Sexual health

Ads for penis-enlargement products and procedures are everywhere. Many pumps, pills, weights, exercises and surgeries claim to increase the length and width of your penis.

But, there's little scientific support for nonsurgical methods to enlarge the penis. And no trusted medical organization endorses penis surgery for purely cosmetic reasons.

Most of the techniques you see advertised don't work. And some can damage your penis. Think twice before trying any of them.

Penis size: What's normal, what's not?

The fear that your penis looks too small or is too small to satisfy your partner during sex is common. But most men who think their penises are too small actually have penises that are considered typical size.

Many men also have an exaggerated idea of what is considered a "typical" penis size.

The length of a non-erect penis doesn't consistently predict length when the penis is erect. If your penis is about 5 inches (13 cm) or longer when erect, it's of typical size.

A penis is considered small only if it measures less than 3 inches (about 7.5 centimeters) when erect. This is a condition called micropenis.

How partners view penis size

Advertisers would have you believe that your partner cares deeply about penis size. If you're concerned, talk to your partner.

Understanding your partner's needs and desires is more likely to improve your sexual relationship than changing the size of your penis.

Don't believe the hype

Companies offer many types of nonsurgical penis-enlargement treatments. They often promote them with serious-looking ads that include support from "scientific" researchers.

If you look closely, you'll see that claims of how safe they are and how well they work haven't been proved. And these products may have potentially dangerous ingredients not listed on the label.

Marketers rely on ads with people who recommend the product. Marketers also may use data that's not accurate and questionable before-and-after photos. Dietary supplements don't need approval by the U.S. Food and Drug Administration. So manufacturers don't have to prove how safe a product is or that it works.

Penis-enlargement products

Most advertised penis-enlargement methods don't work. And some can cause permanent damage to your penis. Here are some of the most widely promoted products and techniques:

• Pills and lotions. These usually contain vitamins, minerals, herbs or hormones that manufacturers claim enlarge the penis. None of these products has been proved to work. And some may be harmful.

• Vacuum pumps. Because pumps draw blood into the penis, making it swell, they're sometimes used to treat erectile dysfunction.

  A vacuum pump can make a penis look larger temporarily. But using one too often or too long can damage elastic tissue in the penis, leading to less firm erections.

• Exercises. Sometimes called jelqing, these exercises use a hand-over-hand motion to push blood from the base to the head of the penis.

  Although this technique appears safer than other methods, there's no scientific proof it works. And it can lead to scar formation, pain and disfigurement.

• Stretching. Stretching involves attaching a stretcher or extender device, also referred to as a penile traction device, to the penis for gentle tension.

  A few small studies have reported length increases of half an inch to almost 2 inches, which is about 1 to 3 centimeters, with these devices. But the activity may be uncomfortable. Also, it needs to have a commitment of at least 4 to 6 hours a day for many months to see results.

  More research is needed to see if stretching is safe and if it works.

Surgery is risky and may not work

Studies of surgeries to lengthen or thicken the penis have found mixed results in safety, whether they work (effectiveness), and patient satisfaction.

At best, surgery may give a slight increase in girth to the penis. Or surgery may add a slight appearance of increased length to the non-erect penis. But it does not change the actual length of the penis. At worst, surgery can cause complications such as infection, scarring, and loss of sensation or function.

Surgical methods of penis enlargement — Not for cosmetic use

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Suspensory ligament

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Suspensory ligament

Suspensory ligament

When the suspensory ligament is cut, the non-erect penis may look longer because more of it hangs outside the body. But it does not change the actual length of the penis.

The need for penis-enlargement surgery is rare. Surgery is typically reserved for men whose penises don't work because of a problem present at birth or an injury.

Some surgeons offer cosmetic penis enlargement using many techniques. But it's controversial and considered by many experts to be unnecessary. And in some cases, it can be permanently harmful. These surgeries should be considered experimental. There aren't enough studies of penis-enlargement surgery to give an accurate picture of risks and benefits.

Examples of surgery done to increase the length or thickness of the penis include:

• Cutting the suspensory ligament. The most widely used surgical procedure to lengthen the penis involves cutting the suspensory ligament that attaches the penis to the pubic bone. Also, skin is moved from the abdomen to the penis shaft. When this ligament is cut, the penis appears longer because more of it hangs down. But it doesn't change the actual length of the penis.

  But cutting the suspensory ligament can cause an erect penis to be unstable. This lack of support during an erection could result in injury to the penis during sexual activity. Also, the ligament can grow back together, causing a shortened appearance of the penis. Cutting the suspensory ligament is sometimes combined with other procedures, such as removing extra fat over the pubic bone.

• Fat injection. A procedure to make the penis thicker involves taking fat from a fleshy part of the body and injecting it into the penis shaft. Results may be disappointing. Some of the injected fat may spread unevenly or be reabsorbed by the body. This can lead to a penis that is curved, unevenly shaped and irregular looking. Scarring and problems with sensation and firmness of erections can also happen. Several other products have been used for injection, but with similar poor results.
• Tissue grafting. Another technique for increasing width or length is tissue grafting. This involves taking a piece of skin and fat layer, called a graft, from another place on the body. This graft is sewn onto the shaft of the penis. Sometimes other graft material is used. None of these procedures has been proved to be safe or to work. The procedures may cause infection and scarring that can deform the penis' shape. They also can affect your ability to get an erection.
• Penis implants. These surgeries involve placing material under the skin of the penis to give it a thicker appearance. Infections and problems with the graft may require another surgery to remove the graft. Shortening, scarring and curving of the penis can happen. The surgery also can affect your ability to get an erection.

A few things that might actually help

There's no guaranteed safe and proven way to enlarge your penis. But there are a few things you can do if you're concerned about your penis size.

• Communicate with your partner. It may be hard to break old habits or to talk about sexual preferences with your partner. But you'll be glad you did, and you may be surprised at the spark it ignites in your sex life.

• Get in shape. If you're overweight and have a "beer gut," the extra belly fat may make your penis appear shorter than it is.

  Regular exercise can make a big difference. Better physical conditioning may not only make you look and feel healthy, but also can improve strength and endurance during sex.

• Talk to your healthcare professional or a counselor. Feeling unhappy about the size of your penis is common. A mental health specialist or your family healthcare professional can help.

Many men feel better with reassurance that they are "typical." Advice about how to better satisfy their partner without resorting to cosmetic penis enlargement also can help.

The bottom line

Many men believe that increasing the size of their penises will make them a better lover or make them more attractive. But chances are your penis is within the typical size range.

Even if your penis is smaller than average, it may not matter to your partner. There's also no proven way to make a penis larger.

The solution to your concerns about penis size may be as easy as talking with your partner or getting in shape. If those steps don't help, try talking with a professional counselor about your concerns.