Does Penile Girth Change With Age?

The 2025 EAU Guidelines on Sexual and Reproductive Health acknowledge that age is a significant risk factor associated with changes in penile structure and function¹. While the guidelines don’t specifically quantify normal age-related changes in penile girth, they recognize that various physiological processes can affect penile dimensions over time. A recent study cited in the guidelines demonstrated that reducing the depth of penetration led to a statistically significant 18% reduction of overall sexual pleasure with an average 15% reduction in length of the penis, highlighting the importance of penile dimensions in sexual satisfaction². According to the guidelines, age-related vascular changes, including reduced blood flow and tissue elasticity, can contribute to decreased erectile function and potentially affect penile girth³. Additionally, hormonal changes, particularly declining testosterone levels associated with aging, may influence penile tissue composition and size⁴. The guidelines note that 45% of men report they would like to have a larger penis, indicating widespread concern about penile dimensions regardless of age⁵.

For men experiencing significant erectile dysfunction with age, the guidelines discuss several types of penile implants that can restore both function and girth⁶. These include inflatable (two-piece and three-piece) and malleable (semi-rigid) implants. The three-piece inflatable implant consists of a pair of cylinders implanted in the corpora cavernosa, a pump placed in the scrotum, and a reservoir containing fluid placed in the retropubic space⁷. This type provides the most natural erection with significant control over both rigidity and girth⁸.

The guidelines emphasize that patient satisfaction rates with penile implants are high, ranging from 87% to 93.8% for patients and 86% to 91% for partners⁹. These satisfaction rates are related to both functional outcomes and cosmetic results, including girth restoration. However, the guidelines caution that proper patient selection and counseling are essential, as some men with body dysmorphic disorder focused on penile size may not benefit from such procedures¹⁰. For men concerned about age-related changes in penile girth without erectile dysfunction, the guidelines recommend addressing modifiable risk factors that may contribute to vascular health, including smoking cessation, regular physical exercise, and management of conditions like diabetes and hypertension¹¹. The guidelines also note that certain medications for cardiovascular disease may have a detrimental effect on erectile function and potentially penile dimensions, whereas newer drugs have exhibited a neutral or even beneficial effect¹². It’s important to understand that the subjective impression of penile size may have a negative effect on sexual functioning and quality of life, impacting sexual life in about 10% of men¹³. This prevalence sharply rises in patients seeking penile augmentation procedures¹⁴. The guidelines emphasize that clinicians should be adept at distinguishing between normal age-related changes, pathological conditions requiring intervention, and psychological concerns that might benefit from counseling rather than surgical approaches¹⁵.