UNDERSTANDING PENILE RETRACTION: CAUSES, NERVES, AND WHAT YOU CAN DO ABOUT IT
Penile retraction, sometimes referred to as penile shrinkage, is a topic that rarely gets much attention unless it’s the punchline of a sitcom. But for many, it’s a real concern that can affect body confidence, intimacy, and overall well-being. So let’s get straight to it: what exactly is penile retraction, why does it happen, and what can you do about it?
What Is Penile Retraction?
Penile retraction is when the penis appears shorter or “pulled in” toward the body. This is often temporary and can happen in response to various factors including cold temperatures, anxiety, stress, pain, physical exertion, or even medications. For some people, it’s just a normal fluctuation in anatomy. For others, it can feel distressing, especially if it seems to be happening frequently or is linked to discomfort or dysfunction.
The Role of the Dartos Fascia
A key player in penile retraction is the dartos fascia. This is a layer of smooth muscle and connective tissue that wraps around the penis and scrotum. It is part of your autonomic nervous system, the same system responsible for controlling involuntary bodily functions like heart rate, digestion, and blood vessel constriction.
When your body goes into fight or flight mode, the dartos fascia contracts, pulling the penis inward. This reflex is a protective mechanism. Smooth muscle, like that found in the dartos fascia, also lines blood vessels and responds to signals from your nervous system to either dilate or constrict. So when your nervous system is activated by stress, anxiety, cold, or pain, the dartos reacts by contracting.
Nerve Pathways That Influence Retraction
Several nerves are involved in this reflexive response. The ilioinguinal and genitofemoral nerves, along with branches of the pudendal nerve (specifically the posterior scrotal nerves), provide sensation and motor input to the dartos fascia and surrounding tissues. These same nerves also connect to the pelvic floor muscles, making the reflex a coordinated response between your pelvic floor, genitals, and nervous system.
The cremaster muscle also plays a role here. It wraps around the spermatic cord and lifts the testicles in response to cold or stimulation. Like the dartos, it is part of the same neural pathway and often acts in tandem during penile retraction.
What About the Bulbospongiosus Muscle?
Some people think that the bulbospongiosus muscle causes shrinkage. This muscle wraps around the base and part of the shaft of the penis, but its main job is to assist with ejaculation and support erectile function by compressing the erectile tissues. It does not contribute to the actual pulling in or shortening of the penis.
Other Contributing Factors
There are a few additional reasons why the penis might appear smaller or retract. One is body composition. Extra fat around the lower abdomen and pubic area can cause the penis to look shorter than it really is. This does not mean the penis is physically shrinking, it just may be less visible.
Pelvic floor muscle tension or guarding can also play a role. If the muscles in your pelvic floor are habitually tight or overactive, they can contribute to a hyperactive retraction reflex. Pain, whether from chronic conditions or acute injuries, can activate the nervous system and lead to the same response.
Certain medications can also affect blood flow to the penis. Amphetamines, commonly prescribed for ADHD, can cause blood vessels to constrict. Since erections and penile fullness rely entirely on good blood flow, restricted circulation can make the penis appear smaller. Everyone responds differently to medications based on dosage, frequency, and individual sensitivity. Always consult your healthcare provider before changing or stopping any prescribed medication.
Penile Retraction After Prostate Cancer Treatment
Men who have undergone treatment for prostate cancer may experience more persistent penile shortening or retraction. Procedures like radical prostatectomy, radiation therapy, or androgen deprivation therapy can affect the surrounding nerves, blood vessels, and tissues. This may result in scarring, reduced elasticity, or loss of blood flow, all of which can contribute to changes in penile length and function.
These treatments are often life-saving, but the long-term impacts on sexual health and body image are often overlooked during recovery.
What Can You Do About It?
Managing penile retraction starts with calming the nervous system. High stress levels, overstimulation, and poor recovery from daily demands can keep the body in a chronic fight or flight state. Here are some practical steps you can take:
Reduce Nervous System Overload
Cut back on stimulants like caffeine and prioritize rest and recovery. Consider adding a daily mindfulness or meditation practice. These practices can help lower the reactivity of your nervous system, relax pelvic floor muscles, and improve blood flow to the penis.
Practice Mindful Movement
Gentle exercises focused on pelvic floor relaxation and mobility can reduce muscle tension and support better genital blood flow. If you’re unsure where to start, search for routines that include stretches for the hips, abdomen, and pelvis.
Try Manual and Mechanical Stretching
Gentle stretching of the penile tissue can help maintain mobility and reduce the tendency for retraction. Using a penis pump daily encourages blood flow and tissue length. Penis sleeves and traction devices offer longer-term stretching support and can help reduce discomfort during daily activities. Check out this video for 6 Essential Stretches
Apply Heat
Warmth helps relax tissue and improve circulation. A warm pack over the pubic or perineal region can be helpful, especially if cold is a trigger for your retraction.
Consider Supplements or Medications
Talk to your healthcare provider about whether a low daily dose of tadalafil may support penile blood flow. Nutritional supplements like L-arginine may also help by increasing nitric oxide levels, which support vascular health.
Consider Other Treatments
Subcutaneous Botox injections in the penis are still experimental, but they are being explored as a treatment for persistent penile retraction or tension. Talk with your provider about risks, benefits, and whether this could be an option for you.
Penile retraction is common and usually not harmful, but that doesn’t mean it should be ignored. If it’s affecting your confidence or interfering with intimacy or function, there are tools and strategies that can help. Understanding how your body works, calming your nervous system, and addressing the contributing factors can go a long way in supporting your penis health.
This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.
