Does size matter?

Wednesday November 12, 2008
Does size matter?
The Doctor SaysBy DR MILTON LUM

Concerns about the size of genital organs are often unwarranted.
MOST humans are concerned about the size of objects. For many, big is beautiful up to a point after which, it may become ugly. For others, small is beautiful again up to a point after which, it becomes unacceptable. Only a few of us have no views on size.
As it is with inanimate objects, so it is with the human body. Many adults are concerned about the size of their genital organs, particularly its relationship to sexual performance and satisfaction.
The paucity of information in the public domain, the gaps in consumers’ medical knowledge, misinformation and advertisements in the print and electronic media and the reluctance of many doctors and health care professionals in discussing such matters have contributed to misperceptions.
Men’s size
The male is fascinated with the penis from an early age. As boys become adults, many become convinced that it would be better if the penis is just a bit longer. Information from friends and advertisements reinforce the perception that there is a relationship between penile length and manhood.
Most females cannot understand this fascination or obsession. There are reports that chance remarks about small penile size, particularly in the bedroom, have led to impotence (erectile dysfunction).
When a male sees his penis, it is at an angle, which makes it appear to be shorter than it really is. But when he sees another male’s penis, there is no such foreshortening effect, so it appears that the other’s penis is longer.
One should remember the facts about penile size. Wessells and his colleagues reviewed publications on penile length in 1996. The average length of a flaccid penis, measured from the base to the tip, is 8.85 to 10.7cm while that of an erect penis is 12.89 to 15.5cm. During an erection, the shorter flaccid penile length of a male will increase more than that of another with a longer flaccid length.
It should be remembered that the vagina can accommodate any penile size as it is distensible because of its capacity to increase in length if an object is introduced gradually. There is no relationship between race, height and penile size. Neither is there a relationship between penile size and sexual performance and satisfaction. Some men have bigger penises than others, just as some men are taller or of bigger build than others but penile size is no indicator of virility.
Concerns about sizes
If one is unhappy about his penis size, it is advisable to consult a general practitioner or urologist. In most instances, reassurance that the penis size is normal is all that is necessary.
Many people advertise their claims of methods of increasing penis size. The expert opinions on the methods are:
· Pills or patches – a complete waste of time
· Penile enlargement exercises – probably futile
· Penile suction devices – probably of little use
· Penile enlargement surgery – uncertain value with risk of bleeding, infections and deformity.
Surgery may lead to the flaccid penis appearing longer but it makes no difference to the size at erection. There are reports of some modest improvement in length with penis stretchers (expanders). Some men may want to reduce the penis size. Although this can be done, there are risks of bleeding, infection and deformity. A urologist should always be consulted prior to the use of devices or surgery.
Female size
The vulva is the visible part of the female genital organs. It includes the clitoris, labia and urethral opening. It is not uncommon for women to be concerned about the size of their vulva and vagina as it plays a major role in their sexuality. A common myth is that a large vagina is associated with excess sex. This is incorrect as the frequency of sex has no impact on vulval and/or vaginal size.
Braun and Kitzinger in their publication Culture, Health and Sexuality put it succinctly: “With the construction of women’s genitals as problematic, the ‘private’ female body becomes a site for potential improvement. Socio-cultural accounts of vaginal size in the West construct a tight (but not too tight) vagina as desirable, and a ‘loose’ vagina as undesirable. In women talk, we found a curious pattern: women identified the cultural desirability of a tight vagina, and noted negative uses to which this is put (such as the positioning of women with ‘loose’ vaginas as promiscuous).
“However, when women described their personal concerns about vaginal size, these were couched in terms of anxiety about being too tight. We argue that constructions of vaginal size are problematic because they create another site of bodily concern for women, and are used to control and abuse women. We suggest that they also reflect a disregard of women’s sexual pleasure, and a lack of familiarity with the functions of the vagina.”
Weber and his colleagues studied the relation of vaginal anatomy to sexual function and concluded: “Vaginal anatomy measured by introital calibre, length and vulvo-vaginal atrophy does not correlate well with sexual function, particularly symptoms of dyspareunia (painful intercourse) and vaginal dryness.”
If a woman has not given birth, there is no way that her vulva or vagina is too big. However, childbirth affects vulval and vaginal size. The more babies delivered vaginally, the more likely the size will be increased. This is because the vaginal muscles and its supporting tissues are damaged during childbirth, particularly when labour is prolonged or difficult.
The increase in vulval and vaginal size can be prevented by adherence to pelvic floor exercises for six months after delivery. This involves tightening up the pelvic floor muscles, like trying to stop passing urine, holding the contraction for 10 to 15 seconds, relaxing for 10 to 15 seconds, repeating the contracting and relaxing for five to 10 minutes and doing the exercises three to four times a day.
Too big
The effects of too big a vagina include less than satisfactory vaginal intercourse for the female and/or male, air and/or water getting into the vagina and descent (prolapse) of the vagina, uterus and other pelvic organs in later life.
There are different treatment methods. Intensive pelvic floor exercises described above for six months will lead to improvement. Working at vaginal muscle developers for some time can also improve matters. A pelvic floor repair done by a gynaecologist brings together and tightens the weakened pelvic floor muscles and tissues.
Many women are concerned that the vulval lips (labia) are too large, too long or protrude unequally. If there are such concerns, a gynaecological consultation will be helpful. In most instances, reassurance that one is normal is all that is necessary. If there is a genuine abnormality, it can be corrected surgically.
Sometimes, a female may feel that her vulva and vagina are too small. They are statistically very rarely correct. A small vulva and vagina may be the result of surgery to the vulva and vagina. Too small a vagina can occur when there is a vaginal septum, which may lead to a double barrel-shaped vagina. The symptoms include inability to insert a tampon, pain on vaginal intercourse or total inability to have intercourse.
The vast majority of women with these symptoms have a normal sized vagina. However, many of them suffer from sustained contraction of the vaginal muscles whenever there is an approach to the genital organs (vaginismus). An internal examination will provide the answer to questions about smallness. A vaginal septum is easily treated surgically. The treatment of vaginismus is challenging and requires an expenditure of time and effort by both patient and doctor. If the vulva and vagina are genuinely small, it can be corrected surgically.
Whenever there are concerns about the size of the genital organs, it is advisable to consult a doctor. To do otherwise is risky and to have an untrained person do the job is to court disaster.
· Dr Milton Lum is chairperson of the Commonwealth Medical Trust. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with.