Koro syndrome

What if you woke up one morning and began to feel like your genital is retracting into your body and there is nothing you or anyone else can do to stop it? While that might sound so unreal, this is the reality some people have had to live with.

The only difference is that you imagine it, and they feel it is actually happening to them. In history, there have been several rare medical and psychological condition.

Some you might have heard of, some you are yet to heard or read about, and others you might never get to know about because of their rarity. Koro syndrome is one of those rare psychological conditions.

What is Koro syndrome?

People often mistake the Koro syndrome for the Kuru virus (laughing death disease), but they are both different things that are unrelated in any way.

The Koro syndrome involves a spurious feeling that some human body parts like the penis, breasts, or vulva are retracting into the body. The word koro originates from a Malaysia and is a word associated with the retraction of the head of a turtle.

History of Koro syndrome

Koro is believed to be a culture-bound syndrome which is characterized by the fear that a vital body part is retracting into the body and will cause death eventually. Most of the ancient literature that documented cases of Koro are related to old Chinese ethnic group.

While Koro is a Malaysian word, the Chinese call it Shuk yang. An example of koro documentation in Chinese history can be found in the old medicine book titled the New collection of remedies of value which was published during the Qing dynasty.

The ancient Chinese medical literature described the koro syndrome as “Yin type of cold qi invasion” that is characterised by a sudden seizure during coitus with the penis running back into the abdomen. The book claimed that a patient of Koro syndrome would die if not treated with “heaty” medication in time.

The claims made in the New collection of remedies of value can be linked to Chinese cultural beliefs and the power of imagination as penis or vulva shrinkage is not medically possible. In Chinese folklore, there is a story about a  certain fox spirit that can wake people up physically and sexually and then shrink their tissues.

Also in traditional Chinese medicine, frequent ejaculation is deadly because it is believed that semen is related to the vital energies of a man and when it is depleted, it can cause illness and death. Also, the yin and yang theory suggests that when there is an unbalanced loss of the yang humour, there is a result of genital shrinkage.

Causes of Koro syndrome

Different factors have been linked pointed as the cause of the Koro syndrome. These factors include Psychosexual conflict, cultural beliefs, Personality factors, premorbid sex inadequacies, impotence, guilt over masturbation, and sexual promiscuity.


One of the common symptoms is anxiety attacks as a result of fear that one is experiencing genital retraction or shrinkage even though there are no visible biological longstanding changes in the genitals.

The only noticeable differences are usually restricted to the decrease that occurs on some parts of the genitals when it comes in contact with cold temperature, and that is very normal.

When victims notice this shrinkage when they come in contact with cold temperature, they begin to panic and imagine that the condition is irreversible. Symptoms can last between two hours to two days, but in cases of chronic koro syndrome, symptoms continue for years.

Chronic cases are linked to body dysmorphic disorder. Asides retraction, other koro symptoms include a perception of loss in penile muscle tone, an alteration in the shape of the penis.

Other thoughts a koro patient might have if they do not perceive retraction include a perception of genital shortening or genital paraesthesia. For ladies with koro syndrome, they fear that the nipples will completely retract into the breasts.

The psychological effect of the koro syndrome is the fear of impending death, fear that a victim is changing into a eunuch, the fear of sexual inactivity and powerlessness, and sometimes the fear of gender change.


Koro is easily diagnosed. The primary criteria for the determination of Koro syndrome in the complaint of genital shrinkage by a patient even though there are no visible physical changes.

Another measure is anxiety and fear of death due to the perceived genital reduction. Other patients who do not exhibit the all required symptoms are said to have koro-like symptoms.


In historical culture-bound cases, patients are reassured and are given talks on sexual anatomy. Patients are also given psychotherapy according to the symptoms they manifest.

However, the prognosis has proven to be better in cases where the victim had a previously functional personality, a short history with a low frequency of anxiety attacks, and also a relatively uncomplicated sexual life.

In situations of sporadic western cases of koro, careful diagnostic workup that includes searching for underlying sexual conflict is common. However, the choice of psychotherapeutic treatment is usually based on the psychiatric pathology discovered.

Other indigenous ancient Chinese treatment includes praying for victim, beating gongs to chase away the fox spirit or flogging out the fox spirit, an augmentation of either the yin or yang using potions and foods for therapy.