Male and female genitals come in all shapes and sizes 1,2.

Your partner’s opinion about how their genitals look can affect how confident they are during sex, and their sexual satisfaction and function1, and negative comments about men’s general physical appearance from their partners can have a negative effect on their body image3. Understanding men’s genital appearance, and knowing what’s normal and what’s not, may help foster a healthy and satisfying sexual relationship.

Penis size

A normal penis size ranges from 5 to 15.5 cm long and 6.5 to 13 cm in circumference (the distance around the outside, or girth) when flaccid, to 7.5 to 19 cm long and 9 to 16 cm in circumference when erect. Only 1 in 10 men think they have a small penis but almost half of men who think their penis is ‘average’ would like it to be bigger4. Men’s partners are, in fact, more likely to be very satisfied with the size of their partners’ penis than the men themselves4.

Penis curvature

It’s normal for a penis to have a slight curve when erect. Some males have more severe curves or bends due to Peyronie’s disease — a condition that affects the connective tissue that surrounds the erectile tissue in the penis. The cause may be as a result of repeated damage or injury to the penis during sexual activity.

Peyronie’s disease can be painful, but the greater problem is that intercourse can be difficult or even impossible. This can be challenging for the mental health of both partners and place strain on their relationship.

Any injury to the penis should be attended to by a doctor to make sure that there’s no underlying problem or trouble with healing.

Circumcision

Circumcision is when the foreskin over the glans (head) of the penis is surgically removed. Circumcision was most prevalent in the 1970s with the majority of baby boys having the procedure, so it’s more common in older men than younger men.

Some males are circumcised in adolescence or adulthood to treat phimosis — a condition in which it is not possible to pull the foreskin back over the glans.

Circumcised men are less likely than uncircumcised men to get urinary tract infections, inflammation of the glans of the penis (and/or foreskin) or get penile cancer (although this is very rare). It’s important for uncircumcised males to clean under their foreskin regularly.

Circumcision does not affect sexual function.

Sexually transmitted infections (STIs)

A sexually transmitted infection (STI) is an infection you get or give during sexual activity. STIs can be caused by viruses (e.g., human immunodeficiency virus, herpes), bacteria (e.g., gonorrhea, syphilis) or parasites (e.g., pubic lice).

Not all sexually transmitted infections cause symptoms, but some can cause rashes, bumps, or sores on and around the genitals. It’s possible for males to show no sign of infection with STIs that can have serious implications for a couple’s fertility.

That’s why it’s best to have regular (3-monthly) sexual health checks if you have a new sexual partner, regardless of whether either of you have any symptoms or signs.

Spots, lumps and bumps

There are lots of different variations in the skin of the genitals but both you and your partner need to see your doctor if you notice any spots or lumps. A doctor can make an accurate diagnosis and rule out anything serious. Soreness, redness or swelling of the penis should be seen by a doctor as soon as possible.

Pearly penile papules

Pearly penile papules are painless, dome-shaped bumps that usually occur in one or more rows along the corona (the rounded border where the head of the penis meets the shaft). They can be flesh-coloured or white and can look like small pimples or skin tags. Pearly penile papules are common types of bumps that occur on the penis, affecting between 1 in 7 to almost half of all men. They are a normal anatomical feature and do not require treatment.

Fordyce Spots

Fordyce spots are small, pale, slightly raised spots, found on the scrotum. They can also be present on your lips or on the snide of your mouth. They’re a type of sebaceous gland and are completely normal. About 4 out of 5 people have them and they’re not infectious.

Lichen sclerosis

Lichen sclerosis (sometimes called balanitis xerotica obliterans, or BOX) is a skin problem that causes white patches on the foreskin and glans of the penis, probably caused by to ongoing irritation or inflammation. It occurs in about 1 in 1000 men. In some cases, the white patches are painless but in others can be painful, itchy or have altered sensation. Lichen sclerosis won’t go away on its own and can lead to serious problems, so it requires a visit to the doctor. Men who are obese, or who smoke or have cardiovascular disease, are more likely to get lichen sclerosis than men without these risk factors.

Molluscum contagiosum

Molluscum contagiosum is the name of a skin condition (and the virus that causes it) transmitted by skin-to-skin contact, or shared towels or other similar items. It causes pale white, yellow or pink dome-shaped bumps with a ‘pit’ in the middle, that occur in groups of up to 30. The bumps are 2-5 mm across. Unlike some other sexually transmitted infections, using condoms does not prevent transmission of Molluscum contagiosum.

The scrotum and its contents

The scrotum is the pouch of skin that hangs below and just behind the penis and contains the testes (some people call them testicles). In some men, one or both testes may be able to move up, out of the scrotum and into the abdominal cavity. This condition should be checked by a doctor to make sure there are no associated problems with fertility.

Males can get cysts, varicose veins and other lumps within the structures contained in the scrotum. In most cases, these are nothing to worry about but if something is noticeable, it’s worth a trip to the doctor.

Your partner should perform regular testicular self-examinations to check for lumps, much like females check their breasts. Although testicular cancer is relatively rare, it can be deadly. But if it’s detected early enough, testicular cancer can usually be cured.

The diverse appearance of peoples’ genitalia is just the same as many other differences in physical appearance. If there’s something about the appearance of your or your partner’s genitalia that you don’t really like, it might help to speak to each other about it, or talk to a sexual health specialist.

If you notice any change in the appearance of your genitals or that of your partner, or if you notice anything that looks or feels abnormal, you should see your doctor.

References

[1] Veale et al., 2015. Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15 521 men. BJU International

[2] Kreklau et al., 2018. Measurements of a ‘normal vulva’ in women aged 15-84: a cross-sectional prospective single-centre study. BJOG: An International Journal of Obstetrics & Gynaecology

[3] Fornaini et al., 2021. The Power of Words: Appearance Comments from One’s Partner Can Affect Men’s Body Image and Women’s Couple Relationship. International Journal of Environmental Research and Public Health

[4] Lever et al., 2006. Does Size Matter? Men’s and Women’s Views on Penis Size Across the Lifespan. Psychology of Men & Masculinity

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