Body-image Pathology: Koro, the shrinking-penis syndrome in transcultural sexology

Abstract

Nineteen years after he had first been known in the clinic as the father of a boy with hypopituitarism, a man requested an appointment for his own problem of penis shrinkage. In a state of confusional panic, he hoped that the same hormonal treatment that pubertalised his son would regenerate his penis in size and potency. He obtained what he termed emotional relief, for which he was profoundly grateful, even though the primary symptoms of premature somatic deteriorative disability did not improve. In this case the shrinking penis syndrome, otherwise known as koro, may be conceptualised as having not a primary etiological origin, but rather a derivative origin as a body-image pathology secondary to a primary disease, of which multiple sclerosis might be an example, that affects, if not wholly, then in part, the erotic functioning of the genitalia. With brief clinical intervention, the patient experienced what he defined as “a big emotional improvement”, despite the persistence of the various somatic impairments that preceded the penis-shrinkage conviction which, itself, disappeared.