Dudley Seth Danoff's Blog, page 3

At Last, The Real Deal Online

We are talking about Viagra, the best-selling drug for erectile dysfunction.

Pfizer, the manufacturer of Viagra, has taken the unusual step of selling its erectile dysfunction drug directly to consumers on its website in an effort to establish a presence in the huge online market. The “little blue pill” is one of the most counterfeited drugs in the world.

We are not talking about chump change here. Pfizer admits that Viagra alone brought in more than $2 billion in sales in 2012. Many experts estimate that Pfizer could be losing hundreds of millions of dollars a year to a huge black market of online pharmacies that cater to men too embarrassed to buy the drug through traditional sources.

Pfizer has made a deal with CVS/pharmacy that allows patients in the United States with a valid prescription for Viagra to fill their order through the new website, which prominently features the slogan “Buy real Viagra.” Patients will need a valid prescription from a doctor but won’t need to visit the pharmacy.

The online sale of Viagra is attractive because the drug has powerful brand recognition. There is widespread competition from counterfeiters, and Pfizer hopes to capitalize on this market.

According to the research firm IMS Health, about eight million Viagra prescriptions were written in the United States last year. Victor Clavelli, a marketing executive at Pfizer, reports that Viagra appears in about 24 million Internet searches a year, often in phrases like “buy Viagra.” There is clearly a disconnect. “Our goal is to just make sure those patients actually get the real Viagra,” said Mr. Clavelli.

Arriving on the market in 1998, Viagra was the first oral medication specifically indicated for erectile dysfunction. Since that time, Pfizer has gone to great lengths to make erectile dysfunction mainstream and to take the stigma away from male impotence. The “little blue pill” has become enormously popular and is widely used. But because of the drug’s popularity and its relative high cost, a vigorous black market developed and expanded as online commerce flourished.

Matthew J. Bassiur, vice president of Pfizer Global Security, said that the company had seen counterfeit medicines manufactured “in filthy and deplorable conditions.” He also noted that some samples of counterfeit Viagra tested by Pfizer had contained “pesticides, wallboard, commercial paint and printer ink.”

It is clear that many people do not realize the terrible risk that taking counterfeit Viagra poses to their general health. These results “motivate us to continue our aggressive global efforts to stop those who prey on unsuspecting patients,” said Mr. Bassiur.

In 2011, Pfizer evaluated 22 websites appearing in the top search results for the phrase “buy Viagra.” Chemical analysis found that about 80 percent of the pills were counterfeit. In addition, the fake Viagra pills contained only about half of the active ingredient (sildenafil citrate) compared with the legitimate product.

But many pharmacies, based both in the United States and abroad, sell legitimate drugs online. These medicines require a doctor’s prescription. Purchasing drugs online from a foreign country is technically illegal, but the federal government does not generally prosecute individuals who purchase medicine in small quantities for their own use.

A spokesman from Pfizer notes that it is difficult to distinguish the legitimate pharmacies from the illicit ones, but the company hopes that the Pfizer brand recognition will reduce the risk of buying a counterfeit.

The cost of the drug remains a problem. The average list price for Viagra is about $22 a pill, while many online pharmacies sell the pills for about $10. Price could become an important factor, but Pfizer hopes the decreased risk of purchasing a bogus and possibly harmful pill will offset the higher cost.

The good news is that customers who buy Viagra through the Pfizer website receive three free pills in their first prescription (which usually contains six pills) and 30 percent off their second prescription. This same promotion and discount, however, is available in a doctor’s office as well. Many in the pharmaceutical industry see Pfizer’s move as part of a continuing effort to market drugs directly to consumers and bypass insurance companies that can be reluctant to pay for so-called lifestyle drugs.

Viagra is the dominant drug for sexual dysfunction (taking 49 percent of the market, followed by Cialis at 39.7 percent and Levitra at 8.6 percent) and is now available online. The bottom line? Be careful what you buy on the Internet—and be sure that the product you receive is the product you paid for.

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!

Size Indeed Matters, Suggests Male Attractiveness Study

Here we go again: Does size matter? Was Freud wrong when he said, “Women have penis envy”? In my experience, women have penis curiosity, and men—wondering if their penis is long enough or wide enough—have penis envy. Freud asked, “What does a woman want?” A new study from Australia suggests that she wants a guy who is tall and well endowed.

Since Darwin, evolutionary biologists have studied the role of female mate choice. Generally, women seem to prefer taller guys with broader shoulders. If we believe the biologists, the relatively larger size of the human genitalia compared with our ape cousins suggests a link by preference. A unique study by biologist Brian Mautz, of the University of Ottawa, Canada, published recently in the Proceedings of the National Academy of Sciences, delivers the message that “penis size does matter for attractiveness.”

In the study, more than 100 heterosexual Australian women, ages 18-53, were shown a series of digitally projected life-size images depicting about 350 varied male outlines in a nonaroused state and were asked to rate the images. The women were told only that the study was measuring male attractiveness. Not surprisingly, the women rated “taller and more broad-shouldered men as more attractive.” This result has been reported in many past studies. Surprisingly, however, being well endowed mattered almost as much as height in this new study.

What makes this study important, says evolutionary biologist Wyatt Anderson of the University of Georgia in Athens, is that “sex and behavior are important parts of evolution for any species, so the results are worth noting.” The study was well controlled and appears to be valid.

One of the most interesting parts of the study was that the attractiveness results stopped increasing when the flaccid penis length exceeded about three inches. This observation supports the idea that the results may have been more a matter of pleasing proportional size in the most attractive male shapes. It is also important to note, from a urologic perspective, that penis size, like almost any other measurable biologic phenomenon, follows the bell-shaped curve. The overwhelming majority of men (particularly in the flaccid state) will fall in the middle of the bell-shaped curve, while the rare exceptions at the low end and the high end can be viewed as outliers.

The study perhaps suggests that, at least in terms of penis size, evolution does have an effect on humans. The authors of the study acknowledge that modern culture may have played a role in what the women rated as attractive. But the study also suggests that “a preference for the well-endowed may have played a role in the evolution of the human male in prehistory” and notes that “people have been wearing clothing for about 170,000 years.”

I can only turn to my experience practicing urology for nearly 40 years. I have seen more penises than can fill the Rose Bowl and have spoken with thousands of women “attached” to many of those penises. Never once has a woman asked me to make her man’s penis longer or wider. However, many women have asked me if I could make it a little bit firmer and attach it to a sweeter guy.

And the debate goes on!

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!

Penis Size and Augmentation

Let’s get the facts on the table at the outset: There is no legitimate or safe way to enlarge your penis! The size of your penis is genetically determined. It is not related to race, height, weight, shoe size, or hand size.

The size of the corpora cavernosa (the two chambers that fill with blood when the penis is erect) is predetermined by heredity. When the chambers are filled with blood at the height of stimulation, both the length and the girth are fixed. Even when surgeons implant a penile prosthesis in a patient with erectile dysfunction (such as after prostate surgery), they must custom measure and fit the implant to the exact dimension of the existing corpora.

Every day on the Internet, I (along with millions of men around the world) get a dozen or more offers to make my penis longer, wider, or more appealing. These ads are promising to “satisfy my dreams.” They offer me a magic potion or a ridiculous surgery that uses a grafting material that “guarantees” to enlarge my penis.

As my friend Thomas Lue, professor at the University of California, San Francisco, and a world-class authority on erectile dysfunction, told me, “The surgical enlargement of the penis is no more effective than taking your penis and whacking it with a large wooden mallet, which essentially results in a flattened, squashed, and mangled ‘Polish sausage’ effect.”

One type of penis enlargement surgery that has been foisted on the unsophisticated consumer who is looking to be the “biggest on the block” consists of nothing more than cutting the suspensory ligaments of the penis. When cut, these ligaments, which are attached to the undersurface of the pubic bone, give the appearance of length by allowing the penis to hang a bit lower. This effect is produced at the expense of losing the erect “angle of the dangle.” Absolutely no length is gained in the erect penis.

The other technique that claims to increase penis length and girth involves applying a grafted material (usually skin, fat, or a synthetic material) within the shaft of the penis. This technique usually leads to an unsightly deformity. Furthermore, this procedure can cause serious damage and complications.

The three oral erectile dysfunction drugs currently on the market (Viagra, Cialis, and Levitra) give one a firmer, but not a bigger, penis. There is simply no effective way to increase the length or width of the human penis. From the sincerest depths of my urologic heart, I pity the patient who tries.

The overwhelming truth is that penis size is inconsequential in most relationships. The majority of women whom I have interviewed have no preference in penis size, as long as it is firm and attached to a loving and kind person. The notion that an enormous penis is somehow a sign of manhood or will somehow magically improve your love life is a myth that is propagated without shame throughout the mass media.

If men spent less time worrying about the size of their penises and more time learning how to use what they have more effectively, then all of the hucksters selling the illusion of happiness through penile enlargement would soon find themselves justifiably out of business.

The Health Benefits of Having Sex

Nothing is more wonderful for the human spirit, body, and mind than the free and uninhibited expression of sexuality. Nothing is more glorious than the joyful sharing of physical pleasure between two generous, enthusiastic human beings. A current plague of confusion and self-consciousness causes most men to have less sex than they would like, and they enjoy the sex they do have a lot less.

As a health benefit, sex should be a fun and relaxing part of your life, not a chore. It is certainly life’s cheapest luxury. But for too many men and women, sex has become a worrisome task—a source of tension, a burden. Sex is viewed as a problem to solve or a test to take. On the contrary, sex should be simple and natural, and it should bring a pleasure that erases worries, tensions, and burdens.

Using your penis for the purpose nature intended not only gives us one of life’s great pleasures but also provides excellent health benefits. Sex is good for your cardiovascular health, your mood, and your psychological well-being. Penis use is a natural tranquilizer with no bad side effects. Sex also provides physical exercise and is excellent for overall fitness. It benefits circulation, stimulates the nervous system and the prostate gland, and clears up mental cobwebs by invigorating the whole body.

Men who are sexually frustrated tend to be tense and irritable, and they often seem angry at the world. Anger is an emotion to be avoided at all costs, as it has an adverse effect on your mental and cardiovascular health. But men who are sexually satisfied and feel good about themselves as sexual beings tend to have a positive outlook and a warm glow of health.

Contrary to certain myths, you cannot wear out your penis with sexual activity. There is no preset allotment of orgasms. Vigorous exercise of the penis is best expressed with the childhood ditty “Use it, use it, you cannot abuse it, and if you don’t, you’re gonna lose it.”

The general condition of your mind and body is reflected in the health of your penis power. For that reason, it is vital for men to maintain a high level of mental and physical well-being. Here are some basic tips:

Get fit and stay fit: A good exercise program is central to overall health and sexual fitness. It takes energy and strength to make love. The muscles of your arms, legs, back, and abdomen are all involved. If your body becomes flabby, your penis also risks becoming flabby. Build up your muscle strength with weights, push-ups, sit-ups, yoga, or whatever exercise you prefer. You don’t have to be sculpted like a Greek god, but it is important to develop muscular strength and flexibility.


Commit to cardiovascular fitness: A vigorous half hour of aerobic exercise four or five times a week is recommended for developing and maintaining cardiovascular fitness. Physical inactivity leads to deterioration of your body as a whole and can also lead to deterioration of your penis power. If you start wheezing or gasping for breath while making love, your penis will get the message that you need to rest, and that is exactly what it will do.


Pay attention to what you eat: A diet low in saturated fat and high in fiber is the most effective diet for maintaining penis power. Getting the proper amount of blood flow is essential to maintaining an erection, and sufficient blood flow depends on clean arteries. Do not gum up the works by ingesting saturated fats and bad cholesterol. If you have ever made love when you felt bloated or constipated, you know how much better you function when your digestive system is not overtaxed. Do not overeat—and make sure you consume plenty of fiber. Wining and dining can be romantic, but the romance withers if you overdo either one. Too much alcohol might increase your desire, but it will surely diminish your penis power. Too much dining will make you feel sluggish, heavy, and tired.

In addition, the maintenance of good prostate health is essential. Reliable evidence supports a low-fat, high-fiber, high-protein diet in addition to regular exercise as part of a good overall regimen to keep your prostate healthy.

Maintain weight control: Let’s face the truth—it is a lot easier to operate smoothly and vigorously in bed if you are not carrying a 20-pound belt of blubber around your waist. Not only are there health risks to being overweight, but for most women, a lean physique is much more attractive than a chubby one. But even more important than how other people see you is your perception of your body. Maintaining a healthy body weight encourages self-confidence and promotes a healthy and positive outlook on life. In addition, if you are overweight and looking down at your penis from above a big belly, you might start thinking of your penis as small because layers of fat obscure so much of it. The illusion of a short penis, in turn, will cause you to think “small” about your penis power.

In general, I have found that men with poor body images have some degree of penis weakness. Men who are comfortable with their bodies and are content with their looks have a higher likelihood for super potency. Believe it or not, men with positive body images are not necessarily hunks. Some good-looking, well-built men have far worse body images than men with ordinary bodies. It is all a matter of how you see yourself. Some men are so insecure and vain that if they do not see a “Brad Pitt” when they look in the mirror, they hate their bodies and ultimately spread a pall of negativity on their self-esteem. Others are content with what nature gave them, as long as they stay in reasonable shape. Every man is capable of realizing his personal body-image goals. To start, set your standards of health and fitness, maintain a regular routine, and above all, have more sex!

 

Birth Control Pills For Men, Not Yet!

I recently appeared on the television show The Doctors to answer questions about the development of a male contraceptive pill.

A lot of interest has been generated because researchers have focused their efforts over the past several years on developing a male contraceptive similar to the female pill. Although this research has been going on for decades, the momentum seems to be increasing, and now scientists have potentially found an effective solution. The big question is, will guys take the pill (and will ladies trust them)?

Current efforts are focused on developing a pill that would block the function of vitamin A in the testes and, theoretically, reversibly turn off sperm production. After 50 years of work, researchers have learned that the conversion of vitamin A to retinoic acid in the testes can be blocked. The main concern is finding a way to block this conversion in the testes without affecting the function of vitamin A and retinoic acid in other tissues. Tests with mice have shown a 100 percent success rate.

Researchers have also found a hormonal-free way to prevent the testicles from producing sperm and are testing a drug that targets a particular protein that is critical for sperm production. The treatment is reversible—when mice were taken off the medication, they became fertile again.

In addition, there are two classes of drugs on the market that cause men to experience retrograde (backward) ejaculation, which, in essence, keeps men from emitting semen during orgasm. However, it is impractical to use these drugs in clinical practice because one is an antihypertensive and the other is an antipsychotic medication. Without modification, they would adversely affect blood pressure and mood.

Hormones delivered by implants, injections, gels, or pills have a profound effect on sperm production. Testosterone suppresses the production of sperm by working directly on the testicles, and progestin sends signals from the brain to the testes to stop producing testosterone. The long-term effects of these medicines are unknown, but current knowledge suggests that prolonged use could increase the risk of heart disease and prostate cancer.

A researcher in India is developing a method called RISUG (reversible inhibition of sperm under guidance), in which a polymer is injected into the vas deferens and blocks sperm transport. According to the developer, the procedure is reversible. RISUG does require a small surgical incision in the scrotum to access the vas deferens. In my judgment, this option does not seem any better than a vasectomy, but the jury is still out. The procedure is now in late phase 3 clinical trials in India.

Remember, no contraceptive measure is 100 percent effective—not even hysterectomy. (Abdominal pregnancies can occur even after a total abdominal hysterectomy.) RISUG may be a promising means of birth control for males, but it is too early to draw any conclusions. The current media hype is unwarranted. Science will have to run its course and complete well-designed clinical trials before this, or any other, method can be recommended.

There is no question that the true need for a male contraceptive pill is compelling. Men produce about 1,000 sperm a second. At the end of the day, the only effective methods of male contraceptives are vasectomies (successfully reversible in greater than 95 percent of cases), condoms, and the tried and true method of “keep your zipper up!”

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!

Birth Control Pills For Men…Not Yet!

I recently appeared on the television show The Doctors to answer questions about the development of a male contraceptive pill.

A lot of interest has been generated because researchers have focused their efforts over the past several years on developing a male contraceptive similar to the female pill. Although this research has been going on for decades, the momentum seems to be increasing, and now scientists have potentially found an effective solution. The big question is, will guys take the pill (and will ladies trust them)?

Current efforts are focused on developing a pill that would block the function of vitamin A in the testes and, theoretically, reversibly turn off sperm production. After 50 years of work, researchers have learned that the conversion of vitamin A to retinoic acid in the testes can be blocked. The main concern is finding a way to block this conversion in the testes without affecting the function of vitamin A and retinoic acid in other tissues. Tests with mice have shown a 100 percent success rate.

Researchers have also found a hormonal-free way to prevent the testicles from producing sperm and are testing a drug that targets a particular protein that is critical for sperm production. The treatment is reversible—when mice were taken off the medication, they became fertile again.

In addition, there are two classes of drugs on the market that cause men to experience retrograde (backward) ejaculation, which, in essence, keeps men from emitting semen during orgasm. However, it is impractical to use these drugs in clinical practice because one is an antihypertensive and the other is an antipsychotic medication. Without modification, they would adversely affect blood pressure and mood.

Hormones delivered by implants, injections, gels, or pills have a profound effect on sperm production. Testosterone suppresses the production of sperm by working directly on the testicles, and progestin sends signals from the brain to the testes to stop producing testosterone. The long-term effects of these medicines are unknown, but current knowledge suggests that prolonged use could increase the risk of heart disease and prostate cancer.

A researcher in India is developing a method called RISUG (reversible inhibition of sperm under guidance), in which a polymer is injected into the vas deferens and blocks sperm transport. According to the developer, the procedure is reversible. RISUG does require a small surgical incision in the scrotum to access the vas deferens. In my judgment, this option does not seem any better than a vasectomy, but the jury is still out. The procedure is now in late phase 3 clinical trials in India.

Remember, no contraceptive measure is 100 percent effective—not even hysterectomy. (Abdominal pregnancies can occur even after a total abdominal hysterectomy.) RISUG may be a promising means of birth control for males, but it is too early to draw any conclusions. The current media hype is unwarranted. Science will have to run its course and complete well-designed clinical trials before this, or any other, method can be recommended.

There is no question that the true need for a male contraceptive pill is compelling. Men produce about 1,000 sperm a second. At the end of the day, the only effective methods of male contraceptives are vasectomies (successfully reversible in greater than 95 percent of cases), condoms, and the tried and true method of “keep your zipper up!”

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!

Young at Heart, Young in Person

An ageless love life begins with a confident approach toward sex. Celebrate Valentine’s Day by exploring the possibilities—don’t let your age stop you.

I cannot reiterate this point enough: attitude is the key to penis longevity. My superpotent patients tell me that sex gives them as much joy at seventy as it did at twenty. Some say it is even better! From my clinical experience, I have concluded that equal pleasure can be obtained from occasional, prolonged intercourse with one orgasm as with frequent, rapid intercourse with multiple orgasms.

Many men give up their sex lives as soon as they start identifying themselves as “old,” especially once they retire. The idea that retirement equals nirvana is an unfortunate myth perpetrated in our modern culture. I have observed in my practice that retirement can lead to inertia, boredom, and stagnation. Many of my older patients, even those who are wealthy, choose not to retire. They may cut back their hours and delegate a lot of responsibility to others, but they remain active, both in work and in play. These individuals tend to be my healthiest, most superpotent patients. They live longer, and the quality of their lives seems better than those who stop challenging themselves and throw in the towel for retirement. Do not voluntarily retire your penis unless you are forced to by circumstances beyond your control, such as a serious illness.

Until recently, our society’s image of aging usually excluded sex. It had been considered unseemly for older people to talk about it, much less do it. I know elderly people who have to sneak around to have sex just as they did when they were teenagers because they know it will be frowned upon by their peers and especially by their own children. Other older people stop having sex altogether because they buy into the notion that they are supposed to give up sex. They suppress their sexuality because it somehow seems inappropriate to express it.

It is my hope that the generation I now see entering their senior years challenges all of that. They deserve active, healthy sex lives as long as they remain physically fit. It will not harm them unless they try to do things their muscles and joints are too weak to manage or they overextend themselves to the point of exhaustion. Do not expect to do at fifty what you could do at forty, or do at sixty what you could do at fifty, and so on. Adjust your sexual activities as your body changes, just as you adjust other activities. Look upon the adjustment as both a new challenge and a new opportunity. As you age, learn to use your mind and imagination to make up in creativity what you may lack in physical strength.

As long as you are able to breathe, move your extremities, maintain relative control over your bodily functions, remain alert enough to identify the date and day of the week, and sustain a positive mental outlook, you can continue to exercise your penis power indefinitely. You can help stay superpotent as you age by maintaining good overall health habits: exercising regularly; minimizing your consumption of fat and cholesterol; controlling your weight; refraining from smoking, excessive drinking, and drugs; watching your blood pressure; and seeing your physician regularly. If you stay physically fit and mentally alert, you can remain sexually active as long as you have the urge.

Most importantly, do not think old! Your body may produce less testosterone; your blood vessels may become partially obstructed and diminish blood flow to the penis; and your muscles and joints may begin to deteriorate. But if your mind is still strong, your penis can be strong, too. The key is not to lament what you have lost. Be grateful for what you still have and make the most of it. Age is not a deterrent to a superpotent man. Rather, it is a challenge and an opportunity. Think of yourself as a singer whose voice is not as powerful as it once was but who more than makes up for it with phrasing, feeling, and subtlety. Think of yourself as an athlete or a dancer whose legs are no longer as strong as oaks but who performs with added grace shaped by the wisdom that comes with experience. If you keep your enthusiasm, you can compensate for or even delay the effects of aging.

If you have penis power, you are young no matter what your age may be. The strenuous use of your penis will sharpen your mind, exalt your soul, and keep you feeling vigorous. In short, you do not stop having sex because you get old—you get old because you stop having sex!

In many ways, your later years should be the golden years for your sexuality. You do not have to get up and go to the office in the morning, you do not have to worry as much about kids and bills, you have less daily stress and fewer pressures, you have more privacy, you have more time, and you can afford the luxury of patience. This is an opportunity for a superpotent man to make the most of his penis power.

I would like to make a prediction. Based on my clinical experience and my understanding of current research, I am convinced that the future bodes well for the sex lives of people now entering their senior years and even better for those now middle-aged. I base this prediction on the burgeoning cultural view that the elderly can be active and fulfilled, even when it comes to sex. This is in addition to the amazing progress that has been made in extending the capacities of other bodily functions. The upper limits of what the body can do have been continuously broadened. In sports, what were once considered insurmountable barriers, such as the four-minute mile and the seven-foot high jump, are all now accomplished routinely. The peak years of athletes have been dramatically extended through unique conditioning procedures, nutritional advances, and medical science. There is no reason why the years of active sexuality cannot be similarly extended. There is no reason why penis power cannot continue to grow in aging men.

In this new century, people will be sexually active into their nineties! For one thing, lifespan will continue to increase. Impressive medical advancements, healthier lifestyles, and new discoveries in the field of genetics will continue. This research holds the promise to prolong life through drugs and genetic engineering. I predict that the quality of life in old age will improve geometrically. The elderly are far more vital and far more dynamic than ever before. In addition, society’s attitude toward sex and the elderly is becoming more permissive. It will no doubt become far more acceptable to be sexually active into old age, a trend that will probably accelerate as the generation that came of age during the sexual revolution approaches seniority. For men who are young now, the golden years will truly provide the opportunity for the enjoyable, leisurely exercise of penis power, as long as they are willing to use it.

 

 

Don’t Let Penis Weakness Spoil Your Valentine’s Day

Since the month of February brings us Valentine’s Day and expectations of love, romance, and sex, now is a good time to discuss the epidemic of penis weakness—and how to avoid it.

I have witnessed an increased development of penis weakness over the last forty years. It is worth analyzing the social conditions that have created this outbreak. One could argue that men have always struggled with this condition. It could also be argued that the increase in penis weakness in recent years is only because men today feel more comfortable talking about their sexual problems. This is not the case. Powerful social and historical factors have contributed to, and continue to create, penis weakness among men today. Each individual case must have an independent evaluation.

One factor that plays a major role in penis weakness is the increased level of stress found in modern society. Men in today’s business world work long hours without enough sleep, exercise, or relaxation. They are often psychologically drained and physically exhausted when they get home. Add financial anxiety, societal pressure, nervousness caused by the rapid-fire pace of modern life, traffic jams, conflicts with bosses, coworkers, or clients, and problems with spouses and children and one can see a picture of conditions that are not conducive to either maximum sexual performance or maximum happiness!

These effects are compounded by the media’s highly romanticized image of marriage and family life—an image that creates impossible expectations. Being at your best at anything, especially sex, is difficult when you feel out of sorts physically or your mind is someplace else, preoccupied by other problems.

Few issues have a more chilling effect on sex than anxiety. Stress, tension, and anxiety exact a heavy toll on an intimate relationship. These forces pollute the atmosphere and fill the bedroom with emotional toxins.

Stress has definite medical consequences that work against normal sexual function. During the stress response, blood moves away from the genitals to supply the large muscle groups of the arms and legs. Anxiety, including performance anxiety, can increase the activity of the sympathetic nervous system. Anxiety can boost the flow of norepinephrine, a chemical that constricts blood vessels. This condition is precisely the opposite of what is necessary for an erection—a smooth flow of blood to the penis through open vascular channels.

This problem is compounded when men use alcohol and drugs in an attempt to cope with stress. As Shakespeare wisely observed, alcohol “provokes the desire, but it takes away the performance.” The same is true of drugs, including nicotine and prescription medications. The drugging of the American male is a major factor in the decline of penis power. The new craze over “Vitamin V” (Viagra) is hardly the solution.

To men who suffer from penis weakness, the Women’s movement, for all its welcome advances, has also contributed to the problem. With increased awareness of female sexuality, female orgasm, and the generally open discussion of women’s sexual needs (by way of women’s magazines, the Internet, television, and films), men now have the added pressure of having to know all of the intricate secrecies of female sexuality. They are expected to perform with the expertise of a twenty-four-year-old pornography star. For some men, this might not be a problem. Sex in general may still be smooth sailing. For most men, however, sex is an obstacle course—a track filled with snares and hurdles in which one scores points for technique as well as for getting to the finish line. The goal is not just to satisfy yourself, it is also all about satisfying your partner. And, in many minds, the man has a responsibility not just to bring a woman to orgasm but to multiple, ecstatic, earth-shattering orgasms. Now that’s pressure!

Both men and women expect sexual satisfaction. Partners also have a responsibility to work together through communication and understanding in order to meet one another’s expectations and to achieve mutual satisfaction. Every man should cater to his partner’s pleasure if for no other reason than to enhance his own. It is important to acknowledge that both genders have been insensitive to the high level of performance anxiety brought on by the new rules. The situation is made even more complicated by the enormous range of variation in female sexuality.

Millions of relationships turn into no-win situations when people aim for some imaginary standard of satisfaction instead of attending to the unique nuances and preferences of their partners. From my clinical observations, the single biggest sexual worry of contemporary men is that they will not provide their partners with orgasms of spectacular quantity and quality. If a man has even one humiliating encounter with a dissatisfied partner, he can succumb to the vicious cycle that begins in self-doubt and ends in penis failure.

Another media-related factor is the idealized image of the sex act itself. And what happens when reality doesn’t measure up to the imagined ideal?

Men blame themselves. They assume something is wrong with them. They think they are failures. And what is the focal point of their disappointment? Their penises, of course. “What’s wrong with it? Why can’t it be bigger and harder? Why doesn’t it do what the throbbing pistons do on the big screen or in books?”

You might not hear men asking those questions, but I do almost every day. Men think they should have a two-foot-long shaft of solid steel between their legs—a shaft that can pump and pound for hours on end.

That’s not a penis. That’s a Home Depot pneumatic drill from aisle six!

Most men measure themselves against standards built on fantasy, not reality. They interpret normal, commonplace experiences as signs of personal failure. There is enormous variety among men with respect to sex drive, capacity, preferences, and standards of satisfaction. Yet men assume there is a state of being called “normal.” They worry that every little sexual idiosyncrasy they have is a sign of abnormality. Worse, if sex doesn’t go as desired, or if they have a disappointing or embarrassing experience, they usually panic. This experience can result in significant self-doubt. Self-doubt creates fear, anxiety, and inhibition. These feelings are bigger obstacles to sexual happiness than having a construction crew in your bedroom (maybe even bigger obstacles than having your mother-in-law in your bedroom!).

Every man I have ever known has, at one time or another, lost an erection or ejaculated sooner than he would have liked.

Every man is, at times, not interested in sex.

Every man has failed to satisfy a partner.

Men who take such events in stride know that they are perfectly normal. They march without hesitation to their next sexual encounter.

These are the men who have penis power.

Performance Anxiety: How to Face It and Erase It!

Something’s wrong with me, Doc,” said Steve, a thirty-nine-year-old lawyer. “I want a complete urologic workup.”

I asked him what the trouble was. “I met this great woman,” he said. “We had a terrific first date on Valentine’s Day. She invited me in, one thing led to another, and before I knew it we were in bed. But I . . . well . . . I couldn’t . . . you know . . .”

I knew all right. I had heard it so many times before from hysterical patients. Steve was terrified that something had gone wrong with his penis, when in reality his failure to get an erection with his terrific new woman had nothing to do with physiology. He had gone through a bitter divorce. It had taken him some time to get used to being single again. On the ill-fated date, it was the first time in many years that he had even kissed a woman in earnest other than his wife. Steve was not impotent, he was just plain nervous. The high romantic expectations related to Valentine’s Day, the newness of the experience, the excitement of meeting someone he liked, and his eagerness to please her and prove himself a worthy bed partner all conspired to create one of the greatest enemies of penis power: anxiety, or more precisely, performance anxiety.

More penis weakness occurs the first time a man is with a particular partner than at any other time. When it happens, men feel so humiliated that they sometimes find any excuse they can to avoid dating that person again, thereby depriving themselves of what might have been a good relationship. It is sad. I have even met men who, after several embarrassments, stayed away entirely from people who turned them on. They became, in effect, celibate prisoners of penis performance anxiety.

The first time with a new sexual partner can be an exciting experience. For some men, however, that very emotional excitement can lead to temporary penis weakness. It can spiral into a pattern of disaster. My advice is to take your time, be patient, stop pressuring yourself, and stop thinking you are inadequate. Find a partner who makes you feel comfortable and unthreatened. It worked for Steve, and it will work for you. You must be willing to face the challenge with the courage it takes to overcome performance anxiety.

Accentuate the Positive

What can be done if you do have performance anxiety? Let us start with the issue of anticipating the use of your penis. When you begin to feel anxious or fearful, you are programming your mind for failure. Stop what you are doing, calm yourself down, and remind yourself of what Franklin Roosevelt so elegantly and succinctly stated during his first inaugural speech at the depth of the Great Depression: “The only thing we have to fear is fear itself.” Losing an erection, unlike losing your job and home, is not catastrophic. What is the worst thing that could happen? You embarrass yourself? You can only be embarrassed if you let yourself be. If you think that a “real man” cannot possibly lose an erection or ejaculate too quickly, then you will be encouraged to know that these things happen to every man at some point in his sexual life. So why should you be embarrassed if it happens to you? And what if you are embarrassed? How bad is that really? Maintaining this positive point of view will keep you calm and lighthearted. If you feel that way, your penis is likely to behave accordingly. If you develop the ability to laugh at both yourself and that unpredictable appendage of yours, you will both be winners.

Get rid of fearful, negative thoughts altogether. There is no valid reason to entertain them. They are the natural enemy of your penis. Mobilize a battalion of positive thoughts, and let them take over your mind. Penis power is the power of positive thinking applied to your penis.

It is a fact that some men with a deeply rooted fear of penis failure need more than just a pep talk. Perhaps a prescription for Viagra, Cialis, or Levitra is just what is needed to break the vicious cycle. However, the “crutch effect” may result in dependence on these medications. I often suggest that patients talk to a psychotherapist and perhaps explore deeper reasons for their anxieties. In most cases, lack of self-esteem is the underlying cause. Their self-image is so low that it affects every aspect of their lives, not just sex.

Lighten Up, Dude

Okay, you are in bed with a sexy partner, whether it is your wife of thirty years or someone you just met. You feel tense. You start to worry that your penis will not get hard or that you might lose the erection that just popped up. What do you do? Your first reaction might be to panic. You might worry so much about your penis that tension builds. You get clumsy. You try to exert your willpower on your organ. You forget about doing all the things that might excite your partner. You cannot appreciate, or even feel, the kisses and strokes your partner is so lovingly giving you. One of two things is bound to happen next: your partner gets turned off and thinks she is doing something wrong or your penis goes limp. From my experience, it is usually both.

The minute you start to feel any anxiety, stop what you are doing immediately and tell your partner about it. Do not make excuses. Do not try to hide it. Own up to it. Explain openly that you are nervous, that this sometimes happens to you. It happens to all men. Tell your partner you want so much to please her, bring her satisfaction, and that her acceptance means a lot to you. Make sure she understands that it is not her fault, she is terrific, and she has not done anything wrong. Tell her it is all in your head, and it will surely go away.

Honesty is always the best policy in general, but when it comes to your penis, it should be the only policy. Ninety-nine percent of the time, candor will improve the situation by diffusing tension. If you have a healthy relationship, your partner will understand. Your partner will appreciate your integrity and your vulnerability. Most people want intimacy, affection, and closeness in bed, so if you communicate these qualities, your partner will not hold your anxiety against you. She will probably reassure you, calm you down, and take the pressure off. If your partner does not act this way, or if she gets angry, gets resentful, or demeans you in a castrating way, you should ask yourself if you are in bed with the right person.

And if you do fail to get an erection? If you do lose it at precisely the wrong moment? If you do ejaculate too quickly? What then? I say laugh it off! You are probably thinking, sure, that is easy for the doctor to say. But I mean just that. Joke about it. Lighten up! I assure you that “real men” can and do laugh at their own penises. They might say funny phrases to their partners like “Oh well, that rascal pulled a fast one on me,” “I cannot get him to behave sometimes, the unpredictable little devil,” or “Do not take it personally.” Remarks like that, expressed in your own words and your own style, should ease the tension and help your penis rise another day, or even the same day. Medically, I can practically guarantee it.

Your partner should appreciate the light touch and will be pleased to know that you are trying to improve your sexual ability. She might start thinking that something is wrong with her. She might be feeling guilty for failing you. She might know you feel ashamed but not quite know what to say or do about it. You can take the lead and break the ice with a good laugh. Who says sex has to be serious?

When you get right down to it, with all the unstated agendas, the physical clumsiness, and the childlike awkwardness, sex is just as suited for slapstick comedy as fine art or soft-focus cinematography. Many people say there is no better turnon than a good, hearty laugh in bed, and nothing sexier than a partner whose sense of humor is compatible with your own. Just do not take your penis so seriously. That is how the trouble starts in the first place.

If you do not succeed, try again and again and again. Do not shy away from using your penis if it falls down on the job once or twice—or any number of times. Do not give up on it. Practice makes perfect in sex, just as it does elsewhere in life. Perseverance is the only way to get over setbacks and gain the confidence you need to overcome your fear of failure. As a last resort, you can always turn to your urologist for the quick but temporary fix provided by medication.

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!

 

 

 

 

Fostering a Healthy Sex Life Fosters a Healthy Relationship

When was the last time you tried something new with your partner? Valentine’s Day presents the perfect opportunity to shake up your sex life. Forget the rules—and create your own.

As a urologist, I cannot emphasize this point enough: do everything in your power to prevent sex from becoming a dull routine. Nothing will bring passion and romance back to a long-term relationship faster than a change in sexual practice or venue.

I remember a fifty-five-year-old patient who was married to a woman he loved for twenty-seven years. He had a bad case of sexual ennui (dissatisfaction resulting from boredom), which led to a brief fling with his dentist’s assistant. That made things even worse at home because he was now inhibited by guilt in addition to boredom. “Jack,” I said, “take Friday off and get your wife to cancel all of her plans. Rent a cabin in the mountains for a weekend. You have not done anything spontaneous and romantic in years. Do it. Tune out the world. No kids, no phone, no television, just the two of you and a fireplace.”

The weekend rejuvenated Jack and his wife, as similar escapes have done for countless couples. In other cases, I have advised patients to take the afternoon off and surprise their wives with flowers and a sunset tryst in a motel. Other couples have done things like pretend they have just met and are having a one-night stand. Or they simply vary their rituals. If you have been initiating sex after you are both washed, undressed, and in bed, try doing it before all of those bedtime rituals. When was the last time you and your partner undressed each other instead of starting out in your pajamas? When was the last time you necked in the living room and carried your partner into the bedroom? Or made love in the kitchen or the shower? Have you tried a different position in the last few years? Have you thought of using props? Browse in any sex shop and you will get countless ideas of how to invigorate your sex life. Above all, use your imagination and see what you come up with.

Hopefully, you will not have to go to extremes, like the wife in Woody Allen’s Everything You Always Wanted to Know about Sex But Were Afraid to Ask, who could only have sex in public places. For the majority of people, simply giving yourself permission to break your own boundaries will elevate your penis power several notches. You might have to do some cajoling to win your partner’s support. That could be translated into a surprising delight for both of you.

Some of my patients have to be told that it is okay to have sex at different times of the day. They have to be told that sex is not just a nighttime activity. Why engage in something as important as sex when your body is at its lowest energy level? Perhaps your penis problem is really a fatigue problem. The penis responds to different biorhythms, as do hormonal secretions and energy levels. This is an important aspect of understanding the intricate relationship between the penis and the body. Concrete scientific evidence to validate this observation is sparse at this time, but research in this area is ongoing.

I do not doubt that fatigue affects sexual energy. For this reason, I encourage my patients to pay close attention to the ways in which their bodies, and especially their penises, respond to different emotional and physical conditions. It is fundamentally important that you be aware of your body’s rhythm. Your sexual responsiveness will change with stress, fatigue, anxiety, or sickness. Your particular rhythms may be better suited to sex at unusual times of the day. Perhaps certain habits—for example, exercise, diet, work schedules—are affecting your sex drive in negative ways. Pay attention to the subtle clues your own body transmits, and you will know where to start making changes. Explore all of your options. Experiment, take risks, and mix things up until you find the right balance for your love life to flourish. What’s most important is not to feel burdened by sex. If your sex life is becoming run-of-the-mill and boring, then take the initiative to spice things up. You will not be disappointed by the results of reviving passion and romance in your relationship.

Millions of men think that something is wrong with them because they do not get “hard on demand.” The persuasive myth in our culture has it that a “real” man will be raring to go anytime, day or night. That proposition could not be further from the truth. A wide range of difference exists among men. Men have their own individual preferences and unique biological templates. There is simply no set time or place you are “supposed” to get aroused. No credible scientific book says you have to have sex a certain number of times a day to be a “real” man. I cannot count the variations. Some men tell me they feel sexiest in the morning, in the middle of the day, at night, or in the middle of the night. The real problem is that most men are just too inhibited to break their old habits or they are afraid their partners will think they are crazy or weird for trying something new. Even if your requests may seem odd, you still have the power to prove yourself to your partner through your performance. If you are passionate and exciting, your partner most likely will not complain.

Morning sex is an especially good way to break the routine. What a terrific way to start the day! So what if you have to skip jogging, rush through breakfast, or get to work a bit late? Morning sex can be just as invigorating as a morning jog and just as relaxing as a cool morning breeze. It is the best wake-up call. It clears the spirit of any tension and shakes the cobwebs out of your body. In fact, a lot of men like sex better in the morning because they wake up with the so-called morning wood or piss hard-on. The explanation for this morning erection is that a full bladder compresses the venous outflow from the pelvic vessels, holding blood in the penis longer than usual. The usual result is a morning erection. Be assured that after morning lovemaking, you will like what you see in the mirror. You will have set the right tone for a great day.

If you are a man who wants to enhance your penis power or if you are a partner who wants to learn how to increase your man’s penis power, then it behooves you to look into alternative sex practices. Countless volumes have been written on this subject, from the Kama Sutra to articles in Cosmopolitan. I will not try to reiterate information that’s already available. However, ask yourself these questions: When was the last time you tried something other than the missionary position? Have you tried letting your partner get on top and control the action? Have you tried “doggy style”? How about not having intercourse at all, but bringing yourselves to climax strictly with oral sex or mutual masturbation? The possibilities are endless. If you cannot conjure up some creative ideas on your own, do not be afraid to go out and find a book or ask a friend for some good tips.

Any change should add a fresh dimension to your routine. I can guarantee that both you and your partner will reap the benefits of a reinvigorated sex life.