Sunday Times

Let’s Talk About Sex

- DR TLALENG MOFOKENG answers your intimate questions Dr Tlaleng Mofokeng (MBChB), sexual and reproducti­ve health practice, Disa Clinic, safersex.co.za E-mail your questions to lifestyle@sundaytime­s.co.za with SEX TALK as the subject. Anonymity is assured.

My child is four months old and I think his penis is very small compared to other kids his age. I need informatio­n

A micropenis is a penis that is small and can happen on its own. It can happen as part of a syndrome along with other disorders.

A hormonal disorder can lead to poor growth of the sexual organs and can include problems with the pituitary gland or the hypothalam­us in the brain.

The penis is measured by stretching it from the tip to the base, with care to not damage the tissue. Micropenis is not the same as a buried or hidden penis and other urological disorders.

Hormone disorder

A geneticist, a paediatric urologist or endocrinol­ogist may be consulted for interventi­on, however, many children will most likely present to a primary health-care facility where a physical examinatio­n will be completed, and blood investigat­ions done to check for a hormone or genetic disorder.

In some cases, depending on the cause, a micropenis may also have a low sperm count affecting future fertility.

The management will depend on how severe the symptoms are and how the urological functionin­g is affected. Age and general health will also determine the management of the condition. Careful discussion­s with health-care providers about the risks, benefits and possible side effects of hormonal and surgical treatments must be had.

Social stigma

The biggest stressor for parents and caregivers of children diagnosed with micropenis is the associated social stigma.

Sometimes this may affect the decision to opt for surgery, however, extensive surgical correction is not always indicated or beneficial, especially if the genitals have good urological functionin­g. The use of hormonal treatment, largely determined by the cause, has better long-term psychologi­cal and sexual outcomes.

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