Dudley Seth Danoff's Blog

November 7, 2014

Men: Reduce Fat, Reduce Your Cancer Risk

This article was originally published on 10/17/14 for www.dralanviau.com


A recent report published in Cancer Prevention Research, a peer-reviewed journal of the American Association for Cancer Research, stated that men who ate a low-fat diet with fish oil supplements for four to six weeks before having their prostate surgically removed had a slower cancer-cell growth in the prostate tissue than men who ate a traditional, high-fat Western diet.


High-fat diet-Cancer-boost


In addition, the study showed that blood obtained from the patients after the low-fat, fish oil diet slowed the growth of prostate cancer cells in a test tube, while blood from men on the Western diet did not. It seems that heightened levels of omega-3 fatty acid from fish oil and decreased levels of omega-6 fatty acid from corn oil directly affected the biology of the cells and slowed prostate cancer growth.


Dr. William Aronson, the study’s first author, said that “the finding that the low-fat, fish oil diet reduced the number of rapidly dividing cells in the prostate cancer tissue is important because the rate at which the cells are dividing can be predictive of future cancer progression. The lower the rate of proliferation, the lesser the chances that the cancer will spread outside the prostate, where it is much harder to treat.” Dr. Aronson went on to say that “based on our animal studies, we were hopeful that we would see the same effects in humans.” This study suggests that following a low-fat, fish oil diet would have a favorable effect on the biology of prostate cancer cells.


It has long been a truism that you are what you eat. And anecdotal evidence tells us that a low-fat, high-protein diet has been beneficial in the treatment of prostate cancer. A large number of my patients follow this diet with favorable outcomes.


Furthermore, the incidence of prostate cancer among African American males is relatively high compared with Caucasians. However, the incidence of prostate cancer in Africans is very low. Theoretically, African Americans and Africans share a common genetic pool; their main difference appears to be one of diet. The African American diet, in general, is very high in fat content, while the contrary is true of the African diet. Diet studies are often difficult to evaluate because the subjects fail to comply with a strict dietary regimen. However, this observation between African Americans and Africans seems to hold up.


In a typical Western diet, about 40 percent of the calories come from fat. In the Aronson study, the group following the low-fat diet was consuming 15 percent of the calories from fat. In addition, this group took five grams of fish oil per day to provide omega-3 fatty acids. Incidentally, omega-3 fatty acids have been found to reduce the incidence of heart disease and to fight inflammation, which has also been associated with certain other cancers.


Further studies are currently being conducted with one group of men following a low-fat, fish oil diet and the other group following a traditional Western diet, and the progression of their prostate cancers is being tracked. Both study groups were taken from a subset of men who have been diagnosed with prostate cancer but have chosen active surveillance (getting regular checkups and biopsies but not receiving treatment for the disease). The results of this ongoing study will be of great interest.


Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).


Read discreetly with the Kindle™ edition of Penis Power™ now available for purchase from Amazon. The Nook Books™ edition from Barnes & Noble and the Sony eReader™ edition from Sony’s Reader Store. Available for under $7.00!


 

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Published on November 07, 2014 10:14 • 4 views

February 6, 2014

The marketing of low serum testosterone (low T) as a common medical condition helped propel sales of testosterone gels, patches, injections, and tablets to about $2 billion in the United States last year, according to IMS Health, a health-care information company. A recent study published in the Medical Journal of Australia noted that the low-T trend is global. From 2000 to 2011, there was a “major and progressive increase” in testosterone use in 37 countries. 

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Published on February 06, 2014 09:38 • 41 views

December 9, 2013

Over the past several years, the media has bombarded us with various treatments for low serum testosterone in men to prevent andropause, the male equivalent of menopause in women.


But in a recent study published in the New England Journal of Medicine, Dr. Joel Finkelstein of Massachusetts General Hospital pointed out that “a lot of things we think are due to testosterone deficiency are actually related to the estrogen deficiency that accompanies it.”


Surprisingly, the new research shows that it may not be a testosterone deficiency that plays a role in a reduced sex drive and more fat as men age but rather a deficiency in estrogen—the female hormone. The study points out that estrogen is needed by men as well as women and offers the first clear evidence that too little estrogen can cause certain “male menopause” symptoms. Testosterone is the main male sex hormone, and in men, some of the testosterone is converted into estrogen. As men age, the levels of both testosterone and estrogen diminish.


When men report to their doctors with the symptoms of andropause—diminished libido, strength, and energy—most physicians prescribe a testosterone patch, cream, or injection. (Testosterone cannot be given by mouth because it is very toxic to the liver when taken orally.) Physicians do not usually prescribe estrogen for men, and the study indicated that the way to remedy low estrogen is to give men testosterone and allow the body to convert it.


The study, which involved 400 healthy male volunteers, aged 20 to 50, separated the effects of testosterone and estrogen by first giving the men a monthly injection that temporarily reduced testosterone production to prepuberty levels. The volunteers were then given various doses of testosterone gel or a dummy gel, and half were also given a drug that prevents the conversion of testosterone into estrogen.


The design of the study allowed researchers to compare the effects of different levels of both estrogen and testosterone on strength, libido, and body composition.


The researchers concluded that muscle size and strength depended on testosterone, body-fat mass depended on estrogen, and both hormones were needed to maintain normal sex drive and performance.


Animal research supports this observation. In one experiment, mice that were altered so they did not produce any estrogen grew fat and had no sex drive. And on the human level, male-to-female transsexuals were noted to have an increased libido when given estrogen.


This new study seems to support the need for testosterone replacement as men manifest signs of andropause. Unlike estrogen, however, testosterone does not fall off as sharply with age as estrogen does in women after menopause.


At the end of the day, if a man’s serum testosterone is below the normal level and he experiences the symptoms of andropause, it seems medically safe, prudent, and efficacious to prescribe testosterone replacement therapy in a monitored environment. As the population ages and the life expectancy increases, the case for prescribing testosterone—to prevent frailty, increase muscle and bone strength, enhance mobility, and improve impaired thinking skills—becomes more justifiable, and its use can be expected to increase dramatically in the years to come.


Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).


Read discreetly with the Kindle™ edition of Penis Power™ now available for purchase from Amazon. The Nook Books™ edition from Barnes & Noble and the Sony eReader™ edition from Sony’s Reader Store. Available for under $7.00!

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Published on December 09, 2013 14:09 • 35 views

October 10, 2013

An estimated 240,000 men will be diagnosed with prostate cancer in America this year.  Hospitals and physicians are always searching for the ultimate treatment for a cure, favorable disease-free survival intervals, decreased patient morbidity, and a reduced risk of secondary cancers and other harmful side effects. Innovative changes have included the widespread use of robot-assisted laparoscopic prostatectomy and proton beam radiation treatment. 


Scripps Health in San Diego is about to open a $230 million proton beam therapy center, only the second one in California and the twelfth nationwide. This move has prompted Blue Shield of California to challenge the high cost of this radiation treatment, compared with the cost and effectiveness of standard radiation therapy.


Blue Shield has notified doctors throughout California that effective October 2013, it will not pay for a proton beam treatment because the insurer claims that simple radiation delivers “similar results.”


Hospitals, in their never-ending quest for the latest in high-tech care, are planning to open nearly 20 more of these proton centers in cities such as New York, the Washington DC area, and Phoenix.


Supporters say that the new proton therapy device, a 90-ton cyclotron, delivers a precise proton beam that affects only cancer cells and spares healthy tissues nearby, reducing the risk of secondary cancers. But insurance carriers quote multiple studies that have found that proton therapy doesn’t yield better results than the older, cheaper alternatives and that this quest for the high-tech advantage is one reason US health-care costs have been spiraling out of control.


Cary Gross, a researcher at the Yale School of Medicine, recently compared the results of 30,000 Medicare patients who received proton beam or standard radiation. He noted that “the rush to adopt proton beam is far outpacing the amount of evidence to support its use” and that “proton beam is really the perfect example of all that is wrong with our healthcare system.” He points out that Medicare has paid more than $32,000 for a course of proton beam treatment, compared with less than $19,000 for conventional radiation.


In defense of the company’s plan to move ahead with the high-tech cyclotron and proton beam therapy, officials at Scripps say that “the benefits of proton beam therapy are well established” and that “some of the research cited by critics is seriously flawed.”


What I find most troubling is that Blue Shield has apparently failed to recognize the long-term benefits of proton beam therapy and the savings that can be achieved over time. For example, proton beam therapy can cut treatment time for breast cancer patients in half compared with using traditional treatment modalities.


The scientific basis for proton beam therapy appears to be well established. The cyclotron speeds protons at nearly the speed of light to form a pencil-thin beam that attacks malignant cells with extreme precision. Traditional radiation bombards a tumor with more of a shotgun approach. The proton beam’s accuracy can be particularly helpful in tumors near a patient’s eyes, brain, or other critical organs.


Roughly 40 percent of patients treated at centers utilizing the cyclotron receive care for prostate cancer, even though the treatment is available for a wide range of tumors in the brain, breasts, and lungs.


Cigna, another large health insurer in California, is also getting into the act. The organization said that it considers proton beam “to be clinically equivalent, but not clinically superior” to standard radiation. As a result, Cigna has concluded that proton therapy isn’t considered “medically necessary” in most cases given its high cost.


Allowing insurance companies to dictate a doctor’s choice of treatment modality for a patient sets a very dangerous precedent. The point of proton beam therapy is to spare normal tissue. If there is an assumption that the therapy costs more, is such a cost justified in terms of the patient’s outcome? The jury is still out, but health plan restrictions based on cost alone is a dangerous practice.


Supporters of proton beam therapy say it helps patients with prostate cancer avoid common side effects from standard radiation, such as incontinence and erectile dysfunction.


Proton beam therapy probably does offer distinct advantages, but Scripps, like other centers acquiring the cyclotron, will have to make every effort to reduce costs so that the cost-effect argument is off the table. Moving forward across all areas of medicine, high-tech, expensive—and perhaps superior—treatment modalities will be coming on line, and the ultimate challenge for the entire health-care industry is to bring costs to an affordable level so patients can avail themselves of these new and better treatments.


Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).


Read discreetly with the Kindle™ edition of Penis Power™ now available for purchase from Amazon. The Nook Books™ edition from Barnes & Noble and the Sony eReader™ edition from Sony’s Reader Store. Available for under $7.00!

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Published on October 10, 2013 10:00 • 60 views

October 3, 2013

What do you call foreplay in a marriage? Answer: begging. This old joke reflects a common problem–one partner wants sex a lot more than the other does. About one-third of the couples seeking marital or relationship help do so because of a marked discrepancy in the desire level of each partner.


It is a fact of life that, on average, men have higher levels of desire than women, and they find themselves in the mood for sex more often than women. No man likes to be rejected, even if he is secure in his partner’s love and knows he is adored. No man likes to beg for sex.


Unfortunately, the problem can get worse if you suppress your sexual frustration. You run the risk of becoming hostile and resentful, usually letting those feelings out in ways that may have nothing to do with the real issue. You might stop initiating sex altogether rather than face the possibility of rejection. You might begin to shy away from all displays of affection. And, of course, you might be tempted to look elsewhere for sex.


I believe that a superpotent man should do everything in his power to fulfill his sexual needs. Naturally, every man’s ideal is to have his partner respond with enthusiasm each and every time he wants to have sex. In reality, coaxing, cajoling, and all forms of seduction might have to be employed, and even some subtle form of bribery (jewelers and florists can attest to that).


No one should be reduced to actual begging, although I have a surprisingly large number of patients who are not above pleading. When approached with a sense of humor, even that may be justified. Superpotent men are pragmatic: they do whatever it takes to get the job done.


The best approach is honest communication. You must break the silence barrier. Talk openly and candidly about your needs and about the discrepancies in your desire levels. Educate your partner. She might not realize how frustrated you feel. She might not understand how demeaning it is to be told no. She might not understand the importance of sex in your overall happiness. You can never know unless you talk to her–she might be perfectly willing to accommodate you and change her behavior so that you can express yourself sexually.


You must also be prepared to listen to her point of view, understand her needs, and negotiate an agreement that can make you both happy. You might have to make some changes yourself, like having sex at different times or initiating it in new ways.


If your efforts fail, then it may be time to see a counselor. If two people care enough about satisfying each other’s needs, they can usually overcome the complications that are caused by a difference in levels of desire.


Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).


Read discreetly with the Kindle™ edition of Penis Power™ now available for purchase from Amazon. The Nook Books™ edition from Barnes & Noble and the Sony eReader™ edition from Sony’s Reader Store. Available for under $7.00!


 


 


 


 


 

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Published on October 03, 2013 03:00 • 60 views

September 11, 2013

A study recently published in the medical journal JAMA Internal Medicine noted that prescriptions given to men 40 and older for testosterone replacement therapy (TRT) increased by 300 percent between the years 2001 and 2011.


An even more astonishing fact? About one-fourth of the men involved had not received a baseline testosterone test. Blame this wave of interest on the plethora of synthetic TRTs now available and the pervasive promotion and constant advertising. But research has repeatedly shown that only about 2 percent of the United States male population ages 40-79 truly needs TRT.


In addition to the heavy advertisement by mainstream pharmaceutical companies pushing products like Axiron, Fortesta Gel, Testim, Bio-T-Gel, and AndroGel, the popularity of these FDA-approved medications has been further accelerated by the technology that allows these drugs to be absorbed transdermally by patch, gel, or cream.


But even when used by men with hypogonadism (legitimately low serum testosterone), there are dangers. All these drugs can cause diminished sperm count, thickening of the blood, and acceleration of a previously undiagnosed prostate cancer.


Compounding the problem (and trying to ride on the coattails of legitimate TRTs) are an endless number of non-FDA-approved supplements that are heavily promoted and overrun by false claims and exaggerated innuendo. These “snake oils” are marketed with promises to melt body fat; improve motivation and zest for life; recharge energy, strength, stamina, and sports performance; enhance sexual performance; and bring back romance. With names like Troxyphen, HexaTest, High T, Manimal, and Andro400, these supplements are guaranteed to benefit the seller far more than the buyer. These products are not FDA approved, nor are they generally tested to see how well they work. Advertisers can make any claim without the need to verify.


“It’s just a bunch of nonsense,” said Dr. Ellis Levin, chief of endocrinology, diabetes, and metabolism at UC Irvine School of Medicine. “People can claim whatever they want, and nobody will hold them to the truth.”


However, hypogonadism is a real medical problem, and patients with abnormally low testosterone levels will benefit from TRT. In order to establish this diagnosis, a blood test measuring testosterone level must be done by a responsible physician or lab. (The normal level of testosterone is 300-1,000 nanograms per deciliter of blood.) The test must be performed twice, once in the morning when levels are at their highest and once after fasting. If both levels are low, such a patient is an excellent candidate for TRT. The level of testosterone must be monitored to ensure that it remains within the normal range to be therapeutic without being harmful.


After a man turns 40, his testosterone will decrease roughly 1 percent a year. But that does not mean that a responsible physician will treat all older men with TRT. The responsible urologist will treat patients only if they are symptomatic, particularly as they age. Symptoms might include loss of energy, “grumpy old man syndrome,” loss of libido, loss of muscle mass, and difficulty with weight control.


Another key issue when dealing with male sexual dysfunction or male sexuality in general is the placebo effect. Over the years, much of male sexuality has been defined as “99 percent between the ears and 1 percent between the legs.” The unscrupulous marketers of non-FDA-approved products and supplements, who often make bold and false claims that we all recognize—love, sex, size, desire, and performance will all be enhanced—rely on this placebo effect. In many well-controlled scientific studies, about 40 percent of patients receiving the placebo report that they experienced effects similar to those experienced by patients receiving the medication. Male sexuality—being so intertwined with imagination, mental gymnastics, the power of suggestion, and the illusion of sex appeal—becomes the perfect foil for the wide distribution and enormous profitability of thousands of male-enhancement products by companies capitalizing on the placebo effect or the power of suggestion.


There is a real place for TRT in patients who are hypogonadal, but these men represent a minority among the number of men who are spending their hard-earned dollars on worthless placebos.


The takeaway message is that if you have legitimate symptoms—weakness, fatigue, loss of libido, increasing abdominal girth, the grumpy old man syndrome—then it is wise to seek urologic care, have your serum testosterone appropriately tested, and, if deficient, use an FDA-approved product in accordance with the directions prescribed by your physician.


Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).


Read discreetly with the Kindle™ edition of Penis Power™ now available for purchase from Amazon. The Nook Books™ edition from Barnes & Noble and the Sony eReader™ edition from Sony’s Reader Store. Available for under $7.00!

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Published on September 11, 2013 03:00 • 83 views

August 15, 2013

A new study published in the Journal of the National Cancer Institute confirmed an earlier study in 2011 that found a higher risk of prostate cancer among men who consumed omega-3 fatty acids, raising new questions about the safety of fish oil supplements.


The research reported a 71 percent higher risk of dangerous high-grade prostate cancer among men who ate fatty fish or took fish oil supplements. These findings were widely reported in the media and generated telephone calls from many of my patients.


Alan Kristal, researcher at the Fred Hutchinson Cancer Research Center and senior author of the study, said, “We’ve shown once again that use of nutritional supplements may be harmful.” Although scientists are still puzzled as to why omega-3 fatty acids appear to be linked to a greater risk of prostate cancer, the findings suggest that these acids are somehow involved in the formation of tumors. A large European study also found the same link between omega-3 fatty acids and prostate cancer.


Researchers concluded that “the consistency of these findings suggests that these fatty acids are involved in prostate tumorigenesis and recommendations to increase long-chain omega-3 fatty acid intake, in particular through supplementation, should consider its potential risks.”


Vocal critics of the study, however, have pointed out reasons to be cautious. First, no fish oil supplements were given to the subjects, and no crossover studies were conducted. Researchers merely looked at blood levels of long-chain fatty acids, such as EPA and DHA, which are found in fish. Second, the study was based only on accumulated data from participants in the Prostate Cancer Prevention Trial, which was conducted from 1993 through 2003. And third, the study reported only an observation that levels of omega-3 fatty acids and the incidents of high-grade prostate cancer were found together in this particular population.


The critics further emphasize that “correlation is not causation.” Observational studies like this one are not randomized or controlled; they simply point to associations. Because the study contains a slew of undocumented variables and contradictory findings, it might be worthwhile pointing out the participants and their possible confounding risk factors:


1. Fifty-three percent of the subjects with prostate cancer were smokers.

2. Sixty-four percent of the cancer subjects regularly consumed alcohol.

3. Thirty percent of the cancer subjects had at least one first-degree relative with prostate cancer.

4. Eighty percent of the cancer subjects were overweight or obese.


These statistics were compiled by Robert Roundtree, MD, chief medical officer at Thorne Research.


I have not yet seen a good peer-reviewed randomized controlled trial testing the effects, negative or positive, of omega-3 fatty acids. Until I do, I must go back to the age-old medical adage Do No Harm. Doctors generally do not recommend fish oil supplements because the true benefits are unclear.


Even though this published study did not evaluate the supplements themselves but rather the blood levels of omega-3 fatty acids, the data strongly supports the connection between omega-3 fatty acids and the incidents of high-grade prostate cancer. Therefore, under no circumstances would I take these supplements, nor would I recommend them to my patients unless I had a compelling reason to do so. To date, I have not found that compelling reason.


Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).


Read discreetly with the Kindle™ edition of Penis Power™ now available for purchase from Amazon. The Nook Books™ edition from Barnes & Noble and the Sony eReader™ edition from Sony’s Reader Store. Available for under $7.00!

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Published on August 15, 2013 10:55 • 67 views

August 9, 2013

It is impossible to come up with a universal definition of premature ejaculation because there is so much variation among individuals. I have met women who are perfectly satisfied with intercourse that lasts two or three minutes, while others are frustrated when their husbands cannot last more than fifteen or twenty. It comes down to individual judgment: do you and your partner feel that you reach orgasm too quickly? If so, there are many practical steps you can take to solve the problem.


The key to prolonging intercourse is to become so well tuned to your own body mechanisms that you can take action to hold off ejaculation before it is too late. Ejaculation is basically a two-step process. As arousal increases, you eventually reach the point of no return: ejaculatory inevitability. That is the moment when you feel that you are going to climax and there is nothing you can do about it. Physiologically speaking, you are correct; there is nothing you can do about it. Once that point is reached, the ejaculation reflex is set in motion, the muscles of the perineum forcefully contract, and the seminal fluid is already on its way out. In seconds, the expulsion stage is triggered. To delay ejaculation, you must be aware enough to do something before the point of inevitability sneaks up on you.


The first step is to pay close attention to physical sensations as you approach ejaculation. Just as you learned when to start braking your car as you approach a stop sign, you can learn to recognize when you are getting too close to the point of inevitability. That is the time to make adjustments. Some men try to distract themselves by thinking of anything besides what is going on: baseball, work, or anything nonsexual. Unfortunately, this is rarely effective. Even if it does slow down the process, it also separates you from the intimate connection of making love and ultimately detracts from your full enjoyment of the moment.


A more effective and far more enjoyable technique is to alter the way you are thrusting at that point: change the angle, speed, or depth of your thrusts, which will shift the sensations away from the head of your penis (the glans, which is the most sensitive part), thereby delaying ejaculation. Intercourse does not have to be limited to deep, rapid thrusts. You can make love slowly. You can move in a circular motion or enter only partway. The variations are limitless. The secret is to pay attention to the sensitivities of your own body and then make the appropriate adjustments to your sexual technique.


You can also stop thrusting entirely. Try suspending motion for a while and just lying together with your penis fully penetrated. It is a great way to reduce arousal and prolong intercourse. It can also be wonderfully romantic. When you feel you can resume thrusting without ejaculating immediately, resume your motion slowly.


Another variable is to withdraw entirely. This “start and stop” method is often used by sex therapists. When you feel yourself nearing inevitability, simply pull out and rest. If your relationship is a good one, your partner should understand the need for this and welcome the opportunity to do other erotic things. This is the time for using your hands, lips, tongue, and any other body part that gives you pleasure while at the same time giving your penis a break from direct stimulation. When you resume intercourse, it will be that much more intense and your total time of penetration will increase. Do not be afraid of losing your erection if you stop thrusting or pull out entirely. You might lose it, but so what? It will come back with the right stimulation.


It is important not to view early ejaculation as a personal failure. If it occasionally happens, it is probably due to a long lapse between orgasms or to nervousness: a new, passionate love affair might be so exciting that the threshold for orgasm is lowered considerably. Even if the problem is chronic, I can assure you that it is not a sign of permanent inadequacy or diminished manhood, but simply a matter of bad habits that can be changed with practice and patience. The good news is that no matter where you start from, you can vastly increase your ejaculatory control.


 


Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).


Read discreetly with the Kindle™ edition of Penis Power™ now available for purchase from Amazon. The Nook Books™ edition from Barnes & Noble and the Sony eReader™ edition from Sony’s Reader Store. Available for under $7.00!

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Published on August 09, 2013 03:18 • 889 views

July 24, 2013

I cannot count the number of men who have asked me–as if it were just some casual question that happened to occur to them at that moment–if the size of their penis was “normal.” No man has ever worried that it might be too big. This preoccupation with penis size is one of the saddest and most complicated issues I encounter as a urologist.


In fact, the variation in size among human penises is less than that for hands, fingers, or noses. Penises can be as short as one and a half inches or as long as eight inches. The number of organs that fall at the extremes are exceedingly few. The average length of a penis in its fully flaccid (relaxed, limp, normal) state is about four inches. The overwhelming majority of men fall within centimeters of that average. Penis girth varies less, ranging between one to one-and-a-half inches in diameter when flaccid.


A very tall man might have a longer penis than a short man, just as he will probably have bigger feet and hands. The difference in penis size between two such men will be far less than that of their other appendages. A short man’s hand might be three full inches shorter than that of a tall man. He might wear a size eight shoe compared to a size thirteen. But his penis might only be a fraction of an inch shorter. I have often seen penises on short men that were as big, or bigger, than those of most professional basketball players.


Of far more importance, given the concerns of most men, is the size of the erect penis. The erect penis averages about six inches in length (although most of my patients prefer the phrase “half a foot long”). More importantly, the variation in the size of the erect penis is far less than that of the flaccid penis. If one man’s penis is five inches long when soft and another’s is three inches long, that two-inch size difference is likely to shrink to near zero when they become erect. It is even possible for the smaller penis to be bigger when erect.


The range in size for erect penises is simply much less than that of flaccid penises. It is as if nature wanted humans to propagate and so made it possible for just about any man, regardless of his overall size, to mate with any woman. So, when you hear men brag that their penises are a foot long, take it with a few grains of salt. They are either rare exceptions or liars. The only technical way they are not lying is if they are adding to their measurements that portion of the penis we do not normally think about because it is inside the body. (The idea is akin to measuring a hose attached to a sink inside a house because the penis actually begins several inches deep in the pelvic cavity.)


When people ask me about the biggest penis I have ever seen, I tell them it did not belong to any of the oversized professional athletes I have examined, nor to any of the Hollywood “studs” who have come through my office. I tell them that it belonged to a short, slightly built old man who was having prostate surgery. A pleasant, mild-mannered, pious man in his eighties, this patient was married to the same woman his entire adult life. Neither of them had the slightest idea of how relatively huge the penis that had sired their nine children was. I have never had so many helpers in the operating room! Half the nurses in the building wanted to assist me just to view this magnificent organ.


Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).


Read discreetly with the Kindle™ edition of Penis Power™ now available for purchase from Amazon. The Nook Books™ edition from Barnes & Noble and the Sony eReader™ edition from Sony’s Reader Store. Available for under $7.00!

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Published on July 24, 2013 03:00 • 1,220 views

July 17, 2013

Every day on the Internet, I get six or more offers on how to make my penis longer, wider, thicker, or more appealing. These ads promise to “satisfy my dreams.” They offer me some magic potion or surgery that “guarantees” to enlarge my penis.


Is there a legitimate way to make your penis any larger? The answer is unequivocally no! Many men have questions about a variety of “enlarging” procedures known collectively as phalloplasty. Surgeons are using a number of techniques, including skin grafts (known as dermal matrix grafts), in an attempt to increase the girth of the penis. These procedures, as well as a lengthening technique that increases penis length by severing the suspensory ligaments, are falsely represented as legitimate ways to increase the size of the penis.


Phalloplasty and lengthening procedures are both inventions of hucksters, charlatans, and fakes. Not only are they ineffective, they are also highly risky. The idea that men need to have huge penises is a cultural myth perpetuated more by men than by women. There is hardly a man alive who does not dream of a bigger penis. Be assured there is no medically or surgically effective way of doing this safely at the present time. To believe otherwise is to subject your penis to gross disfigurement.


My advice to the misinformed men out there is do not believe the enlargement and enhancement “bigger is better” ads appearing on the back pages of men’s magazines. They are totally illegitimate! Rather, just take a good look in the mirror, gaze down at that friendly organ hanging between your thighs, and be happy with it. If it functions well, then you have nothing to worry about. Do yourself the favor of treating it as a friend. Protect it from the mutilation that will occur if you trust anyone who promises an unobtainable result.


Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).


Read discreetly with the Kindle™ edition of Penis Power™ now available for purchase from Amazon. The Nook Books™ edition from Barnes & Noble and the Sony eReader™ edition from Sony’s Reader Store. Available for under $7.00!

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Published on July 17, 2013 03:30 • 233 views