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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.

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

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.

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

Evidence shows that these changes in themselves can have a positive effect on sexual function, Boyle says.

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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.

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

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.

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

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

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.

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

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.

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See additional information.

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

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

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.

He says he has patients who have developed Peyronie's disease due to violent stretching of the penis through jelqing.

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.

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

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

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What men don't know about it.

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Chicago urologist Laurence A.

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.

Richard, New York.

WebMD does not provide medical advice, diagnosis or treatment.

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Laurence A.

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

But Lamm says these remedies may be appropriate for men who have experienced a decline in sexual performance but do not suffer from a diagnosable sexual problem.

"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.

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.

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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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.

Sexual performance declines naturally as men age, doctors say.

Testosterone deficiencies can also affect mood and energy levels.

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

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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.

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

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

"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.

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"Penis-lengthening surgery is also an option for men, but it is a highly controversial procedure.

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