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Can long periods of sexual inactivity cause reduction in size and function?

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New study shows that lack of regular stimulation can lead to a decrease in penis size over time.

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What happens to a man's reproductive organ when he goes through a long period of sexual inactivity?

A new study shows he loses as much as two centimetres of penile length.

Penile disuse atrophy, which is the reduction in the size and function of the penis is caused by factors such as abstinence, medical conditions, or lifestyle choices leading to extended sexual inactivity, making the penile tissue less elastic, said Prof Emin Özbek, a urologist from Istanbul, Turkey. 

The urologist wrote in a peer-reviewed research paper in April singling out lack of sexual inactivity as the leading cause of penile disuse atrophy.

“The primary cause of penile disuse atrophy is a lack of regular sexual activity or stimulation,” he said, adding that “going a month or more without having sex may cause men and women to experience increased stress levels due to sexual frustration, anxiety, depression, and anger issues.”

Like any muscle or tissue in the body, he explains, the penis requires regular use to maintain its health and function.

When it is not regularly stimulated, he cautions, it can lead to a decrease in size and a loss of erectile function over time.

So, who is at greatest risk of developing penile atrophy?

The Centers for Disease Control and Prevention (CDC) recently released a report showing that young men aged up to 27 years old (Generation Z), born in the internet and social media era, which has kept them busy, are having less sex compared to the older generation.

Speaking to Lifestyle, Fanuel Ogutu, 23, popularly known on TikTok and Instagram as Flossy Trukid agrees with the study findings.

“As a Gen Z, I am very busy. Between school, content creation, and joining the protests to fix this Kenya, sex is not a priority,” he says.

“I will start thinking about it in the next 10 years because I am ruthlessly working to build an empire and be a successful man,” he adds.

For Wisdom Emmanuel, 22, the last he had sex was in 2021, and it was out of curiosity.

“I learned that sex is an expensive venture; it’s just too costly to spend a lot of money on dates, taking someone’s daughter to the salon, feeding her when her parents are still alive, and taking care of her when I need to prioritise me and my future,” he says.

“Most of my male friends and I have these discussions, and they are of the same mentality. It’s true that as Gen Zs, sex is not larger than life because we are focused,” he says.

Elizabeth Nduta, 19, wonders why it is surprising that her generation is not having as much sex as widely thought.

“People forget that Gen Zs are spiritual people. Apart from being digital natives, we have seen how sex has affected relationships; broken marriages, and even made things painful for others. Why is it surprising that sex for us is not a priority?” she says.

“My male friends and I go on dates to discuss ideas that will give us business opportunities and help us make money. That’s more important, and it is why we chose to be celibate,” she adds.

How long?

So how long does it take for a sexual organ to shrink when one is celibate?

David Kinanga, a consultant surgeon and urologist in Nairobi, says this varies from person to person and is largely influenced by two main things.

“First, what drives sexual function primarily is the male hormone known as testosterone, which picks up at 24. At this age, the sexual energies of young men are at their peak, after which their sexual drive dips over time as they age,” he says.

Secondly, male organs are maintained by these hormones and if there is a drop in testosterone, it is not unlikely that a few of the organs will go through atrophy, he explains.

“The organ enlarges as you age, it enlarges because of an imbalance between testosterone and the female hormone known as oestrogen. Remember, men and women have testosterone and oestrogen, it’s just that women have more oestrogen and less testosterone, while men have more testosterone and less oestrogen,” he tells Lifestyle.

Just like Lamarch’s theory of evolution, which states that “a characteristic which is used more and more becomes bigger and stronger, and one that is not used eventually disappears," Dr Kinanga says that the penis is a stretchable organ.

“This therefore means that if you are feeding it every other time, it’s likely to maintain, if not increase, its length. If you are not feeding, it won’t be fitting, which many people describe as shrinking,” he says.

The urologist further adds that the most important thing is to address the issues that may be leading to low sexual drive.

“There are diseases like Peyronie’s disease caused by repeated penile injury, typically during sex or physical activity. A scar tissue, called plaque, forms under the skin of the penis and builds up inside the penis, in the thick elastic membrane called the tunica albuginea [the tough fibrous layer],” he says, adding that the tunica albuginea helps keep the penis stiff during an erection.  

“The penis becomes bent and small because of the disease, but now, to a layman, they may think it is because they are not having sex that this has happened.”

Patients with cancer of the penis or testis may experience atrophy of the male organ too.
“It is because the male hormone went down, not because they are not having sex,” explains Dr Kinanga.

This is why he urges Kenyans to go for tests.

“People always try to justify why they should have more sex or have it often using atrophy the same way they say that if you are having more sex, then the chances of prostate cancer decrease. It’s men trying to say, we should be having sex often,” he says.

However, Prof Joachim Osur, a reproductive and sexual health expert, says there is no scientific basis for ‘shrinking genitalia’.

“Nuns and Catholic priests remain celibate for life and there is nothing abnormal about them. People don’t have to be sexual for any part of their bodies to be normal,” Prof Osur argues.