“Penile Atrophy” is never something you want to hear a doctor say about you, or even really think about.

It’s one of those word pairings that just makes men cringe, like “testicular torsion” and “women’s literature.”

Even worse, it’s a natural part of the male aging process.

Remember: our bodies are built to reproduce, preferably before we turn 40. Once we reach a certain age, our body starts to pay less attention to upkeep on the sex department.

That means penile atrophy – the shrinkage of the male gonads – is waiting in all of our futures. The only question is what cause we’ll see first.

1. Penile Atrophy and Low Testosterone

Reduced testosterone can hurt your penis size in two different ways:

  • It results in weaker erections, making its maximum size while erect smaller than before (source)
  • It can cause the clinical condition hypogonadism in which your testicles and penis shrink in size as a result of insufficient testosterone (2).

In either case, low testosterone is the culprit. Nearly all age-related penile atrophy actually happens as a result of your body producing less testosterone in later years.

What to do about it: eat testosterone-friendly foods, reduce your intake of soy and other estrogen-producing substances, exercise more – especially power lifting and sprints, get outside.

2. Penile Atrophy and Arterial Plaque

Arterial plaque is a buildup of calcium, fatty deposits, and similar junk on the insides of your blood vessels.

As it gets worse, the route your blood takes to your penis gets thinner and harder to navigate.

Ultimately, the buildup makes it so blood flow to your junk is slow, unreliable, and infrequent.

Since the size of your erect penis relies on that blood flow, when the flow suffers so does your size.

Further, the same kind of buildup happens in the spongy tissues around your penis.

Their maximum capacity goes down, and with it the size of your erect member.

What to do about it: get cardiovascular exercise, drink pomegranate juice, up your intake of magnesium, vitamins K2 and C, and amino acids.

3. Penile Atrophy and Stress

When you’re stressed out, your body produces a hormone called cortisol.

Cortisol is great for protecting you from injury while in battle with a saber-tooth tiger, or for helping you run away from an enemy at maximum speed.

But too much of it is bad for your long-term health and for your penis (3).

  • First, the stuff can overwhelm testosterone production in your Leydig cells, contributing to overall lower testosterone and all the problems with that I already mentioned.
  • Second, the same process interferes with your Nitrous Oxide production. This is because the last thing a body in danger wants is faster, easier blood flow. So cortisone shuts that down.
  • Finally, cortisone increases your body’s production of aromatase, which eats your testosterone and turns it into estrogen.

You already knew stress was bad for you in general. Now you know it’s bad for you little buddy, too.

What to do about it: get regular moderate exercise, spend time with friends, meditate, take ashwagandha to reduce cortisol production.

4. Penile Atrophy and Smoking

I’m going to keep this one short and sweet.

Smokers have smaller penises than non-smokers, according to research at the Boston University School of Medicine (4).

Smoking contributes directly to erectile dysfunction because of the ways it harms your circulatory system.

Smoking cessation improves erectile health in as little as four weeks.

Smoking. Is. Bad. For. You.

What to do about it: quit smoking! This can’t be the first time somebody told you that. And yes, vaping counts as smoking. Knock it off.

5. Penile Atrophy and Belly Fat

Belly fat is bad for your penis size now, and bad for it later on, too.

Right now, the more belly fat your body has, the more estrogen and the less testosterone your system produces (3).

Belly fat stimulates your body to produce that aromatase I mentioned earlier, throwing your sex hormone balance out of whack.

Later on, belly fat creates a vicious cycle. If you’re lean, your body craves exercise and your testosterone production pushes you to do it.

Belly fat makes exercise harder and less fun, and lower testosterone reduces your motivation.

Which means you’re more likely to get fatter than to get rid of the fat you have.

In both cases, it can lead to penile atrophy by way of killing your testosterone levels.

Also, when men gain weight around the stomach, the penis retracts  because it is attached to the abdominal wall.

When the stomach expands, this forces the body to pull the penis inward.

That’s why losing a little weight can help guys restore their size to what they remember.

What to do about it: lose 10-15 pounds. Eat right. Exercise more. Keep it off. Bonus points for testosterone-boosting activities like HIIT workouts, power-lifting, and competitive sports.

6. Penile Atrophy and Celibacy

Animal experiments and observational studies of humans confirm that having sex improves sexual health.

Regular orgasms with the help of a partner promote hormonal health vital to maintaining your biggest and hardest erections (5).

It’s sort of a “use it or lose it” situation.

Guys who go a long time without having sex can experience up to two inches of loss in their flaccid length.

Erectile dysfunction issues may contribute to celibacy for some men, especially if they leave their ED untreated.

Men who have sex frequently and then stop for an extended time still experience this issue.

When your goal is to be a great football player, you need to play the game a lot.

If you want to have fantastic sex, make love frequently. Having sex only once per week can reduce erectile dysfunction risks by at least 50%.

What to do about it: go get laid. If that’s not really on the table for you just now, do exercises where you touch yourself until you’re good and hard but not to orgasm.

Masturbation (especially to hard-core pornography) has the opposite effect and can contribute to penile atrophy.

7. Prostate Gland Removal

Almost three-quarters of men who have their prostate gland removed experience penile atrophy.

Researchers are unsure of why this happens, but it could be due to the shortening of the tube that connects the penis to the bladder that occurs during the surgery.

8. Peyronie’s Disease (PD)

Peyronie’s disease forms when fibrous scar tissue starts developing inside of the penis.

The result is a curved erection that can bend enough to make having sex painful.

Although this condition happens to guys more often as they age, it can happen to anyone who experiences frequent micro-injuries to this area.

The bending or curving that happens with PD can also reduce the circumference and length of the penis.

This condition sometimes goes away naturally, but it often stays persistent or gets worse over time.

Only surgery to remove the scar tissue can reverse the problem.

9. Prescription Medications

Some prescription medications list penile atrophy as a known side effect.

Antipsychotics, antidepressants, and Adderall are the most common drugs that guys take that cause this issue.

Guys who suspect that this issue might be causing penis shrinkage should not stop their meds cold turkey.

Many prescriptions require time to build up to a therapeutic level.

Quitting the regular dosage could cause other unwanted side effects, some of which could be potentially dangerous.

Causes of Penile Atrophy – Conclusion:

Before you go, I need to mention one cause of apparent penile atrophy.

It doesn’t go on the list, because it’s not your penis actually getting smaller.

Instead, if you put on belly fat your penis looks smaller because your belly is overshadowing it.

It’s like how you look normal-sized standing next to normal people, but tiny standing next to a professional wrestler.

The presence of the wrestler doesn’t shrink you, but it makes you look shrunken in the photo you took.

If you’re worried about penile atrophy, consider each item in the list above. Which is the most likely culprit?

What can you do to fight and reverse it, given the probable cause?

You may need to try multiple solutions before you find the one that’s right for your situation.

Luckily, all of the solutions above have benefits for your general health, so no harm done while you’re trying and erring.


We like to discuss opposing views here on ExpandPenis and even though we’re not huge fans of testosterone replacement we’d be doing our readers a disservice if we didn’t look at both sides of the equation.

Let’s go…

Does Low Testosterone Cause Penile Atrophy?

Guys can experience penile atrophy if their testosterone levels are below average.

It may also impact the size of their testicles.

Most men experiencing low testosterone levels see shrinkage in both areas.

It can even cause the testicles to change from being firm to soft and somewhat squishy.

Although receiving testosterone supplements or treatments can help to restore the length and girth that gets lost with this condition, the testicles don’t see a return to their previous volume without medical intervention.

If young men determine that their penis size is below average at a very young age, it may be possible to enlarge it with testosterone treatments.

It is even a practical treatment approach for those guys dealing with a micro-penis. 

When Do I Need to Worry About Penis Shrinkage?

The loss of length in the penis can be distressing for some men. It is even worse if guys aren’t expecting this issue.

The time to worry about this problem is when you experience erectile dysfunction and penile atrophy simultaneously.

This set of symptoms is a recipe that could indicate that your body is cooking up some heart disease.

If you feel out of breath, have trouble sleeping, or experience abnormal heartbeats with penile atrophy, you should see a doctor immediately about your symptoms.

Acute penis atrophy may also be a sign of severe dehydration. When you don’t get enough water to drink, your body releases an enzyme called angiotensin.

This enzyme causes the blood vessels in your body to start restricting. That means less blood flows to the penis, making it harder to achieve an erection.

What Could Be Causing My Low Testosterone?

Testosterone levels start decreasing each year after guys reach the age of 30. Although some men only lose a little, it can be a substantial loss for others.

Up to 40% of older guys may be dealing with testosterone levels that are low enough to trigger penile atrophy. 

Anyone can be affected by low testosterone. Young men, children, and even newborns can encounter this problem.

For most men, stress is a leading cause of the acquired circumstances that can lead to low testosterone.

Several physical or emotional stressors from surgery, illness, relationships, or professional duties can cause hormone production to shut down.

Inherited conditions and diseases can also contribute to low testosterone levels.

Guys might have a pituitary gland condition caused by small tumors or improperly functioning kidneys that trigger penile atrophy.

A condition that affects the hypothalamus called Kallmann Syndrome can trigger lower testosterone production. 

Guys with an HIV or AIDS diagnosis may experience low testosterone levels if the disease affects their testes, hypothalamus, or pituitary gland.

When the symptoms of the disease, illness, or condition start receiving treatment, guys may experience an increase in their testosterone levels.

That process can lead to a reverse of the penis shrinkage.

Low Testosterone Issues Caused By Injury

Some guys experience penis atrophy and shrinkage because of testicle damage received during an injury.

When men experience trauma to both testes, the physical circumstances limit the amount of testosterone the body products.

Guys who didn’t receive the mumps vaccine and contracted the disease can experience a similar outcome.

Mumps is known to injure the testicles, even with a minor infection. It is not uncommon to experience up to 50% atrophy when dealing with this health issue. 

Some inherited conditions can also cause low testosterone levels, such as undescended testicles or Klinefelter’s Syndrome.

Since these issues are present at birth, treatment options start immediately.

A condition called hemochromatosis can also cause penile atrophy.

This issue happens when there is too much iron in the blood, causing the testicles to fail or damage to the pituitary gland.

How to Treat Problems with Penis Shrinkage

Most guys can start treating the issues they experience with penile atrophy by making some lifestyle changes.

For guys who are smokers, cutting out cigarettes from your daily routine can help to restore penis size as the chemicals work their way out of the body.

If belly size or weight gain contributes to the atrophy, losing a few pounds can restore the appearance of the penis.

Guys with a curvature or bend to an erect penis may need to speak with a doctor about an ultrasound.

Discovering the extent of scar tissue development can help to develop a treatment plan that makes an erection more comfortable.

Medication-related issues with penile atrophy are often fixed with dosage adjustments.

When low testosterone is the culprit of penile atrophy, guys must get to the root cause of the issue if they want to start the recovery process.

The first step is to increase your physical activity levels.

Most guys need about 150 minutes of moderate exercise each week to maintain their health and wellness.

Combining that movement with a healthy diet can help to restore testosterone levels naturally.

Some men may need to avoid medications like prednisone or opioids to see improvements to their testosterone production.

Should I Consider Testosterone Replacement for Penile Atrophy?

When lifestyle changes are not helping with penis shrinkage problems, guys may need to speak with their doctor about starting a testosterone replacement therapy treatment.

When men have enough of this hormone, it helps them to achieve higher health levels and a more profound well-being.

Most guys work with a treatment team to create a carefully formulated treatment plan to avoid the unwanted side effects of testosterone replacement.

Men can experience increased red blood cells, decreased sperm, testicle shrinkage, acne, or an enlarged prostate when addressing this health issue.

Natural remedies may be helpful for some guys.

Taking vitamin and mineral supplements, getting enough Vitamin D, and getting enough sleep each night can restore testosterone levels to their current baseline. 

How does testosterone replacement therapy work? Doctors will first want to confirm through blood tests that you don’t have enough of this hormone.

Once the need for testosterone replacement is confirmed, guys receive one of five different treatment options.

Skin patches are the preferred option when a small hormone boost is needed.

The transdermal product gets placed on the upper body or arm, and it gets applied once daily.

Gels are another option to consider…

Men can apply this topical treatment daily, while some get used inside of the nose.

Pumps provide the prescribed amount that can restore testosterone levels and work to reverse penile atrophy issues.

A mouth patch is a relatively recent addition to the testosterone replacement therapy treatment options.

It is a table that sticks to the upper gum above the incisor. You would take it twice per day so that the hormone goes through the oral tissues, directly into the blood.

When testosterone levels are exceptionally low, doctors may recommend direct injections to restore health and penis size.

Although oral testosterone pills are available, this treatment option may adversely impact the liver.

It is considered the choice of last resort if the other methods are not working.

What Can I Do About Penile Atrophy?

Every situation is different for guys who believe that they may have penile atrophy issues to correct.

Older men may need to try multiple solutions before they start seeing a reversal of their length and circumference issues.

If testosterone therapy is the best choice to treat penis shrinkage, it may take some time for the results to develop.

Every man is a little different biologically. Some men may not even experience a reversal, while others might see restoration with increases to muscle mass and bone density.

Penile atrophy may be a natural part of the aging process for some guys, but it doesn’t always need to be that way.

When your concerns are directly related to low testosterone, it may be possible to treat the condition. 


The Dark Side of Testosterone Deficiency: I. Metabolic Syndrome and Erectile Dysfunction

Symptoms of sexual dysfunction among men from infertile couples: prevalence and association with testosterone deficiency.

Low Serum Testosterone and Sex-Hormone-Binding-Globulin in Massively Obese Men

Association between Cigarette Smoking and Erectile Tumescence: The Mediating Role of Heart Rate Variability

Sexual Abstinence And Immobilisation Stress Decreased Nitrate + Nitrite Concentration And Increased Necrotic Of Penile Corpus Cavernosum Smooth Muscle And Endothelial Cells Of Adult Male Mice

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