Koro syndrome: What to know about genital shrinkage

Recent reports of suspected disappearances of manhood across the country have sparked alarm among men who are afraid of losing their potency and virility.

The Federal Capital Territory Police Command said on Friday that 62 cases of alleged male disappearance had been recorded around the region.

It is frequently assumed that the absence of manhood is for ritual purposes. However, the issue could be attributed to a medical condition known as Koro syndrome.

What is Koro Syndrome?

According to a study published in the National Library of Medicine, Koro syndrome is a multi-tiered condition that manifests as an overwhelming belief that one’s sexual organs are retreating inside the body.

The study, identified as ‘Koro Syndrome: Epidemiology, Psychiatric and Physical Risk Factors, Clinical Presentation, Diagnosis, and Treatment Options,’ revealed that the illness is connected with moderate to severe anxiety attacks as well as a dread of impending death.

According to Yukino Strong of the Medical College of Wisconsin’s School of Medicine, the disease primarily affects young boys who believe in sex-related myths, and many people can present with anxiety, sadness, or even psychosis.

According to Strong and co-authors, while most cases of Koro are self-limiting, the condition is detrimental to one’s self-esteem and quality of life, and some people may resort to drastic, physically damaging tactics to avoid genital retraction.

According to the study’s authors, men fear their penis shrinking into their abdomen, while women fear their vulva and breasts shrinking into their abdomen and chest—all of which is followed by impending death.

Dr. Maymunah Kadiri, Medical Director and Chief Psychiatrist at Pinnacle Medical Services, defined the Koro condition, also known as the shrinking penis condition, as a rare mental health disorder that has captivated and perplexed medical experts and researchers for centuries.

“It often manifests during times of heightened stress, anxiety, or social unrest within these communities. Individuals experiencing significant life changes, relationship issues, or societal pressures may be more susceptible to developing this syndrome.

“The fear of genital retraction can become a symbolic representation of their anxieties, magnified and distorted within the confines of their cultural beliefs,” She stated this on her Facebook page.

It is not a spiritual attack or witchcraft, she claims, but it may be treated.

According to another study published in the NLM, Koro syndrome is a psychological disease characterized by acute anxiety and a deep-seated fear of penis shrinkage and eventual retraction into the abdomen, which will result in death.

The study, titled ‘The Koro (genital retraction) syndrome and its association with infertility: a case report,’ stated that the association of the Koro (genital retraction) syndrome with a pathological condition of the urogenital system is uncommon.

Risk factors

“Although the pathogenesis of Koro is unclear, it is known that education, age, gender, and marital status are considered risk factors. Notably, Koro epidemics can occur through the proliferation of fears, opinions, and rumours through news and media, and the clinical course (lasting from days to months) is usually self-limiting.” according to the first study’s authors.

Physical risk factors and comorbidities for Koro syndrome, according to them, typically entail genital or urogenital dysfunction.

“Infertility, a tumour of the corpus callosum, and urethrocutaneous fistula all lead to secondary Koro syndrome in males. Genital pain was also associated with fear of genital retraction in a patient who was diagnosed with anxiety disorder and Koro syndrome,” they stated.

Clinical presentation, diagnosis

According to the specialists, Koro syndrome is characterized by a person’s acute anxiety episodes caused by their overpowering feeling that their sex organs are retracting and disappearing into their body and that this retraction is fatal, despite the fact that no physical alterations to these organs have occurred.

“Individual episodes of these anxiety attacks usually last several hours but can persist for as long as two days. Chronic sufferers of Koro can experience these episodes for decades. There have been reports of Koro patients simultaneously experiencing psychotic depression, and Koro symptoms are highly likely to lower patients’ self-esteem and overall mental well-being.

“Diagnosis of Koro consists of both psychological evaluation and physical examination of the genital organs, the latter of which is used to rule out physical disorders such as hypospadias or measurable, sustained genital retraction. The major diagnostic criteria are patients’ report of genital (i.e. penis) retraction despite objective evidence, subsequent fear and anxiety, and physical attempts to prevent or reverse the retraction,” they said.

Management and Treatment

Medical, psychological, and social interventions are used in therapy and management.

“Anxiolytics, antidepressants, sedatives, or antipsychotics are prescribed based on patients’ co-presenting psychiatric conditions if applicable because improvement in these psychiatric conditions is often associated with dissolution of Koro symptoms,” they noted.