From cave paintings to graffiti from all the cities in the world. From Michelangelo’s David to any teenager’s notebook. The penis is probably the most represented human organ throughout history. More than an appendix, it has become an icon. The only organ that comes close is the heart, whose schematic drawing is the representation of love and affection. Perhaps, reflects urologist Blanca Madurga Patuel (Valencia, 65 years old), it is because this organ is also a symbol. It is the hallmark of the man, the macho, the virile. It doesn’t just happen in the art world. Many expressions refer to the male sexual organ. Many conversations revolve around him. Men talk a lot about their penis, but not so much in a medical context. While women go to the gynecologist regularly from the age of 20 and have certain medical information regarding their genitals, they grow up without that clinical reference. Men do not go to the andrologist until they have a problem or to the urologist until they are over 50. The lack of medical knowledge is quickly made up for on the Internet, where biased or false information further entangles a difficult conversation, full of myths, taboos and ignorance.
Madurga knows this well, who has been consulting for 30 years. This urologist works as a professor at the Hospital del Mar, in Cádiz, and is an associate professor at the University of this same city. Just published Everything you need to know about the penis and never dared to ask (Editorial Planeta), a pleasant book about those 10 (yes, the average is 10) centimeters that everyone talks about and few know.
Ask. What should men know about our penises but we dare not ask?
Answer. Many things. A man only goes to the andrologist when he has an extremely serious problem, because first he has to overcome a cultural resistance, a general fear, because there is a lot of myth around the penis that relates it to being a macho, a leader, a strong guy. Most men, when they come for a consultation, what they want to know is if what is happening to them is normal. If it is normal to get older and have sexual potency decrease. It is normal that erections do not last as long as they should. If the size of his penis is normal or suffer a trigger. Approximately 52% of men between 40 and 70 years old have erectile dysfunction, in most cases moderate. So yes, it’s normal. They are simple doubts that generate many problems because they have an enormous social stigma associated with them. If you think about it, even the term impotent has a very pejorative connotation. I hate that word.
Q. And what word do you think would be more appropriate?
R. It is not necessary to catalog the person, but rather what happens to them. And what happens to him is that he has erectile dysfunction. Helplessness suggests that we cannot do a thing and we will never be able to do it. And erectile dysfunction is a disorder that may simply be temporary.
Q. He talks to me about sizes, but he hasn’t given me a figure.
R. Several things must be taken into account on this topic. The first thing is that the average size of a penis that is considered normal is achieved by counting the measurements of the entire population, of all the subjects. Logically in those measurements, since there will be one who has a penis of 30 centimeters and another who has one of six centimeters. And they are both normal. But the measurement is approximately ten centimeters when erect. The erect penis is always measured, because it is not known how much a relaxed penis will multiply in size. There are very large penises at rest that do not grow and small penises that double their size. It must also be taken into account that this average is made throughout the world and in the countries of sub-Saharan Africa they have one or two centimeters more on average. So that myth that black men have giant penises is not true. There are differences, but they are small. Many people talk about micropenis when these, which are those less than six centimeters when erect, are very rare. And unfortunately they are usually associated with syndromes.
Q. In the last 30 years, new generations have grown up thanks to food. This is something that is known and discussed. It is even more surprising to know, as he explains in his book, that their penises have also grown…
R. Clear. The penis grows in line with the body. After all, it is made up of vascular tissue, especially blood vessels and covered by skin, which is generated with proteins. When you have a diet based more on protein, like the current one, the bodies develop more. We are taller than the previous generation. Girls have menstruation earlier, there is earlier development. And the boys of the new generations have, on average, larger penises.
In the book, Marduga draws on meta-analysis Worldwide Temporal Trends in Penile Length, published in 2023. This analyzed 75 studies carried out from 1942 to 2021, including data from 55,000 men. “Erection length increased significantly over time in several regions of the world and in all age groups,” his conclusions explain. “After adjusting for geographic region, age and population, the length of the erect penis increased 24% in the last 29 years.” A graph shows that the average went from barely exceeding 12 centimeters in 1990 to exceeding 15.5 in 2021.
Q. But that doesn’t mean they have less complexes. How has easy access to porn changed our perception of our own penis?
R. A lot. Regarding size and performance. I have been working in this for 35 years and there has been an increase in consultations, especially in very young patients. They will never reach expectations that are completely false, because porn is not real life. Young people have access to a lot of information about sex, but that does not guarantee that they are well informed. More than 90% of the information about the penis on the internet is misleading or downright false. I did some work on it, I scoured about 300 pages and saw two, from two prestigious urologists, talking seriously about penis size. The rest were false, exaggerated, with the sole purpose of selling miracle products. There is an impressive industry behind it, all these complexes move a lot of money. Sex sells, especially if it is based on lies. And the problem is that the majority of men who have a problem stay there, only a minority come later for a consultation. The rest are left with that false information. The Internet is the anteroom of the andrologist.
Q. There are many myths surrounding the penis, but science has proven the truth of some, such as the one that relates its size to the size of the nose…
R. It had always been considered an urban legend, until a Japanese group did a study demonstrating this similarity. [El estudio, publicado en 2023, analizó a 1.100 varones y demostró que el tamaño de la nariz “es un predictor significativo del tamaño del pene, confirmando la veracidad de un antiguo mito”]. The lengths would have to do with the levels of testosterone to which the fetus is exposed during pregnancy. But that same relationship does not exist with other parts of the body.
Q. It is interesting to know that this obsession with the big penis is cultural. They are fashions…
R. Indeed, there was a time during the Renaissance where sex was considered obscene. And then having a very large member was something in bad taste, it was not fashionable. Now the idea has become popular that having a large member symbolizes being more of a man, being the alpha male, the chief of the tribe. But at that time, the smaller the penis, the better. There are many examples of this ideal of beauty in art, for example in Michelangelo’s David, who has a very small penis compared to that huge, muscular body. But who knows, maybe the small penis fashion is back again. And all those who have it big will spend money to adapt and reduce it [risas].
Q. About the testicles, what is the most recurring doubt?
R. Many ask if it is normal for one to hang more than the other. And this, in reality, has an anatomical explanation. Normally, the left testicle hangs more than the right, not because it weighs more, but because the vessels that carry the cord of the testicle are longer on the left side.
Q. Phimosis operations in Spain have increased from 5,000 to 29,000 in the last five years. Why this boom?
R. Yes, it is something we see more and more in consultations and it is a good habit. First, because it promotes the hygiene of the penis, not having a foreskin means that the glans is exposed to the air, and not as much smegma is secreted. This prevents penile cancer. And it also reduces infections in women, there are studies that indicate that Arab and Jewish women [donde la circuncisión se hace por motivos religiosos a todos los niños] They have a lower incidence of cervical cancer. Normally, we Westerners tend to intervene on the foreskin when necessary, when it causes problems. For example, when a patient is diabetic. In these cases, since the urine has a greater amount of sugar, this facilitates infections with germs and bacteria, it is a perfect breeding ground. And recurrent infections can occur. With the increase in obesity and diabetes in first world countries, it is normal that we have more older patients who want to undergo phimosis surgery.
Q. In his book he not only focuses on young people, he talks a lot about older men and sexuality in the elderly.
R. We are animals. Yes, we are smart. Yes, we have evolved. But we do not stop being animals that are born, grow, multiply and die. There comes a time when, well, we no longer multiply due to a biological limitation. But why not continue having sex? I get 70-year-old men who tell me that they want more capacity, to be able to have more sex, and I think it’s great. Active sexuality improves quality of life. It has been seen that in nursing homes, those who have sex tend to live longer. Sex is life. And I would also like to highlight the case of the LGTBI group. Older people who in their day could not show their affection. There are still negative stereotypes about the sexual lives of older people, but especially in this group, who have suffered so much and have had to hide, they should not do it now. They don’t have to hide from anything.
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