From cave paintings to graffiti. From Michelangelo’s David to every teenager’s notebook. The penis is probably the most depicted human organ in history. More than an annex, it has become a symbol. The only other organ depicted as often is the heart, which has become a representation of love and affection. Perhaps, thinks urologist Blanca Madurga Patuel, 65, the penis is so often depicted because it is also a symbol, representing virility and virility.
This is seen beyond art. In language too, many expressions refer to the male sexual organ. Conversations often revolve around this. Men talk about their penises a lot, but not often in a medical context.
While women regularly go to the gynecologist from the age of 20, men only go to the andrologist when they have a problem and generally only start seeing a urologist from the age of 50. and misinformation abounds on the Internet, further complicating a difficult conversation full of myths, taboos and ignorance.
With 30 years of experience, Madurga knows this well. The urologist works as a professor at the Hospital del Mar, in the Spanish city of Cádiz, and is an associate professor at the University of Cádiz. She just published the book Everything you need to know about the penis and never dared to ask (in English: Everything you need to know about the penis and never dared to ask), which is based on meta-analysis Global time trends in penis length, published in 2023. This analyzed 75 studies carried out from 1942 to 2021, including data from 55,000 men. “Standing length has increased significantly over time in several regions of the world and across all age groups,” the research states. “After adjusting for geographic region, subject age and population, erect penis length has increased by 24% over the past 29 years.” A graph shows that the average penis has grown from just over 12 centimeters in 1990 to over 15.5 in 2021.
Madurga speaks to EL PAÍS about the facts and fiction behind the male reproductive organ.
Question. What should men know about penises that they don’t dare to ask?
Answer. Several things. A man only goes to the andrologist when he has an extremely serious problem, because he must first overcome cultural resistance, a general fear, because there are many myths around the penis that connect it to machismo, leader, a strong guy. Most men, when they come for a consultation, want to know if what is happening to them is normal. If it is normal to age and sexual potency decreases. While it is normal for erections not to last as long as they should. If his penis size is normal or if it is normal to lose an erection. About 52% of men between the ages of 40 and 70 suffer from erectile dysfunction, in most cases moderate. So yes, it’s normal. These are simple doubts that trigger many problems because they are associated with a huge social stigma. When you think about it, even the term impotent has a very pejorative connotation. I hate this word.
Q. And which word do you think would be most appropriate?
A. It is not necessary to label the person, but rather what happens to them. And what happens to him is that he suffers from erectile dysfunction. Helplessness suggests that we cannot do anything and that we will never be able to do it. And erectile dysfunction is a disorder that may just be temporary.
Q. You told me about penis size, but you didn’t give me a number.
A. There are several things to keep in mind about this. The first thing is that the average penis size considered normal is obtained by counting the measurements of the entire population, of all subjects. Logically, in these measurements, there will be someone who will have a penis of 30 centimeters and another who will have a penis of six centimeters. And both are normal. But the average is about 10 centimeters erect. We always measure the penis when erect, because when the penis is relaxed, we don’t know how much it will multiply in size. There are very large penises at rest that do not grow and small penises that double in size. It must also be taken into account that this average is made all over the world and in sub-Saharan African countries they are on average one or two centimeters taller. The myth that black men have giant penises is therefore not true. There are differences, but they are minimal. Many people talk about micropenis even though these penises, which are those less than six centimeters when erect, are very rare. And unfortunately, they are usually associated with syndromes.
Q. Over the past 30 years, new generations have become taller thanks to nutritional improvements. This is something that is known and discussed. It is more surprising to discover, as you explain in your book, that their penis has also grown…
A. Of course. The penis grows as it aligns with the body. After all, it is made of vascular tissue, in particular blood vessels, and covered with skin, generated by proteins. When you have a more protein-based diet, like the current one, the body develops more. We are bigger than the previous generation. Girls begin to menstruate earlier, development occurs earlier. And boys from new generations have, on average, larger penises.
Q. But that doesn’t mean they have any fewer complexes. How has easy access to pornography changed men’s perceptions of their penises?
A. A lot. Especially in terms of size and performance. I have been working in this field for 35 years and we are seeing an increase in consultations, particularly among very young patients. They will never achieve completely false expectations, because porn is not real life. Young people have access to a lot of information about sexuality, but this does not guarantee that they are well informed. More than 90% of penis information on the Internet is misleading or downright false. I worked on it, went through about 300 pages and saw two, from two prestigious urologists, talking seriously about penis size. The rest was false, exaggerated, for the sole purpose of selling miracle products. There’s an impressive industry behind it, all these resorts bring in a lot of money. Sex sells, especially if it’s based on lies. And the problem is that the majority of men who have a problem do not act, only a minority comes later to consult. Others are left with this false information. The Internet is the andrologist’s antechamber.
Q. There are many myths surrounding the penis, but science has proven some to be true, like the one that links penis size to nose size…
A. This was always considered an urban legend, until a Japanese group conducted a study demonstrating this similarity. (The study, published in 2023, analyzed 1,100 men and showed that “nose size was a significant predictor of penis size,” confirming “the truth of a long-ago myth.”) Lengths may have to do with the levels of testosterone that the fetus is exposed to during pregnancy. But this 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. These are fashions…
A. Indeed, there was a time in the Renaissance when sex was considered obscene. At the time, having a very large member was in bad taste, it wasn’t fashionable. Today, the idea that having a tall member symbolizes being more of a man, the alpha male, the leader of the tribe, has become popular. But in this era, the smaller the penis, the better. There are many examples of this ideal of beauty in art, for example in the work of Michelangelo. David, who has a very small penis compared to this huge muscular body. But who knows, maybe the small penis trend is back. And everyone who has a big penis will spend money to adapt it and make it smaller (laughs).
Q. When it comes to the testicles, what is the most common question?
A. Many wonder if it is normal for one to hang more than the other. And this actually 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 from the testicle are longer on the left side.
Q. Over the past five years in Spain, the number of phimosis operations, generally referred to as circumcision, has increased from 5,000 to 29,000. What is behind this boom?
A. Yes, this is something that we see more and more in consultations and it is a good practice. First, because it promotes penile hygiene, the absence of a foreskin means that the glans is exposed to air and less smegma is secreted. This prevents penile cancer. And it also reduces infections in women. Some studies indicate that Arab and Jewish women (where circumcision is performed on all children for religious reasons) have a lower incidence of cervical cancer. Normally, Westerners tend to operate on the foreskin when necessary, when it causes problems. For example, when a patient is diabetic. In these cases, as the urine contains a greater amount of sugar, this facilitates germinal and bacterial infections, it is a fertile ground. And recurrent infections can occur. With the increase in obesity and diabetes in industrialized countries, it is normal that more elderly patients wish to undergo phimosis surgery.
Q. In your book you don’t just focus on young people, you also talk a lot about older men and older people’s sexuality…
A. We are animals. Yes, we are smart. Yes, we have evolved. But we do not cease to be animals that are born, grow, multiply and die. There comes a point where, well, we no longer multiply because of a biological limitation. But why not continue to have sex? I get 70-year-old men who tell me they want more capacity, to be able to have more sex, and I think that’s great. Active sexuality improves quality of life; It has been found in nursing homes that people who have sex tend to live longer. Sex is life. And I would also like to highlight the case of the LGBTQ+ collective. Old people who, in their time, could not show affection. There are still negative stereotypes about the sex lives of older people, but especially in this group, who have suffered so much and had to hide their sexuality, they shouldn’t have to do that now. They don’t have to hide anything.
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