Urologist, Dr. Landon Trost, joins the Erectile Dysfunction Radio Podcast this week talking about penile length, erections, and medical conditions that impact your penile health.
The Male Fertility and Peyronie's Clinic was founded in July of 2019 by Dr. Landon Trost in Orem, Utah. Dr. Trost had previously served as the head of male infertility and Peyronie's Disease at the Mayo Clinic in Rochester, Minnesota. More about his clinic: https://malefertilityandpeyroniesclin...
The clinic specializes only in male infertility and Peyronie's Disease, which allows for a high level of specialization for these conditions.
Dr. Trost is the inventor of RestoreX. Penile traction therapy is used to treat penile curvature and length loss. Learn more about it here: https://www.restorex.com/
Expert Insights on Penis Size, Perception, and Solutions: A Conversation with Dr. Landon Trost
Dr. Landon Trost, a board-certified urologist specializing in male fertility and Peyronie’s disease, offers clarity on one of men’s most anxiety-provoking topics: penis size and erection length. Drawing on years of clinical experience and research, Dr. Trost addresses common misconceptions, measurement methods, medical conditions affecting length, and evidence-based options for those seeking change.
What Is Considered Normal Penis Size?
Defining “normal” penis size is less straightforward than many assume. Dr. Trost explains that average erect length is typically around 5 to 5.1 inches, with the 5th and 95th percentiles ranging from about 3 to 6 inches. However, these numbers can vary depending on how measurements are taken. In medical settings, the “stretched length” is often used as a surrogate for erect length: the penis is stretched out, and the measurement is taken from the pubic bone to the tip. This method accounts for the suprapubic fat pad, which can obscure true length, especially in men with higher body fat or age-related changes. Regional and ethnic differences also play a role in what is considered average[1].
Girth is even trickier to measure reliably, but a general rule is that average penile girth is about half an inch less than the length—typically around 4.5 inches. Scientific studies often avoid reporting girth due to variability in erection quality and measurement technique[1].
Buried Penis vs. Micropenis: Understanding the Terms
Buried penis refers to a condition, often related to severe obesity, where the penis becomes enveloped by surrounding tissue and skin, sometimes leading to hygiene issues, infections, or pain. Severity varies, but the underlying problem is usually excess fat or scarring in the pubic area.
Micropenis is a rare, pediatric diagnosis, defined by an adult stretched penile length of about one to one-and-a-half inches, not caused by fat or scarring but by hormonal or developmental issues. True micropenis is extremely uncommon in adults and is often misapplied as a term in online discussions[1].
How Common Is a Problematically Small Penis?
Dr. Trost notes that less than 5% of men have a penis size that would warrant medical intervention. Most concerns are rooted in perception, comparison to previous size, or partner comments rather than objective deficiency. The distress is often psychological, stemming from anxiety, negative partner feedback, or perceived loss over time due to aging or medical conditions.
Causes of Perceived and Actual Loss of Length
Perceived loss: Most commonly due to obesity, where the fat pad obscures visible length, though the actual length remains unchanged.
Actual loss: Conditions like diabetes (which causes tissue scarring and reduced elasticity) and Peyronie’s disease (which can cause dramatic loss of one to three inches) are leading causes. Post-prostatectomy patients often report perceived loss, but objective measurements usually show no change. Rare causes include recurrent priapism or scarring from self-injection.
Does Size Really Matter?
Functionally, most men within the 95th percentile have no issues with sexual activity. In long-term relationships, penis size is rarely a concern and, in some cases, greater length can cause discomfort (e.g., hitting the cervix during intercourse). Girth tends to be more important for partner satisfaction in heterosexual couples, while length, girth, and rigidity all play roles in *** couples. Younger men and those with multiple partners may experience more anxiety due to direct comparisons and social pressures[1].
Penile Lengthening: What Works and What Doesn’t
Surgical options: Generally discouraged due to high complication rates and reserved for extreme cases (e.g., concurrent penile implant surgery).
Traction devices: The only non-surgical method with consistent evidence. These devices gently stretch the penis, typically resulting in about a one-inch increase in length over three months, with diminishing returns thereafter. The process is gradual, and further gains are possible with continued use, but at a slower rate. The effectiveness is proportional—men with longer starting lengths may see greater absolute gains[1].
> “Most studies would say after about three months of use you gain about an inch and then any ongoing use of traction beyond that will be maybe a quarter inch or something.” — Dr. Landon Trost
Who Benefits from Traction Devices?
Studies show high satisfaction among men with conditions like Peyronie’s disease or post-prostatectomy, with 85% or more reporting they would use the device again. Gains typically represent about a 10% increase over baseline length. There is little data on men without disease who simply want to lengthen their penis, but Dr. Trost suggests those without significant scarring may achieve even better results. Importantly, there are no significant safety concerns reported with traction use in these studies[1].
Distinguishing Between Physical and Psychological Concerns
Dr. Trost emphasizes the importance of distinguishing between true anatomical issues and psychological distress (body dysmorphia). Men who have always had the same size but become distressed are more likely to benefit from psychological support, while those who have lost length due to disease or injury may benefit from medical intervention. True body dysmorphia is marked by a lack of insight and persistent preoccupation despite objective normalcy[1].
Key Takeaways
Most men who worry about penis size are within the normal range and do not require intervention.
Measurement methods matter—a proper stretch measurement is more accurate than visual estimation.
Traction devices are the only proven non-surgical method for lengthening, with typical gains of about an inch.
Psychological factors play a major role in distress about size; support and counseling may be appropriate for those without objective deficiency.
Men with disease-related loss of length may benefit most from medical therapies, but even they should have realistic expectations.
Dr. Trost’s insights provide reassurance and evidence-based guidance for men concerned about penis size, emphasizing that most worries are unfounded and that safe, effective options exist for those who genuinely need them[1].
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