Coping WIth Koro or the Fear of Genital Retraction

Concerned looking man

Experienced Skins/Getty Images 

Koro is the fear of the genitals shrinking and retracting into the body. Koro is sometimes referred to as genital retraction syndrome. Cases of this fear have been reported around the world in Asia, Africa, Europe, and the U.S. Females occasionally suffer from a variation of koro in which they believe that their nipples are retracting. Interestingly, koro often appears as an epidemic in which multiple cases are reported simultaneously within a specific geographic area.

Symptoms

First identified in ancient China, koro almost always follows an identical pattern. The sufferer first experiences a tingling sensation in the genitals, followed by a rapid-onset panic attack. This quickly leads to a sudden and pervasive fear that the genitals are disappearing. In Asia, this fear is almost always accompanied by an imminent fear of death, although this element is often missing from reports in other parts of the world. The sufferer normally asks friends or relatives to physically manipulate his genitals to stop them from retracting, which sometimes leads to injury. The anxiety subsides quickly when a culturally acceptable treatment is used, from exorcism to potions.

Causes

Koro has been described as a panic disorder that centers around the genitals. It appears to be heavily influenced by cultural beliefs, which might explain why epidemics are common. For example, in some West African outbreaks, the sufferers believed that, rather than retracting into their bodies, their genitals were being stolen for occult reasons. During the "Burning Times" of medieval Europe, witches were held responsible for genital retractions in the local population. The symptoms subsided when the witches were appeased.

Personal and cultural morals, religious doctrine and current mental health status often play a role in individual cases. A 2008 study in the Journal of German Psychology found that many sufferers reported a recent sexual encounter that made them uncomfortable, such as an extramarital affair. Some had a history of preoccupation with their genitals. Some reported high levels of fear, guilt or shame. Others were immature and lacked sexual confidence. Still, others had an existing mental health disorder or a history of substance abuse. Although the specifics vary for each case, it appears that the highest risk for koro exists in people who are already experiencing fear, anxiety, or guilt.

Treatments

Indigenous treatments for koro vary dramatically and are often influenced by current events. For example, an outbreak might be blamed on an invading force or an individual rival. Defeating the foe is sometimes the recommended treatment in these situations. In other cases, indigenous treatment might include an exorcism, rest, herbal treatments, or other healing practices.

In the Western world, Koro is often treated as a specific phobia. Antidepressant medications are often prescribed. Some research shows that antipsychotics are sometimes helpful in reducing symptoms. If you're suffering from koro, talk therapy may help you learn new and healthier ways of relating to your body.

Because it's common for people with this fear to have other conditions, Western mental health professionals often perform a full workup to determine exactly which factors are in play. In many cases, treating the underlying condition also causes the koro symptoms to subside.

It's also important to rule out physical causes for the koro symptoms. Pain, tingling and other physical symptoms are common in koro but could also indicate an underlying physiological condition. It's a good idea to visit the urologist if you're experiencing these symptoms.

Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • Garlipp, P. "Koro - a Culture-Bound Phenomenon: Intercultural Psychiatric Implications." German Journal of Psychiatry.

By Lisa Fritscher
Lisa Fritscher is a freelance writer and editor with a deep interest in phobias and other mental health topics.