Why is my erection smaller than it used to be?
A smaller or weaker erection is most often a sign of erectile dysfunction, which affected 19.2% of men aged 30 to 80 in one German study and becomes more common with age. Treatment for prostate cancer and conditions that scar the erectile tissue can also change penile size. Guidelines do not link erection size to hydration.
Is a smaller erection a sign of erectile dysfunction?
Erectile dysfunction means a persistent inability to get and keep an erection firm enough for satisfactory sex. A weaker erection can look smaller, so a change in firmness is usually more relevant than a change in size alone.
Erectile dysfunction has physical causes, such as problems with blood vessels, hormones and nerves, and psychological causes, and most cases involve both. Its risk factors include age, diabetes, high blood pressure, heart disease, obesity, lack of exercise and smoking, and the medical history records how firm and how long-lasting erections are during sex and in the morning.
Can prostate cancer treatment change penile size?
Men having active treatment for prostate cancer are told about sexual changes beyond erectile dysfunction, including lower desire, changes in orgasm, loss of ejaculation, curvature like Peyronie's disease and changes in penile size. The European guideline makes this a strong recommendation.
After prostatectomy, a newer traction device preserved penile length better than no treatment, and traction has also helped restore length after prostate surgery. Early use of a vacuum device after surgery has an excellent effect on erections with no serious side effects.
Can scarring or Peyronie's disease be the cause?
Peyronie's disease causes scarring in the penis and can lead to curvature, shortening and erectile dysfunction. It is more common in men with erectile dysfunction and diabetes and typically begins between 50 and 60, although it also occurs in younger men. It is often underdiagnosed, and a US survey found definite disease in 0.7% of men and probable disease in 11%. The assessment records pain on erection, lumps, deformity, length, girth and erectile function, and penile traction has helped restore length lost to the condition.
"Men who have a history of conditions causing tunical scarring, corporal fibrosis, or loss of cavernous smooth muscle should be informed that the prosthesis is unlikely to restore penile dimensions to those present before these conditions occurred." Source 2, p. 31
Does a penile implant make the erection look smaller?
Some men feel the penis is shorter after implant surgery than it was during a full erection before surgery. Measured losses are small, averaging 0.74 cm at one year in one study, and the lack of glans swelling during an implant erection is one reason the penis can look shorter.
Other reasons include weight gain over the pubic area, inaccurate memories of size after years of erectile dysfunction and loss of tissue elasticity after a long period without full erections. These points are discussed before surgery so that expectations are realistic.
Does dehydration affect the size of an erection?
Neither the European nor the American guideline describes dehydration or hydration as a cause of a smaller erection. A persistent change in erections is assessed in the same way as other erectile dysfunction, starting with a medical and sexual history, a physical examination and blood tests for glucose, blood fats and testosterone.
Because erectile dysfunction can be an early sign of heart and blood vessel disease, this assessment also looks at heart risk factors. Many of the causes it finds, such as diabetes and high blood pressure, can be treated as the first step.