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Koro Syndrome: The Irrational Fear of Lethal Genital Shrinkage

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Koro Syndrome is mostly found in China, Japan, and India. It's the obsessive fear that the genitals are shrinking, or retracting into the body, and that when they finally do disappear, you will die. How does a doctor even begin to treat such a syndrome? Take a look at a very strange, and specific, delusion.

Koro goes by many names because it spans several cultures with different languages. It's thought that the term "koro" comes from Malay, and refers to a turtle's head as it retreats into the shell. Considering that koro syndrome is the belief that the genitals — usually the penis but in women's case, the nipples — are retreating into the body, the metaphor is apt, but disturbingly vivid. Since it's purely a psychological disorder, the main dangers of koro are health problems caused by anxiety, and the occasional practice of either asking other people to take hold of the genitals and pull them back out, or trying to pull them back out of the body oneself.


Koro is mainly seen in young Asian men who are ignorant about physiological puberty and who have heard of the syndrome as an physical disorder, and not a psychological one. Occasionally there are parents who diagnose the fictitious disorder in their children, or spouses who see it in each other. As the fear mounts, sufferers become convinced that this is either an omen or a cause of their imminent death. Time doesn't always alleviate this disorder. One sufferer was 41 before he sought treatment specifically for koro, and had spent fifteen years tying a string around his penis and attaching the string to a hook above his bed at night in order to keep it from shrinking.

What's most noted about koro is the fact that it is almost exclusively found in east Asian countries. Scientists don't know whether this is due to some intrinsic cultural tendency towards a specific type of worry, or whether the syndrome started as a rumor or legend that's being taken literally as more people talk about it. Some doctors have noted that, since koro has become more widely known to western countries, there have been sporadic cases in the west. These cases tend to be associated with other psychological illnesses, though, while koro in Asia is often seen in otherwise perfectly healthy people.


Most studies note that the major and most damaging symptom of koro is fear. It's fear that keeps people thinking about it, fear that can distort their view of their own genitals, and fear that causes them to take extreme measures to "pull the penis back out" of their body, which has been known to cause injury and death. The usual treatment is either anti-anxiety or anti-psychotic medication, to help the sufferer regain an objective view.


Via The German Journal of Psychiatry, NCBI, and BMJ.