Koro: Cultural Taboos, Psychological Factors, and Clinical Insights

Introduction:

Psychiatric conditions are characterized by clinically significant impairments in a person's behavior, emotional regulation, or cognition. It is usually associated with distress or dysfunction in key areas of function. There are various types of mental disorders. Mental disorders are also called mental illnesses. Mental illness is a broader term that involves psychosocial disorders, psychiatric disorders, and psychiatric conditions associated with functional impairment, significant distress, or risk of self-harm.

What Is Koro or Genital Retraction Syndrome?

Koro syndrome is a psychiatric disorder typically characterized by acute and intense anxiety. Men complain of contractions of the penis or fear of dying as the penis is pulled into the abdomen. Originally, the syndrome was described as a culture-specific disorder. Recently, there have been sporadic cases in Europe and the United States called Koro-like syndrome. They are likely to get psychiatric or neurological disorders. Women also suffer from some variation of this condition. In the case of women, they believe their nipples are being retracted. The word is borrowed from Malay, which means the head of a turtle (or tortoise) and refers to what the head looks like when pulled back into its shell. Koro syndrome is also known as genital retraction syndrome.

What Are the Causes of Koro?

Acute anxiety and fear of genital recession leading to death represent Koro syndrome. The main causes of this mental disorder fall into the following categories.

1. Cultural Factor:

• Restrictive social norms about one's body and sexuality.

• Cultural norms and expectations of penis size.

• Possession belief.

2. Psychological Factors:

• Feeling guilty about masturbation and impotence.

• Multiple sexual partners.

• Premorbid impotence.

3. Biological Factors:

• Psychosocial conflict.

• Personality factors.

What Are the Risk Factors for Koro?

Physical Risk Factors: Physical risk factors are listed below:

• Involve genital or genitourinary dysfunction.

• Infertility.

• Corpus callosum tumors.

• Urethrocutaneous fistulas.

• Genital pain.

• Cannabis and alcohol-induced hepatitis.

Psychiatric Risk Factors:

• Anxiety.

• Cultural attitudes and beliefs.

• Feelings of inadequate masculinity.

• Schizophrenia.

• Obsessive-compulsive disorder.

• Major depression.

• Mild cognitive impairment due to Alzheimer’s disease.

• Neuropsychiatric disorder.

What Are the Symptoms of Koro?

The signs that a person may have Koro are listed below:

• Patients first feel a tingling sensation in their genitals.

• Rapid onset of panic attacks.

• Sudden, ever-present fear that the genitals will disappear.

• Fear of imminent death.

• Physically manipulating the penis to prevent it from withdrawing and sometimes getting hurt.

When to Get Help for Koro?

A person should get a professional medical checkup if they have the following symptoms:

• Acute perception of penile contractions.

• A tingling sensation in and around the genitals.

• Fear of imminent danger, including death.

• Prevents retraction by pulling the penis by mechanical means.

• History of genital obsession.

• Feelings of fear, anxiety, or guilt about the size of the genitals.

• A panic-like reaction to seeing or touching the genitals.

• Measuring the penis frequently and pulling to make it bigger.

• Physical sensations such as pain and tingling.

Koro syndrome can also be a symptom of another related medical problem. It is important to rule out the physical reasons for the symptoms. Pain, tingling sensation, and other physical symptoms are common with Koro syndrome, but it may also indicate an underlying physiological condition. If someone notices these symptoms, they should see a urologist for a comprehensive examination.

How Is Koro Diagnosed?

For diagnosis of Koro syndrome, the following options are present:

• Physical Examination - Physicians rule out any physical conditions that may result in the symptoms.

• Laboratory Test - This may involve screening for alcohol and drugs and checking the thyroid function.

• Psychological Evaluation - The doctor or psychotherapist will talk to the patient about their symptoms, thoughts, feelings, and behavior patterns. To answer these questions, the patient may be asked to complete a survey.

What Are the Management Options of Koro?

Psychiatrists in the West usually treat Koro syndrome as a phobia. However, a standard treatment for Koro syndrome usually addresses the underlying psychological problem that causes anxiety. Management of anxiety disorders includes medication and therapy. Additionally, talking to a psychologist about therapy for issues related to sexual expectations can help develop a positive attitude about one's body. The therapist will also analyze possible cultural causes of Koro when developing a treatment plan.

What Are the Complications of Koro?

Individuals with extreme anxiety related to the Koro syndrome can resort to physical methods to prevent what is considered a penile recession. These individuals can perform mechanical penile traction or fixation. Similarly, women can be seen grabbing their breasts, pulling on their nipples, or inserting iron pins into their nipples. These violent attempts often result in injury and sometimes even death.

How to Prevent Koro?

There is no sure way to prevent Koro syndrome. However, if a person has the symptoms, they can control them by taking steps to manage their stress, increase their resilience, and boost their low self-esteem.

• Paying Attention to Warning Signs - Work with the doctor or therapist to find out what might be causing the thoughts of a shrinking penis.

• Get Regular Medical Care - Do not miss a physical examination or skip a visit to the general physician, especially if one is not feeling well.

• Take Steps for Overall Wellness - A healthy diet, adequate sleep, and regular physical activity are important. Try to maintain a regular schedule. If one has trouble sleeping or has questions about diet or physical activity, talk to the doctor.

• Avoid Excessive Masturbation: Excessive masturbation can interfere with a person’s daily life and elevate the risk of mental illness and depressive symptoms.

• Avoid Watching Excessive Porn: Excessive consumption of porn may lead to guilt, depression, and anxiety in individuals.

• Education and Removal of Social Stigma: Education is seen as an important means of overcoming stigma and discrimination through increased awareness and understanding of this condition.

Conclusion:

Koro is the fear of the genitals contracting and retracting into the body. Koro is sometimes called genital recession syndrome. Cases of this psychiatric condition have been reported worldwide in Asia, Africa, Europe, and the United States. Women sometimes suffer from a variation of Koro that they believe causes the nipples to be retracted. Awareness and understanding of this condition are important. Proper psychiatric management may help individuals with this condition lead a healthy and happy life.