These men have body dysmorphic disorder: a skewed view of their body compared to what’s normal.
It’s a common problem, especially in the Middle East, says Dr Ghanem. The men with penis worries who come to his clinic at Cairo University have usually been stressing about it since puberty, he told Love Matters at the World Congress for Sexual Health.
Most of them are young and unmarried, and dread the prospect of first-time sex. They’re terrified to show their partner what they believe is a tiny penis.
Older married men sometimes have similar concerns, says Dr Ghanem.
'They say they’ve had this small penis problem all their life. When we ask if it affects their sex life, they say no. Then we ask what their wife thinks about it. They say, 'She doesn’t know my penis is small!"'
Dr Ghanem saw 250 men at the clinic in two years, all convinced they had unusually small penises. Yet 98 per cent of them were wrong.
So what’s actually normal? Dr Ghanem says his own findings tally with international figures.
'The normal range is from 7 to 17 centimetres erect. The average is around 12 centimetres. With most of the patients we see complaining about a small-sized penis, it turns out to be average sized or slightly larger!'
Hard to convince
True two-centimetre ‘micropenises’ are very rare. The same goes for conditions like ‘hidden penis’ caused by over-circumcision, which can be helped by surgery.
Surely Dr Ghanem’s patients are thrilled when he tells them they’re perfectly normal after all? 'They’re actually very hard to convince,' he says. 'That’s why it’s termed body dysmorphic disorder.'
'It’s really a mental problem. They just seek advice from one doctor after another until they fall victim to an ad on the internet promising something that won’t be delivered, or they go to someone who promises penile enlargement surgery.
'So far we don’t have evidence that it can enlarge the penis by more than one or two centimetres. These guys expect five or ten centimetres!'
So how did they get such a mixed-up idea of what’s normal? 'It’s a cultural thing,' the professor says. Men are always joking about penis size and they get the impression it’s incredibly important.
'When you ask them what they think the normal penis size is, they say 20 centimetres or something absurd like that. Most of them they say they’ve noticed in the changing rooms that their friends have larger penises. So their perception is wrong.
'Sometimes it’s because they assume what they see in pornography is normal. We try to explain that probably professional porn actors are chosen because they’re outside of the average scale!'
Fortunately Dr Ghanem has been able to convince almost all his body dysmorphic patients that they’re normal. The key is to make sure they know you’re taking their feelings very seriously, he says.
First he does a professional measuring job so there can be no mistake about how their penis really matches up to the normal range. Then it’s mostly a matter of filling in their basic knowledge about sex, he says.
The patients need to know that it’s not the size of the penis that matters, but how stiff it is. And that to give their partner pleasure, it’s the clitoris they need to bear in mind – some don’t actually realise it’s on the outside, but think it’s somewhere deep inside the vagina, the professor says.
'And finally, we explain that pleasure is really related to love matters and emotional things rather than an excessively huge penis!'
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