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‘Am I Normal?’ Check Biggest Study Yet Of Penis Size, Among 15,000 Men

From the paper "Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men" in the British Journal of Urology International, © BJU International, posted with permission granted by Wiley.

From the paper “Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men” in the British Journal of Urology International, © BJU International, posted with permission granted by Wiley.

In Dr. Abraham Morgentaler’s 26 years as a urologist who treats issues of male sexuality, he has seen thousands of patients, and “probably there hasn’t been a single one who hasn’t paid attention to his penis size on some level,” he says.

“Most men tend to believe they’re smaller than average, and there’s some distortion about what reality is,” says Morgentaler, director of Men’s Health Boston and author, most recently, of “The Truth About Men and Sex: Intimate Secrets From the Doctor’s Office.”

A new study could help combat some of that reality distortion.

Combining 17 previous published studies for a total of 15,521 men, it amounts to the biggest review to date of medically measured penis size, says its lead author, Dr. David Veale of King’s College London. It processed the data into “nomograms,” or graphical diagrams, like the one above, familiar to parents as the typical form for the growth charts that pediatricians use.

From the press release on the paper (metric conversions mine), which is titled “Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men”:

The nomograms revealed that the average length of a flaccid penis was 9.16 cm [3.6 inches], the average length of a flaccid stretched penis was 13.24 cm [5.21 inches], and the average length of an erect penis was 13.12 cm [5.165 inches]. The average flaccid circumference was 9.31 cm [3.66 inches], and the average erect circumference was 11.66 cm [4.59 inches]. There was a small correlation between erect length and height.

So those are the averages, but the great beauty of a nomogram is that it can also give you a sense of the distribution of the variation, and you may have already noticed that the curve above looks strikingly flat. That is, there’s just not much difference, except at the extreme edges.

If your erect penis is 11 centimeters, that puts you down in the 10th percentile; if your erect penis is 15 centimeters, that puts you way up in the 85th percentile. Quite a jump, for a little over an inch.

“What’s interesting is, when you look at the curves, you see that most penises actually are fairly similar in size,” Dr. Morgentaler says. “You really have to go to the extremes — the top or bottom 5 or 10 percent — to really see some big differences. And truthfully, in my practice, I would say that’s exactly right. Most men have penises roughly the same size.”

But somehow, many men who are average think they’re below average. The study notes:

“Men may present to urologists or sexual medicine clinics with a concern with their penis size, despite their size falling within a normal range. This type of concern is commonly known as ‘small penis anxiety’ or ‘small penis syndrome.’ Continue reading

Elderly Man (Me) Found In Snow With Punctured Lung But Still, At 79, I Ski

Author Ralph Gilbert, who suffered a punctured lung in a ski accident, and his son, Keith, his rescuer (Courtesy)

Author Ralph Gilbert, who suffered a punctured lung in a ski accident, and his son, Keith, his rescuer (Courtesy)

By Ralph M. Gilbert
Guest Contributor

Traumatic pneumothorax: the presence of air or gas in the pleural cavity, which impairs ventilation and oxygenation, caused by a severe trauma to the chest or lung wall. Symptoms are often severe, and can contribute to fatal complications such as cardiac arrest, respiratory failure, and shock.

Every time I tried to lift my head the sky began to spin. Then I felt the nausea. I knew that I had to get up out of the snow but after a few attempts, I just lay back, exhausted. Suddenly, a spray of powder was kicked onto my face as a young ski patrolwoman executed a hurried skid stop. She bent down and put her cold face next to mine:

“Sir,” she said looking into my unfocused eyes. “Are you all right? Do you know where you are, sir? Where are you, sir?”

“Huh?”

I realized that she wasn’t asking a particularly hard question, but I just couldn’t come up with an answer.

“I don’t know,” I replied.

She helped me to my feet.I looked around and saw the other skiers.

“I’m skiing…right?”

She radioed for help. The next thing I knew, I was being leaned back into a toboggan. Fighting the nausea and afraid that I would have to throw up, I asked to be tipped over momentarily before they restrained me to the sled for my ride down.

I regained consciousness in a strange hospital ER.

A young woman was standing over me. She asked: “Do you really think, sir, that a man of your age should be skiing alone in the glades?”

I hated that question. I found it particularly humiliating. As an intrepid, former U.S. Army trooper, I didn’t want to be talked to that way, especially by a woman who asked me the same questions my wife often asked.

Tests indicated a concussion. Upon release, I was told to buy a new helmet (each helmet can absorb only one crash), and not to ski for a week. I took only one day off, which I thought was plenty. I then purchased a new helmet and two days later I was back up on my skis again.

My next accident a few years later was to be worse, much worse.

Age denial? Not So Much

Before I tell you that story, I’d like to note that I’m not in total age denial. Now 79, I spend less and less of my après-ski time trading embellished ski stories with my buddies in smoky bars. These days, when we go on our annual ski trip, I can be found at night alone in my little room, carefully applying ice packs and winding compression bandages around my ill-treated joints.

I reject the idea, however, that I am suffering from any age-related diminution of muscle tone, balance or endurance. My ski dreams are still intact even if my body is not. I do realize that I should avoid the super steep double black diamond trails that I once traversed. But I just can’t resist.

Why? By story’s end, I’ll try to explain.

Male Bonding

Each year, twelve of us, former army buddies at Fort Bliss, Texas go on a ski trip together. We had trained as Nike Missile crewmen back in 1958 during the Cold War. Our job was to join with others to protect the City of New York.Stationed in a darkened radar van, we were to monitor our radar screens for Russian bombers. Our Nike Missiles were buried in concrete shafts near us. Our vantage point was Spring Valley, New York, which otherwise is known for kosher chickens and Hassids. If we saw any Russians in the air we were to electronically challenge them, then shoot them down. Continue reading

The Lowdown On ‘Low T': Men’s Health Craze Booming Despite Risks

NPR reports that sales continue to soar for prescription testosterone to treat men plagued by low energy and a sluggish sex drive even while doctors fret over risks:

The number of testosterone prescriptions written in the U.S. more than tripled in the past decade. But researchers suspect that much of the testosterone dispensed at low-T clinics isn’t tracked, since it’s often bought with cash. This unfettered flow of testosterone — officially a controlled substance — has raised concerns among doctors who specialize in hormonal problems.

“In most doctors’ offices, you don’t see a big shingle over their door saying, ‘Get your testosterone here!’ ” says Dr. Edward Karpman, a board certified urologist and the medical director of the Men’s Health Center at El Camino Hospital in Los Gatos, Calif. Karpman says low-T clinics aren’t in the business of treating the complex medical problems that often masquerade as low energy and decreased sex drive. Those can include sleep apnea, depression and, perhaps most importantly, heart disease.

(Linden Tea/flickr)

(Linden Tea/flickr)

“Any man who presents, especially in his 40s and 50s, with new onset erectile dysfunction is at an increased risk for cardiovascular disease and even heart attack or myocardial infarction,” says Karpman.

Hormone treatment itself isn’t without risk: A recent study of more than 55,000 men found a doubling of heart-attack risk among older men who used testosterone. Younger men who had a history of heart disease had a higher incidence of nonfatal heart attacks. In addition, men who are on prolonged high-level testosterone replacement therapy can experience testicular shrinkage.

Earlier this year, WBUR’s Tom Ashbrook highlighted the risks of prescription testosterone and explored the meteoric rise of the ‘Low T’ diagnosis. Continue reading

Coerced Sex Common For Teen Boys And Young Men, Study Finds

A few nights ago, unable to wind down, I was searching for something to watch and stumbled across the film “Adore.” It’s about a pair of lifelong friends (grown women) who end up having affairs with each other’s young, hunky, 19- or 20-year-old sons. My first reaction was the same as one Netflix commenter:

“…if this had been two pals and each other’s teen daughter; well, you get the point. The movie would not have been made, or if so, it would have had an entirely different hue-to say the least. DOUBLE STANDARDS.”

Or, as A.O Scott wrote in his New York Times review:

“It is worth noting that the same movie about a couple of dads sleeping with each other’s 20-year-old daughters would need, at a minimum, to confront the ickiness of the situation. Really, such a movie would be unlikely to make it into theaters, in spite of the commonness of real-life relationships between older men and younger women.”

(Dustin Hoffman, Anne Bancoft in "The Graduate"; Movie-Fan/flickr)

(Dustin Hoffman, Anne Bancoft in “The Graduate”; Movie-Fan/flickr)

The film isn’t about sexually coercion; but it is about boundary breaking, and I thought of it again reading this new study on the pervasive, but largely unexamined problem of sexual coercion among boys and young men.

The study, published in the journal Psychology of Men and Masculinity, found that coerced sex is fairly common for teenage boys and college-age men and can lead to psychological distress and risky behavior, such as sexual risk-taking and alcohol use.

From the American Psychological Association news release:

A total of 43 percent of high school boys and young college men reported they had an unwanted sexual experience and of those, 95 percent said a female acquaintance was the aggressor…

“Sexual victimization continues to be a pervasive problem in the United States, but the victimization of men is rarely explored,” said lead author Bryana H. French, PhD, of the University of Missouri. “Our findings can help lead to better prevention by identifying the various types of coercion that men face and by acknowledging women as perpetrators against men.” Continue reading

Why To Exercise Today, Guys: Better Prostate Cancer Outcomes (And We May Know Why)

There are about 2,617,682 men currently living with prostate cancer in the United States, according to the National Cancer Institute. And sometimes, at this age, it seems like everywhere you look, another man is getting diagnosed, watching and waiting, or getting treated for prostate cancer.

(DorteF/flickr)

(DorteF/flickr)

Exercise has already been shown to lower the risk of death among prostate cancer patients, but now, researchers report that may have a clue why, and it’s to do with brisk walking.

It turns out that “men who walked at a fast pace prior to a prostate cancer diagnosis had more regularly shaped blood vessels in their prostate tumors compared with men who walked slowly,” according to new findings presented in San Diego at the American Association for Cancer Research-Prostate Cancer Foundation Conference on Advances in Prostate Cancer Research.

Here’s more from the news release:

Men who engage in higher levels of physical activity have been reported to have a lower risk of prostate cancer recurrence and mortality compared with men who participate in little or no physical activity. The biological mechanisms underlying this association are not known.

“Prior research has shown that men with prostate tumors containing more regularly shaped blood vessels have a more favorable prognosis compared with men with prostate tumors containing mostly irregularly shaped blood vessels,” said Erin Van Blarigan, Sc.D., assistant professor in the Department of Epidemiology and Biostatistics at the University of California, San Francisco. “In this study, we found that men who reported walking at a brisk pace had more regularly shaped blood vessels in their prostate tumors compared with men who reported walking at a less brisk pace.

“Our findings suggest a possible mechanism by which exercise may improve outcomes in men with prostate cancer,” continued Van Blarigan. “Although data from randomized, controlled trials are needed before we can conclude that exercise causes a change in vessel regularity or clinical outcomes in men with prostate cancer, our study supports the growing evidence of the benefits of exercise, such as brisk walking, for men with prostate cancer.” Continue reading

Did You Get A Recession Vasectomy?

Dear Male Readers:

Please help us figure out if this phenomenon is real:

Researchers gathered in Boston for a meeting of the International Federation of Fertility Societies and American Society for Reproductive Medicine were presented with this provocative but non-published nor peer-reviewed theory: the financial meltdown of 2008 (and the subsequent slow economic recovery) are driving more men to get vasectomies.

(kristykay22/flickr)

(kristykay22/flickr)

From WebMD:

…researchers looked at the numbers of men having vasectomies at their facility in Wisconsin from June 2005 through October 2012. They also tracked the median income in Wisconsin during those years and the median U.S. income.

“We found as the median income for Wisconsin declined, the rate of vasectomies annually went up,” Dr. Anand Shridharani, a men’s reproductive and sexual health specialist at Erlanger Health System, in Knoxville, Tenn said. In 2005, 91 men had a vasectomy and the median state income was $54,269. In 2010, 239 men had a vasectomy and the income had dropped to $50,547.

“Comparing the number of vasectomies performed per year from 2005 to 2008 versus 2009 to 2012, the difference [an increase] is statistically significant,” Shridharani said.

“The suspected reason is that having an unexpected child would increase the cost of living,” he noted. “People are having children older, and older people are more in tune with what children cost,” Shridharani suggested… Continue reading

It’s The Carbs: ADHD In Childhood Linked To Adult Obesity, Study Finds

(Tobyotter/flickr)

(Tobyotter/flickr)

Ned Hallowell is a Sudbury, Mass. psychiatrist and expert on ADHD who suffers from the condition himself. Today, he spoke with NPR about a new study in the journal Pediatrics that found boys with ADHD are more likely to become obese men compared to children without the condition. Hallowell is quoted saying the results seem reasonable:

“It makes sense, because they’re self-medicating with carbohydrates. Carbs do the same thing that stimulant medications do — promote dopamine,” says Hallowell, who wasn’t involved in the latest study. “So you get the gallon of ice cream at midnight.”

With impulse control often a problem for people suffering from the disorder, Hallowell also says that nutrition should be part of an ADHD treatment plan. Continue reading

Study: Male Baldness, Thinning Crown, Linked To Heart Disease

Here’s a good news/bad story story for men losing it up top.

First the bad: in a new analysis, male baldness is linked to an increased risk of heart disease, the online journal BMJ Open reports.

(world on jan/flickr)

(world on jan/flickr)

The silver lining: the risk is greatest for men with a “thinning crown” as opposed to a receding hairline, the study finds. Indeed, receding hairlines aren’t linked to a higher risk at all.

Researchers suggest several possible explanations: such baldness may be a sign of insulin resistance (implicated in diabetes); chronic inflammation or a heightened sensitivity to testosterone, “all of which are involved directly or indirectly in promoting cardiovascular disease.”

More from the BMJ news release:

Male pattern baldness is linked to an increased risk of coronary heart disease, but only if it’s on the top/crown of the head, rather than at the front, finds an analysis of published evidence…

A receding hairline is not linked to an increased risk, the analysis indicates.

The researchers trawled the Medline and the Cochrane Library databases for research published on male pattern baldness and coronary heart disease, and came up with 850 possible studies, published between 1950 and 2012.

But only six satisfied all the eligibility criteria and so were included in the analysis. All had been published between 1993 and 2008, and involved just under 40,000 men. Continue reading

Regret Over Shorter Penis After Prostate Cancer Treatment, Study Finds

Patients facing treatment for prostate cancer expect to be warned of certain dismal side effects: erectile dysfunction and incontinence, for instance. But a new study suggests men should be warned of another possible complication: a shorter penis.

The new report found that a small number of men enrolled in a prostate cancer study complained to their doctors that their penises seemed shorter following treatment (though no actual measurements were taken). Some of the men reported that even this perception of a shortened penis interfered with their intimate, emotional relationships and caused them to regret the type of treatment they chose.

(Wikimedia Commons)

(Wikimedia Commons)

Prostate cancer is the second most common cancer in men, with about 241,740 new cases diagnosed last year, according to the American Cancer Society. Obviously prostate cancer can be serious: it’s the second leading cause of cancer death (behind lung cancer) in American men.

But most men diagnosed with prostate cancer will live — and live with the short- and long-term implications of the type of treatment they choose to undergo. While the problems of erectile dysfunction and incontinence are widely known as possible side effects, few studies have been done on treatment-related penile shortening. But doctors say it can and does happen — though it’s rarely discussed with patients.

In the current study, which was based on surveys completed by physicians treating 948 men with recurrent cancer, a total of 25 patients (2.63%) complained of a shorter penis. Complaints were most common in men who underwent surgery to have their prostate removed (19 of 510 men) and those treated with male hormone-blocking drugs combined with radiation therapy (6 of 225 men), researchers report. None of the men on radiation therapy alone complained of this particular problem.

These numbers are clearly small; but researchers say the phenomenon, due to its intimate nature, is likely underreported. The takeaway from this study, they say, is that the possibility of a slightly shorter penis after treatment should be made clear to patients as they consider their therapeutic options; a frank discussion upfront might minimize later regret. “Physicians should discuss the possibility of this rarely mentioned side effect with their patients to help them make more informed treatment choices,” the study, published in the medical journal Urology, concludes.

From the January issue of the journal Urology

From the January issue of the journal Urology

Lead author Paul L. Nguyen, M.D., a radiation oncologist at Dana-Farber Cancer Institute and Brigham and Women’s Cancer Center in Boston, said the novelty of the work is that it shows how even the perception of a shorter penis can profoundly impact a man’s quality of life and lead to regret. “Some people might think this is frivolous — who cares about a slightly shortened penis — but it really does affect people’s lives,” he said in an interview. “If guys [in the study] had this bad result they were much more likely to regret the path they chose. This is important to talk about up front when people are making their decisions.” Continue reading

Cost Study Adds To Growing Research On Benefits Of Circumcision

Preparing for a ritual circumcision

Preparing for a ritual circumcision (Cheskel Dovid/Wikimedia Commons)

“You realize, of course, this is a purely cosmetic procedure.”

That snarky-toned remark by a neonatologist is imprinted in my memory forever, tinged by the extra distress it caused me. I’d just been through a scary pre-term birth and the anxiety of more than a month of hospital care for my baby son. Now he was finally almost ready to go home, still weighing only a little over five pounds, and the last thing I wanted for him was another procedure.

But the research I’d done persuaded me that circumcision was not just a venerable tradition; it had real health benefits, both shorter-term and when he reached maturity. I knew about the growing movement among men who denounce it. I’d also heard an earful from our babysitter about the penile problems of boys in Europe, where circumcision is rare.

We chose circumcision, but apparently more and more American parents are tipping the other way — and the health results could prove expensive. NPR’s Scott Hensley has just posted an excellent “Shots” piece on the potential tab for the decline in circumcision and its background. Right now, about 55 percent of American boys are circumcised, he notes, down from a peak of 79 percent. But a growing body of research — including this Johns Hopkins study last fall — finds that circumcision has significant health benefits, preventing sexual diseases and urinary infections.

Scott writes about the latest study, on costs:

Johns Hopkins researchers analyzed how declines in circumcision would affect future health care costs, including what would happen if the rate fell to 10 percent, which is the average in Europe. The change — up or down — in HIV infections is the biggest factor. So what’s the tab? If the circumcision rate fell to 10 percent, the annual net increase in health care costs would be about a half-billion dollars a year. The findings appear in the latest issue of Archives of Pediatrics and Adolescent Medicine.

Johns Hopkins pathologist Aaron Tobian, senior author on the paper, tells Shots an increase in health costs tied to less frequent circumcision is already happening. He lays some of the blame on the American Academy of Pediatrics, whose 1999 policy statement says the “data are not sufficient to recommend routine neonatal circumcision.”

Tobian says that data gathered since then show that position is wrong. “The trials were amazingly consistent,” he says. Continue reading