Archive for September, 2014

Kegel and the Game “Telephone”

September 27, 2014

Andrew Siegel, M.D.

When I was in junior high school (yes, junior high…no such thing as middle school back in those dark ages!) we had parties and played silly games such as “spin the bottle” and “telephone.” In both games a group of us would sit in a circle, and with respect to the more sedate “telephone,” the first person would whisper a few sentences into the ear of the person sitting next to him or her. That person would repeat it to the next person, and so on around the circle. The last person would announce the message they heard. The message that the final person announced was virtually always very different and distorted from the original message, usually in a very funny way. My point is that the final “product” bore little, if any, relationship to the original, with each step in the communication process resulting in increasing adulteration.

And so it is with the exercise program that gynecologist Arnold Kegel popularized 65 years ago, with which the game “telephone” has seemingly been played. What is being bandied about now as Kegel exercises bears little to no resemblance of what Arnold Kegel described so brilliantly in his series of medical articles. As a consequence of this adulteration, current Kegels are often ineffective Kegels. Arnold Kegel died in 1981; if he were alive today to see the distortion and misinterpretation of his legacy, I am certain he would be unpleased.

I have carefully studied all of the medical journal articles that Arnold Kegel crafted in the late 1940s. In these scientific works, he explained his program of pelvic floor exercise that he used successfully on thousands of his female patients. I will happily provide PDF copies of Kegel’s articles to any reader interested in the classic, original, unadulterated works. I have distilled Kegel’s message to the following four principles:

  1. Muscle education with the development of the nerve pathway from brain to pelvic floor muscles.
  2. Feedback to confirm to the exerciser that the proper muscles are being used.
  3. Resistance that challenges the exerciser.
  4. Progressive intensity against resistance so that the exerciser can measure and monitor progress over time as pelvic floor muscle strength increases.

So, in accordance with the seminal work of Arnold Kegel, pelvic floor exercises should incorporate muscle education, biofeedback, resistance, and progressive intensity. Kegel recognized four phases of the process of pelvic floor muscle strengthening: “awareness, transitional, regeneration, and restoration.”

Now here is the problem—if you Google search “Kegel exercises” you will get over one million results, but virtually every exercise “program” that you read about—even those publicized by esteemed medical institutions—are knockoffs and meager dilutions of the rigorous resistive pelvic floor exercise regimen advocated by Arnold Kegel. These current programs require very little time, limited physical effort and most often lack in using the benefit of resistance.

Your search will often uncover a printable pamphlet suggesting a several month program of 10 contractions squeezing against no resistance to be done three times daily while stopped at a red light when driving your car or at other down times. What these current programs share in common is that guidance, training and direction are inadequate with programs lacking the feedback to confirm the engagement of the proper muscles. It is of no surprise that many who undertake these ineffective, bastardized pelvic floor muscle exercises ultimately abandon them as they fail to help the situation at hand. The recommendation of doing these exercises while multitasking is a recipe for certain failure. Properly executed pelvic floor exercises—like physical therapy—demands attention, focus and gravitas.

Exercise physiology has taught us that when it comes to muscle training, doing lots of sets with low resistance develops tone and definition, whereas doing fewer sets with maximum resistance builds strength and bulk. The same physiology can be applied to the hidden pelvic floor muscles. A successful exercise program mandates intensity to be successful as muscle adaptation will not occur unless the muscle is subjected to sufficient stresses and resistance.

Kegel devised the “perineometer,” a resistance device that enabled women to work out their pelvic floor muscles against the force of resistance. This device gave visual biofeedback regarding the engagement of the proper muscles and the actual strength of those muscles and allowed women to witness the gradual increase in the strength of their pelvic floor muscles. In terms of intensity, Kegel’s recommendation was “twenty minutes of exercise three times daily, with a total of at least 20-40 hours of progressive resistance exercises spread over 20-60 days, keeping records of maximum contractions each exercise period.” This is a far cry from any of the current programs that you will come across! Additionally, most exercise programs do not utilize a tool that parallels the essential role played by Kegel’s perineometer.

So many of the mainstream programs out there do not hold muster and are terribly ineffective. There is an enormous demand for effective pelvic floor muscle training programs, and the number of people who could potentially benefit from an effective program that adheres to the successful foundational principles laid down by Arnold Kegel is huge. So what to do?

And thus was born the concept of the Private Gym pelvic floor training program, developed through the collaborative efforts of an international team of experts including myself. The Private Gym’s Basic Training program strengthens the pelvic floor muscles with a series of progressive male Kegel exercises without resistance. The Resistance Program uses resistance equipment to maximize pelvic floor muscle strengthening. This program completely adheres to the foundational principles of Arnold Kegel, and then some. The Private Gym program incorporates muscle education, biofeedback, progressive intensity, and resistance. The new dimension added is progressive resistance, so that as pelvic floor muscle strength increases, the trainee can increase resistance accordingly. In other words, as your pelvic muscles get stronger, they can be challenged with increasing resistance. With Kegel’s perineometer, women worked out against the same resistance and over time were able to generate stronger contractions, but with the Private Gym resistance device, you not only develop strength by making progress against resistance, but ultimately increase the resistance in order to optimize the strength of the pelvic floor muscles.



And don’t worry ladies, our Private Gym for women program is in the works.

Wishing you the best of health,

2014-04-23 20:16:29

Andrew Siegel, M.D.

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:

Note: As Arnold Kegel popularized pelvic floor muscle exercises in females in the late 1940’s, so I am working towards the goal of popularizing pelvic floor muscle exercises in males. This year I published a review article in the Gold Journal of Urology entitled Pelvic Floor Muscle Training in Men: Practical Applications to disseminate the importance and applications of these exercises to my urology colleagues. I wrote Male Pelvic Fitness: Optimizing Sexual and Urinary Health, a book intended to educate the non-medical population. Finally and most importantly, I, along with my partner David Mandell and our superb pelvic floor team, co-created the Private Gym male pelvic floor exercise DVD and resistance program.

For more info on the book:

For more info on the Private Gym:





















Game Plan for Healthy Sexual Functioning

September 20, 2014

Andrew Siegel MD

shutterstock_side view manjpeg

Know the Fundamentals:

Erections are not on the basis of a bone in the penis as they are in many mammals. Erections occur when blood fills the erection chambers of the penis and is trapped in place. The blood pressure within the penis elevates so high that it is in hypertension range, giving rise to a bone-like rigidity and hence the slang term, boner.

The penis is a marvel of hydraulic engineering, uniquely capable of increasing its blood flow 50 times over baseline within nanoseconds of sexual stimulation, transforming its shape, size and constitution. This is accomplished by smooth muscle relaxation within the penile arteries and within the sinuses of the erection chambers.

Once the blood fills the erection chambers, closure of the penile veins and contractions of the pelvic floor muscles effectively trap the blood in the penis and maintain the high blood pressures necessary for a sustained erection.

Know the Statistics:

The Massachusetts Male Aging Study showed that after age 40 there is a decline in all aspects of sexuality. Erectile dysfunction (ED) is present in about 40% of men by age 40 with an increase in prevalence of about 10% for each decade thereafter. Although there are many causes of ED, the common denominator is insufficient blood flow to fill the erection chambers of the penis, or alternatively, sufficient inflow but poor venous trapping, both often caused by a decline in smooth muscle relaxation with aging. As one of my patients referred to his penis: “It’s like walking around with a dead fish.”

Know the Score:

Performance ability with any physical activity declines as we get older and this explains why most professional athletes are in their twenties or thirties. Although everything eventually goes to ground, hopefully it will do so slowly. Young men can achieve a rock-hard erection simply by seeing an attractive woman or thinking some vague sexual thought. As we get older, it is not uncommon for erotic thoughts or sights to no longer be enough to provoke an erection, with the need for direct touch. Some of the common male sexual changes that occur with aging are: diminished sex drive; decreased rigidity and durability of erections; decrease in volume, force, and trajectory of ejaculation; decreased orgasm intensity; and an increase in the time it will take for recovery before being able to get another erection.

Know the Opponents: Gluttony and Sloth:

 Healthy eating habits, exercise, adequate quality and quantity of sleep, tobacco avoidance, use of alcohol in moderation, stress avoidance, and a balanced lifestyle will optimize sexual potential. Abide by the “Golden Rule of the Penis”: Treat your penis nicely and it will be nice to you in return; treat your penis poorly and it will rebel.

Fuel for Performance:

A healthy diet will reduce the risk of sexual dysfunction. Eat a variety of wholesome natural foods including fresh vegetables and fruit, plenty of fiber, lean protein sources, legumes and healthy fats including nuts, avocados and olive oil. Avoid eating processed foods and minimize sugar, refined carbohydrates and highly saturated animal fats.

Stay in Peak Form:

Try to achieve “fighting weight” to maximize your performance in the sexual arena.

Train for Performance:

Exercising—including cardio, core, and strength training—is vital for health in general and sexual health in particular. When it comes to sexual health, it is vital to focus on the all-important pelvic floor muscles (PFM). PFMT (pelvic floor muscle training) will help optimize erectile function and prevent/treat ED.

To understand why PFMT can help your performance in the bedroom, it is necessary to have some understanding of what the PFM do. When you have an erection, the bulbocavernosus muscle and ischiocavernosus muscles engage. Contractions of these muscles not only help prevent the exit of blood from the penis, enhancing rigidity, but also increase blood flow to the penis—with each contraction of these muscles, a surge of blood flows into the penis. Additionally, they act as powerful struts to support the roots of the penis (like the roots of a tree), the foundational support that, when robust, will allow a more “skyward” angling erection (like the trunk of a tree). The bulbocavernosus muscle also serves the role as “motor” of ejaculation, pushing semen out of the urethra when it contracts rhythmically at the time of sexual climax.

If you increase the strength, tone and condition of these muscles through PFMT, they will function in an enhanced manner—namely more powerful contractions with more penile rigidity and stamina as well as improving ejaculatory issues including premature ejaculation.

The Private Gym is a comprehensive, interactive, easy-to-use, medically sanctioned and FDA registered follow-along exercise program that helps men strengthen the PFM. The PFM—as with all skeletal muscles—adapt and increase in strength in direct proportion to the demands placed upon them, enhancing their strength, tone, durability and responsiveness.

The Basic Training exercise program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and The Complete Training program provides the maximum opportunity for gains through its use of the Private Gym’s resistance equipment. Think of the Private Gym as “Penis 90X.”

For great content on exercises to improve your sex life, see slide show written by Lisa Jey Davis for LiveStrong:

Talk to your Private Gym Coach:

Go to the Private Gym website: where you can have a private chat session with a trainer.

Wishing you the best of health,

2014-04-23 20:16:29

Andrew Siegel, M.D.

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health:

Private Gym:


The Flight of the Phallus

September 13, 2014

Andrew Siegel MD

During the tedious process of boarding an airplane, as I stood in the gateway queue, my eyes caught sight of a poster ad stating the following: Size should never outrank service. This referred to the smaller size regional jets that offer first-class, Wi-Fi and other amenities. Later, I saw another poster ad for the same airline stating: How fast the flight goes isn’t always up to pilot. As a physician interested in language and sexual issues, I find these figures of speech that have double meanings amusing and entertaining.

I can’t think of a more quintessentially phallic structure than an aircraft and a better metaphor for male sexual function and dysfunction than aeronautics. The following are definitions, as they apply to aeronautics as well as the penis and sexual function:

Aircraft: a machine capable of flight—the penis

Pilot: the person who sits in the cockpit and controls the aircraft—the owner of the penis

Cockpit (I really like this word!): the front of the fuselage where the pilots sit—the head of the penis, a.k.a., the glans of the penis

Fuselage: the body of the aircraft—the shaft of the penis

Horizontal and vertical stabilizers of the tail: aircraft parts that provide stability to keep it flying straight—the pelvic floor muscles (ischiocavernosus and bulbocavernosus) that stabilize and support the posture of the erect penis

Flight: the process of flying through the air that includes a launch, a flight pattern and a landing—involvement in sexual activity

Launch: the takeoff—the act of obtaining an erection

Flight pattern: the aircraft’s movement after takeoff—the details of the sexual act

Landing: the conclusion and most difficult part of the flight, which requires skill, precision and timing to perform competently — ejaculation/orgasm

Cruising Altitude: the altitude at which most of a flight is flown en route to a destination—a fully rigid erection
Jet fuel: fuel designed for use in an aircraft—in erectile terms, penile blood flow
Fuel line: the means by which fuel is pumped from the storage tanks to the engine—the penile arteries
Thrust: the propulsive force of an aircraft—the surging power of the erect penis

Throttle: a device for controlling the flow of fuel to an aircraft’s engine—the nerves that control the smooth muscle in the penile arteries (that govern constriction vs. dilation) and in the smooth muscle of the erectile tissue within the penis, as well as the pelvic floor muscles that control the blood pressure within the penis by compressing the penile roots

Failure to Launch: a condition in which the aircraft is unable to get airborne—the inability to achieve an erection

Emergency landing: unanticipated landing before the scheduled arrival time—premature ejaculation

Aborted Landing: when an aircraft is about to land, but the pilot halts the landing and regains altitude deferring the landing—delayed ejaculation

Ground Time: the amount of down time between landing and the next flight—refractory period

Mayday: distress signal indicative of a significant problem with the aircraft or flight—a major sexual failure that disrupts the sexual process that could be an issue with erection or ejaculation

Aeronautics provides an excellent metaphor for male sexual improvement, for example, enhancing function via pelvic floor muscle training. Pelvic floor muscle training programs accord the pilot more control, allowing the pilot to fly longer, fly at a higher altitude, as well as to take off for a second flight with less ground time. One thing pelvic floor exercises cannot do is to turn a Boeing 727 into an Airbus A380, but we all know that size should never outrank service!


Wishing you the best of health,

2014-04-23 20:16:29

Andrew Siegel, M.D.

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health:

Private Gym:


September 6, 2014


Did you figure out the title? It is not the imaginary word “Rupnok”; nor the initials of my children (I have three and not six), rather, each letter or two stands for a different word, as is the case with texting abbreviations, in this example: “Are (R) you (U) peein’ (PN) okay (OK)?” This is in fact my license plate and I would estimate that 90% of folks do not figure it out, which makes me smile as I appreciate the subtlety of my tags. I can’t think of a more concise summary of what I do for a living (voiding dysfunction)—my profession in 6 letters—not bad at all!

In urology, we are quite fond of acronyms—abbreviations formed from the initial letters of other words and pronounced as a word, like NASA.

One of the most common issues that I deal with as a urologist is LUTS (lower urinary tract symptoms). The major areas of LUTS are OAB (overactive bladder), UAB (underactive bladder), SUI (stress urinary incontinence), POP (pelvic organ prolapse), BPH (benign prostate hyperplasia) and BOO (bladder outlet obstruction).

Overactive Bladder (OAB) A condition in which “irritative” LUTS are present: the compelling urgency to urinate, urinary frequency, nighttime urinating, and at times, urgency incontinence. It is often due to involuntary contractions of the urinary bladder, in which the bladder contracts without its owner’s permission.

Underactive Bladder (UAB) A condition in which the bladder muscle does not contract with the necessary force, resulting in ineffective urinating with incomplete emptying or the presence of urinary retention.

Stress Urinary Incontinence (SUI) A condition that can be present in both men and women in which there is urinary leakage associated with a sudden increase in abdominal pressure, such as may occur with sneezing, coughing, laughing, exercising, changing one’s position, etc.

Pelvic Organ Prolapse (POP) A condition in females in which there is weakness or laxity of the pelvic support tissues that often follows childbirth, resulting in descent of the pelvic organs into the vaginal space or even outside the vagina. This can involve the bladder, cervix/uterus, small intestine, rectum, and at times, the vagina itself.

Benign Prostate Hyperplasia (BPH) A condition of benign growth of the prostate gland that often accompanies the aging process, has a strong genetic influence and requires the presence of adequate levels of the male hormone testosterone.

Bladder Outlet Obstruction (BOO) A condition in which there is obstruction of the outlet of the urinary bladder. This may be on the basis of BPH but can also be caused by scar tissue in the urethra or the presence of a dropped bladder in a female, resulting in a kink in the urethra. In any of these situations there is obstruction to the flow of urine, typically resulting in obstructive LUTS including a weak urinary stream that is hesitant and intermittent with prolonged emptying time and incomplete emptying.

Bottom Line: RUPNOK?… or do you have LUTS with OAB, UAB, SUI, POP, BPH, or BOO? If so, it may be time to see a GU MD (genital-urinary medical doctor) for a H&P (history and physical) and consider PFMT (pelvic floor muscle training).


Wishing you the best of health,

2014-04-23 20:16:29

Andrew Siegel, M.D.

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health:

Private Gym:

Exercise Your Penis…REALLY?

September 2, 2014

Andrew Siegel M.D.   Blog # 170


Your penis is an organ that wears many hats. It directs your urinary stream with sometimes laser-like precision (although this precision goes to pot as you age); when erect it allows for vaginal penetration; and at the time of climax, it permits passage of sperm to reproduce the species. Pretty remarkable in terms of its multi-functionality and handiness, similar to a Swiss Army knife, but really so much better! In terms of sexuality and fertility, the ability to achieve an erection is a must, and this is predicated on an adequate penile blood flow, which is the “rocket fuel” of penile erections.

Your ability to obtain penile rigidity is a matter of hydraulics—maximizing inflow of blood while minimizing outflow. I need to get a bit medical to explain this: Your penis contains 3 erection chambers that fill with blood. They are composed of sinuses, virtually identical to our nasal sinuses, and an erection occurs when the sinuses become congested with blood. Blood inflow is caused by smooth muscle relaxation in the penile arteries and in the sinuses. As the sinuses fill up, they compress the penile veins to block the outflow of blood. And hence you have a tumescent penis, plump, but not yet rigid.

So how do you go from plump to rigid? The pelvic floor muscles are the key players in the transformation from a tumescent penis to a rigid penis. They compress the deep, inner part of your penis, creating rigidity by aiding closure of veins and by elevating the blood pressure within your penis so that it is well above systolic blood pressure. An erect penis is a hypertensive penis (really a very good thing), and it is this tremendous pressure that causes bone-like rigidity. If this penile blood pressure at the time of a rigid erection were experienced in the arteries of your body, it would be considered a hypertensive crisis! So, the only organ in the body in which high blood pressure is not only healthy, but also desirable, is your penis.

With aging, the smooth muscle of all of our arteries tends to become stiffer and less able to relax, resulting in high blood pressure (a very bad thing) for many of us. The penis is not spared, as the smooth muscle of the penile arteries and sinuses stiffens and is less able to relax. Unfortunately, stiff smooth muscle in the penis does not lead to a stiff penis…in fact, quite the opposite. Additionally, our pelvic floor muscles weaken with age, like many of our skeletal muscles. Between the smooth muscle stiffening and the weakened pelvic floor muscles, we have the perfect storm for ED.

Where are your pelvic floor muscles? They are located between the scrotal sac and the anus, the saddle region where your body is in contact with a bicycle seat. In the 1940s, gynecologist Dr. Arnold Kegel popularized pelvic floor muscle exercises (“Kegels”) in women to improve their sexual and urinary health. Men have similar pelvic floor muscles and an equivalent capacity for exercising them, with parallel benefits to sexual and urinary health. It’s high time that we demand equal pelvic rights!

Male pelvic floor muscle exercises date back to ancient times, having been described in ancient Greece and Rome by Hippocrates and Galen respectively. Performed in the baths and gymnasiums, these exercises were thought to promote general and sexual health, spirituality and longevity.

Most men are unfamiliar with pelvic floor muscles exercises, let alone with their pelvic floor muscles. Unfortunately, many physicians are not very knowledgeable regarding the pelvic floor and the benefits of fitness in this area, and do not see themselves as instructors of pelvic floor muscle training. Regrettably, our medical culture—heavy on prescription writing and surgery—does not typically promote lifestyle improvement and exercise programs such as pelvic floor training. I would like to explain to you why such exercises are well worth your time and effort.

There is exercise and then there is EXERCISE; for example, there is walking (moving is good) and then there is running with interval training (a great workout). When it comes to exercising your skeletal muscles, using resistance training—working against an opposing force—stresses your muscles to enhance strength, tone, power, durability and responsiveness. By gradually and progressively overloading the muscles working against the resistance, they will adapt by getting bigger and stronger. Imagine repetitively doing arm curls without weights as compared to doing curls with weights, in which case the added resistance will rapidly and effectively create muscle growth and accelerated strength.

Kegels 101 involves repetitions of pelvic floor contractions without resistance. How do you accelerate to Kegels 401—pelvic floor muscles with resistance? Dr. Kegel designed a resistance device for women called a “perineometer” that was inserted into the vagina to provide a means of squeezing against something and a way to measure the strength of the squeeze. Men don’t have a vagina, but they do have a rectum, and one way to do resistance training is to use a perineometer placed in the rectum. Not a very appetizing thought though, is it?

Remember that your pelvic floor muscles engage when you have an erection. When you contract these muscles, your penis magically lifts up towards the heavens with each contraction. Since the pelvic floor muscles govern this upward deflection, they can be challenged to lift up more than just the weight of your penis.

And thus was born the concept of the Private Gym resistance workout for men. Whereas the Private Gym’s Basic Training program strengthens the pelvic floor muscles with a series of progressive male Kegel exercises without resistance.


The Resistance Program uses resistance equipment to maximize pelvic floor muscle strengthening. The equipment consists of an ergonomic weighted base and magnetic weights that attach to the base. It is placed on your erect penis, which is raised up and down by contracting the pelvic floor muscles in accordance with the follow-along DVD program, subjecting the pelvic floor muscles to resistance. Your muscles will gradually and progressively adapt to the load placed upon them and will strengthen in accordance with the resistance



When one first hears about progressive resistance training for the penis, their reflex reaction is often: Are you kidding? Really? Seriously? REALLY? Weights for the penis? You must be joking! No way. When Dr. Arnold Kegel in the late 1940’s first proposed his concept of the perineometer that gets placed in the vagina in order to do progressive resistance exercises, he likely received many similar responses from both his patients as well as his medical colleagues. What, shove that up my vagina and squeeze? And this was the 1940’s, decades before the sexual revolution!

If one can discard their conservative prejudices and carefully consider the principle of resistance training for skeletal muscle adaptation, they will realize that resistance training for the pelvic muscles is no different than resistance training for any other skeletal muscle, a bona fide means of creating strength and endurance. Resistance training is a “boner-fide” (sorry—I couldn’t help myself) means of maximizing your pelvic floor muscle growth.

In terms of resistance training of the penis, the Private Gym clearly is superior and more user friendly and less invasive than using a rectal resistance device, with the limitation that it can only be used in those men who can obtain a sufficiently rigid erection, whether naturally, or with the help of pills such as Viagra, Levitra, Cialis and Stendra.

The Private Gym Company was established after recognizing that there was an unmet need for a means by which a pelvic floor muscle-conditioning program could be made accessible and available in the home setting. The premise behind the Private Gym is to help achieve pelvic floor fitness and optimize sexual and urinary health.

Adaptation of skeletal muscle is an accepted scientific precept and if you have ever had your arm or leg in a cast, you can understand the detrimental effect of disuse on muscle tone and strength. The corollary is that if you have ever done weight training, you understand the beneficial effect of resistance training on muscle tone and strength.

Elston Howard was a New York Yankee who invented the batting “donut,” a circular lead weight that slides onto baseball bats and is used by on-deck batters. This added weight during practice swings makes the bat feel very light once it comes time to step up to the plate and remove the weight. Howard employed the resistance principle to heighten power—use the weighted bat in practice and when it comes time to step up to the plate, you’re going to perform better. This principle will work on your “bat,” too—utilize resistance training in practice and when it comes time to “step up to the plate,” you’re going to perform better. The Private Gym resistance turns conditioning into a weapon that is capable of producing “outstanding” erections, maximizing stamina, and tremendously boosting one’s confidence.

Bottom Line: Resistance training is utilized for creating strength and endurance for every group of skeletal muscles in the body, and the pelvic floor muscles should be no exception. The pelvic floor muscles are skeletal muscles and, just like the biceps and pectorals, they will adapt in a positive way to the resistance (load) placed upon them.


Wishing you the best of health,

2014-04-23 20:16:29

Andrew Siegel, M.D.

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health:

Private Gym: