#i was years old when I discovered that doctors can put testosterone injection in your butt. idk how im going to survive that

[paperbaldi]

Ouch

[micropenisunveiled-blog]

Is My Penis Too Small?

Jan. 19, 2012 -- Is my penis too small? That's a question that men aren't likely to ask their friends or sex partners.  But behind the closed doors of a doctor's examining room, it's a common question.  Pediatric urologist Lane S. Palmer, MD, chief of pediatric urology at Cohen Children's Medical Center, New Hyde Park, N.Y., hears it a lot.

"Fathers often will ask it about their sons -- and, while in the office, will ask about themselves," Palmer tells WebMD.

Men worried about their penis size usually have some other excuse for seeing a doctor, says Bruce R. Gilbert, MD, PhD, director of reproductive and sexual medicine at the Smith Institute for Urology in Lake Success, N.Y.  "When they come in for something else, they ask, 'Oh, by the way, I am concerned about the length of my penis,'" Gilbert tells WebMD. "Most are men in the 20-to-40 age group. But some are aged 40 to 50, and some even older men ask."

The vast majority of these men are in for a surprise. Worry about small penis size is common. Abnormally small penis size is not.

Penis Size: What's Normal, What's Not

You might think that as long a man's penis works, he would have no problem with it. You would be wrong.  Penis size is a key element of a man's self-image. Yet when he's not boasting to other men, the average man significantly underestimates the relative size of his penis.

Here's an example: Over a two-year period, 67 men asked an Italian hospital for surgical correction of a small penis. All turned out to have normal-size penises.

"A few days ago, I had a patient who spent an hour taking measurements of his penis and thinking it is too small," Gilbert says. "Yet it was normal."

That man isn't alone. About 45% of his brethren want a bigger penis. Never mind that 85% of heterosexual women say they are satisfied with their partners' penis parameters.

Many men worry about the size of their erections. Many more worry about how their penis looks when it's limp, studies find.  So how can a man know if he's normal, super-sized, or small? Not by his shoe size, a common and disproved myth about estimating penis length. Like so much else in life, direct measurement is the key.

How to Measure a Penis

Men may be surprised to learn that penis length isn't measured on the erect penis. Too many variables are involved.  Instead, the most reliable penis measurement is called SPL -- stretched penis length. The longer a man's SPL, the longer his erect penis length, according to studies done on brave young men who volunteered to have erection-stimulating penis injections.

To learn your SPL, measure the penis while it's flaccid. Press the ruler tight against the pubic bone at the base of the penis. Don't just measure from where the penis separates from the scrotum, or you'll lose precious centimeters. Now gently, but very firmly, stretch the penis as far as it will go. Measure from the pubic bone to the tip of the stretched penis.

Did you get five and a quarter inches? If so, you are exactly normal. Most adult men are within about a half inch of 5.24 inches, according to statistics Palmer has compiled. Nearly all studies of penis length come up with a similar measure.  If you're a little smaller than that, you've got lots of company. Just as many men are below average penis size as above it.

How big is big? According to Palmer's statistics, only 0.6% of men have an SPL of 6.8 inches or more. But too big isn't what men tend to worry about.

Micropenis: When a Penis Really Is Too Small

There is, of course, such a thing as a very small penis. The medical term "micropenis" applies to the 0.6% of men with the smallest penises. According to Palmer's statistics, an SPL of three and two-thirds inches or less indicates a micropenis.

Even then, U.S. doctors hesitate to recommend surgery for a man whose SPL is longer than three inches. That's because surgery is controversial and risky.

Micropenis isn't usually something a man discovers when he's an adult. It's usually caused by genetic or hormonal abnormalities that cause other, more serious health problems early in life.  That's because the penis starts to develop when a fetus is just 8 weeks old. By week 12, the penis has developed and begins to grow. During the second and third trimesters, male sex hormones cause the penis to grow to normal length. Factors that interfere with hormone production and hormone action stunt penis growth.

When discovered in infancy, micropenis can be treated with testosterone, which can stimulate penis growth in childhood, even after puberty. While the safety and long-term efficacy of this treatment remains to be proved, available data suggest the treatment does not affect normal development during puberty.

For adults with micropenis, the options are few.

"For true micropenis, there is not much you can do that is adequate for the adult patient, except for putting in a penile prosthesis," Gilbert says.  Fortunately, micropenis is a rare condition. Far more common is what Palmer and colleagues call "the constellation of conditions that make the penis look diminutive and small" -- inconspicuous penis.

Inconspicuous Penis: When Size Isn't the Only Issue

"Inconspicuous penis means a penis that is hard to see," Palmer says.

Micropenis -- a truly tiny penile shaft -- is the rarest of the conditions under the umbrella term "inconspicuous penis."

Other forms of inconspicuous penis that may have remained untreated until adulthood are webbed penis and buried penis.

"The webbed penis indicates the scrotum has connected to the underside of the penis so it pulls the penis inward," Palmer says. "Usually the penis is at right angles to the scrotum. But in webbed penis, the scrotum is high riding and the separation from the penis is not clear."

Buried penis occurs when the penis is hidden below the skin. This can happen because of excessive belly fat in the front of the abdominal wall droops down to conceal the penis. It can also happen when the connection to the scrotum is absent and the penis withdraws inward toward the pelvis. Another form of buried penis occurs when a too-large foreskin makes the penis look buried.

Webbed penis can be addressed via surgery. Buried penis may require only weight loss, and perhaps liposuction. There are also surgical procedures that can correct the problem.

Small Penis Syndrome

It's been dubbed small penis syndrome: the belief that you aren't a real man because you don't have a big penis.

Perhaps one reason men often believe this is that most men have no idea what a normal-size penis looks like. When asked to guess, most guess wrong. About 15% of men just throw up their hands and admit they don't know, one study found.

Another reason is pornography. Palmer tells the story of a teen patient who was in agony over his small penis size. But examination showed he was perfectly normal. It turned out that the boy had been viewing Internet pornography, from which he got a distorted picture of normal male anatomy.

And because penis size is such a major part of a man's body image, men suffering from body dysmorphic disorder often focus on the size of their penises.

Body dysmorphic disorder and other psychiatric issues that may underlie small penis syndrome may require professional psychological help. But Palmer and Gilbert say that most men need only reassurance that they really are normal.

"I give the patient a physical and get his personal history and social history," Gilbert says. "If he has no medical problem, I speak positively. I tell him that he has a normal phallus that is no different in function from any other healthy man. I give him confidence."

Palmer notes that the law of averages dictates that some men will have smaller penises than others. This does not make them abnormal.

"If a man has perfectly normal penis function, he must reconcile with the fact that his penis is what it is," he says. "You cannot make a short person tall. People have to accommodate to their own anatomy."

Can Surgery Make a Small Penis Larger?

It's hard for a man to open his email without encountering an offer of a drug, device, or surgical procedure that will give him a bigger penis.

Sure, that stuff is just spam. But are there legitimate ways to lengthen a penis?

"There isn't much to make the penis larger," Palmer says. "Surgically, there is not much to significantly increase penis size or girth that is not fraught with significant complications."

Procedures known as "augmentative phalloplasty" promise to make a penis wider in girth. And because these procedures add weight to the penis -- by grafting fat from another part of the body -- they make the penis a half-inch or so longer when flaccid.

"Getting a uniformly even expansion of girth is unpredictable and often does not lead to a good outcome," Palmer says. "You have to hope you do not get a lumpy penis. This is not an easy thing to do."

Most men do not know that only about two-thirds of their penis protrudes from their bodies. The other third, held in place with ligaments, provides the leverage for sexual function.

One surgical technique cuts these tendons and allows the penis to protrude another inch or two. Gilbert takes a dim view of the technique, because the penis loses its leverage.

"When surgeons take the inside part of the penis and move it out, the most common outcome is their erection no longer goes up but down," he says. "If a man is unhappy with his penis length, he is going to be unhappy with a penis he has to pick up and insert. I've had men ask me, 'Can you put it back the way it was?'"

Gilbert says that because of the high complication rate, malpractice insurance rarely covers penis-lengthening procedures.

All of these procedures are considered "experimental surgery." Severe complications include -- but are not limited to -- penis shortening, a lumpy or uneven appearance, scarring, sexual dysfunction, and curvature of the penis. These complications often cannot be corrected.

Can Devices Make a Small Penis Larger?

Traction devices that stretch the penis may actually add an inch or so to penis length, based on small studies and anecdotal reports. Gilbert says he is following two patients who are using these devices in an effort to make their penises longer.

"These devices have to be worn for several hours a day, for many months," he says. "Most people, even if they are highly motivated, don't have that kind of time. So I'm not sure a lot of patients have the time or energy or perseverance to do that."

Vacuum devices may help men with erectile dysfunction achieve an erection -- but they do not make the penis larger.

Can Regenerative Medicine Make a Small Penis Larger?

However, there is one area of research with intriguing possibilities: regenerative medicine. Scientists have been able to grow animal penises in the laboratory by seeding scaffolds with the animals' own cells. These penises then were successfully transplanted.

Already a group of researchers in Beijing, China, have reported using a similar technique to treat 69 patients with what they called small penis syndrome. In this case, the tissues were grown from the patients' own scrotal skin and grafted to their penises to increase their girth.

"With regenerative medicine, the sky is the limit," Palmer says. "We might have this as an option down the line."

"Regenerative medicine is still not ready for prime time," Gilbert says. "These things have a lot of potential, but nothing we can offer to patients in the near future."

SOURCES:

Lane S. Palmer, MD, chief of pediatric urology, Cohen Children's Medical Center, New Hyde Park, N.Y.

Bruce R. Gilbert, MD, PhD, director, reproductive and sexual medicine, Smith Institute for Urology, Lake Success, N.Y.

Srinivasan, A.K. The Scientific World Journal, 2011.

Wiygul, J. and Palmer, L.S. The Scientific World Journal, 2011.

Panfilov, D.E. Aesthetic Plastic Surgery, March-April 2006.

Jin, Z. Journal of Andrology, September-October 2011.

Wood, D. and Woodhouse, C. The Scientific World Journal, 2011.

Wylie, K. and Eardley, I. BJU International, 2007.

Chen, J. International Journal of Impotence Research, 2000.

Mondaini, N. International Journal of Impotence Research, 2002.

Lever, J. Psychology of Men & Masculinity, 2006.

Yang, B. Journal of Reconstructive Aesthetic Surgery, 2009.

Shaeer, O. and Shaeer, K. Journal of Sexual Medicine, March 2009.

Tiggemann, M. Journal of Health Psychology, November 2008.

Ghanem, H. Journal of Sexual Medicine, September 2007.

Aghamir, M.K. BJU International, April 2006.

Shamloul, R. Urology, June 2005.

Shah, J. and Christopher, N. BJU International, October 2002.

Lee, P.A. and Reiter, E.O. Adolescent Medicine, February 2002.

Wessells, H. Journal of Urology, September 1996.

Nikoobakht, M. Journal of Sexual Medicine, November 2011.

Levine, L.A. and Rybak, J. Journal of Sexual Medicine, July 2011.

Dixson, B.J. Archives of Sexual Behavior, June 2010.

Nugteren, H.M. Journal of Sexual and Marital Therapy, March 2010.

Savas, M. Journal of Andrology, September-October 2009.

Gontero, P. BJU International, March 2009.

Dillon, B.E. International Journal of Impotence Research, November-December 2008.

Tiggeman, M. Journal of Health Psychology, November 2008.

Dillon, B.E. International Journal of Impotence Research, posted Dec. 5, 2008, on Medscape.com.

[testosteroneandhgh-blog]

The High Price of Low Testosterone Levels

From energy, sex drive, and strength and muscle-building capabilities, low testosterone levels can quickly deplete a man of his defining male qualities. Unfortunately, with age, males become more and more naturally inclined to sluggish hormone production and depletion. It’s called Low-T, and their overall health often pays a high price for it. It’s a conundrum that’s left many turning to hormone replacement therapy as a possible treatment. Is it right for you?

You’ve Got A Testosterone Problem... Now What?

Not too long ago, I stood in my bathroom, syringe loaded with hCG in hand, asking that same question. Now, human chorionic gonadotropin, or hCG, isn’t a growth hormone, illegal steroid, or even testosterone. It’s actually a natural glycopeptide hormone formed in human placenta. It’s extracted from the woman’s urine and purified into Pregnyl for injection. So, that sounds icky enough, right? The real issue is if you’re better off with it or suffering through the side effects of Low-T? While hCG is also used as a fertility treatment, in the case of Low-T, it’s used to help the testes produce more testosterone. It has potential negative effects. More on that later. How did I know I had a hormone problem to begin with? I went to my doctor and had a simple blood test because I was having classic symptoms of belly fat I couldn’t shake, weaker erections, low energy, etc. My blood work showed that my testosterone level was under 240 ng per dl when it should be between 300 and 1,000. A second test a few weeks later measured my free testosterone, which is the actionable T that binds with receptors. It was only 45 picograms, which is about the amount a typical boy entering puberty would have floating around. Well, isn’t that lovely. According to NYC endocrinologist and author of “Keep It Up: The Power of Precision Medicine to Conquer Low T and Revitalize Your Life” Dr. Florence Comite, free testosterone should be 150 to 250 pg per ml. It’s important to understand that free testosterone isn’t just the ‘maleness’ of a man. It’s responsible for supporting almost every major system in the body, including organs, arteries, bone density, muscle mass, and even healthy hair. It’s been linked to several serious diseases, including diabetes and heart disease. In other words, Low-T can be a major health problem. Male testosterone levels begin to steadily and naturally decline in the late 30s and continues at a rate of one to two percent drops per year thereafter. It such a gradual decline that most men don’t even notice the side effects until sometime in their 50s. Technically, it’s called hypogonadotropic hypogonadism, but to the lay population, it’s often just called andropause or male menopause. Hi, I’m Joe, and I have male menopause. Again, great news, right.

What Are My Options For Raising Testosterone Levels?

My hormone therapy physiciangave me several pharmaceutical options, including under the skin implants, external gels, under-the- skin implants, and testosterone injections. Each physician-supervised therapy has their own set of pros and cons that you should thoroughly discuss with your practitioner. As a family man, topical treatments were a no-go since it could easily be transferred to others through contact. I found hCG injections most appealing for the ease and naturalness of it. According to Dr. Comite, hCG is a viable therapy option for men who haven’t completely stopped making T. It’s more like a start button for T production by mimicking luteinizing hormone.

Benefits Of T-Therapy Replacement

Clinical science is supporting a number of benefits and positive outcomes of hormone replacement therapies like TRT.

• Body Composition In one UCLA study, men given T gel gained over four pounds of new muscle over six months and almost seven pounds over 18 months. Dr. Comite points out that improved body composition further translates to existing disease processes; diabetics, for example, may see reversed insulin resistance and the ability to better metabolize sugar.

• Bone Density Osteoporosis isn’t just a disease attacking women. Of brittle bone fractures occurring in the 50+ age range, four in 10 are in males. Studies have proven that bone mineral density increases with T-treatment, especially for the spine and hips.

• Cardiovascular Hormones like T are thought to play a significant role in keeping arteries flexible to dilate and constrict in accordance with blood flow. Studies have discovered that low T levels are common in men with cardiovascular disease and/or its risk factors.

• Sexual Function The journal, Clinical Endocrinology, published a review of 17 independent studies concerning sexual function and testosterone supplements. It found that supplementation for three months yielded improved libido, increase in spontaneous nighttime erections, and more frequent sex.

Do You Really Have A T-Problem?

Today, there are over 5 million U.S. males diagnosed with Low-T, and an estimated 12.5 million more with undiagnosed and untreated T deficiencies. Even with the undiagnosed numbers, statistics show that the number of T prescriptions written between 2001 and 2011 for males 40-years-old and up tripled. And, medical personnel are reporting that males younger and younger are seeking T therapy. According to Dr. Larry Lipshultz, chief of male reproductive medicine and surgery at Baylor College of medicine, T has been optimized by younger gym crowds as an it-factor. This it-factor trend may be largely thanks to the $100 million in marketing dollars that pharmaceutical companies spend each year marketing T-based therapies. They use leading questions and suggestive messages to encourage treating numbers where symptoms may not even exist. The fact is that T-based therapies remain somewhat controversial due to the potential risks of long-term treatment, such as testicle shrinkage, prostate cancer, breast enlargement, and cardiac arrest. Wary doctors continue to cite the unknown safety and efficacy issues and uncertainty of benefits that exist from a lack of comprehensive medical research. Here’s a good example: While professor of medicine at the University of North Carolina and author of “Rethinking Aging” Nortin Hadler promotes exercise over putting a “silly compound” into your body and exposing your organs to unnecessary risks from androgen exposure, associate clinical professor of urology at Harvard Medical Abraham Morgentaler doesn’t believe the aging effects of Low-T should be ignored. Morgentaler points out that no one would argue that glasses shouldn’t be worn because the eyes get weaker with age. This line of thought leads one to believe that there’s no reason not to treat T issues with the same diligence as other age-related disease processes. If you look at the research, Morgentaler makes a lot of sense to the layman. Are T therapies really any different than the hundreds of pharmaceuticals out there, such as statins, that solve one problem at the potential risk for developing others? Plus, much of the research simply contradicts its predecessor research. Back in 2011, Morgentaler and Lipshultz actually monitored men with untreated prostate cancer who also had hormone replacement therapy with T for over two years. The study, published in the Journal of Urology, found no growth of the cancer nor worsening of symptoms a year later. The bottom line here is that if you’re looking for a consensus on the safety and effectiveness of T replacement, you won’t find it. TRT is something you should speak with a medical expert about, confirm that you have an actual clinical problem, and then thoroughly discuss your options and pros and cons of each before deciding on T injections or any other treatment option. Look for physician supervised testosterone therapy and hgh therapyfor men. Dr. Lipshultz suggest clinicians treat symptoms, not lab results, and warns that many facilities are targeting clients with false anti-aging promises and failing to carefully track their patients. Levels of T in the circulatory system must be monitored carefully to make sure it’s high enough for positive effects and low enough to avoid unwanted negatives.

What Are The Known Negative Effects Of T Replacement?

• Reduced sperm production by suppressing natural T production.

• Reduced testicular volume .

• Possible lower HDL cholesterol

• Thicker blood due to higher red blood cell concentrations, which may cause risk of blood clots and strokes.

• Possibility of aggression if your already inclined to it; T simply makes your brain more sensitive to the social cues that create aggressive outbursts.

My Decision To Treat Low-T

I’m not one to tamper with nature... well, unless the reward vs risk favors me. In the case of my T problem, I felt treatment was a reward worth the potential risks. Insurance doesn’t cover it. So, I’m paying a high cost for my improvements, but I ultimately feel assured that the results are not only good for my personal lifestyle, happiness, and appearance but also my overall health. Given that I have pre-diabetes and a family history of heart disease, I also feel some peace knowing that I’m taking a positive proactive step for prevention of future health problems.

My decision boiled down to two key points:

1. Having a trustworthy treatment center dedicated to patient knowledge, safe and precision practices, and a comprehensive monitoring strategy.

2. Lab work that confirmed the hormone imbalance was congruent with how I felt and my body was behaving. Since starting my treatment and enacting some positive lifestyle changes concerning my diet and exercise, I feel like a new person. I’ve gained muscle. My skin is firmer. My blood sugars are under control. My T levels are up in the normal range. My libido is alive and well, and I have the tools to get the job done. I have the energy, stamina, and positive mindset to work toward each of my personal, professional, and health goals. I haven’t had a single negative come out of my decision. The above is enough to make me at peace with my T decision. What will your decision be on T?