A recent advice column published by Slate captured viral attention by addressing a relatable and somewhat awkward question: can an adult penis really shrink over time, or might it just seem that way? The letter writer, reflecting on a sexual encounter with an ex-boyfriend after five years apart, noted that one part of her ex “seemed… smaller than before.” This personal observation sparked a larger conversation on whether penis size can change, what could cause such changes, and whether memory plays tricks on us. Recent research, expert opinions, and medical consensus shed important light on these sensitive, yet significant, questions for both Thai and international audiences.
Penis size and its changes over a lifetime is a topic shrouded in myths and misconceptions. For many Thai men—and their partners—worries about size or changes in size are not uncommon. Cultural attitudes in Thailand, as elsewhere, often tie masculinity and confidence to sexual performance and body image. Yet recent research reveals a much more complex, and reassuring, picture than urban legends or popular “sin-sod” (dowry) tales might suggest.
Aging, for instance, is often blamed for a shrinking penis. However, leading medical studies, including evidence summarized by The Conversation and Verywell Health, indicate that natural aging alone doesn’t directly cause a decrease in penis length or girth. Analyses comparing measurements across age groups typically find little difference, and many supposed reductions are, in fact, illusions caused by other factors like weight gain around the pubic area, which can mask the visible length of the penis (The Conversation; Verywell Health; WebMD).
More significantly, genuine shrinkage in penile size can be linked to specific medical conditions and lifestyle factors. This includes Peyronie’s disease (a condition that creates scar tissue in the penis), side effects from prostate surgery or cancer treatments, hormone imbalances (notably low testosterone or hypogonadism), and some medications used for prostate health or hair loss. A buried penis, in which abdominal fat surrounds the base, can also create the impression and effect of shortening (Verywell Health).
One fascinating and newly explored mechanism is changes in erection frequency and quality. Insights from a 2024 study on mice, summarized by The Conversation, show that frequent erections help maintain the number of penile fibroblasts—specialized cells needed for maximizing healthy blood flow in the penis. The more frequent the erections, the more fibroblasts are present, and the easier it is to achieve and maintain erections. This is echoed by Dr. Charles Welliver (director of men’s health at Albany Medical College), who explained to Slate that the decrease in spontaneous and nocturnal erections that comes with aging or erectile dysfunction may lead to long-term shrinkage, as reduced blood flow negatively affects penile health. As Dr. Welliver put it, “the length maintenance is more about the erections and semi-erections (chubs if you will) that happen when not having sex,” indicating that “training” the penis through regular, natural erections—including those occurring unconsciously during sleep—plays a significant role (Slate; The Conversation).
The research further suggests a profound connection between penile and overall vascular health. Penis function is often a warning sign: erectile dysfunction can signal underlying problems such as hypertension, diabetes, and heart disease, both commonly rising with age in Thailand. Dr. Rob McLachlan, a reproductive health specialist, told The Conversation: “Erectile dysfunction can hint at serious health problems such as heart disease, high blood pressure, diabetes and disorders of the nervous system. In this way, the penis reflects vascular health in the rest of the body. So having erectile dysfunction can predict your risk of a future heart attack or stroke” (The Conversation).
But what about memories? The original Slate letter also raised the possibility of “nostalgia,” or remembering things more generously than they really were. Psychologists confirm that human memory, especially of past intimate experiences, can be subject to distortion—the “rose-colored funhouse mirror of nostalgia.” In the absence of precise measurements, personal recollections may exaggerate or minimize perceived size, influenced by emotion, length of time, or one’s confidence at the moment. Therefore, what might seem like shrinkage in some cases is actually a trick of memory.
Among the medical conditions that do cause actual shrinkage, Peyronie’s disease stands out. Scar tissue can develop in the penis, often as a result of years of microtrauma from sexual activity or injury, causing it to curve and shorten. Experts note that this affects about 6.5% of men over 70 and can reduce length by 0.5 to 1.5 centimeters, often accompanied by pain and erectile dysfunction. Treatments range from penile injections to traction therapy and surgical options, with early intervention delivering the best outcomes (Verywell Health).
Other genuine reductions in size are more transient, such as after radical prostatectomy or radiation therapy for prostate cancer. Studies find that, although men may lose up to one centimeter in length, most will recover their baseline size within 1-3 years after surgery or completion of treatment. Conversely, long-term, suppressed testosterone (androgen deprivation therapy) can shrink the penis by as much as three centimeters, but this too is often reversible (Verywell Health).
Thai men may find many of these factors relatable, especially since obesity and cardiovascular diseases are rising in the Kingdom alongside increased sedentary lifestyles and westernized diets. Cultural beliefs and the quest for strong family lineage through sons are sometimes accompanied by heightened concerns about sexual health, virility, and self-esteem. Yet, medical experts emphasize that mild, gradual changes are normal parts of aging, while sudden, severe or painful changes warrant prompt attention from a healthcare provider (The Conversation; WebMD).
What can men in Thailand do to look after penile health?
Firstly, maintaining overall cardiovascular health is critical. This includes a balanced Thai diet—full of vegetables, fish, lean meats, and limited in added sugar and processed foods—regular exercise, keeping a healthy body weight, not smoking, and moderating alcohol consumption. Men should also seek regular checkups for diabetes, high blood pressure, and cholesterol, as these conditions often present with subtle, early changes in sexual function before more serious symptoms develop. For anyone experiencing persistent erectile dysfunction or noticeable changes in size or shape, seeking advice from a trained urologist is essential, as these could be signs of treatable, underlying conditions (Verywell Health).
Supportive communication within couples also matters. Partners can reduce anxiety about perceived changes by recognizing the complexity of human intimacy, and that mutual satisfaction and understanding are more important than any numerical measurements. Popular culture in Thailand, especially sexual health education initiatives led by urban hospitals, is increasingly incorporating frank and open discussion about male reproductive health.
Looking forward, research is exploring whether “erectile training” (such as encouraging regular, spontaneous or induced erections) could help maintain penile size and function in men at risk for decline. Animal studies suggest that it is not just frequency, but the quality and variability of erections—especially during sleep—that help preserve healthy tissue. There is speculation about whether pills like sildenafil (Viagra) or tadalafil (Cialis), already common in Southeast Asia, might be preventative when used regularly by aging men, though this requires further clinical research (PMC article).
For Thai men, the key takeaway is that the penis, like the rest of the body, is sensitive to health, aging, and lifestyle. Small, gradual changes in size and function are normal and usually not cause for alarm. However, sudden or dramatic shrinkage, pain, severe curvature, or new erectile issues always deserve professional assessment—both to relieve anxiety and to address underlying medical issues that might otherwise go untreated. And while memory can play tricks, open confidence, healthy living, and prompt care offer the best route to lifelong sexual wellbeing.
For practical steps, Thai men and their partners are encouraged to:
- Practice regular physical activity such as walking, cycling, or swimming.
- Maintain a healthy Thai diet rich in vegetables, fish, lean protein, and low in excess sugars and fats.
- Avoid smoking and excessive drinking, both risk factors for cardiovascular and urological diseases.
- Seek annual health check-ups, especially after turning 40, for blood pressure, blood sugar, and cholesterol.
- Discuss any major penile changes openly with a healthcare provider.
- Remember that a fulfilling sexual relationship is built on communication and understanding, not physical measurements alone.
For more specific prevention and support, Bangkok’s major hospitals and family practitioners offer both sexual counseling and specialist referrals, often with a culturally sensitive approach. Public campaigns like Thailand’s Men’s Health Awareness Month also provide materials in Thai and English, helping demystify common fears. As scientific research advances, health professionals continue to share new findings about penile health, helping Thai society move toward openness, accuracy, and mutual respect.
For those experiencing concerns about penile size, function, or changes over time, understanding the science, reaching out for support, and taking care of one’s overall health are the surest paths to long-term confidence and satisfaction.
Sources:
- Slate – Sex Advice on Penis Size Change
- The Conversation – Here’s what happens to your penis as you age
- Verywell Health – Can a penis get smaller permanently?
- WebMD – Ways Your Penis Changes as You Age
- PMC – The aging penis: what is it trying to tell us?
- The Conversation – Erections: what we learned from mice could help with sexual health in men