Results from a study of over 4,000 men from the Archives of Sexual Behaviour, found that one of the keys to a happy sex life could be something as simple as self-acceptance. They used the ‘Index of Male Genital Image’ (IMGI) to study the men’s perceptions of their genital size, and perhaps unsurprisingly the men who were dissatisfied with their genital size were less likely to report being sexually active.

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SOURCES: Karen Boyle, MD, assistant professor of urology and director of reproductive medicine and surgery, Johns Hopkins University School of Medicine. Laurence A. Levine, MD, professor, Rush University Medical Center and director of male sexual function and fertility, Chicago. Steven Lamm, MD, assistant professor of medicine, New York University and author, The Hardness Factor. Richard, New York. Bob, New Jersey. WebMD Medical News: "Penis-Lengthening Surgery Questioned," "Small-Penis Syndrome Questioned."
Penis length surgery involves cutting the ligament with which the penis is attached to the pubic bone and grafting added skin to the base to increase length. This will increase the size of the flaccid penis by up to 2cm, but it doesn’t affect the size of the erect penis. The cut ligament may also not provide the support it originally did, which means that you might find your erections less satisfactory as a result. There is also a risk that this type of surgery may cause the side effect of pain during sex.

Penile shrinkage can occur for many reasons, many of which we’ve discussed, such as prostate cancer and surgery, erectile dysfunction, Peyronie’s disease, or perhaps even aging. In some cases, the use of PDE5 inhibitors, which are erectile dysfunction medications like Viagra, may be used to treat shrinkage. For example, in men dealing with shrinkage due to testosterone deprivation therapy, erectile dysfunction drugs like Viagra, Levitra, and Cialis may be used to manage shortening of the penis by increasing the blood flow to the tissue [22].
One of the questions that gets asked a lot is about finding something that will permanently extend the size of your penis. Nothing, other than painful and not always successful surgery, can permanently extend the size of your penis.  The American Urological Association [6] does not promote penis augmentation surgery as effective or beneficial. Sometimes, these surgeries even leave the penis smaller than before [7].
Penis extenders and traction devices are other options often advertised to make your penis bigger, and they are designed to stretch the penis by exerting traction on it. One small study done on 23 men saw a small increase in both flaccid penile length and stretched penile length after using a penile extender [7]. Another small study on 15 patients saw more significant gains in length after six months of using penile extenders, along with improvements in erectile function [8]. It’s important to note that both of these studies are very small, and while they look promising, further studies on penis extension and penis stretching are needed.
According to the website of one such product, the safe application of traction encourages tissue cells to divide and multiply, a process called cytokinesis. Over time and with great effort this will lead to tissue growth. The FDA considers these low-risk devices (Class 1) and so provides only general controls intended to be followed by manufacturers.

“I have personally recommended this to men and I have received lots of great feedback regarding its long(er) term use. It’s a hydropump, so it works by using water when you’re in the shower or bathtub. To fully understand this, it’s important to know that the penis has three soft chambers, the corpora cavernosa (two large one’s on the top of the penis) and the Carpus Spongiosum (a smaller one on the bottom of the two). When these two fill with blood, you get an erection. What Bathmate or a penis pump can do is expand these chambers, thereby allowing more blood to fill in."
There are several penis extender enlargement devices on the market, but the PenisMaster stands out as one of the best traction-based penis stretching device. This penis enlarger device is effective at slowly stretching the tendon that is most closely related to penis lengthening. And unlike the cheaper extenders, the wide fastener belt on the PenisMaster …
Thankfully, I’ve avoided the emergency room. After six weeks of daily rice socks and side-side-stretching, my penis has, in fact, lengthened. I’m embarrassed to admit how satisfying it felt to notch six inches on my ruler. And I’m confident those increases would continue if I stuck with Big Al, but I think I’ll stop here. After all, as Nelson explains, the average penis is 5.16 inches, so at just over 6, I’m already in the 70th percentile. “You’re an inch bigger than average and thick,” he says. “Holy shit, what more do you want?”

Male aging can cause changes in libido and erectile function, and one study found an association between age, testosterone deficiency, and cavernosal fibrosis (shrinkage of the penis). Although the link is tenuous, it still is there, and the study concluded that further studies are needed to determine whether testosterone treatment, alone or along with PDE5 inhibitors (such as Viagra) may reduce the risk of cavernosal fibrosis [28].
“The majority of men who come in seeking penile enlargement are average,” says Lipshultz. “I just don’t think men have a realistic idea of what normal is. Hence they think that they are below normal when actually they’re average.” (For the record, the average erect penis measures 5.6 inches, according to research published in the Journal of Sexual Medicine.)

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