Archive for June, 2015

Penis Insecurity…And How To Overcome It

June 27, 2015

Andrew Siegel MD  6/27/15

shutterstock_side view manjpeg

In a recent article in the New York Times, Seth Stephens-Davidowitz concluded: “The degree of a man’s worry about his genitals is profound…. male body insecurity is not far behind female body insecurity.”  Men Google search “my penis” more commonly than any other body part. Of the top 10 queries, nine involve size, the first and second being “How to make my penis bigger?” and “How to make my penis longer?”, respectively. Questions regarding penis enlargement seem to be primarily a male concern as men make 170 searches on this topic for every one women make

Why Are We So Hung Up (No Pun Intended) On The Penis Is General And On Size In Particular?

  • Hey, we only have one penis so it is a very special and important organ, right up there with the brain, huh? What an unusual organ with a life of its own. So, no shame with the desire for a fine, handsome, well-proportioned specimen without blemishes or flaws and a magnificent locker room and bedroom presence. A man’s relationship with his penis just may be one of the most important relationships in his life!
  • On the subject of brains and penises, it is clear that women tend to think with their brains, and men with their penises. For women, emotional aspects of sexuality reign supreme, whereas for men, the “little” head often dominates, giving the penis a magified sense of importance that is probably undue and unwarranted.
  • The penis dangles in the middle of our bodies and may be the male “center of gravity.” It is always at arm’s length away and is a handy multi-purpose tool, terrific for aiming our urinary streams and certainly a most pleasing accessory. With a little stimulation it enlarges and stiffens—a miracle of nature like watching time-lapse photography—how cool is that? No other body part has that capacity. For those who relish instant gratification, the penis is the toy of choice!
  • Another term for the penis is “manhood,” the penis representing courage, strength, fertility and sexual potency. Our manhood contributes to our masculine identity, virility, vitality, “swagger,” confidence, self-assurance and self-esteem. Concerns about penis size are intensified by cultural messages in which penis size is used as a measure of masculinity.  Did you know that Shakespeare coined the term “swagger” as well as thousands of other commonly used words in currency?  (Thank you for that bit of trivia, Isabelle.)
  • It is human nature to desire not to be middle of the road, but to excel. We want to literally “stand out” from our fellow man. We live in a competitive society in which being average is considered mediocre, like a “C” grade in school, and this is particularly the case when it comes to penises. Ladies, don’t ever tell your man that his penis is “average”!  SPA (Small Penis Anxiety) is a real entity.
  • Our world is “penis-centric” and penis-looking things are usually men’s things – guns, cars, rockets, cigars, skyscrapers, jets, etc.
  • American popular culture dictates that bigger is better, whether it is houses, automobiles, boats, food portions, breasts, buttocks or penises.
  • Undoubtedly, some of our sexual partners want to “size us up,” both literally and figuratively.  Regardless of our sexual abilities and skills, we know that we may be judged and sexual partners may have expectations strictly based on size and we worry that our partners may not be satisfied with our penis size. When we are in a sexual situation we want to feel that we are at least “competitive” with those whom we might be compared.
  • Having a possession that females lack gives us a sense of power—the “sword” versus the “sheath.” In the hierarchy of power, those with the largest weapons have a perceived advantage.  Did you know that the word “vagina” is derived fromt he Latin word meaning “sheath”?
  • The well-endowed male stars in the porn industry have created a bit of an inferiority complex for your average Joe.

Now For The Sad News

Reality check: If there were an effective and safe means to increase penile size, you would know about it already. What you see is what you get. Sorry! Blame your mother and father for the genetic blueprint you inherited. You can’t make your penis bigger any more than you can make yourself taller…it is what it is.

So, What To Do?

The Internet is overrun with male “sexual enhancement” products that claim to increase one’s penis size. They capitalize on male insecurity, which has created a huge market, with hordes of men willing to pay top dollar for products that have misleading claims and are often mislabeled, contaminated and falsely advertised. Unfortunately, such supplements are exempt from the stringent regulatory oversight applied to prescription drugs, which requires reviews of a product’s safety and effectiveness before it goes to market. Please don’t waste your money!

How about surgery? Penile enlargement surgery is risky,  rarely effective and certainly not ready for prime time. Some techniques are “sleight of penis” procedures including cutting the suspensory ligaments, disconnecting and moving the attachment of the scrotum to the penile base, and liposuction of the pubic fat pad. These procedures unveil some of the “inner” penis, but do nothing to enhance overall length. Other procedures attempt to “bulk up” the penis by injections of fat, silicone and other tissue grafts. The side effects can include an unsightly, lumpy, discolored, painful and perhaps poorly functioning penis—a far cry from a “proud soldier” and more like a “wounded warrior.” Please stay away from penile enlargement surgery and the entreprenurial surgeons who advertise it!

So, you can’t make it bigger, but that is not to say that you can’t make it better. You can maximize the magical powers of your pelvic floor muscles to improve both erectile and ejaculatory function by training these hidden, but all-important muscles that play a vital role in erection and ejaculation. The Private Gym is a comprehensive, interactive, follow-along exercise program that strengthens the male pelvic floor muscles–and is the only program of its kind.

A clinical trial of the Private Gym was recently completed. Participants had either no or minimal erectile dysfunction and went through the 8 week program, completing 4 weeks of Basic Training, a series of progressive and graduated “Kegel” exercises, and thereafter 4 weeks of Complete Training using patented resistance equipment.

Preliminary Findings of the Private Gym Clinical Trial

  • Erectile strength: 75% improved; 25% greatly improved
  • Orgasm intensity: 90% improved
  • Ejaculatory control: 40% improved; 25% greatly improved
  • Ejaculatory force: 75% improved; 12% greatly improved
  • Confidence: 90% improved; 50% greatly improved
  • Sexual pleasure: 60% improved; 38% greatly improved

Comments from the participants included the following: “I’m more in tune with my body”; “More confidence”; “Increased ejaculate volume”; “Improved sexual experience”; ”I’m surprised that muscles affected sex”; “I have increased sexual prowess”; “I get pre-cum for the first time”; “Improved premature ejaculation”; “The resistance made a big difference”; “Saved my marriage”; “Now I understand that it needs exercise like any other body part”; “I feel younger”; “I do it during sex and she orgasms”; “Sex is more fun.”

Conclusions From Clinical Trial Of Private Gym

  • Improves ED: Better erections and ejaculation in men with mild ED.
  • Improves Function In Men Without ED: Enhances erections and ejaculation in men with normal function, significant and unprecedented findings.
  • Resistance Accelerates Results: The resistance program expedites the results beyond the capacity of the non-resistance program.
  • Welcomed: The program was enthusiastically and positively embraced.
  • Confidence: A prevailing finding was that sexual confidence and self-assurance improved dramatically.

For more details about the results of the clinical trial please visit: http://www.privategym.com/how-it-works/clinical-trial-results/.

 So, realistically, in the quest for a larger member, the best we can hope for is to accept the endowment given us by nature and optimize our sexual function by staying fit and keeping our pelvic floor muscles well conditioned. We can’t make it bigger, but we can make it better and cultivate the sexual confidence to overcome penis insecurity.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

6922

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”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Kindle, iBooks, Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Co-founder of Private Gym: http://www.PrivateGym.com–available on Amazon and Private Gym website

The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to properly strengthen the pelvic floor muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic strength and tone. This FDA registered program is effective, safe and easy-to-use: The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximum opportunity for gains through its patented resistance equipment.

“Welcome To The Club”

June 20, 2015

Andrew Siegel MD 6/20/15

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(Thank you Pixabay for above image)

“Welcome to the club.” These four words have become my favorite response to a variety of the presenting complaints of my middle-age patients. As a fifty-something year-old male, I am a member of this club, the one in which things are not necessarily bad or problematic, but certainly different from the way they used to be.

I find that this sentence—gently stated in a heartening manner with a smile on my face—is calming and reassuring to my patients who are uncertain if they have a genuine medical issue that they might need to be concerned about. By being told that they are “members of the club,” they immediately understand that their complaint is not only common and shared by many of their peers, but also is to be expected and is not a major concern.

“Things fall apart, the center cannot hold.” –Chinua Achebe

Things change. We get older and we look and function differently…again, not necessarily badly, but differently. Unfortunately, humans do not come with a “user manual” that explains what to expect as we age, which could help us make the distinction between the normal expectations of aging as opposed to problems that demand medical attention. On my bucket list is to write such a “Manual of Man,” at least from a urology perspective, discussing the urinary, genital and sexual changes to be expected with the aging process. The challenge is to recognize the difference between “normal aging” and “pathological aging.”

On Becoming A Slack In The Sack

Sex Drive

After age 40, you are still interested in sex, but not nearly with the all-consuming passion you had decades before. Testosterone levels fall ever so gradually, resulting in this decrease in sexual appetite. That stated, libido seems to be the element of male sexuality that survives the longest, intact to some extent long after the penis functions only to allow you to stand to urinate. However, what was once a raging “fire” may now be mere “embers.”  It can be a source of great frustration to have functioning software but poorly functioning hardware!

Erections

You still may be able to get a respectable erection, but now it probably requires a bit more effort—often demanding touch for full arousal, whereas at one time it took only a smidgeon of erotic stimulation. Although the penis may be capable of getting hard enough for penetration, it has probably lost some of the rock-star majestic rigidity of yesteryear. Although the erection still can defy gravity, it might not have quite the angle it used to. On occasion the erection may soften before the sex act is completed. Nighttime and morning erections are fewer and farther between. Getting a second erection after climax is difficult, and you probably have more interest in going to sleep rather than pursuing a sexual encore.

Ejaculation and Orgasm

Ejaculation becomes noticeably different. The volume of semen is diminished and you question why you are “drying up.” Climax happens with less force and arc, sometimes just a mere dribble; your once “high-caliber rifle” is now a “blunt-nosed handgun.” Orgasms are unquestionably different with loss of some kick and intensity. At times, it may feel like nothing much happened—more “firecracker” than “fireworks.” Sperm quality also tends to go by the wayside with aging, but who really cares since procreation is for the next generation!

The penis often becomes less sensitive, not only making it more difficult to achieve and maintain an erection, but also at times giving rise to difficulty achieving climax, with delayed ejaculation. Perhaps this is an improvement over the premature ejaculation that may have been an issue when you were younger.

Changes In Genital Anatomy

Shrinkage

Not a day goes by in my urology practice when I don’t hear the words: “Doc, my penis is shrinking.” The truth of the matter is that the penis can shrink from a variety of circumstances, but most of the time it is a mere illusion—a sleight of penis. Weight gain causes a generous pubic fat pad—the male equivalent of the female mons pubis—making the penis appear shorter. However, penile length is usually intact, with the penis merely hiding behind the fat pad, what I call the “turtle effect.”

There are genuine reasons for penile shrinkage such as treatments for prostate cancer including radical prostatectomy and testosterone deprivation as well as “disuse atrophy,” penile “wasting” resulting from not using the penis as nature intended. Additionally, with aging there is often a fatty plaque buildup within the penile arteries, loss of erection chamber smooth muscle and elastic tissue (replaced with scar tissue) and weakening of the pelvic floor muscles. This results in less elastic and expansive erection chambers that do not fill up and trap blood properly.  It also causes a loss in penile length, girth and the ability to maintain the high penile blood pressures that cause bone-hard rigidity. If scar tissue forms on the sheath of the erectile chambers, it can cause penile curvature and pain with erections, a.k.a. Peyronie’s disease.

On Becoming Slack In The Sac

While the penis may shrink, the scrotal sac expands, time and gravity being cruel conspirators. This smaller penis and larger and looser scrotum–appearing like the genitals of an old hound dog snoozing on the veranda–is not a particularly appealing sight! While the sac expands, the testicles often shrink in size. One of the complaints voiced not infrequently by middle-aged and older men is that their testicles hang down loosely, similar to pendulous breasts in older women. At times, men complain that when they sit on the toilet, their scrotum touches the toilet water. Ouch! The scrotum may hang so low that when you pass wind, your testicles may become airborne like a kite flying erratically in a sudden gust.

Urinary Woes

The only male organs that get bigger with age are our noses, ears, scrotums and prostate glands. Unfortunately, the prostate is wrapped precariously around the urethral channel and as the prostate enlarges it can constrict the flow of urine. You may observe a weaker stream that hesitates to start, takes more time to get going and longer to empty, starts and stops and the sensation that you have not emptied completely. You might notice that you urinate more often, get up one or more times at night to empty your bladder and when you have to go, it comes on with much greater urgency than it used to. Almost universal with aging is post-void dribbling, that annoying dribble that occurs after emptying your bladder.

Bottom Line: If you are a middle-aged male and are experiencing some of these symptoms, “Welcome to the club.” If these symptoms become annoying and interfere with your quality of life, it is time to check in with your friendly urologist!

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

6922

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”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Kindle, iBooks, Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Co-founder of Private Gym: http://www.PrivateGym.com

available on Amazon and Private Gym website

The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to properly strengthen the pelvic floor muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic strength and tone. This FDA registered program is effective, safe and easy-to-use: The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximum opportunity for gains through its patented resistance equipment.

 

You Can’t Make It Bigger

June 13, 2015

Andrew Siegel MD   6/13/15

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(New Jerseyans might recognize the lighthouse at Barnegat Bay)

Male Body Insecurity

In “Searching for Sex,” in The Sunday Review of the January 24, 2015 NY Times, Seth Stephens-Davidowitz studied Google online searches and observed: “The degree of a man’s worry about his genitals is profound.”  He concluded: “We are so busy judging our own bodies that there is little energy left over to judge other people’s, and maybe if we worried less about sex, we’d have more of it.”

Men Google more questions about their penises than any other body part. For every 100 questions about their genitals, there are 67 for the heart, 57 for the eyes and 40 for the head. One of the most commonly searched subjects is how to make one’s penis bigger, which seems to be primarily a male concern, because for every search women make regarding penis size, men make 170 searches. Of the top 10 questions about “my penis,” nine involve size, the first and second being “how to make my penis bigger” and “how to make my penis longer,” respectively. Interestingly, women have nearly as many concerns about their vaginas as men do about their penises. They want to know how to shave it, tighten it and how to improve its taste and scent. 

Sexual Enhancement Products

Not a day goes by where I am not bombarded with spam messages in my email inbox advertising drugs that claim to increase penis size. Additionally, not an office session happens in my urology practice when I don’t have at least several patients ask me about these products or bring in a print ad to ask my opinion.

The Internet is overrun with male “sexual enhancement” products that claim not to improve one’s sexual function but to increase the size of one’s penis. They capitalize on male body insecurity, which has created a huge market for these products, with hordes of men willing to pay top dollar for claims that are misleading and underhanded and products that are often mislabeled, contaminated and falsely advertised. The New York Attorney General recently accused four major retailers (GNC, Target, Walgreens and Walmart) of selling fraudulent and potentially dangerous herbal supplements and demanded that the products be removed. Unfortunately, such supplements are exempt from the stringent regulatory oversight applied to prescription drugs, which require reviews of a product’s safety and effectiveness before it goes to market. Do not waste your money!

What The FDA Has To Say

Although the FDA does not have the jurisdiction and regulatory powers over “natural” and “herbal” supplements that they have over prescription medications, they have still managed to restrain unscrupulous companies. According to physicians and federal experts, these products with claims that they can enlarge one’s penis are not only deceptive, but also potentially dangerous. The FDA has issued numerous public warning notifications in an effort to curb the sale of these often-tainted products and supplements. They have notified consumers that many of the products contain sildenafil, a.k.a. Viagra. The unknowing consumption of sildenafil can pose major health risks including precipitous drops in blood pressure in men on nitrate medications, which are commonly used for cardiac conditions.

You Can’t Make It Bigger, But You Can Make It Better

Okay gentleman, let’s do a reality check. Mother nature determined that you were to have a penis with its size determined by the genetic blueprint you inherited from your parents. You can’t make your penis bigger any more than you can make yourself taller…it is what it is. Nature is nature, but don’t forget about nurture. We do have some say in the way it functions, just as we have some say in what kind of physical shape our bodies are in and how they function.

How To Make It Better:

  • Use It Or Lose It. Your penis needs to be utilized the way nature intended. Erections keep your penile smooth muscles and tissues richly oxygenated, elastic and functioning well. Sexual intercourse on a regular basis protects against ED.
  • Maintain A Healthy Lifestyle. A healthy diet, a trim weight, keeping fit through balanced exercise (cardio, resistance, core, stretching), avoiding tobacco, avoiding excessive alcohol and managing stress are the keys to a healthy lifestyle.
  • Exercises Specifically Geared For Sexual Function. The penis contains smooth muscle, which can only be “exercised” through achieving erections. However, the pelvic floor muscles (PFM) that engage at the time of sexual activity are skeletal muscles; the ischiocavernosus PFM is the “erector” muscle and the bulbocavernosus PFM is the “ejaculator” muscle. Participating in a male Kegel exercise program such as the Private Gym will increase the strength, tone, and endurance of the PFMs, enhancing erectile and ejaculatory function and capacity.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

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”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Kindle, iBooks, Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Co-founder of Private Gym: http://www.PrivateGym.com

The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to properly strengthen the muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic strength and tone. This FDA registered program is effective, safe and easy-to-use.  The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximum opportunity for gains through its patented resistance equipment.

 

Performance Anxiety (Stage Fright)

June 6, 2015

Andrew Siegel MD  6/6/15

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(Thank you, Wikipedia Commons for the use of the image above)

No matter how sexy you think sex is, it comes down to some very unsexy biology, chemistry and physics. I will briefly review the science of the male sexual response and how certain chemicals in the right place at the right time can cause you to be a real Romeo, or alternatively, doom you to having a soft-as-a-marshmallow, good-only-for-standing-up-when-you-pee penis.

“It is like a firstborn son—you spend your life working for him, sacrificing everything for him, and at the moment of truth he does just as he pleases.” Gabriel Garcia Marquez, Love In the Time of Cholera

“The penis does not obey the order of its master, who tries to erect or shrink it at will. Instead, the penis erects freely while its master is asleep. The penis must be said to have its own mind, by any stretch of the imagination.” Leonardo da Vinci

Sex Ain’t Simple Sex is a complicated event that depends upon a number of systems working together in harmony: The endocrine system (produces sex hormones), the central nervous system (where sensations of sexual arousal are experienced and processed), the peripheral nervous system (provides nerve control), the vascular system (blood flow) and the pelvic floor muscles (elevate penile blood pressure to provide rock-hard rigidity).

The Mind-Body Connection The mind-body connection is nothing short of profound and one’s emotional state—which obviously varies from moment to moment—is responsible for the release of a “cocktail” of internal chemicals that can make or break an erection, despite all of the aforementioned systems being in perfect working order. In other words, one’s internal “biochemical environment” at any given moment in time can influence these systems in such a way that may lead to a bone-hard erection or at times, no erection at all.

Stress—The Erection Killer Under certain circumstances—particularly stress—internal chemical release can cause a situational erection problem. Performance anxiety (stage fright—the stage usually being the bedroom) is often due to emotional stress that causes the release of adrenaline, the “flight or fright” chemical that causes tightening of blood vessels and restricts the blood flow to the penis. This is the same chemical that causes one’s pupils to dilate, blood pressure to rise and pulse and breath to quicken. Adrenaline is a great chemical to have onboard when you are in precarious situation, such as being chased by a lion in the jungle. By causing dilation of the pupils, a rise in pulse and blood pressure and rapid breathing, it prepares you to confront the danger in a turbo-charged state so that you can perform optimally. The last thing on your mind in this situation is sex, and by restricting blood flow to non-vital organs including the penis, blood flow is directed to where it will best serve you to get out of the precarious situation. So, stress does not belong in the same sentence as sex, and when it does, it is a formula for a losing situation. Emotional stress can have many causes including a new sexual partner, worry about getting an erection, guilt, work concerns, worry about child care or caretaking of parents, financial woes, unemployment, or life in general (who isn’t stressed?). For some men, the stress of having to wear a condom can cause the inability to obtain or loss of an erection, known as condom-associated erectile dysfunction.

Fact: On the rare occasion that a man has a prolonged erection (a.k.a. priapism), an adrenaline-like drug needs to be injected directly into the erectile chambers of the penis in order to cause the erection to subside. When anxiety strikes, adrenaline is precisely what dooms your erection. The adrenal glands pump out adrenaline, which circulates to all organs, including the penis, and presto, the blood flow to the penis is choked off and the erection is history.

The Chemistry Of Love With erotic stimulation or touch, the erectile chamber nerve (cavernosal nerve) releases nitric oxide, which in turn causes the release of cyclic guanosine monophosphate (cGMP). This causes the erectile chamber arteries (cavernosal arteries) to dilate and blood to gush into the penis and also causes the smooth muscle of the erectile chambers to relax, allowing space for blood to fill the chambers. You now have a plump penis, congested with blood. The pelvic floor muscles then engage and further increase the pressure within the erectile chambers, and voila, you have a rigid erection. After ejaculation, the enzyme phosphodiesterase (PDE) is released. PDE is the flaccidity chemical that by decreasing levels of cGMP, results in a return to the flaccid state by a reversal of the aforementioned chemical mechanisms. Viagra, Cialis, Levitra and Stendra work by inhibiting PDE.

Let’s say that you are emotionally stressed before entering an erotic situation or become stressed after it has started. Enter adrenaline in high enough levels and that erection will never occur or if it does so, will rapidly be lost. Adrenaline is your friend in life and death situations, but not in the bedroom!

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

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”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Kindle, iBooks, Nook, Kobo) and paperback: http://www.MalePelvicFitness.com

Co-founder of Private Gym: http://www.PrivateGym.com–available on Amazon and Private Gym website The Private Gym is a comprehensive, interactive, follow-along exercise program that provides the resources to properly strengthen the pelvic floor muscles that are vital to sexual and urinary health. The program builds upon the foundational work of Dr. Arnold Kegel, who popularized exercises for women to increase pelvic strength and tone. This FDA registered program is effective, safe and easy-to-use: The “Basic Training” program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and the “Complete Program” provides maximum opportunity for gains through its patented resistance equipment.