Peyronie’s disease occurs when plaques (areas of hardened scar tissue) form in the penis, just below the skin. Eventually, the penis might start to curve and, for some men, shorten.

If you experience penis shortening after prostate surgery, know that it may reverse in time. For most men, penis shrinkage won’t affect their ability to have enjoyable sexual experiences. If the shrinkage is caused by Peyronie’s disease, decreased blood flow and low testosterone work with your doctor to develop a treatment plan.

No matter what the cause is, penile shortening or shrinking can be distressing. Many men associate their masculinity with their penis size and worry that they might be seen as “less of a man” or unable to please a sexual partner.

Men who find that their self-esteem suffers after shortening are encouraged to see a sexologist. If they are concerned about sexual performance, they might talk to their partner and health care provider.