When sexual problems are mentioned, from a woman’s perspective the first things that usually come to mind are difficulty with penetration, pain during intercourse, or problems related to orgasm.
When we shift the perspective to men, the most common concerns are erectile dysfunction and premature ejaculation.
But what if none of these problems exist? If the female partner can have intercourse comfortably and can reach orgasm, and the male partner can maintain an erection and ejaculate at the expected time—does that mean everything is truly fine? Is only the result important, and not the process? Let us introduce you to a newer concept: “Lost Penis Syndrome.”
Lost Penis Syndrome refers to a situation in which, due to excessive vaginal widening or decreased muscle tone, the male partner cannot adequately feel the vagina during sexual intercourse. Although its exact frequency is unknown, it is a commonly observed sexual concern among couples. While it may initially present as reduced sensation during intercourse, it can lead to more serious relationship problems over time.
The phrase “I don’t feel anything during intercourse” is something we frequently hear from female patients. It is often followed by: “My husband says he doesn’t feel anything either—he feels as if his penis is in an empty space.” This describes Lost Penis Syndrome well. When expressed by the male partner, it may sound like:
Although initially perceived as a sensation issue, in the long term this condition may lead to significant consequences. Gradually decreasing pleasure, difficulty reaching orgasm and ejaculation, and unsatisfying sexual experiences can reduce sexual desire and frequency of intimacy for both partners.
Problems that begin in sexual life may eventually affect the entire relationship. A healthy and satisfying sexual life is one of the cornerstones of a happy partnership.
Men experiencing Lost Penis Syndrome may develop not only relationship issues but also personal psychological difficulties. The most common is a sense of inadequacy.
Men who believe they cannot provide pleasure or sexual satisfaction to their partner may begin to question their sexual ability or penis size. This feeling can deepen over time and may lead to significant psychological distress. Some men even start seeking penile enlargement procedures for this reason and present to clinics with such concerns.
What are the underlying causes of Lost Penis Syndrome? In the absence of a pathological condition related to penile size, what factors can make the penis feel as though it is “lost” inside the vagina? The most common cause is excessive vaginal widening. This widening is usually associated with vaginal childbirth, and sometimes with pregnancies even if delivery did not occur vaginally.
However, in some cases, significant vaginal relaxation can be seen even in women who have never given birth or even been pregnant. This condition is known as Vaginal Relaxation Syndrome (VRS). In such cases, genetic factors and collagen (connective tissue) structure should be considered.
Another cause may be weakness of the pelvic floor muscles (hypotonicity),which prevents the vagina from adequately gripping the penis during intercourse. In some patients, none of these factors are present. Instead, a frequently overlooked cause is hyperlubrication, meaning excessive vaginal lubrication during intercourse. In these women, much greater-than-normal vaginal wetness occurs with sexual arousal—or sometimes even without it—leading to reduced sensation for both partners.
The most important aspect of treatment is addressing the underlying cause. Treatment is highly individualized, and different approaches may be more suitable for different patients.
In a young patient with no history of pregnancy but genetically weak connective tissue, vaginal laser treatments may provide excellent results. In contrast, for women over 35 who have had multiple vaginal deliveries, vaginal tightening surgery may be the most effective and satisfying option.
For women with pelvic floor muscle weakness, teaching and ensuring regular performance of Kegel exercises can lead to dramatic improvement. Among energy-based treatments, besides various vaginal laser systems, radiofrequency therapies are also available.
As with all sexual dysfunctions, the key in Lost Penis Syndrome cases is understanding the couple’s real underlying problem. Many couples—especially male partners—feel embarrassed to express these complaints openly, which may lead to missing the main factor.
A couple married for two years applied to our clinic from another city. The 26-year-old female patient’s main complaint was that her vagina felt more flexible and wider than normal, leading to reduced pleasure during intercourse.
While preparing her for examination, we also had a one-on-one discussion with her partner. We discovered that he also had multiple sexual concerns and had developed feelings of inadequacy regarding his penis size.
He repeatedly asked what the “normal” penis size should be and described feeling as though his penis was “lost” inside the vagina during intercourse, attributing this to being too small. These thoughts had gradually reduced his sexual desire and pleasure. In reality, his penile size was within normal limits, though convincing him of this was not easy. This was a clear case of Lost Penis Syndrome.
On examination, the female patient had vaginal relaxation. Despite being only 26 years old and having never been pregnant or given birth, she had moderate vaginal widening, attributed to her genetic collagen structure.
She also reported vaginal gas leakage (vaginal flatus) during intercourse, especially in certain positions, which made her feel uncomfortable.
After discussing with the couple, we decided to begin vaginal CO₂ laser treatment. Two sessions were performed at two-month intervals. At a follow-up discussion in the third month, the couple reported significant improvement in their sexual life and increased pleasure for both partners.
The patient noted a noticeable reduction in vaginal gas complaints and increased vaginal sensitivity, making it much easier for her to reach orgasm. The male partner no longer felt his penis was “lost” during intercourse, and his obsessive concerns about penis size had resolved. He now understood that his size was within normal limits.
Assoc. Prof. Süleyman Eserdağ, MDCosmetic Gynecologist & Sexual Therapist
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