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Koro is a fear of the genitals or breasts retracting into the body. Also known as genital retraction syndrome, this irrational distress is seen more commonly in East and Southeast Asia—China, Malaysia, India, Singapore, and Thailand—as well as other regions such as Africa. This acute anxiety is influenced by culture and traditional beliefs. "Koro" is originally a Malay word that means head of turtle; "keruk," which means to shrink. Koro syndrome was added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and listed as an other specified obsessive-compulsive and related disorder. It is also listed in the International Classification of Diseases.
While the human genitals naturally retract in cold temperatures or weight gain, Koro is an irrational fear. People who suffer feel a loss of sexuality and life, and that the problem is fatal. Koro can come about if a person feels guilt over sexual activity or even shame about masturbation. Koro affects more men than women. To alleviate their symptoms, men may try to secure the penis with a string or other device, while women may stick pins into their breasts.
The age range of individuals who suffer is wide, from adolescence to adulthood. It may be more common among younger people because of the onset of hormones and changes in the body during this period in life.
Co-occurring conditions can include severe anxiety, the fear of death, depression, body dysmorphia, and psychosis, among others. The person also generally has low self-regard and a poor quality of life.
The person who has Koro may worry about becoming sterile, turning into a eunuch, or even turning into a woman. The individual may feel they are cursed or possessed by spirits.
Koro is similar to body dysmorphic disorder. BDD is related to obsessive compulsiveness, and a person who suffers from this has an intense preoccupation with flaws in appearance, including body shape, facial features, skin, hair, and genitals, among others.
Men who suffer from Peyronie's disease have fibrous scar tissue under the skin of the penis, which causes it to curve and bend. Erections may be shorter as well as painful. Peyronie's is not related but it can co-occur with Koro.
Taijin kyofusho is found in Japan and Korea. Koro syndrome is not the same as taijin kyofusho, which is a fear that parts of their body or body functions are embarrassing, offensive, or otherwise displeasing to other people.
Also seen in South Asia, dhat is anxiety about the alleged loss of semen in urine. These men feel weak, fatigued, sexual dysfunction, listless, and sleepless, among other symptoms. The Indian doctor Narendra Wig coined the term in the 1960s. Dhat may have some cultural connection with Hinduism. Ancient Ayurvedic texts say that one drop of semen is formed from 40 drops of bone marrow.
Psychotherapy can be effective. However, it’s important that the individual be open to such treatment. Koro is a culture-specific syndrome, and people who suffer from it may hold strong beliefs—for example, that sexuality is shameful, and this may make it more difficult to treat.
If the person suffers underlying and primary disorders—for example, psychosis or depression—treatment through antidepressants or anti-psychotics will also help relieve the symptoms of Koro.
