Anxiety is everywhere, floating freely through the air, passing from person to person like a virus on the wings of a sneeze. While some of us feel nervous about our jobs, our health, or our families, others feel a very personal dread about our own bodies. Preoccupied by physical appearances, we can become distracted from what matters most in life, and turn instead to worrying about some highly specific body part. If, by chance, we zero in on the piece of ourselves most closely associated with intimacy — our genitals — we might shut down entirely.

This is not some fanciful idea, or is it theoretical hogwash. Evidence from one study of 367 military personnel, all men, and no one older than 40, found those who felt most satisfied in terms of male genital self-image had lower levels of sexual anxiety and better sexual functioning. And what about the self-doubting ones, those who disliked the appearance of their member? The researchers found the opposite to be true in some (though not all) cases. Dissatisfaction led to anxiety, which led to sexual difficulties — a vicious cycle.

So what’s a guy to do?

Panic is the anti-answer, so let’s end that now. Like any situation, this one demands some straight up facts, so let’s begin there. The first and most important fact is to forget what you’ve seen in photographs, in movies, or on the web. Based on a sample of 1,661 guys, the average self-reported erect penis length is 5.6 inches. Technically, according to the Mayo Clinic, a penis is not even considered small unless it measures less than three inches when erect.

If these scientific facts do not change your feelings, consider the fact that maybe, like a woman bombarded by photoshopped images of "vixens" who have been surgically enhanced, you may also be comparing yourself to some unreality and suffering needlessly as a result. In fact, one 2005 study appearing in the journal Urology found exactly this to be the case. Of 92 patients who complained of a short penis, almost all of them had “overestimated the normal penile size,” noted the authors. More importantly, not one of these men actually had short penises.

Dr. Dudley Seth Danoff, author of The Ultimate Guide to Male Sexual Health: How To Stay Vital at Any Age, has seen more than 100,000 patients (no exaggeration) over his 30 years as a practicing urologist. According to this graduate of both Princeton and Yale, enhancement is not a common request, but a fair number of patients have asked him, "What can I do to make my penis larger?" Still, as Danoff told Medical Daily, “There isn’t a man alive who wouldn’t like a larger penis.”

Brandon Bartling, store manager of The Pleasure Chest, an erotic store located in New York City's West Village, understands this as well. His store carries any number of products that cater to this manly desire, everything from dietary supplements to a “penis extender, which is a sleeve that you literally wear over your penis to increase length and girth. Kind of like a thick, firm condom in a phallus shape,” he told Medical Daily in an email. He added his customers tell him that “the Blue Wolf pills work the best to help boost one’s ability to obtain firmer, longer lasting erections, while others swear by the Bathmates line of Hydromax and Hercules pumps.”

Though some companies have claimed using their pumps daily will "garner permanent results over time," Bartling added, "I’m not certain that these claims have ever been verified.” 

Bartling hit the nail (let's call it that) on the head.

The fact is verification is sadly lacking for nearly all of the male enhancement products on the market, while in many cases, there are definite warnings against these products. Specifically, the Food and Drug Administration (FDA) issued a warning against dietary supplements to enhance male sexual performance, noting many have undisclosed ingredients that may be harmful. This government agency also cautioned against penis enlargers and erection-maintaining rings in at least one public alert.

According to Danoff, most of the “thousands of [products] on the market today rely on the placebo effect.” The well-known placebo effect simply means that “about 40 percent of people,” in Danoff’s words, will report a positive result when given a useless product and told it will work. “When it comes to things sexual, the power of suggestion is overwhelmingly more than what goes on between your legs,” said Danoff, explaining how once you’ve paid your $39.99 for a pill or a device, you’ll be inclined to believe it really works.

Yet, according to science (and Danoff), supplements and sleeves will not enlarge the penis. After all, he said, the penis consists of paired corpora cavernosa and a single corpus spongiosum, the size of which are determined genetically. Even surgical enhancement fails.

“There’s no legitimate way to do it,” Danoff said, explaining that, unlike the breasts or the nose, the penis is not a static organ, it needs to move, and “there’s not a grafting material that’s suitable for that.” While there is one procedure that involves cutting the suspensory ligament, this only gives “an illusion of length,” he said. It doesn't actually extend it.

More importantly, surgical treatments, according to one recent study conducted at the University of Turin, Italy, are "characterized by a high risk of complications and unwanted outcomes." And such unwanted outcomes should be feared. “The most unhappy patients I’ve ever seen are patients who have received surgical enhancements,” Danoff said.

However, there is one tiny hope dangled before our eyes by the very same Italian study. When tested, the “traction method” of penis enhancement, the authors say, did result in growth.

As the name implies, the traction method involves the phallus being placed in an extender and then stretched daily. One team of researchers quoted in the study reported average growth of 0.7 inches (flaccid) in participants who used the method for four to six hours each day over four months. Another team reported an average increase of nearly an inch (0.9 inches, flaccid) plus some slight improvement in girth after similar treatments lasting a course of six months.

According to the website of one such product, the safe application of traction encourages tissue cells to divide and multiply, a process called cytokinesis. Over time and with great effort this will lead to tissue growth. The FDA considers these low-risk devices (Class 1) and so provides only general controls intended to be followed by manufacturers.

If the size of your organ gives you anxiety, take a moment to step back and read all the available science and then proceed with relief and caution. In the end, you might do well by remembering these words.

“It’s not women who have penis envy, it’s men,” said Danoff. He noted that it’s never the sexual partners who complain about penis size, instead they ask him if the existing penis could be “attached to a sweeter, nicer guy.”