Sizing up: the science of sex.

Men's Fitness, Jan, 2002, by Ken Goldberg

Q: I hate the idea of scalpels you-know-where, but I wouldn't mind more bulk in my briefs. What's the lowdown on penis enlargement?

A: Given his druthers, the average guy would prefer a penis different from the one he's got: longer, bigger around, straighter, even smaller--you name it. There is no more sensitive subject.

Unfortunately, we don't really know what qualifies as "small" or "big." Only Kinsey's 1948 study looked at an ample number of men (3,500) and used thorough statistical methods. That work found an average penis length of 3.89 inches flaccid and 6.21 inches erect. Average circumference was 3.75 inches flaccid and 4.85 inches erect.

What is too small? I could offer a statistical definition based on the above numbers, but I doubt that it would sway anyone. Basically, too small is whatever a man thinks is too small. After all, we're not talking function here. Size has nothing to do with satisfying a partner or producing offspring. At one of the most prolific surgical practices for penile augmentation, four out of five patients choose surgery because of "self-image." This probably has more to do with the locker room than the bedroom.

I won't try to talk you out of wanting a different penis. Instead, I'll tell you about the various methods that attempt to deliver one.

STRETCHING THE TRUTH

The penis is not a muscle; you cannot build it up through exercise. But it certainly can be stretched. The problem is keeping it stretched.

One method of stretching is the vacuum pump. By placing the penis inside a cylinder and sealing it against the abdomen, pressure can be reduced around the penis, helping it to inflate with blood. A constriction ring applied to the base of the penis keeps the blood in once the pump is removed. Constriction rings, a.k.a. cock rings, should be left in place no longer than 30 minutes. After that, you risk damaging delicate tissue, which could lead to permanent damage.

Over the decades, hundreds of my patients have used vacuum pumps to achieve erections. When used appropriately, they are safe and effective, so much so that the FDA approved them--for treating erectile dysfunction, that is, not for growing bigger penises. Pumps may make the penis somewhat larger than it normally would be when erect, but the effect is temporary. (For more on penis pumps, see Health Update, July 2001.)

Likewise, there are myriad sites on the Internet that would like to sell you programs by which you can stretch your penis. From having you tug on it with your hands to applying contraptions, they all claim to somehow permanently elongate or increase in volume the tissues of the penis. None of them has been proved to work long-term.

For the most part, there's probably not much harm--other than to your wallet--in such machinations. I do worry, though, about aggressive manipulation of the penis. On the whole, it's a pretty durable organ, but it can be damaged. Fractures are possible when erect, and it's possible that abuse could lead to the scar tissue that causes Peyronie's disease, a painful condition marked by severe curvature of the penis.