Missing Penis or Shrinkage? What to know about Koro syndrome

In recent times, the reported cases of alleged disappearance of manhood across the country have led to panic attacks concerning fear of loss of potency and virility in men.

On Friday, the Federal Capital Territory Police Command revealed that about 62 cases of alleged disappearance of manhood have been reported across the territory.

Oftentimes, it is believed that the disappearance of manhood is stolen for ritual purposes. However, the problem might just be due to a health condition called Koro syndrome.

 

What is Koro Syndrome?

Koro Syndrome, according to a study published in the National Library of Medicine, is a multi-tiered disease presenting as an overwhelming belief that one’s sex organs are shrinking into the body.

The study titled, ‘Koro Syndrome: Epidemiology, Psychiatric and Physical Risk Factors, Clinical Presentation, Diagnosis, and Treatment Options,’ disclosed that moderate to severe anxiety attacks are associated with the condition, along with a fear of imminent death.

 

The study led by Yukino Strong of the School of Medicine Medical College of Wisconsin stated that the condition typically affects young males who believe in sex-related myths, and many individuals can co-present with anxiety, depression, or even psychosis.

Strong and co-authors said though most presentations of Koro are self-limiting, the condition is harmful to one’s self-esteem and quality of life, and some individuals may go through extreme, physically injurious measures to prevent genital retraction.

 

The study authors explained that, for men, there is a fear of the penis shrinking into the abdomen, and for women, there is a fear of the vulva and breasts shrinking into the abdomen and chest—all followed by impending death.

The Medical Director and Psychiatrist-in-Chief at Pinnacle Medical Services, Dr Maymunah Kadiri, described Koro Syndrome, also known as the shrinking penis syndrome, as a rare mental health disorder that has intrigued and puzzled medical professionals 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 wrote on her Facebook page.

According to her, it is not a spiritual attack or witchcraft, but it has a treatment.

 

Another study published in the NLM said Koro Syndrome is a psychiatric disorder characterised by acute anxiety and a deep-seated fear of shrinkage of the penis and its ultimate retraction into the abdomen, which will cause death.

The study titled, ‘The koro (genital retraction) syndrome and its association with infertility: a case report,’ noted that the concurrence of the koro (genital retraction) syndrome with a pathological condition of the urogenital system has rarely been described.

 

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.” the first study authors noted.

The physical risk factors and comorbidities for Koro syndrome usually involve dysfunction of the genitals or the urogenital system, according to them.

“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 noted.

 

Clinical presentation, diagnosis

Continuing, the experts said Koro syndrome is characterised by a person’s acute anxiety attacks due to their overwhelming belief that their sex organs are retracting and disappearing into their body and that this retraction is fatal, despite the lack of actual physical changes to these organs.

“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

The treatment and management involve a mixture of medical, psychological, and social interventions.

“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 stated.

 

Lara Adejoro

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