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NEW Ordering Options for the Ultimate Male Enhancement Book!

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NEW Ordering Options for the Ultimate Male Enhancement Book!

We have two new updates for those interested in the book:

1. Bitcoin now accepted for eBook sales. Go HERE to order using BitCoin via BitPay.

2. Instant download now available for eBook purchases using credit card or PayPal.

Remember to use code PEGYM10 for your 10% discount!

The post NEW Ordering Options for the Ultimate Male Enhancement Book! appeared first on PEGym.


This Man Tried to Enlarge His Penis by Injecting It With Petroleum Jelly—and It Went Dangerously Wrong

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This Man Tried to Enlarge His Penis by Injecting It With Petroleum Jelly—and It Went Dangerously Wrong

His DIY penis enhancement landed him in the hospital for a month.

By Jessica Migala

* This article is a repost which originally appeared on Health

Consider this your public service announcement for the day, something you might want to pass along to the guys in your life: Don’t inject petroleum jelly into your penis in an effort to make it larger.

One 45-year-old man living in the South Pacific learned that the hard way after he came down with gangrene on his penis. Yes, gangrene—a condition that causes body tissue to rot away. Details of this man’s diagnosis is newly published in the medical journal Urology Case Reports.

Wait—record scratch. How did this happen?

As the case report details, the man went to the ER with a “severe deformity of the shaft of the penis, which had been progressively worsening over the course of five days,” the authors wrote. The man said that his shaft was itchy and bled when he scratched it. After the area began to swell and he started feeling weak and feverish, he went to the ER.

The ER reported his symptoms as a fever of 101 degrees F and a fast heart rate. His penis also had necrotic skin, aka dead tissue.

Doctors thought they knew what was responsible for his symptoms: The man explained that two years earlier, he injected petroleum jelly into the shaft of his penis because he thought that would make his penis bigger. (The authors wrote that in some parts of the world, this is a common thing for men do.)

The docs opened up his penis to drain pus and fluid. They reported finding a lot of petroleum jelly around the shaft, which they removed. They diagnosed him with a type of gangrene called Fournier’s gangrene, which basically means gangrene of the genitals. Blood tests also were positive for staph and other bacteria.

Petroleum jelly is often recommended by dermatologists as a top-notch moisturizer, and it certainly seems harmless on skin. But it’s not harmless when it’s injected under the skin, and it’s safe to say that no doctor has ever given the go-ahead to inject it into the penis, especially as a way to make it bigger.

The petroleum jelly in the shaft was bad enough, but the authors of the case report explain that the man made things worse by scratching his penis, breaking the skin, and introducing the bacteria that sparked the infection. That eventually cut off blood supply to tissues and lead to Fournier’s gangrene, the researchers explained.

To treat Fournier’s gangrene, the man spent time in the intensive care unit taking antibiotics. He then was visited by plastic surgeons, who did skin grafts on his penis to replace the dead tissue. After a month, he was discharged from the hospital—*and his case report serves as something of a warning for any guy thinking of trying his own DIY penis enlargement.

*Editor’s note: For information on safe, healthy penis enlargement alternatives check out PEGym!

The post This Man Tried to Enlarge His Penis by Injecting It With Petroleum Jelly—and It Went Dangerously Wrong appeared first on PEGym.

Yes, Penis Dysmorphia Is A Real Thing

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Yes, Penis Dysmorphia Is A Real Thing

Penile body dysmorphic disorder goes beyond wishing to be bigger. Men say it affects many parts of their lives.

By Brittany Wong

* This article is a repost which originally appeared on HuffPost US

“Nobody wants someone to look at their penis and say, ‘Yeah, that will work I guess.’”

Steven, a 30-year-old welder from Los Angeles, has a perfectly normal-sized penis. In fact, going by a recent study which found that the average erect penis size is 5.16 inches long, he’s a little larger than average.

But in his teen years through his early 20s, he had what he calls “penis issues.”

“I always just believed I was on the small side of average, and anyone that said otherwise was just trying to make me feel good or otherwise manipulate me,” Steven, who asked to be identified only by his first name to protect his privacy, told HuffPost.

He felt confident in his looks in other areas ― he hit the gym regularly and was told he was good-looking. But none of that mattered to him; by the internet porn standards he’d absorbed through the years, he believed he wasn’t stacking up physically.

“Growing up in the internet age with readily available porn, it gave the impression that every guy out there is packing a monster penis except for you,” he said.

This mentality took a major toll on his sex life.

“It’s easy to get this false impression that a girl you hook up with would later tell stories about you being the one small cock she found in the wild, or she would tell the next guy she’s with about how he’s so much bigger than the last guy,” he added.

Comparison is the thief of joy, especially when it comes to penis size. At the time, Steven was dealing with what sex experts call penis dysmorphia (or what’s more generally called “penile body dysmorphic disorder” or “penile BDD.”)

Penile BDD isn’t an actual diagnosis in the Diagnostic and Statistical Manual that psychiatrists and psychologists use for diagnosing mental disorders; instead, it’s considered a subcategory of body dysmorphic disorder (BDD) that’s hyper-focused on the penis.

Penis dysmorphia is much more than simply wishing your penis was bigger, said Stephen Snyder, a sex therapist and host of the podcast “Relationship Doctor.”

Much like generalized body dysmorphia, men with penile BDD are so preoccupied with perceived defects or flaws in their appearance ― in this case, size ― that it causes them real distress. Sometimes, it leads to avoidant social behavior.

“Men who suffer from penis dysmorphia may compulsively measure themselves over and over, avoid dating, practice home-enlargement techniques they see promoted on the internet and even seek penis enlargement surgery,” Snyder told HuffPost.

As with regular body dysmorphia, it doesn’t matter that the size differential is insignificant and undetectable to others. The condition can affect anyone: those who are well-endowed, average, under-endowed, growers and showers ― you name it. (In fact, one study in the British Journal of Urology suggested that most men who go for penis enlargement surgery have normal-sized penises.)

A girl texted me back, ‘OMG you’re so f**king thick.’ Most would take this as a compliment but it was lost on me, I felt like yet again I was being lied to.Steven, 30

It’s hard to say how common penis dysmorphia is, though, since people with BDD often don’t seek help from a mental health professional, Snyder said.

“You know you’re dealing with it if you’ve suffered significantly or have your life be impaired as a result, and have engaged in maladaptive behaviors ― avoiding dating or that constant need to measure yourself,” Snyder said.

The good news? In a recent study of American men, 85.9% of guys reported being more or less satisfied with their genitals. But if you’re dealing with penis dysmorphia, size matters a whole lot; you’re never satisfied, and any positive feedback you might hear is basically ignored.

Porn’s Role In Penis Dysmorphia

Part of the reason some men have penile BDD is that their expectations are warped by porn, where well-hung actors ― statistical outliers, really ― are the norm.

In his book “The Penis Book: A Doctor’s Complete Guide to the Penis,”  urologist Aaron Spitz says that roughly 40% of men who come to urologists’ offices seeking penis enlargement surgery got the idea that they were under-endowed from watching porn when, in fact, they are normal.

“A huge problem with pornography is that, although most guys intuitively know it’s not ‘real,’ few men have any other frame of reference to compare themselves to,” Spitz told HuffPost. “Unless a straight guy happens to be a urologist like me, he really has a very limited understanding of the pageantry of the penis in all its various shapes and sizes.”

Hell, even porn stars are surprised by what they see in real life compared to what’s on PornHub.

“In the industry, the average penis size is often over 8 or 9,” Theo Ford, an adult film performer, told HuffPost in April. “Funnily enough, I often forget that that’s the case and am almost surprised if I meet a guy with an average penis size.”

“In porn, even I could potentially feel inadequate,” he admitted. “I’m not sure how the general public feels about themselves if they only see very hung guys, but I hope they, too, remember that porn is simply a fantasy.”

I think I stayed a virgin for so long because I let my dysmorphia consume me. I adopted a defeatist mentality. Luke, 24

The pressure to be porn-perfect is harder on some men in particular. Given how popular “big black cock” (BBC) videos are on porn sites, Black men in particular struggle with size issues. (Subreddits about penis size are full of men of color lamenting how porn portrays them: the exaggerated ideas about their genitalia and the industry’s ugly, highly-stereotyped view of Black sexuality.)

Growing up as a Black teen in South Bend, Indiana, Luke, 24, said his penis dysmorphia went hand in hand with his porn addiction.

“The whole BBC myth made me exceptionally self-conscious to the point I just told myself, if women are expecting something special from me, I’m just going to disappoint them, and in that case, I might as well not put myself in situations to disappoint,” Luke, who asked to withhold his last name for privacy, told HuffPost.

Because of anxiety about his size, Luke was a virgin up until a few months ago.

“My penis measures in at a hair over seven inches but because of all the porn I’d seen, I believed I was average at best and definitely small for a Black guy,” he said. “I think I stayed a virgin for so long because I let my dysmorphia consume me. I adopted a defeatist mentality.”

How To Deal With Penis Dysmorphia Without Getting A ‘Dick Job’

Spitz said men should talk to a doctor or a therapist before undergoing any type of surgery. Generally, as long as your body is healthy and functioning, there’s no good reason to stress over dimensions you don’t control, he said.

“Take your natural body, keep it as healthy as you can, and enjoy it, and just as importantly, bring someone else enjoyment,” he said.

It doesn’t help to constantly measure yourself, either.

“Compulsive self-observation and self-measurement tend to make the anxiety of penile dysmorphia worse,” Snyder said. “It’s important to cut way down on compulsive checking.”

Even if you’re not considering surgery, if you’re actively avoiding dating or measuring yourself nonstop ― the two big warning signs of PBDD ― it might be worth talking to a therapist or specialist about your concerns.

Both Luke and Steven said they’ve moved past their days of avoiding sex. They’re less consumed with size. Talking about penis dysmorphia on Reddit with other guys who’ve experienced it has helped. So has taking a more realistic view of porn ― and at times, cutting back on watching it.

“Of course every guy wants the porn reaction … nobody wants someone to look at their penis and say, ‘Yeah, that will work I guess.’ But you do your research and realize how exaggerated porn can be,” Steven said.

What’s helped most is going on actual dates, he added.

In real life, he realized, most women are far less fixated on length than men are. (In fact, if women are interested in anything, it’s girth, since a wider penis does a better job of stimulating the entire clitoral structure. And obviously, there are other ways to please a woman that don’t involve your penis; work on your oral and digital sex skills.)

And of course, the same holds true for queer men. Yes, some men are very vocal about their “bigger is better” preference, but not all guys are seeking the same kind of sexual partner or the same sort of sex.

Today, Steven gets that people want to share their bed with someone decent, regardless of dick size.

“You have to be someone that others actually want to have sex with,” he said. “Your first concern shouldn’t be your penis size and how many tenths of an inch it is bigger than average. Focus on taking someone out and being kind, charming, funny, entertaining and genuine instead.”

Luke understands that now, too.

“Eventually I realized I have more to bring to a relationship than just the size of my penis, whether it’s big or small,” he said. “My size won’t matter if I have the personality of a rock.”

The post Yes, Penis Dysmorphia Is A Real Thing appeared first on PEGym.

Men and Porn: Why Is the Pull of Porn So Strong?

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Why Is the Pull of Porn So Strong?

By Brett

* This article is a repost which originally appeared on The Art Of Manliness

This week we’re running a four-part series about the effects of pornography on the brain. The first step in understanding these effects is to understand the relationship between your noodle and dopamine, and how this interplay makes the pull of porn so strong. I truly feel that understanding this dynamic is the crucial foundation to making a decision about what role you want porn to play in your life, and also to ultimately quitting this habit. So I’ve made this and tomorrow’s post fairly in-depth. But I have also kept the info very accessible, and I think those who read the articles in their entirety will find them worthwhile. But if that’s simply not for you, feel free to skip to the recap at the end. 

Dopamine and Your Brain 

Our brains are composed of billions of cells called neurons that send messages to each other through an electrical-chemical process. Without getting too technical about how this works, the important thing to understand for this discussion is that the neuron delivering the message releases a chemical called a neurotransmitter into the synapse – the space between the neurons — and over to a receiving neuron. The receiving neuron catches the neurotransmitter with its receptors and then generates electricity so it can communicate to another neuron. This process repeats itself a bajillion (that’s a scientific term) times a day.

Different neurotransmitters communicate different things. What they all have in common is that their primary purpose isn’t to make you “happy” or fulfilled, but to ensure that your carcass survives so that you can pass on your genes.

An integral part of our brain’s system for increasing our chances of survival and reproduction is creating the strong desire and drive to do or seek out those things that will help us fulfill those aims. We have to want to eat, we have to want to seek shelter, and we have to want to have sex. The neurotransmitter that gives us our drive to fulfill these impulses is dopamine.

Dopamine is released whenever we encounter rewards, or “natural reinforcers,” that help us survive. Things like food, sex, novelty (new things may lead to new survival-boosting benefits), and friendship (you’re more likely to survive in a group) sit at the top of the natural reinforcer hierarchy. Once we encounter one of these potent rewards/reinforcers, a neural pathway is created (more on neural pathways below). Dopamine keys in on the reward system in our brain, and drives us to repeat the same behaviors that helped us attain those rewards previously.

The more something helps with our survival and reproduction, the bigger the “squirt” of dopamine our neurons experience, and the stronger the drive to repeat the behavior. For example, different types of food release different levels of dopamine. Because our hunter-gatherer ancestors lived in feast and famine mode, it made evolutionary sense to load up on as many calories as possible while the getting was good. Foods high in fat and sugar provided the most energy benefits, so our ancestors’ brains evolved to release a lot of dopamine when they encountered high fat and high sugar foods. Our brains continue to do the same thing in the modern word, which explains why when given the choice between a Five Guys burger and a dry salad, our gut instinct is to go with the burger and shake. Dopamine drives us towards sweet, carby, and high fat foods.

Sexual stimulation and orgasm give our brain’s reward system the biggest natural shot of dopamine of all. Which makes sense. From an evolutionary perspective, the entire measure of our creation is to reproduce and pass on our genes. So seeking for and wanting sex should be our primary evolutionary drive. That big dopamine shot that results from orgasm then goes on to wire our brain’s reward system to repeat whatever behavior we did to get sex so we can continue to get sex in the future.

Isn’t Testosterone Responsible For My Sex Drive?

Contrary to popular belief and cheesy internet ads, it isn’t testosterone that plays a central role in a man’s sexual libido and ability to get an erection, it’s dopamine. Testosterone plays more of a supportive role in our sex drive by stimulating the brain to produce more dopamine. So while low T can result in low libido, it’s because there isn’t enough T to stimulate sufficient dopamine for a healthy sex drive. It is therefore possible for a man to have high total and free testosterone levels, but low dopamine (or blunted dopamine sensitivity – more on that later), and thus a low or absent sex drive. Testosterone’s dopamine-stimulating abilities also explain why testosterone replacement therapy companies advertise that increasing your T can give you more energy and drive to do other stuff in life. It’s not the T itself, but rather the dopamine that T triggers in the brain that gives you that boost. The more you know.

The release of dopamine starts amping up your sex drive when you see someone attractive. This increase will motivate you to do whatever your culture says you need to do to woo that person and eventually get them into bed. If you’re the old-fashioned type, that process can take a while. If you’re a Don Juan and the gal is open to casual sex, maybe a few hours is all you’ll need. Whatever the timetable, dopamine levels and hence sex drive will continue to increase as you move towards consummating your desire. The powerful urge to copulate created by spiking levels of dopamine as you get closer and closer to actually having sex partly explains those moments when people say, “I don’t know what happened. One moment we were on the couch watching Louie and the next minute we were making the beast with two backs.”

Once we achieve whatever reward dopamine was driving us towards, the levels of this neurotransmitter drop off. With sex, dopamine levels peak right around the moment of orgasm (to help wire our brains to seek out sex again in the future), but then decrease afterwards because we’ve accomplished our biological imperative to spread our seed. (Your brain doesn’t know if your seed never made it past the end of your condom. As far as your neurons are concerned, it’s “mission accomplished.”) The post-coitus drop in dopamine partly explains the male “refractory period” after sex. (In case you didn’t know, after a man orgasms, it’s physiologically impossible for him to have another orgasm for a period of time. Could be minutes, could be days. Depends on the guy.) When we orgasm, a hormone called prolactin is released which represses dopamine. No dopamine, no sex drive, no boner.

Porn, Novelty, and the Coolidge Effect

Remember when I mentioned above that one of our evolved natural reinforcers is novelty? Our brains are hardwired to seek out novelty because new things can provide survival and reproductive advantages. Whenever we encounter anything new — a new email, a new gadget, a new food — we get a shot of dopamine, which makes us want to look for more new things. We’ve all got an irrepressible treasure hunter streak in us. Thanks to a process called habituation, the familiar just doesn’t provide the same kind of dopamine hit as the novel. Habituation explains why the new car that we were so motivated to get for months and months doesn’t excite us nearly as much after just a few weeks of driving it around town.

We also get that shot of dopamine whenever we encounter a new attractive woman other than our current partner. Our brains are hardwired to seek out as many different (novel) sexual partners as possible. Again, from a reproductive perspective it makes sense that being exposed to a variety of attractive sex partners would jack up dopamine in our sexual reward circuitry, particularly in men. For males, the goal is to reproduce with as many different females as possible to create as many progeny as possible, with as much genetic variation as possible to increase our possible blood lines.

This drive for multiple new sex partners even when you already have an available and willing one is often called the “Coolidge Effect” after a conversation the president supposedly had with his wife:

The President and Mrs. Coolidge were being shown [separately] around an experimental government farm. When [Mrs. Coolidge] came to the chicken yard she noticed that a rooster was mating very frequently. She asked the attendant how often that happened and was told, “Dozens of times each day.” Mrs. Coolidge said, “Tell that to the President when he comes by.” Upon being told, President asked, “Same hen every time?” The reply was, “Oh, no, Mr. President, a different hen every time.” To which the president replied, “Tell that to Mrs. Coolidge.”

To understand the power the Coolidge Effect has in increasing dopamine levels let’s take a look at two experiments.

In the first, a lucky male rat was placed in a cage with four or five female rats. He immediately had sex with all of them until exhaustion. Panting and rolled over in a sexual stupor, the male rat was nudged and licked by the female rats to keep going, but he didn’t respond. The tuckered-out rodent was no longer interested in doing the deed. But as soon as the researchers put a new female rat in the cage, old Mr. I’m Too Tired became alert and sarged over to have sex with the new female, while still ignoring his old harem. This rat’s ability to have sex with a new female despite having been previously sexually satiated all came down to dopamine. The first crew no longer gave him those potent dopamine squirts because, well, they were now boring. Been there, done that. But the new female caused an uptick in dopamine due to novelty and bam! the male rat’s sex drive was back. The Coolidge Effect explains why people are tempted to cheat, even with someone significantly less attractive that their long-term partner; the pull of novelty, any novelty, can be quite strong.

A similar experiment was done to show the Coolidge Effect in humans. Instead of putting a lone man in a room with four or five different women to have sex with (there likely would have been plenty of volunteers, but the ethicality would have been questionable), researchers showed test subjects an erotic film while their penises were attached to monitors to measure arousal. After 18 viewings of the same film, arousal had decreased dramatically. These guys had gotten used to seeing the same woman having sex with the same dude, so dopamine levels dropped. But on the 19th and 20th viewings, researchers showed a new clip and atten-hut! arousal skyrocketed once again. Sexual novelty increased dopamine levels, which increased sexual arousal.

How Online Porn Has Changed Your Brain

Alright. So what does all of the above have to do with internet porn?

Well, dopamine plays a central role in why you want to look at porn. Understand how dopamine works, and you understand why you are attracted to porn.

Porn is a substitute for actual sex, but your brain doesn’t know that. It reacts to a picture of a naked woman or a video of people having sex the same way it does a real life naked woman or you actually having sex. When encountering sexual images, your brain is going to ramp up dopamine levels, driving you to orgasm — whether that climax is fostered with another human being or is self-induced.

Dopamine also explains why certain types of porn are more compelling than others, and how in extreme cases men prefer porn to actual sex.

A still picture of a naked woman will jack up dopamine levels the first time you see it, but after a while that same picture just won’t do it for you any more. Your brain has become habituated to that stimulus. In order to be aroused again, you’d need to increase dopamine levels by injecting more novelty into your sexual fantasies with a new picture of a different naked woman.

But as time goes on, simply looking at any picture of a naked woman won’t get you aroused. You need something more. Well, you get a bigger squirt of dopamine whenever you watch others have sex in a porn video because the live action activates your mirror neurons, making you feel like you’re the one having sex. The stronger the stimulation, the bigger the shot of dopamine to the reward system, and hence the greater desire you have to watch that porn video.

But as the study above showed, after repeated viewings, even an erotic film can become like watching a boring documentary. It just won’t offer the same kind of dopamine hit you got the first time you watched it, and will eventually fail to arouse you. Again, this is due to habituation. To become sexually aroused again, you need to increase dopamine levels by watching something new, be it a video with a new woman or a video with some new sex practice you’ve never seen before. Add the novelty, increase the dopamine, and sexual arousal returns.

You’re probably seeing a common theme here: novelty. Porn offers the sexual novelty that dopamine has hardwired you to seek. The more you successfully find new sexual experiences, the more dopamine you get, which reinforces the desire to look for even more sexual novelty. Porn’s easy access to new “experiences” is part of what makes it so alluring.

Now before the internet, this wasn’t much of a problem. Once a man in the pre-internet porn years got habituated to his “girly” magazine, he had to trek over to the adult bookshop or the convenience store in the seedy part of town to get a new one. If he wanted to watch a pornographic film, he’d have to go to a XXX theatre or maybe a porno booth in that bookstore where he got his mags. Whether getting magazines or seeing films, it was a lot of rigmarole to get porn, plus there was the risk of getting caught and experiencing social shame. So, many men just didn’t bother. Even when he could have the magazines or videos delivered to his home, that happened maybe once or twice a month. If he had kids, he had to find a place to stash his porn and then find time when his family wasn’t around so he could exhume his collection and view it in privacy. Again, a lot of rigmarole.

So while porn offered some sexual novelty back in the day, there were barriers put in place due to technology (or the lack thereof) and social mores that made access to new and novel porn difficult and time-consuming. Because the dopamine hits from the new and novel didn’t come easy, getting hooked on porn was difficult and most men didn’t experience the many problems that modern porn users report.

Fast-forward to today. Thanks to the internet, you now have an infinite variety of porn on tap 24/7. Dopamine spikes due to sexual novelty have never been easier to achieve. No more trudging to the adult bookstore, no more going to great lengths to hide your porn. Just bring it up on your laptop or mobile device in the privacy of your home or at the bathroom at work. You can have multiple tabs open in your browser for different porn sites featuring a whole host of different virtual sex partners. As Gary Wilson notes in Your Brain on Porn, in “ten minutes, you can ‘experience’ more novel sex partners than your hunter-gatherer ancestors experienced in a lifetime.”

Internet porn doesn’t just provide access to novel sex “partners,” but to novel sexual experiences as well. You’re not just limited to watching a couple have sex missionary style, but can watch a wide variety of sexual acts. Just as novel sex partners will jack up dopamine levels, so will observing different sex acts. And as we’ll discuss tomorrow, dopamine levels also spike when we encounter things that shock us or gross us out. The more intense the emotional experience we have when we encounter porn, the more dopamine is released into our brain’s reward system. Which is why you may find yourself searching for kinkier and kinkier porn even though part of you finds it repulsive. All of this novelty is just a click away. As you experience more and more dopamine squirts to your reward system with new types of porn, connections in your brain’s reward circuitry strengthen, increasing your drive to seek even more sexual novelty. On and on the cycle goes.

Neuroplasticity, or, Why You Have the Urge to Look at Porn Whenever You Get Bored or Open Up Your Web Browser

So dopamine is what drives you to want to look at porn. And thanks to the internet, you have access to an unlimited variety of sexual “experiences” that when viewed, send out squirt after squirt of dopamine in your brain, which drives you to search for more and more porn.

At the same time, without you even knowing it, those dopamine squirts are also strengthening neural connections that are responsible for the behavior that keeps those neurotransmitter hits coming.

Porn is literally rewiring your brain.

You’ve probably heard the phrase “neurons that fire together, wire together.” It aptly describes the way we learn things. Everything you know – how to walk, how to throw a football, who won the World Series in 1989 — is made up of connected neurons firing in sync with one another. The stronger the connection, the less you have to think about doing or remembering the thing you’re trying to recall. You don’t have to think about walking, for instance, because the neurons involved in walking have a strong connection that began being formed as toddler. However, trying to remember information for a history test that you just crammed for the previous night might be more difficult because the neurons involved in that memory haven’t fired enough together to create a strong connection.

Neurons firing and wiring together is also how our habits are formed. When you receive a shot of dopamine after receiving some reward, be it food or sex or novelty, your brain is strengthening the neurons that fired and wired together to achieve the reward so that you will repeat the process and can get it again in the future. This rewiring involves connecting the cues and behavior that led to a respective reward.

This cue-behavior-reward connection is what author Charles Duhigg calls “The Habit Loop,” and understanding it can go a long way in helping you understand your porn habit (and break it).

Habit researchers have shown that almost all cues (the thing that reminds or triggers your brain to seek a reward through a certain behavior) fall into one of five categories:

  • Location
  • Time
  • Emotional State
  • Other People
  • Immediately-preceding Action

Again, your brain is paying attention to cues that are connected with the reward. Once it recognizes the cue, dopamine is released to get you craving and wanting to do whatever it takes to get the reward. Think Pavlov’s dogs here. At the beginning of that experiment, it was just food that got the dogs salivating. But then they were introduced to the cue of a metronome, and after a while just that sound would get them salivating for their reward.

With porn, the associated cue could be sitting down at your computer late at night when everyone else is asleep. If you’re John Mayer, the cue would be being in bed when you first get up in the morning. For many guys, being in bed right before they go to sleep is a cue. Coming across a porn image by accident while surfing Tumblr could be a cue to start looking for more porn. Heck, just visiting Tumblr might be a cue to start looking for more porn.

Cues don’t even have to be external. The most common porn surfing cues are emotional states. Many men find themselves surfing for porn when they’re depressed or bored or even distracted. For them, the pleasure of porn offers relief from these unpleasant emotions.

Once the cue triggers the dopamine production that ramps up your motivation to view porn, a behavioral routine is automatically set in motion. A routine is a behavior or set of behaviors that get you to the reward of orgasm. So let’s say your cue to look for porn is when you’re at your computer late at night after everyone has gone to bed. Once that happens, without even really thinking about it, you open up your web browser (in incognito mode, of course) and go right to PornHub to commence a session of porn browsing and masturbating. The cue-behavior/routine-reward circuit is complete. Your brain releases a huge squirt of dopamine right around orgasm, reinforcing the neural connections associated with the cue, routine, and reward so that next time you have the same cue (at your computer late at night), you’ll get that itch to start your routine to get more porn. Repeat this circuit over a period of a few days or weeks, and you’ve got yourself a strong neural connection that leads to you checking out porn without even really thinking about it. That’s how porn can become a strong habit or even an addiction (we’ll talk more about the habit vs. addiction distinction in the next post).

Recap

Let’s review what we’ve covered today.

The reason porn is so alluring is because of dopamine. Dopamine is what makes us crave or seek out evolutionarily advantageous rewards. Sex is the strongest natural reinforcer of behavior and releases the most amount of dopamine in our brain when we successfully orgasm. Our brain doesn’t differentiate between porn-induced sex fantasies and actual sex, so we get the same big squirt of dopamine, and the same incredibly strong drive to orgasm, with porn as we do with real life sex. Basically, when you look at porn, your brain thinks you’re a heroic tribesman out on the savanna, and is shouting “Atta boy! Spread that seed! Spread that seed!” when in reality you’re hunched over your laptop, the light of the screen illuminating your dead-eyed gaze, as you clench a wad of tissues.

The more habituated we get to a stimulus, the less dopamine our brains release in conjunction with it. Getting the same hit as before necessitates seeking out sexual novelty, and high-speed internet porn provides this in spades. This easy access to a wide variety of new sexual scenes and practices makes internet porn all the more alluring and desirable thanks to the dopamine hits your brain gets every time you click over to a new porn clip or picture.

Not only does dopamine create the craving to surf for porn, it’s also strengthening the neural connections in your reward circuitry that are responsible for the behaviors that lead to you actually looking at and masturbating to porn. Your brain comes to associate certain environmental or internal cues with the reward of orgasm so that whenever you encounter these cues, a behavioral routine is initiated that leads you to your favorite porn site. Your brain releases more dopamine in response to successfully getting porn, and orgasming from it, which strengthens this neural cue-routine-reward circuit, making porn surfing a habit that’s extremely difficult to shake.

And there you have the brain science of why internet porn is so incredibly alluring and habit-forming.

But, the question remains…should you even care? Why not just give the old brain what it craves and not worry about it? To the possible negative effects of this course, is where we will turn in part 3.

The post Men and Porn: Why Is the Pull of Porn So Strong? appeared first on PEGym.

HAPPY HALLOWEEN! Save 10%

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HAPPY HALLOWEEN! Save 10%

HAPPY HALLOWEEN!

No tricks here – we’re all about the treats!

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ABOUT THE BOOK:

From the Founder and Lead Trainer of MaleEnhancementCoach.com, comes a playbook to help men achieve the size, strength and stamina they’ve always wanted in the bedroom.

After helping thousands of men reach their male enhancement goals, AJ “Big Al” Alfaro brings a comprehensive guide to transform every man’s sexual health and fitness.

The Ultimate Guide to Male Enhancement will…

  • Show you how to naturally and SAFELY increase your penis length and girth

  • Teach you how to increase your sexual stamina, to last as long as you and your partner want

  • Unveil the secret to becoming multi-orgasmic (Yes! Men can be multi-orgasmic too!)

  • Provide you with detailed exercises, including photos, plus exercise routines to follow, for those just starting off to men who have been pursuing male enhancement for years

  • Give you practical training advice for any exercise routine, whether that be strength training or cardio

By the end of The Ultimate Guide to Male Enhancement, you’ll have all of the tools you need to truly maximize your sexual health and be a master in the bedroom!

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Videos do include nudity. As such, these may not be suitable for work place viewing.

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Smelly Penis Ruining Your Sex Life? Here’s How You Can Prevent It

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Smelly Penis Ruining Your Sex Life? Here’s How You Can Prevent It

* This article is a repost which originally appeared on LatestLY

Just imagine how embarrassing would it be if your girlfriend complained about your penis being smelly! A smelly penis reflects badly on you, because it clearly hints that you have no sense of genital hygiene. It’s not an uncommon phenomenon when a penis gives out a foul odour and if it does, then there are chances you could also be having smegma buildup. Smegma is a mixture of oils and skin cells around the penis, especially under the foreskin. If you are uncircumcised, the buildup is more. Too much smegma, if you don’t shower enough or wash your penis regularly, can create smelly white chunks that can breed bacteria. Yuck!

This isn’t a hazardous condition but that doesn’t mean you don’t treat it. A smelly penis can have adverse effects on your sex life. Among the many sex queries on the internet today, the one about a foul-smelling penis is most common. So, how do you tackle it? What are the causes of it and how can you prevent it from occurring again? We help you out.

The Causes and Symptoms of a Smelly Penis

Apart from smegma, there are quite a few other reasons that could possibly be the cause of a bad-smelling penis. STDs like gonorrhoea, chlamydia, balanitis, yeast infection and UTI (Urinary Tract Infections) can be the cause for it too. The accompanying symptoms range from itchiness, redness, swelling, irritation to a burning sensation while peeing. Cloudy or pink urine, enlarged prostate and a frequent need to pee even if you don’t pass much urine are also some of the symptoms to look out for.

What Can You Do For Prevention?

1. Using a condom while having sex is a must. Unprotected sex not only paves way for unwanted pregnancy but also unwanted STIs.

2. Don’t forget to wash your penis thoroughly after having sex.

3. To get rid of a smelly penis, it’s important you practice hygienic habits. Cleaning and washing your genitals every day is the simplest and easiest way to avoid a smelly penis.

4. Don’t wear underwear without patting it dry. After cleaning it, make sure you pat dry under the foreskin and penis.

5. Avoid wearing underwear that’s too tight.

6. Trim your pubic hair regularly.

Bad smelling penis has implications beyond your sex life. If you don’t get to a doctor on time or practise better hygiene, your health may take a turn for the worse.

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Pumping, Porn, & the Stop and Starts Exercise: Ask The Experts

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Big Al, of MaleEnhancementCoach.com, answers questions about Pumping, Transitioning away from porn, and the Stop and Starts Exercise for the high EQ trainee in this Ask the Experts article.

If you have questions you’d like answered in an Ask the Experts article, please PM Big Al.

Q. I researched yesterday about pumping…

…and everyone on every forum recommends no more than 40 minutes per day, usually split into 2 sessions throughout the day.

What do you think about that? Isn’t the “extreme” pumping of 2+ hours maybe too extreme and dangerous? The last think I want is to permanently damage my penis.

Big Al: The “Extreme Pumping” guideline you’re referring to is for advanced pump training. It’s exceeding rare for anyone to work up to two hours of pumping, and you certainly wouldn’t start off at 40 minutes+ per day!

My initial recommendation (as seen HERE) is to start with FIVE minutes of pumping a day. That being said- as with any activity- you build conditioning with time and effort. As long as you progress with very small but regular increases to your training loads- and you’re monitoring your EQ and other PIs- there should be no reason why you wouldn’t be able to work up to 40+ minutes.

Q. I have read the three-part Detraining article. As I understand it…

…the transition period you mention consists of abstaining from porn as well as physical stimulation until I adapt the lack of porn stimulus and my EQ naturally improves again. At that time I can start the stamina routine once more.

Would you recommend still doing daily kegels? Not erect kegels due to the physical stimulus required but kegels in a flaccid state which can be performed anywhere and anytime throughout the day. Since the kegel exercise plays a prominent role in EQ as well I would like to continue a daily flaccid kegel regimen for continued PC muscle improvement. What are your thoughts regarding this?

Big Al: The tough part is the (usually) weeks long process of going from a lack of porn and poor adaptation to turning the corner on it. This demands you approach your training objectively- see it as a tool towards improved gains and not as something to get stressed about. Accept the fact that there’s going to be that necessary period of transition, and it’ll make it much easier for you to adapt.

You can perform flaccid Kegels but they should be part of a structured regimen. You do NOT want to overtrain the pelvic floor! That being said, you should strive to do your best to perform kegels with an erection.

You should also strive to develop the capacity to perform Erect Kegels- AND you should include the Stop and Starts exercise in your training repertoire to speed up the conditioning process.

Q. You recommended doing Stop and Starts. On your website…

…I’ve read that this exercise is for building endurance.

I don’t have any stamina problems – quite the opposite: sometimes it takes me quite a while to finish. And if I have sex for a long period of time, I tend to lose my erection a bit I don’t think I need to build more endurance in terms of “lasting longer” but “lasting harder”. Also if I go for a second round, it’s a lot harder to get an erection and more common to lose it.

Big Al: The Stop and Starts is the most inclusive exercise you can perform in that it aids in ALL aspects of male enhancement development. If one had time to perform only one male enhancement exercise it should be the Stop and Starts.

For the purposes of enlargement training, having as high a level of EQ as you can develop will be vital to maximizing gains. You’ll need to aim for an even higher level of EQ than you’d expect for unencumbered sexual performance.

In your case, you might consider performign the “Reverse” Stop and Starts to decrease your sensory threshold.

The post Pumping, Porn, & the Stop and Starts Exercise: Ask The Experts appeared first on PEGym.

Share Your Thoughts & Enter to Win a $50 Amazon Gift Gertificate!

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Share Your Thoughts & Enter to Win!

We’d like to show our thanks to those of you who purchased The Ultimate Guide to Male Enhancement!

We’d love to hear your thoughts about it!

Simply tell us (and the world) what you think of The Ultimate Guide to Male Enhancement and you’ll be entered to win a $50 Amazon gift certificate!

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Entries will be accepted until December 31st, 2019. Winners will be selected at random by January 15th, 2020. Winners will be notified by e-mail.

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Peyronie’s device improves length, curvature

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Peyronie’s device improves length, curvature

By John Schieszer

* This article is a repost which originally appeared on Urology Times

Researchers at the Mayo Clinic report that they have developed a legitimate penile traction therapy (PTT) device for men with Peyronie’s disease (PD) that may work when used for just 30 to 90 minutes daily.

Investigators looked at the device (RestoreX) in a recent study, and preliminary findings suggest using it for 30 to 90 minutes daily may result in statistically significant improvements in penile length and curvature after 3 months with no significant adverse events.

“We were a bit surprised by the findings. Up until this study and the creation of this device, no traction device had shown efficacy when used for less than 3 hours a day, with many studies requiring 6 to 8 hours daily. Even then, the studies often showed very minimal or mixed results,” said study investigator Landon Trost, MD, a urologist at Mayo Clinic, Rochester, MN.

Dr. Trost and his colleagues assessed the safety and efficacy of the RestoreX PTT device in 120 men with PD, who were randomized to one of four groupings (RestoreX for 30 minutes once per day, RestoreX for 30 minutes twice per day, RestoreX for 30 minutes three times per day, or a control group). All the men were treated for 3 months and then entered an open-label phase for an additional 3 months.

The authors found that PTT significantly improved penile length (+1.4 cm [+9.9%] vs. +0.3 cm [2.1%], p<.01) and helped with primary penile curvature (–9 degrees [–18.9%] vs. –1.0 degrees [–2.4%], p<.01) versus controls after 3 months of treatment. There were also significant improvements in the psychological/physical domain of the questionnaires for the treatment arms (PTT –2.6 vs. –0.5, p=.01). Significant improvements were seen in the ability to penetrate compared to baseline, with 38% reporting restored ability to penetrate versus 0% in the controls (p<.01). The authors also found that 19% of the PTT-treated men were able to eliminate their need for surgery.

Dr. Trost said in his practice he had not seen clinical improvements using previously existing devices, and it was nearly impossible to get men to use the older devices for 3 hours or more daily.

“Although we had expected to see modest improvements in length and curve, we were surprised by the percentage of men achieving a successful result; 94% and 77% experienced length and curvature improvements, respectively. The most surprising finding of the study, though, was that it appeared to improve erectile function by a clinically meaningful amount,” Dr. Trost told Urology Times.

The study, which was presented at the AUA annual meeting in Chicago, included 117 men. The authors had 3-month data available on 85 patients (66 patients in PTT arms and 19 controls). The mean age of the men was 58.4 years, and the mean duration of PD was 45 months. The mean primary curvature was 45.7 degrees and mean stretched penile to coronal length was 11.5 (1.4) cm, which was non-significant between PTT patients and controls.

Safety was the primary outcome for the study, and secondary outcomes included penile length, curvature, and subjective responses to standardized (IIEF, PDQ) and non-standardized questionnaires. The authors conducted assessments at baseline and 3 and 6 months after starting therapy, and they found that adverse events with PTT were all mild and resolved quickly after completing therapy. They included mild discomfort (44%), erythema (39%), and sensory changes (15%).

“For this study, we picked a very difficult to treat group, all-comers, including those with prior surgery, hourglass, injections, chronic phase, calcification, etc., and used an intent-to-treat analysis. We also blinded our team performing measurements so that the impact of our biases couldn’t influence the outcomes,” Dr. Trost said.

Curvatures were assessed from before/after photographs that were reviewed without knowledge as to the patient’s assignment (control vs. device).

“We really wanted to know if this therapy truly worked or not. We have no tolerance for introducing another ‘snake oil’ into the men’s health arena,” said Dr. Trost.

Several roles for device

He said there are a few roles for the device. It could be used as a stand-alone therapy for PD to improve length and curvature, as an additive therapy with collagenase clostridium histolyticum (XIAFLEX) to significantly enhance curvature outcomes and increase length, or to restore length in men who have lost length due to medical conditions such as diabetes or have undergone a prostatectomy.

“Given its cost-effectiveness compared to other treatments and minimal side-effect profile, it would make sense as a first-line therapy. I think it’s too early to know if it has a role in improving erectile function or if it makes sense to use in other scenarios, such as pre-penile prosthesis for example,” Dr. Trost said.

He said the benefit of penile traction therapy in general is that it is very safe, with only minor/transient side effects. The downside is that it takes time to see improvements, particularly with curvature.

Edward Cherullo, MD, a urologist at Rush University Medical Center, Chicago, said with many of these patients, the management of scar tissue is the major issue.

“I think it has some utility in the properly selected patients,” Dr. Cherullo told Urology Times.

“I think it is promising. It is not surgical or a pharmacological approach. The surgery and injections are not without risks,” said Dr. Cherullo, who was not involved with the study.

The technology behind the aforementioned device was developed by Dr. Trost in cooperation with Mayo Clinic Ventures. To mitigate potential conflicts, Dr. Trost elected to not invest in the licensing company in order to be able to perform research studies evaluating its efficacy.

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New Book Q&A Video With AJ “Big Al” Alfaro

NEW Addition to the Ultimate Male Enhancement Book Site- Instructional Videos!

Sorry guys, having big feet doesn’t mean your penis is super-sized – it’s all in the toes

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SOLE SEARCHING Sorry guys, having big feet doesn’t mean your penis is super-sized – it’s all in the toes

Becky Pemberton

* This article is a repost which originally appeared on THE Sun

MOST people know the phrase “you know what they say about men with big feet”, but is this cheeky saying true?

Scientists set out to see if the old wives tale of big feet equalling a whopping penis was accurate– and men with big shoes may no longer have a reason to brag.

It turns out, from a 1993 Canadian study, that there was no strong correlation between penis and foot size.

Scientists noted: “Height and foot size would not serve as practical estimators of penis length.”

This was supported by a similar study done across the pond in the UK in 2002, with researchers concluding: “The supposed association of penile length and shoe size has no scientific basis.”

However, there may be a body part that could be an indicator of your penis size; your toes.

What is the average penis size in the UK?

According to Target Map, Britain’s average erect schlong is from 3.5-5.8 inches.

But research from London clinic International Andrology clinic has slightly different results.

This may be because they asked 1,000 blokes to reveal their own size (which could have led to a few extra inches being added).

They found the average penis length in the UK is 6.36 inches.

Men with the largest members live in Wales, according to the survey, with the average size in that region measuring 6.56 inches.

At the bottom of the table with the smallest penises in the UK was the East Midlands, which came in with an average of 6.11 inches.

In 1999, a Korean study found that the circumference of the penis was slightly correlated to the length of your first and third toes.

Although a slight link occurred, it was deemed to be a weak indicator.

Scientists wrote: “Human body index including the size or characteristics of body extremities is not enough to predict the penile size.”

Meanwhile, in Greece in 2002, it was found that there is a “statistically significant” correlation between the penis length and index finger length.

So there you have it! Next time someone brags about the size of their trainers you may want to take the connotations with a pinch of salt.

The post Sorry guys, having big feet doesn’t mean your penis is super-sized – it’s all in the toes appeared first on PEGym.

In-Depth stamina Training Questions: Ask The Experts

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Big Al, of MaleEnhancementCoach.com, answers questions about Lengthening Devices, Client Study & Sexual Recovery/Training in this Ask the Experts article.

If you have questions you’d like answered in an Ask the Experts article, please PM Big Al.

Q. By the time I’m done I’m tired and it’s a struggle to get the proper erection levels.

…Can I just do the stamina stuff first? Why do you recommend doing stamina exercises at the end of a workout?

Big Al: There are deliberate reasons for putting the stamina exercises at the end of a workout:

-Stamina exercises in and of themselves become better ENLARGEMENT exercises after the tissues have been pre-stretched with more traditional enlargement exercises like Squeezes and stretches.

-If one can get to the point to where they can perform a successful stamina session after a thorough enlargement workout, then performing fresh for sexual activity will be much less of a challenge. This is true on physical and psychological levels.

-The Stop and Starts usually ends in ejaculation. Ejaculating and then attempting to train immediately afterwards can be uncomfortable.

Q. When you talk about emotional visualizations and not fantasizing about sex, this makes it harder for me to perform.

…What is your reasoning behind this? Are there any exceptions to this rule?

Big Al: It’s understandable that using erotic imagery- porn or mental fantasies- make the process of getting and maintaining an erection easier. The main reason why you want to ensure you’re not using erotic imagery in your training is that it creates a conditioning effect.

Here’s a very common example: You’re having sex and your penis starts to falter in it’s erection a bit. You go into your mind and think about whatever you typically use to masturbate to- a favorite porn clip, a prior scenario, etc. What normally happens is you achieve the desired effect- your penis gets erect, and you finish the session.

Afterwards, you ask yourself why do I have to think about other things when I’m with a live partner? As before, the reason is conditioning. By learning to develop focus on what you’re feeling during manual Stop and Starts, you learn to extract maximum sensory benefit from the activity. That way, when you’re engaging in live sexual activity you’ll be able to focus solely on your partner and not have to rely on mental erotic imagery.

There’s an exception to this rule. If you’re in a committed relationship you can fantasize about your partner. That way, you’re matching up what’s in your mind to reality.

Q. I find it’s easier to maintain an erection if I perform a lot of Kegels during my Stop and Starts.

…Is this OK?

Big Al: A well timed Kegel can be useful in helping to hold back or accelerate erections. When the process is refined, it can even allow one to experience Male Multiple Orgasm (MMO). Even the occasional Kegels during the movement to give your erection a boost is OK, but you don’t want to spend the entire Stop and Starts session Kegeling.

One reason is overtraining. If you follow a standard stamina protocol you’re going to be performing Kegels before your Stop and Starts. A more vital reason is negative conditioning. MANY who’ve Kegeled excessively during Stop and Starts eventually find they have to Kegel constantly just to maintain an erection. For obvious reasons, this isn’t a requirement you want to impose upon yourself.

The post In-Depth stamina Training Questions: Ask The Experts appeared first on PEGym.

Black Friday Special: 15% DISCOUNT!

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Black Friday Special: 15% DISCOUNT!

For one week only, you can now get 15% off The Ultimate Guide to Male Enhancement, by industry expert, AJ “Big Al” Alfaro. Available in both paperback and eBook formats.

Learn all of the secrets Big Al has used to help thousands of men reach their male enhancement goals! 

Paperback – eBook – Video Series

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Use Coupon Code BFPEGYM2019

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Real Men Feel: Ep. 157, What’s The Deal with Male Enhancement?

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Real Men Feel: Ep. 157, What’s The Deal with Male Enhancement?

What’s The Deal with Male Enhancement? Episode 157, November 12, 2019

Author and coach, AJ “Big Al” Alfaro, helps men in an area that they are often most uncomfortable seeking help; their penis. AJ is also the founder and lead coach at MaleEnhancementCoach.com, where he specializes in helping men increase their sexual health, with programs for both the body and the mind.

Please read the rest of the interview and see the video HERE!

The post Real Men Feel: Ep. 157, What’s The Deal with Male Enhancement? appeared first on PEGym.


The Ultimate Guide To Male Enhancement Video Q&As

Study: ED questionnaire lacks crucial questions

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Study: ED questionnaire lacks crucial questions

By Jeni Williams

* This article is a repost which originally appeared on UrologyTimes

Chicago-A patient-reported outcomes survey that is widely used to determine whether men are experiencing erectile dysfunction (ED) fails to ask three critical questions that could uncover whether men truly have ED and the extent to which they face challenges, researchers say.

In a presentation at the AUA annual meeting in Chicago, one research methodologist said there are three obvious problems to using the six-question version of the International Index of Erectile Function (IIEF-6) to assess erectile function:

• Men who respond that they are not sexually active are not asked why—and their answer significantly lowers their survey score. Yet for many men, lack of sexual activity is not due to a loss of sexual function.

• Men are not asked whether they are using erectile aids.

• Because men do not report use of erectile aids, physicians miss an opportunity to ask patients to rate their level of sexual function with these aids.

“Too often, a man who says he is not having sex is automatically defined as having ED when that may not be true. If someone is not having sexual activity, you cannot assume that person has ED. You must ask additional questions,” Andrew Vickers, PhD, attending research methodologist, Memorial Sloan Kettering Cancer Center, told Urology Times.

Once men share the answer to this question, it’s important to adjust survey results to reflect the reason men are not having sex. Only in doing so can health care professionals gain valid insight into a man’s sexual health, Dr. Vickers said.

The study was conducted by researchers at the University of Michigan Medical School, Ann Arbor and Memorial Sloan Kettering Cancer Center under the direction of Karandeep Singh, MD, MMSc, assistant professor of learning health sciences and assistant professor of medicine for the University of Michigan Medical School. The study was supported in part by funding from the National Institutes of Health/National Cancer Institute, Blue Cross and Blue Shield of Michigan, and the National Institute of Diabetes and Digestive and Kidney Disease.

Men with prostate cancer who had undergone radical prostatectomy were asked to complete the existing version of IIEF-6 as well as adjusted versions that added a question about the use of erectile aids, instructed men to respond to the survey based on their level of erectile function without use of aids, and asked men who reported not having intercourse to share the reason why. EPIC sexual function scores were analyzed for men who reported no sexual activity on the IIEF-6.

A total of 24,732 surveys were completed by 6,780 men as part of their routine care. The results show the extent to which the IIEF-6 provides limited insight around erectile function in some men who have undergone radical prostatectomy.

Study: ED questionnaire lacks crucial questions: Page 2 of 2

Among the 16,573 surveys that included data around the use of erectile aids, 15% reported the use of erectile aids, predominantly injections (89%). A simple modeling analysis showed that before a question around the use of erectile aids was introduced, some men would report their level of erectile function using the aids; others would assess their erectile function without the use of aids.

Among men who stated they were not having sexual intercourse, 46% gave reasons other than ED for the absence of sexual activity, including lack of a partner, sexual orientation, sexual preference, and health problems of the female partner. In men who were having sexual intercourse, doubling the first three questions on the survey resulted in almost perfect scores compared with the full IIEF-6.

In the 251 men who reported not having sexual activity, 13% reported they continued to have erections sufficient for sexual activity. Meanwhile, 5.6% reported scores of at least 65 on the EPIC sexual function domain.

Adjusting the survey to provide more detailed and informative insight into the erectile function of men who have undergone radical prostatectomy “is an easy fix,” Dr. Vickers said.

“The problem is not in calculating a group average. The problem is in working with individual patients,” he added.

It’s also important to ensure patients understand what is meant by the word “intercourse,” Dr. Vickers said.

“Some men think ‘sex’ means ‘intercourse’ [only],” he said.

 

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L-Citrulline and L-Arginine: This One-Two Amino Acid Punch Can Improve Circulation—And Your Love Life!

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Scientific studies show the combination of L-Citrulline and L-Arginine increases Nitric Oxide production for cardiovascular, immune boosting, and sexual health benefits!

This article is a repost which originally appeared on US Smart Publications

You have probably heard of the amino acid L-arginine, which is also called simply arginine.It is well known in the nutrition science community for its ability to increase nitric oxide production resulting in a wide variety of health benefits. But you probably have not heard much about its powerful amino acid cousin, L-citrulline, or just citrulline.If you eat at least six cups of watermelon every day then you’re getting an adequate dose of the amino acid citrulline. Citrulline’s name is actually derived from the Latin word for watermelon—citrullus—because it was first isolated from the fruit in 1930.1

What does L-Citrulline and L-Arginine do?

Together they help:

– Support cardiovascular health by boosting nitric oxide production and helping blood flow more easily throughout the body

– Support healthy blood pressure and boost the immune system

– Detoxify the liver and eliminate ammonia from the body

– Improve sexual stamina and enhance recovery from an intense workout

Who might benefit from taking a supplement containing
both citrulline and arginine?

– Anyone who wants to support healthy blood pressure Individuals who want to avoid angina (chest pain)

– Individuals who want to avoid leg pain due to poor blood circulation

– Anyone who wants protection from heart attack and stroke

– Men suffering from erectile dysfunction

– Athletes who want a faster recovery

How are citrulline and arginine related?

As soon as citrulline enters the kidney, vascular endothelium and other tissues, it is converted into arginine. Plasma and tissue levels of arginine increase, which is necessary for the production of nitric oxide and relaxation of blood vessels. An additional benefit of supplemental citrulline is that it helps eliminate ammonia, a highly toxic substance, from the liver.

Will citrulline and arginine help my sex life?

The answer is yes. Arginine has been well studied for its ability to enhance sexual satisfaction. Both men and women report longer and more intense orgasms when their intake of arginine increases. Additionally, arginine is often used by men to achieve long lasting and harder erections. Since citrulline is a precursor for arginine and arginine is a precursor to nitric oxide, you can combine the two for enhanced sexual pleasure and vascular health.

But you’re probably not eating six cups of watermelon every day, and actually it isn’t recommended. Watermelon is high in fructose (fruit sugar) and it’s a natural diuretic, so you’d be spending a whole lot of time in the bathroom.

In addition to watermelon, citrulline is found in cucumbers and cantaloupe, at very low levels, as well as the milk protein casein. But since it is a nonessential amino acid, you don’t have to rely on getting citrulline from food. It is manufactured from other nutrients in your body, however, you only manufacture it if you are young and healthy and producing those other essential nutrients in adequate amounts!

The citrulline and arginine combination plays an essential role in your body

Citrulline, like arginine, is important in vasodilation, the widening of blood vessels, resulting from relaxation of smooth muscle cells within the vessel walls, especially in the large arteries and veins and smaller arterioles.

The endothelium (inner lining) of blood vessels uses nitric oxide to signal the surrounding smooth muscle to relax. This results in a relaxing of the blood vessels, and increased blood flow.

In the body, citrulline is converted to the amino acid arginine, which goes on to make another important substance—nitric oxide. When citrulline enters the kidney, vascular endothelium and other tissues, it can be readily converted to arginine, thus raising plasma and tissue levels of arginine and enhancing nitric oxide production.2

The importance of nitric oxide to healthy blood flow

As stated, nitric oxide is integral to relaxing blood vessels which is necessary for healthy blood flow to the heart and genital area in both men and women, and throughout the body. Nitric oxide helps the blood vessels maintain their flexibility so that the blood flow is unrestricted. This, in turn, helps maintain healthy blood pressure, and a healthy sexual response.

When your vascular system is working efficiently there is less chance that a blood clot will form, which means there is less chance of having a heart attack or stroke.

Nitric oxide helps prevent blood clots because it prevents blood aggregation or platelets from becoming sticky. When platelets are not sticky they can move in a single file through the capillaries.

But if they are sticking together it’s like trying to move a dozen people through a crack in the wall. There is nowhere for the platelets to go, so a blood clot forms.

Additionally, nitric oxide works as an antioxidant that reduces the possibility of immune cells adhering to artery walls. This helps keep down inflammation,
which most health professionals agree is a major cause of the plaque formation that contributes to atherosclerosis.

What inhibits adequate nitric oxide production?

– People who have atherosclerosis, diabetes or hypertension (high bloodpressure) often show impaired nitric oxide pathways.3

– Over-consumption of salt can impair nitric oxide production.4

– Aging—as we get older there is a decrease in nitric oxide production because the body makes less citrulline and arginine.5

Boosting nitric oxide production with nutritional supplements

Supplemental arginine helps the body produce more nitric oxide, and it helps with conditions that improve when blood vessels are relaxed, such as atherosclerosis and intermittent claudication (difficulty walking due to pain in leg muscles because of inadequate blood supply).

Even more importantly, new studies are showing that supplemental citrulline also assists in nitric oxide production by boosting blood levels of arginine. It does this because it is more readily absorbed and bioavailable than arginine alone, and it bypasses metabolism in the liver and gastrointestinal tract and is readily absorbed in the kidneys.6, 7

Citrulline and arginine scientific studies

In the first study to show that oral supplementation with citrulline raises blood levels of arginine, 20 healthy volunteers were given 6 different dosing regimens of placebo, citrulline, and arginine.

After one week of oral supplementation, the citrulline dose increased plasma arginine concentration more effectively than arginine alone.8

A study in humans also showed the citrulline supplementation’s “time release” effect on arginine production. In this study an oral dose of 3.8 grams of citrulline resulted in a 227% peak increase in plasma arginine levels after 4 hours, compared with a 90% peak increase with the same dose of arginine.7,9

Thus, acute oral administration of citrulline appears to be considerably more efficient at raising plasma levels of arginine over the long term than arginine itself.7

Reduces blood pressure

In another recent study, citrulline supplementation was shown to reduce blood pressure in 17 young (average age 21.6 years) men with normal blood pressure after they were submitted to a cold pressor test (CPT). (A cold pressor test is a cardiovascular test done by having the subject immerse his hand into a bucket of ice water for one minute. Blood pressure and heart rate are then evaluated.)

Even more importantly, new studies are showing that supplemental citrulline also assists in nitric oxide production by boosting blood levels of arginine.

Integrative Therapeutics – Vasophil Drink Mix – Arginine and Citrulline Combination – Support Cardiovascular, Vasodialation, Blood Flow, & Sexual Function – Sour Apple Flavor – 30 Sachets

The men were randomly assigned to four weeks of oral citrulline (6 grams/day) or placebo in a crossover design. Blood pressure was measured after the blood pressor test. The results showed that compared to placebo, oral citrulline decreased brachial systolic blood pressure (-6 +/- 11 mm Hg), aortic systolic blood pressure (-4 +/- 10 mm Hg), and aortic pulse pressure (-3 +/- 6 mm Hg) during CPT but not at rest, suggesting improved production of nitric oxide under stress.10

Boosts immune system function

Citrulline’s beneficial effects on nitric oxide were also demonstrated in a group of male professional cyclists who took 6 grams of oral citrulline before a race. Researchers found that the racers’ levels of arginine increased, as well as their neutrophil immune cells.11

Citrulline’s enhancement of immunity may benefit endurance athletes as it has long been noted that immune defenses drop after an intense athletic event, increasing susceptibility to infection.12
Pharmaceutical drugs that stimulate nitric oxide production

Of course “Big Pharma” has developed a number of drugs that work to increase the production of nitric oxide in the body, but as usual they don’t work with the body like natural amino acids do and they are loaded with side effects.

Nitroglycerin and amyl nitrite serve as vasodilators because they are converted to nitric oxide in the body.

Sildenafil citrate, popularly known as Viagra®, stimulates erections primarily by enhancing signaling through the nitric oxide pathway in the penis.

But as mentioned, these drugs come with a long list of side effects, including headache, vision impairment, flushing, and rare but serious effects including heart attack and stroke.

Taking supplemental citrulline in combination with arginine is a great way to relax your blood vessels and avoid plaque build-up without drug side effects.
What to look for in a supplement

For each gram consumed, citrulline is more effective at raising nitric oxide levels (in vascular endothelium) than arginine alone. This is because approximately 50% of the arginine gets converted into other amino acids by the intestines and the liver. As the conversion of citrulline to arginine is not immediate, arginine will provide faster results.

As a convenient daily supplement in capsule form, citrulline is the best choice. This is because 6 grams (6,000 miligrams) of arginine is required to gain benefits. For those wanting to avoid swallowing a hand full of capsules, look for an arginine drink mix. Avoid pure arginine powder as the taste is awful, and the pH can burn the throat.

Taken together, you can get an immediate boost of nitric oxide production from the arginine, while allowing the citrulline time to produce additional arginine, for prolonged nitric oxide production.

This one-two punch of arginine and citrulline is a promising treatment for cardiovascular disease involving arginine deficiencies, reduced nitric oxide availability, and vascular dysfunction.

Together, citrulline and arginine supplementation is a natural and safe means of providing your body arginine, both short and long term. This combination can increase the natural production of nitric oxide, help reduce your chances of having a heart attack or stroke, boost your immune system, and improve your love live, all without the side effects of pharmaceutical drugs.
How are citrulline and arginine related?

As soon as citrulline enters the kidney, vascular endothelium and other tissues, it is converted into arginine. Plasma and tissue levels of arginine increase, which is necessary for the production of nitric oxide and relaxation of blood vessels.

An additional benefit of supplemental citrulline is that it helps eliminate ammonia, a highly toxic substance, from the liver.
Will citrulline and arginine help my sex life?

The answer is yes. Arginine has been well studied for its ability to enhance sexual satisfaction. Both men and women report longer and more intense orgasms when their intake of arginine increases. Additionally, arginine is often used by men to achieve long lasting and harder erections.

Since citrulline is a precursor for arginine and arginine is a precursor to nitric oxide, you can combine the two for enhanced sexual pleasure and vascular health.
References

Collins JK, Wu G, Perkins-Veazie P, Spears K, Claypool PL, Baker RA, Clevidence BA. Nutrition. 2007 March.

Abstract ↑
Romero MJ, Platt DH, Caldwell RB, Caldwell RW. Therapeutic use of citrulline in cardiovascular disease. Cardiovasc Drug Rev. 2006 Fall-Winter;24(3-4):275-90.

Abstract ↑
Dessy, C.; Ferron, O. (2004). “Pathophysiological Roles of Nitric Oxide: In the Heart and the Coronary Vasculature”. Current Medical Chemistry – Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry 3 (3): 207–216.

Abstract ↑
Osanai, T; Fujiwara, N; Saitoh, M; Sasaki, S; Tomita, H; Nakamura, M; Osawa, H; Yamabe, H et al. (2002). “Relationship between salt intake, nitric oxide and asymmetric dimethylarginine and its relevance to patients with end-stage renal disease.”. Blood purification 20 (5): 466–8. doi:10.1159/000063555. PMID 12207094

Abstract ↑
Kang L, Reyes RA, Delp, JM. Aging impairs flow-induced dilation in coronary arterioles: role of NO and H2O2. Am J Physiol Heart Circ Physiol. 2009 September; 297(3): H1087–H1095. Published online 2009 July 17. doi:


Cynober L. Pharmacokinetics of arginine and related amino acids. J Nutr. 2007 Jun;137(6 Suppl 2):1646S-1649S.

Abstract ↑
Romero M, Platt D, Caldwell R, Caldwell R. Therapeutic Use of Citrulline in Cardiovascular Disease. Cardiovascular Drug Reviews Vol. 24, No. 3–4, pp. 275–290.

Abstract ↑
Schwedhelm E, Maas R, Freese R, Jung D, Lukacs Z, Jambrecina A, Spickler W, Schulze F, Boger RH. Pharmacokinetic and pharmacodynamic properties of oral Citrulline and Arginine: impact on nitric oxide metabolism. Br J Clin Pharmacol. 2008 Jan;65(1):51-9. Epub 2007 Jul 27.

Abstract ↑
Kuhn KP, Harris PA, Cunningham GR, Robbins IM, Summar ML, Christman BW. Oral citrulline effectively elevates plasma arginine levels for 24 h in normal volunteers. Circulation AHA Scientific Sessions 2006; abstract 1692, p. II-1339.

Abstract ↑
Figueroa A, Trivino JA, Sanchez-Gonzalez MA, Vicil F. Oral Citrulline supplementation attenuates blood pressure response to cold pressor test in young men. Am J Hypertens. 2010 Jan;23(1):12-6. Epub 2009 Oct 22.

Abstract ↑
Sureda A, Cordova A, Ferrer MD, Tauler P, Perez G, Tur JA, Pons A. Effects of Citrulline oral supplementation on polymorphonuclear neutrophils oxidative burst and nitric oxide production after exercise. Free Radic Res. 2009 Sep;43(9):828-35. Epub 2009 Jul 6.

Abstract ↑
Chinda D, Nakaji S, Umeda T, Shimoyama T, Kurakake S, Okamura N, Kumae T, Sugawara K. A competitive marathon race decreases neutrophil functions in athletes.Luminescence. 2003 Nov-Dec;18(6):324-9.

Abstract ↑
Halstead, Bruce W., M.D. The Science of EDTA Chelation Therapy. Golden Quill Publishers, Inc., Colton, CA., 1979.


Robbins, S.L.; Cotran, R.S.: and Kumar, V., eds. Pathological Basis of Disease. New York: W.B. Saunders, 1984.

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What to know about diphallia (double penis)

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What to know about diphallia (double penis)

Diphallia is a rare genetic condition that occurs when a male baby is born with duplication of the penis.

This article is a repost which originally appeared on MedicalNewsToday

There are different types of diphallia, ranging from partial to complete penile duplication. Having two completely developed penises, or true diphallia, is very rare.

Ever since the first description of diphallia in 1609, researchers have only reported 100 additional cases worldwide. It may occur in 1 in every 5–6 million live births.

This article takes a closer look at diphallia, including its symptoms, causes, effects on a male’s life, and the possibilities for treatment.

What is diphallia?

A person with diphallia may have a partial to complete penile duplication.

Every case of diphallia is unique, and the amount of duplication varies with each. Most males with this condition will have two penises of about the same size, located side by side.

Some males will have a larger penis located above a second, smaller penis. For others, the duplication will only affect the head of the penis.

Earlier classification described three types of diphallia:

  • a duplication of only the tip of the penis, or the glans
  • bifid phallus, wherein each penis has only one column of soft tissue (the corpus cavernosum) instead of two, as is normally the case with true diphallia
  • complete diphallia, wherein there is a complete duplication of the penis

However, current classificationsTrusted Source claim that there are only two types of diphallia: true diphallia and bifid phallus.

Diphallia usually occurs alongside other birth irregularities. These can include:

  • a cleft scrotum
  • hypospadias, wherein the opening to the urethra is on the underside of the penis, instead of the tip
  • duplication of the urethra in both penises
  • no urethras in either penis
  • abnormal heart muscles
  • two bladders
  • a missing anus
  • atypical muscles attached to the bones
  • irregular positioning of the scrotum
  • irregularities affecting the public bone
  • misshapen, rotated, or extra kidneys
  • complications of the kidney and colorectal systems

Males with diphallia are at greater risk of spina bifida. They are also more likely to be sterile.

How does it happen?

Diphallia is a genetic condition that comes about during the development of the fetus.

The genetic irregularity that causes diphallia takes effect during the development of the genitals.

Some researchers suggest that exposure to drugs, infections, or other damage between the 23rd and 25th day of gestation could lead to diphallia, as this is a crucial stage of fetal development.

How does diphallia affect a male’s life?

Males with diphallia are often able to urinate through one or both penises. They may also be able to have erections and ejaculate with one or both penises.

Depending on the individual situation, males with this condition may be able to have a normal sex life and have children.

However, there tends to be an increased risk of poorly functioning kidney and colorectal systems. For this reason, infants with diphallia may have a higher risk of death due to infections.

That being said, this may not be the case when diphallia is not associated with other irregularities.

Treatment

Surgery is the only treatment option for diphallia. Treatment is not always necessary, however.

A surgeon will usually perform this surgery at birth or very soon after. The procedure will vary based on how much duplication there is and the presence of other birth irregularities.

Because each case of diphallia is unique, the surgery to treat it can be complicated and difficult. The primary concerns are:

  • making sure that the male will be able to urinate normally and have erections
  • reducing the potential risk of infection
  • reducing structural irregularities

The timing of the surgery will be an important factor due to the male’s likely age. As doctors often diagnose diphallia at birth, there may need to be several surgeries over time.

Individuals with diphallia often have other birth irregularities, such as hypospadias, duplicated urethras, and cryptorchidism (wherein one or both testes do not descend). Researchers reportTrusted Source that in many cases, surgeons can repair the physical irregularities associated with diphallia.

In one case, surgeons treated some of the infant’s irregularities soon after birth, but they only removed the additional penis when the individual was a toddler.

Males with diphallia do not always opt for treatment, as in the case of a 54-year-old male whose doctor diagnosed diphallia during an examination for a hernia. Surgeons repaired the hernia, but the patient did not deem it necessary to remove the smaller penis.

Summary

Diphallia is a rare genetic birth irregularity in which a male infant is born with duplication of the penis. This duplication can involve only the tip of the penis or result in two fully functioning penises.

When males are born with diphallia, they often have other birth irregularities as well.

Surgery is the only way to treat diphallia. Surgeons may address diphallia and additional birth irregularities in several stages.

Males with diphallia can lead full and healthy lives.

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