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Many men would clearly rather spend $20, $50, $100 on the Internet than go to the doctor and get real information.

When Boyle's patients come to her with bottles of herbal supplements, she tells them she cannot vouch for their safety or effectiveness unless the FDA has reviewed the claims on the label.

Most importantly, erectile dysfunction may be an early predictor of heart disease.

Sexual performance declines naturally as men age, doctors say.

"I see a more confident man in front of me from using this product," she says.

Boyle tests for testosterone levels and prescribes it as a topical gel, though she warns it is only safe when prescribed and monitored by a physician.

And how to get out of it.

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Sometimes men with erection problems or a diminished libido have low levels of testosterone, Boyle says.

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It's ironic that the male preoccupation with enhancement seems to be independent of the needs of women, the supposed benefactors of improved sexual performance.

The group also refuses to endorse surgeries that inject fat cells in the penis with the goal of increasing penile girth.

WebMD does not provide medical advice, diagnosis or treatment.

Men who are overly preoccupied with penis length tend to have unrealistic expectations of surgery and should seek counseling instead, the authors wrote.

"All the pills, topical creams, and gels are worthless.

"PaginationHere's what guys should watch out for.

He says he's gained over 2 inches of erect length.

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"In younger or younger middle-aged men, ED is often the first sign of atherosclerosis.

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For men with performance issues who are physically healthy, Boyle often prescribes counseling, such as marriage counseling for men with relationship issues or psychiatric help for men who are preoccupied with a problem in penile appearance.

WebMD Medical News: "Penis-Lengthening Surgery Questioned," "Small-Penis Syndrome Questioned.

Just ask Bob, a retail manager from New Jersey.

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"I didn't feel manly enough," he tells WebMD.

So there should be plenty of ways to satisfy your partner that have nothing to do with pills, creams, surgery, or devices.

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Richard, New York.

Nonprescription testosterone, such as the kind used by some bodybuilders, is dangerous, she warns.

The device cost $298, but Richard says the effect on his self-confidence has been priceless: "It made a world of difference to me.

Nonpresciption methods of male enhancement and male enlargement range from the possibly effective to the downright dangerous.

) SOURCES: Karen Boyle, MD, assistant professor of urology and director of reproductive medicine and surgery, Johns Hopkins University School of Medicine.

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Atherosclerosis, a condition in which fatty deposits build up inside arteries, may restrict blood flow to the penis and cause erection difficulties.

Levine, MD, professor, Rush University Medical Center and director of male sexual function and fertility, Chicago.

But ever since he was a young boy, Richard couldn't get over the feeling that his penis was too small.

For young men with sexual performance problems and no signs of physical problems, Boyle may prescribe counseling and a low dose of Viagra as they work out issues of insecurity.

Chicago urologist Laurence A.

Bob, New Jersey.

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The most sensitive nerves in the vagina are found close to the surface, Lamm notes, and the clitoris is found on the vagina's outside.

All it took was 25 months and over 2,600 hours wearing the device, typically five hours a day, seven days a week.

Instead of furtively turning to untested methods, men with persistent concerns should consider opening up about them with their doctors.

After four months of wearing the device, he says his flaccid penis has stretched from 3 inches to over 5 inches; erect, he has gone from less than 6 inches to over 7 inches.

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All rights reserved.

"The small blood vessels that go to the penis can become diseased much earlier than the [larger vessels that go to the heart," Karen Boyle, MD, a urologist at Johns Hopkins School of Medicine, tells WebMD.

)Could FastSize work on men of normal penile length? Levine says it might.

She also says the lengthening has enhanced their sex life, though she had no complaints before.

Does working out give it a boost?You will receive your first newsletter with our next scheduled circulation!© 2005 - 2019 WebMD LLC.

But that makes it a true rarity among the nonprescription methods of male enhancement.

It's a testimony to men's abiding insecurities about sexual performance.

"In some cases, men are harming themselves in the pursuit of a bigger penis.

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But many doctors are wary of traditional medicines.

Then, in the back of a weightlifting magazine, he saw an ad for the FastSize Extender, a device that claims to make the penis longer and fatter through traction.

Richard's wife has also been supportive.

Laurence A.

Our email inboxes fill up every day with advertisements for pills, ointments, supplements, and contraptions aimed at enhancing penis size, sexual stamina, or libido.

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Richard, the mechanic from New York, got results faster than Bob, but still wore the device under his clothes for about eight hours a day.

A 2006 study found that only 35% of men were satisfied with the outcome of surgery, which added only half an inch, on average, to length.

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.

He was shocked to notice a difference within a few days.

But a rapid or severe decrease in performance or libido can be a red flag.

A recent study found that 85% of women are pleased with their partner's penis proportions, but 45% of men say they want a larger penis.

The FastSize Extender device promises results, but it's far from quick and easy.

Levine cites "jelqing," a technique involving hours and hours of intense stroking.

At the end of the six-month study, which was funded by the maker of the FastSize Extender, Levine found increased penile length and reduced curvature in every man and increased girth in seven of the men.

)The Internet is rife with scammers who seek to prey on men's insecurities, Levine says.

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Calling the results "remarkable," Levine now prescribes the device to many of his Peyronie's patients and reports no significant complications.

Lamm has endorsed an herbal remedy, marketed under the Roaring Tiger label, that combines horny goat weed and other herbal extracts with the amino acid L-arginine.

"If a woman can have a breast enlargement and it makes them psychologically feel better," he reasons, "then perhaps we should have the same thing for men.

"I was afraid my girlfriend would think I was a freak, but she was supportive because she felt a difference in her satisfaction and I felt more confident in myself," Bob tells WebMD.

In public bathrooms, he'd use the handicapped stall.

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The American Urological Association says a common form of lengthening surgery (involving cutting the suspensory ligament of the penis) has not been shown to be safe or effective.

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These men should be also be controlling their weight and cholesterol level, limiting their alcohol intake, and quitting smoking.

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He has a loving wife who has always enjoyed their sex life.

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Richard began wearing the device almost eight hours a day, every day.

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Steven Lamm, MD, assistant professor of medicine, New York University and author, The Hardness Factor.

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He felt embarrassed in gym locker rooms and when standing naked before his wife.

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(Levine has also worked as a paid consultant to FastSize Extender.

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* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.