Can Low Testosterone Cause Anxiety and Depression?

October 6, 2022 / Men’s Health

Low testosterone levels can mimic symptoms of depression and cause anxiety over time

This article is a repost which originally appeared on Cleveland Clinic healthessentials.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our takes:

‧ Low testosterone will manifest itself via several symptoms.

‧ Depression can be a symptom but can also be a contributing factor to developing low T.

‧ Having too high levels of T may result in irritability/becoming easily angered.

If you’re experiencing low sex drive, diminishing energy and overall fatigue, you may feel like it’s just another part of getting older. But if you’re a man or a person assigned male at birth (AMAB) and you’re experiencing a host of physical symptoms, coupled with a consistent depressive mood, you could actually be dealing with hypogonadism (low testosterone) or undiagnosed depression.

But figuring out whether you’re dealing with depression or low testosterone is tricky and requires further examination from a healthcare provider. Urologist Lawrence Hakim, MD, explains more about the connection between low testosterone and your mood, and how these conditions may be related.

How low testosterone impacts your mood

Androgens, including testosterone, are the hormones that give people their “male” and “female” characteristics. They also play a critical role in puberty, the development of your sexual reproductive system and your ability to reproduce.

You can think of all hormones, including androgens, like switches on a circuit board: When the production of these hormones are turned on or off, different things happen. You can experience physical, mental and emotional changes whenever production of these hormones increase, decrease or stop completely. The severity of these changes can vary widely from one hormone to the next, and these changes don’t happen in a vacuum. When the levels of one hormone changes, others may change in response. An increase in one hormone might mean a decrease in others. And when you have these hormonal imbalances, it can cause a variety of conditions to develop.

Testosterone levels tend to decrease normally as you get older, but they can also fluctuate for many reasons. Studies show these changes in testosterone can impact your mood in different ways. And these changes can occur in response to many different factors, including stress, lack of sleep, changes in your diet, aging and increasing or decreasing your physical activity.

If your testosterone levels are too high, for example, you may feel irritable or quick to anger. In comparison, low testosterone can make you feel extremely tired, depressed, weak or low in energy.

“People with hypogonadism, or low testosterone, will often say they have no energy, no desire for sexual activity and that they noticed a decrease in muscle mass,” says Dr. Hakim.

“In fact, hypogonadism is often associated with increased fat mass and reduced muscle mass, which can lead to obesity and other health risks, including cardiovascular disease. Those are all common signs and symptoms that may be associated with low testosterone.”

Signs and symptoms of low testosterone and depression

Low testosterone and depression share a lot of the same symptoms, including:

‧ Irritability.
‧ Mood swings.
‧ Decreased libido.
‧ Fatigue.
‧ Lack of motivation.
‧ Social withdrawal.
‧ Anxiety.
‧ Difficulty focusing.
‧ Interrupted sleep and restlessness.

“When we say people are depressed, what are we describing? We’re often describing someone as having low energy and no desire to partake in activities that normally bring them pleasure — these are common things we see with low testosterone, too,” notes Dr. Hakim. “Sometimes, people are actually misdiagnosed with clinical depression and they might instead have low testosterone or hypogonadism. It is therefore important to rule-out a physical cause of the condition, such as hypogonadism, prior to treatment.”

Various physical symptoms may be associated with either depression or low testosterone. People who have depression might complain of back pain or neck pain, but might not experience other symptoms typically associated with low testosterone that include:

‧ Decrease in muscle mass.
‧ Increase in breast tissue.
‧ Loss of strength.
‧ Sudden weight gain.
‧ Erectile dysfunction

And if you also have depression or even an anxiety disorder, your symptoms may worsen over time if low testosterone levels are leading to a further decline in sexual performance and libido.

“If you come in to see your doctor with any of these symptoms, especially if you have some form of sexual dysfunction, it is important to evaluate your total and free testosterone levels, since hypogonadism may be the underlying cause,” advises Dr. Hakim. “You don’t want to ignore low testosterone. You want to address it as well as look for any other underlying diagnosis that needs to be addressed.”

When to see a doctor

If you’re experiencing physical symptoms like sudden weight gain or decrease in your sex drive or sexual performance and other mental and emotional symptoms, you should talk to a doctor about testing your testosterone levels. There are many effective treatment options to restore your testosterone levels to the normal range, if your testosterone levels are abnormally low. But even if you discover you don’t have low testosterone levels, understanding those test results will often provide some reassurance and help your healthcare provider better understand and manage your symptoms.

“Many of these symptoms, especially as men get older, can be due to other factors such as stress, anxiety, pressure, work, aging, relationship issues and even other medications,” says Dr. Hakim. “Ultimately, a multispecialty approach is important to assure the best outcomes and patient satisfaction.”

How Men Can Boost Their Fertility For Better Odds Of Conception – Exclusive

By Brynna Standen/Updated: Oct. 7, 2022 12:49 pm EDT

This article is a repost which originally appeared on Health Digest.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our Takeaways:

· Only 30% of fertility complications are due to complications in the woman alone.

· There’s a cultural stigma against infertility in men.

· Male fertility can be caused by a number of factors.

While in theory, the idea of trying to get pregnant sounds like a whole lot of fun (wink, wink), for some couples it can start feeling a little more like one of the Sphinx’s riddles — difficult to navigate and laden with pressure and high stakes. In the U.S., one in eight couples have difficulty conceiving (per Fertility Answers). While fertility experts agree that only 30% of these cases can be attributed to a complication in the woman alone, society often seems to be in silent agreement that fertility issues start and end with women.

This unspoken consensus seems to point toward a gender bias within the medical field. A 2006 review published in Medical Anthropology Quarterly found that out of 157 articles published on the topic of fertility, only one was centered around men. Adding to this, a 2016 study published in the American Journal of Preventive Medicine reports that in federally funded clinics that offer family planning services, 81% of them educate women on preconception care, while only 38% of them provide the same education opportunities to men.

Health Digest sat down for an exclusive interview with Dr. Justin Dubin — a urologist and men’s health specialist practicing in South Florida, and co-host of the men’s health podcast “Man Up: A Doctor’s Guide to Men’s Health” — who gave us the scoop on the stigma surrounding male fertility and offered advice on how men can boost their fertility, giving them and their families the best chance at conception.

Shifting the focus

Well aware of the societal bias surrounding fertility struggles, Dr. Dubin wants men to understand their role in family planning. “When it comes to fertility and family planning, it’s important for guys to remember that it takes two to tango,” he asserts. While there are certainly times that fertility issues solely fall on the female, Dr. Dubin points out, “In couples struggling with fertility, 50% of the time there is a male factor component to the couple’s fertility problems. In fact, 30% of the time, a couple’s fertility issues are strictly due to the male! Despite these statistics, there continues to be an unfair focus and pressure on female partners when it comes to family planning issues.”

When it comes to examining why a couple is having trouble conceiving, Dr. Dubin notes, “Women are often the only ones to see a doctor for a fertility workup. Guys need to know that if their partner is getting evaluated for fertility, they should too. Not only does it take some pressure off your partner, there is a chance that getting evaluated by a urologist can help you achieve your family planning goals. It’s time we shift the focus of fertility away from women and back to the couple as a whole,” he declares, adding with encouragement, “Guys, see a doctor!”

The stigma of infertility in men and how to get tested

Women aren’t the only ones who face stigmas surrounding infertility. “Most men don’t like seeing a doctor, especially when it comes to discussing topics like fertility that they often associate with masculinity,” says Dubin. “Fortunately, the fertility workup is fairly straightforward. Typically, when you see your doctor there are three components to a male fertility workup.” He explains that it starts with semen analysis. “A semen analysis is a test in which you provide a semen sample. It is the gold standard for a male fertility evaluation. Basically, we look at the amount and quality of the sperm in your sample to assess your fertility status.” For men still intimidated by the process, Dr. Dubin offers, “Based on both your comfort level and access to facilities, the sample can be collected either at home or in a lab.”

Next, Dr. Dubin explains that blood work is useful. “Like female fertility, there are certain sex hormones that play a role in male fertility and sperm creation. Testosterone is an example of a common hormone we look at.” Men should also get a physical exam, and give their doctors a detailed medical history, while they’re at it. “Male fertility can be impacted by so many different things that it is important for your doctor to hear your story,” Dr. Dubin says. “In addition to a good history, getting a physical exam helps with the big picture of what is going on.”

Expert tips on boosting male fertility

When it comes to male fertility, it’s not as simple as playing with the cards you were dealt. “Male fertility is interesting because lifestyle choices can actually make a big difference on some men’s fertility. When it comes to overall health, it is important to remember: what’s good for your heart is good for your parts. Men who smoke cigarettes, are overweight, inactive, and eat poorly are more likely to have low testosterone and fertility issues. Eating healthy, exercising, and losing weight can help improve fertility.” While low testosterone can play a role in the struggle toward conception, Dr. Dubin reveals, “One important medication that can compromise your fertility is taking testosterone. If you are considering having kids at any point, I would not recommend starting without talking with a doctor.”

While we may have assumed this one was an old wives’ tale, Dr. Dubin clarifies, “If you are actively trying to conceive, you should avoid exposure to wet heat, [like] saunas and hot tubs. The heat can create a less favorable environment for sperm and temporarily cause a decline in sperm numbers.” Last but not least, let’s talk lube. “If you are a couple who uses lubrication during intercourse, the kind of lubricant that you use can make a difference. Most lubricants do not provide favorable environments for sperm and can potentially compromise fertility. When it comes to lubricants that are good for family planning, we recommend using Pre-Seed.”

Finding support at home

Because of the sensitive nature of fertility — especially when it is proving to be an issue — Dr. Dubin stresses the importance of communication between couples. “Fertility is a sensitive topic for men to discuss as most guys associate it with their masculinity and what they consider makes them a man. At the same time, conception and family planning is a two-way street and if there are concerns about their sexual health or fertility status, it is important that their partner talks with them about it. Communication is key for couples struggling with fertility.” Offering one final tip to couples who may be having a hard time, Dr. Dubin says, “Focusing on the fact that this is a couple’s issue, not a male or female issue, should help relieve specific pressures and should motivate both partners to be active in the process and hopefully each get evaluated.” Teamwork makes the baby-dream work!

 

 

 

 

 

 

 

 

 

 

 

 

A Doctor with Hard Flaccid – Updates and Advice

A Doctor with Hard Flaccid – Updates and Advice

by Romero MD

Original post: A Doctor with Hard Flaccid – Updates and Advice

Hi everyone I am 26 years old and I recently developed this mythical problem called Hard Flaccid.
I am a medical doctor. I finished medical school a few months ago, and I am currently applying for Obstetrics-Gynecology.

First, my story. I have been practicing PE, intermittently, for the past 4-5 years. Basically, only manual stretches (I am satisfied with my girth), but, like many others, I think my injury was caused by Edging and excessive Kegeling, which I have been practicing for over 10 years, for stamina training and erection quality.

And without knowing the extreme importance of Reverse Kegeling. Every time I have sex, I also do intense kegels, in order to last 60-90 minutes of penetration. I know, I know… maybe it’s a little too much… But my girlfriend and I have always liked long love sessions Almost 2 months ago, while I was having sex with my girlfriend, I started to lose my erection suddenly, after performing an intense Kegel, during a sex position that placed my penis at a downward angle (so, I did a “very weighted Kegel”).

I thought I might have torn a muscle or ligament, and we stopped at that moment. The next day, I woke up with a hyper contracted and cold penis. As it didn’t seem to be a penile fracture, nor did I have any skin lesions, hemorrhages or bruises, I decided to simply rest. Because I thought that any fellow urologist would tell me to simply do the same – to rest.

After two weeks of online research, I discovered my diagnosis – Hard Flaccid/CPPS. However, I only have/had symptoms related to the anterior/superficial pelvic floor (Ischiocavernosus and Bulbocavernosus Muscles). I don’t have pelvic pain, difficulty passing stools or other posterior/deep pelvic floor symptoms. But I have/had:

– Sudden erectile dysfunction (9-10/10 to 4/10)
– Sudden premature ejaculation (90min to 3-5min)
– Hyper contracted penis (Hard Flaccid). Which improves sitting, lying down, with Reverse Kegels and with heat; and worsens standing, with physical activity, with Kegels and with Involuntary Kegels
– Cold and soft glans (sometimes scrotum and penis too)
– Mild urinary retention
– Loss of morning and spontaneous erections
– Slight bend of the penis to the left, from the base of the shaft. (IC injury?)
– Slight downward curvature of the penis, from the middle of the penis (BC injury?)
– And a slight twist of the entire shaft, clockwise (IC injury?)

The next day, I visited the Urology Department at my hospital. I was observed by 4 urologists. As expected, none of them had ever heard of Hard Flaccid… After explaining the whole story, situation and symptoms, I was medicated with:

– Ibuprofen (anti-inflammatory), for 7 days
– Cyclobenzaprine (muscle relaxant), for 30 days
– Tamsulosin (alpha blocker, to decrease all sympathetic nervous activity, stressful or non-stressful, to the pelvic floor), for 30 days
– Total sexual abstinence (masturbation and sex), for 30 days, which I was already doing for 2 weeks.
After these 30 days, I will have an appointment with one of the best Andrologist in my country, which will be on August 27

So, after 3 weeks, I have been doing a lot of research (books, websites, forums) … And, according to my symptoms, I am almost sure that I had/have a strain of the Left IC Muscle (and maybe the Left and/or Right BC), which is, consequently, contracting the anterior/superficial pelvic floor and the penile smooth muscle (giving rise to the Hard Flaccid and the shortening of the penis, while it is erect) and, consequently, compressing the pudendal nerve, dorsal nerve and pudendal arteries, giving rise to all the other symptoms.

And that’s why REVERSE KEGELS are so important for the progressive relief of all the symptoms.

Treatments. What I have done to recover:
– Ibuprofen, Cyclobenzaprine, Tamsulosin
– Extraordinary healthy eating (Proteins, vegetables and fruits. Very important in the recovery of any injury) and supplementation (Ginkgo Biloba, Ginseng, L-Arginine, Fish Oils, Vitamins E, D, C, B complex and Zinc)
– No masturbation, no sex, NO PORN. And no pictures, no Instagram girls, nothing. Just hugs and kisses from the girlfriend. (Alright… We make love, but only with my hands and mouth. I don’t let her touch my penis… I was in this hardmode for 4 weeks. In the last week, I have been trying very light Edging (5 minutes of very light massage, very soft touches, always with REVERSE KEGEL), every other day, to give a little physiotherapeutic stimulation to the tissues. But without ejaculation (to avoid the Involuntary Kegels associated with orgasm, to keep my libido high and to increase the likelihood of spontaneous erections)

– Lots of REVERSE KEGELS/Front Reverse Kegels, throughout the day.
– Very light and Soft Squeezes (“massages”) of the flaccid penis, while Reverse Kegeling, to help relax tissues, throughout the day.
– Belly Breath Combos, Hindi Squats and Happy Baby, along with Reverse Kegeling.
– Light external massages, on the anterior/superficial pelvic floor
– 1 hour of STRETCHING (flexibility training) every other day – Pelvic Floor, Hamstrings, Psoas, Piriformis, Quadriceps, Adductors and Abs. (All along with Reverse Kegeling and Belly Breaths). Again, hardmode – Static, Dynamic and Weighted Stretches. I’m literally training to do the front and side splits.

– HEAT. Heat relaxes muscles and dilates arteries, increasing blood flow and, consequently, relieving symptoms. I wear shorts, under my pants, during the day. When I get home, I wrap my lower body in a blanket and I use a hot rice sock sometimes. And I place a big and soft pillow under my buttocks, when I am sitting in my chair.

– Sleep. A lot. (Very important in the recovery of any injury)
– I am a very active person (running and weighted calisthenics), but I stopped this type of physical activity since the day of the injury (to avoid Involuntary Kegels). However, I am doing some bodyweight Squats and Hip Thrusts (along with Reverse Kegels) before stretching. I read somewhere that gluteal and posterior chain strength is also important.

– ABSOLUTELY NO STRESS (!!!). I have always been a very calm and peaceful person, in all situations of my life. But, after reading that Hard Flaccid was highly influenced by stress and anxiety, I am now completely in a “ZEN state with the Universe” Buddhist monk style.

Not only to avoid any nerve discharge from the Sympathetic Nervous System to the pelvic floor (and, consequently, Involuntary Kegeling, which prolongs the contraction of the pelvic floor muscles, which worsens the compression of nerves and arteries), but also to prevent the rise of Cortisol and Adrenaline and, consequently, the drop in testosterone levels. And (as many of you claim) this is absolutely essential.

I was a little stressed during the first week (before I knew the real diagnosis) and my penis was terrible… Hard Flaccid like a rock, with a loss of 1.5inches in BPFL. After knowing that I really have to relax completely, I immediately felt the first improvements in 3-4 days.

However, on the other hand, I am very convinced that I did a muscle strain, at least, of the Left IC. Those left curvature and left twist… Hmmm… On August 27, I will ask for an MRI. If the radiologist tells me it is normal, I will try to take the images to more doctors.

So… after almost 2 months, I have improved a lot – Now, I only have hard flaccid if I’m standing. A few times, I don’t even have it standing. It happens when I get up after doing Reverse Kegels for a few minutes (or sitting for a while in a more comfortable position) and continue to do Reverse Kegeling while I’m standing. This was impossible 1 month ago.
– The morning erections are progressively coming back
– 3 days ago, I’ve managed to have a 8-9/10 erection during the mini Edging sessions.
– However, I still have a slight bend to the left and the clockwise twist, during erection (I no longer have the downward curve), and I lost about 0.5 inches in BPEL…

1- Now, I would like to ask Pegym’s brightest minds and everyone in this group who is still recovering from Hard Flaccid, what are the most recent updates on this disease/symptom? Regarding physical treatment, exercises, medications and supplements. What am I missing? Where can I improve to speed up recovery?

2- I have been thinking about starting to do a small daily session of Kegels/Front Kegels/IC kegels… In order to give a physiotherapeutic stimulus, just like any other muscle injury. But I’m afraid it could get worse… What’s your opinion? (See post 26)

3- What do you think about adding very light and soft manual penile stretches? (along with Reverse Kegeling) I feel a lot of relief with the soft squeezes. But, in these, the applied force is perpendicular to the penis. I’m not sure if extra parallel force will be beneficial for the tissues. (See post 26)

4- Okay, the last question might be a little funny, but I think it might be relevant. I think I have an injury mostly on the left side. So, is it more advisable to rest the penis in the left groin or in the right groin? It tends to get softer on the right, but naturally falls to the left. (See post 26)

Thanks a lot for reading my story Best regards to the entire PEGym community
And thank you so much, for saving me during the past 2 months UPDATES: post 21, post 23 (stress management), post 26, post 29, post 63, post 66 (HF & Stretching)

So if your penis isn’t working well there are some people you might see:

So if your penis isn’t working well there are some people you might see:

By Pegasus

Your GP
Now this guy is a generalist and has some knowledge in a variety of areas. Problem is not likely to know a great deal about this specific area. So he (or she) will send you to a specialist. Problem is he may not know which one to send you to. There are 4 main areas of interest.

Uro
A uro does deal specifically with the penis area so if you have an actual injury to the penis this is the person to pick it up. Now he might tell you that you have venous leak and need surgery when a few kegel or increasing your test level might be all you need. On spotting if you have an actual injury though this is the guy to see. We get many guys though come onsite and a uro has been no help to them.

Now problem is they will not know much about pelvic floor or hormone issues. They might not even know the pelvic floor can cause penis issues (ok I know this is hard to believe but it’s true). Now until there education tells them when to send guys to a physio (and that could be many years) you might have to work it out for yourself.

Now the guys onsite like me can give some pointers. So that brings us to physio who work on pelvic floor.

Physio
For some time this site has worked with guys on their pelvic floor an area poorly serviced by mainstream medical.

However this is changing and Physio are starting to do some good work in this area. They have some difficulties though. The Uro have had to be dragged kicking and screaming to the realisation of the impact of the pelvic floor on male sexual function.

The Physio still get little recognition that they are out there working in this space from either the Uro or even GP’s, thus the average punter will have no idea. Also this area is new and developing and they have limited mainstream science to work with. Still they have moved forward and done worthwhile work.

Now so far this seems straightforward if you have an issue with the penis see a uro a problem with the pelvic floor see a physio and an issue with the hormone system you would see a hormone specialist an endo.

Endo
Now there is a real problem here because the “normal” level of testosterone for instance is set too low. The result of this is a GP will do a test and tell you your test level is normal and not send you to an Endo and even if he does the Endo may say normal and send you on your way while you have a real physical problem. Additionally hard as it is to believe many Endo seem unaware natural methods of test increase even exist let alone how effective it can be.

Now natural test increase methods can be a solution to the hormone issue but if after a real guts effort they are not you will have to navigate this difficult area to get some help.

Now any and all of these specialists may tell you that you have no physical issue and it’s in your head. The problem with this is they know little of each others work and it might just be a matter of seeing the right physical specialist. Historically the in your head argument has been so overused it has lost a lot of cred never the less it remains a common source of penis issues.

Head issues
Now various therapists deal with these problems but there are several issues with it. The historic and even current overuse of this statement means it can be hard to convince a guy to consider this possibility.

Additionally the issue might be part mental and part physical stress/anxiety can play into all types of physical problems.

So there you have it to some extent you are going to have to find your way through this if you want mainstream help. Other members and the Mod team will try and help you and in fact a lot of my effort onsite in devoted to just that.

In addition we have ideas onsite that are of use in there own right so a plethora of info on the pelvic floor, info on natural test increase methods and hey sometimes a sympathetic ear can help to.

Suggested links:

Ok some good hormone info

optimal testosterone

Nutrition for testosterone increase

Low testosterone in the young and ED ,eq ,low libido

Effectiveness of natural testosterone increase

some really good information about testosterone

Pelvic floor

MUST READ Resources – Pelvic Floor Issues, Hard Flaccid, Chronic Pelvic Pain Syndrome

Male Pelvic Floor – resource

Does Penis Girth Matter? And How to Measure Yours

Does Penis Girth Matter? And How to Measure Yours

Does Your Girth Down There Matter? We Looked Into It.

Alex Manley

This article is a repost which originally appeared on AskMen

Edited for content

Whether you’ve spent hours upon hours fretting about your size, or find that your sexual partners seem to care way more than you do, penis size just seems to be one of those things people love to obsess over — and sadly, that might not be ending any time soon.

But one thing that often gets overlooked when discussing penis size is which metrics, specifically, are important.

Whenever someone says how big their penis is, they’re almost certainly using a figure to describe the length, not the girth.

There are probably a few reasons for that, but the upshot is that penis girth is something that might be getting, ahem, short shrift compared to length.

In order to size up the penis girth issue, AskMen spoke to a handful of doctors and sex experts about what a so-called ‘normal’ girth is, whether girth matters, and what to do if you’re unsatisfied with yours. Here’s what they had to say:

What Is Penis Girth?

Given that ‘girth’ isn’t a word we use very often, you might not be 100% familiar with the concept.

“The girth of the penis is the circumference or width of the penis,” says Kayla Lords, sexpert for JackandJillAdult.com. “When we talk about the thickness or width of a penis, we’re talking about the girth.”

How to Measure Your Penis Girth

As for how you come up with your penis girth measurement, it’s pretty simple — if you have a tape measure you can wrap around things. If not, you can also try using a piece of string or ribbon, marking the points where it meets, and measuring the length of that section.

As for how and when, penis girth “can be measured when flaccid and erect (although most men care more about girth when erect), and people usually measure the penis at its thickest point,” says Dr. Jason Winters, founder and director of the West Coast Centre for Sex Therapy.

Average Penis Girth for an Adult Male

Whether you just rushed off to measure yourself, already have your girth memorized, or haven’t the faintest idea, you might be wondering what’s considered average.

Of course, it’s important to remember that the human body is endlessly variable.

“A 2014 review study, which included the data from 15 previous studies (total sample size of more than 15,000 men), found that the average girth for a flaccid penis was 3.67 inches (9.31 cm) and the average girth for an erect penis was 4.59 inches (11.66 cm),” says Winters.

However, regardless of whether yours comes close to those numbers or not, Dr. Lamia Gabal of Prestige Medical Group suggests you don’t have much to worry about, at least from a health perspective.

“From a medical perspective, there is really no concern about girth in general,” she says. “Certain disease states, such as Peyronie’s disease, can give deformities that are painful or interfere with sex. But if there is no pain and you are able to perform, then there is absolutely no need for concern.”

How Penis Girth Impacts Sexual Pleasure

Yes, penile girth can definitely impact pleasure (for better or worse) for both you and potential partners, depending on where your measurements land.

For You

The good news? Penis girth doesn’t appear to directly impact your sexual pleasure, according to Winters.

“No study has addressed this,” he says. “It’s very likely that a guy’s anxiety about his penis size would have a much greater (negative) impact on his sexual pleasure than the actual size his penis is.”

Lords, however, notes that, at the far ends of the spectrum, being extra girthy could impact the amount of pleasure being felt.

“When it comes to the pleasure a man feels or their partner feels, a lot has to do with what the body can handle and what feels good,” she says. “If a man cannot fully penetrate a partner, wrap his hand around his penis, or experience oral sex fully because of his girth, the pleasure he feels during those activities may be limited. It doesn’t mean that he can’t or won’t have sexual pleasure, only that he and his partner may have to adapt to the reality of a larger than typical girth.”

Similarly, it’s possible that an incredibly narrow penis — particularly during penetrative sex with a wider-than-average orifice — could lead to slightly reduced pleasure for you, if it means there’s less skin contact overall.

For Your Partner

You’ve probably heard people argue that penis girth is more important to length when it comes to a penetrated partner’s pleasure — but how much true is there to that?

“Many people prefer more girth than length from their partner’s penis,” notes Lords. “For people with vulvas, a thicker penis gives them a full or stretched feeling that can be quite pleasurable, where a longer penis may hit the cervix, which can be extremely painful for some.”

As for those with girthier penises, “extra lube may be required, as well as longer time spent arousing the partner to be penetrated so they’re fully relaxed and better able to be penetrated by a thicker penis,” she adds.

RELATED: Best Sex Positions for Big Penises, Illustrated

For Winters, it’s important to remember that not everyone loves that “full of stretched feeling” described above.

“If asked directly, most women rate slightly above average size penises preferable, in both length and circumference,” he says. “Some women prefer deep penetration; others do not. Some women prefer feeling full; others do not. It’s safe to say, though, that most women do not prioritize penis size when it comes to sexual satisfaction. Many other factors have been shown to be much more important (e.g., direct stimulation of the clitoris, partner’s skills, sexual openness, sexual attentiveness, etc.).”

Whether your penis is on the thicker side, on the thinner side, or right in the middle, being a good lover has more to do with what’s going on between your ears than what’s going on between your thighs.

Can You Increase or Decrease Your Own Penis Girth?

It’s hard to talk about penis size without someone, somewhere, wondering, “Can I make it bigger, though?” and girth is no different.

But the distance between “Can I” and “I did” is a vast one, fraught with things like technical feasibility, accessibility, and cost, among others.

While this probably shouldn’t surprise you, there’s no easy and cheap way to make your penis naturally girthier — at least, not for the foreseeable future.  [Editor’s Note: There are plenty of techniques for increasing the girth of your penis using manual exercises on PEGym.]

That being said, if for one reason or another you’re stressed out that your penis is just too skinny, there are options at your disposal. For starters, you could wear something around your penis to artificially make it seem thicker, commonly known as a penis sheath.

“It’s possible to temporarily and slightly increase your own girth with penis sheaths,” says Lords. “The increase in girth depends on the size of the sheath.”

You can also try to increase your girth by optimizing what you’re working with by pumping it full.

“You can also use a penis pump, which forces more blood into the penis, but does not guarantee a specific increase in girth,” adds Lords. “That’s largely due to the current size of your penis and how much blood flow is increased to the penis with a pump.”

Then there’s the nuclear option: penile surgery.

“Similar to the size of a man’s pants, where the length does not change but the waist increases as a man gains weight, penile length is fixed, but girth can be augmented,” says Dr. Judson Brandeis, GAINSWave’s Director of Clinical Excellence. “To improve girth, urologists can inject bulking agents like fat or fillers between the skin and the erectile bodies. However, this lasts for only a year, and can give the penis a lumpy appearance.”

According to Brandeis, similar aesthetic issues also plague “a silicone penile implant that urologists insert under the skin.” While it can increase your girth by up to 2 inches, it also tends to give the penis “a somewhat awkward shape,” he notes.

Winters doesn’t think surgery is the magic solution, either, describing the current medical options as “surgical interventions that don’t tend to leave men feeling much better about themselves.”

“The gains are marginal, and the cost is high,” he says.

So what’s an under-girthed penis-haver to do?

At the end of the day, your best bet might just be to love yourself for who you are. Quite frankly, your sexual partners probably don’t care as much about penile girth as you do.