Koro: The Shrinking Penis Phobia

Defining Koro

It is a syndrome that’s culture-specific and characterized by the fear (read: overpowering belief) of the penis and/or testicles reducing to nothingness and bringing over death. This is not dependent upon any visual stimuli but is entirely psychological, the reason why it is found mentioned in the Diagnostic and Statistical Manual of Mental Disorders rather than on any journals related to sexual troubles. The syndrome – though has Malaysian origins – has been accounted to start mass hysteria in specific regions of Africa, Asia and Europe during the Middle Age. Supposed causes were witches and their magic: people were thinking that witches could steal the penis and put the stolen organ in a small box!

It is interesting that koro syndrome shares a lot of similarity with anorexia nervosa, in which, the patient’s perception of his body is very different from others’. This classifies koro as a depersonalization syndrome, the primary symptom of which is a distorted perception of the body, which the sufferer feels to be disastrous.

Primary and secondary Koro: The causes and damages

In short, Koro is the fear of going against the cultural mandate (bigger the penis, greater is the man) and becoming more vulnerable to social pressures. The details are as follows:

i. Primary Koro: This is triggered by the relative size of the genitalia either in comparison to others’ or by anything (e.g. illness or weakness, exposure to cold etc.) that causes penile muscles tighten up temporarily and shrink the organ slightly. This makes the victim undergo an overwhelming fear of losing his manhood and sometimes, even life.

As a solution to the problem, mechanical anchors are widely used to stop further shrinking of the genitals and these anchors could be either strings or metal wires. However, it is the extreme state of anxiety – characterized by sweating, fainting and palpitations – that needs to be feared most and the attacks can be either isolated or chronic, each spanning between 20 and 60 minutes.

Out of the fear, the victims often inflict damages on their organs (in an attempt to pull out the retracted part); however, minor damages resulting from the anchoring attempts – such as bleeding and bruising – can easily be dealt with unless they transform into an infection. And as far as psychological complications – or to say, psychosexual complications – go, it can be severe depression leading to impotence.

ii. Secondary Koro: This is when patients exhibit additional psychological abnormalities; in plain words, depression receives company from paranoia and schizophrenia, which may have roots in dormant subconscious desires and/or phobias; for example, fear of castration.

Signs that the syndrome has affected

Apart from an acute anxiety noticed in most patients due to a falsely perceived genital retraction/ shrinkage (due to cold, anxiety etc.), there are no other detectable symptoms. However, it’s also a change in penis shape (due to loss of penile muscle tone) that triggers such panic, the incident being taken as genital paraesthesia (shortening).


Besides psychological counseling for extremely anxious sufferers, there are physical methods to boost their confidence levels. An Andropenis traction device or another brand of stretching device can do a great job on their overall sexual anatomy. Even a loop string or a clamping device onto the penis can be helpful, but due to associated risks it is not recommended by experts. So, should you feel that your penis is shrinking, besides a serious psychological analysis a medical traction device could be helpful. They are not cheap, the treatment will take time, so patience will definitely be your best ally. But first, a treatment with antidepressants is important to elevate the mood of the patient, without which, no further psychological treatment can be administered.

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