Having practiced urology for more than 30 years and having examined more men than can fill the Rose Bowl, I have heard every myth conceivable with regard to sex and would like to share my top 10 myths with you (in no particular order):

Myth #1. Size Matters!

The unique size of every man’s penis is determined at birth by the size of the corpora cavernosa—the two chambers within the shaft of the penis that fill with blood during an erection. There is no medical or surgical way to increase the length or width of the penis. Since the power of the mind has the most significant influence over sexuality, the only advantage a man with a large penis might have is that he thinks he has an advantage. “Think big and you will be big” is the most important message for a man to know about size. What really matters is the size of a man’s self-esteem and the size of his heart, not the size of his penis. Even if penis size did matter, nothing can be done about it. I have asked the wives and girlfriends of many of my patients about penis size. Not one of them has asked, “Dr. Danoff, can you make my man’s penis longer or wider?” But what they have asked is if I could “make it a bit firmer and attach it to a nicer, more pleasant, and generous guy!” Remember, contact of the tip of the penis (the most sensitive part) against the clitoris, the most up-front structure in the vagina, leads to orgasm. In most cases, size is irrelevant.

Myth #2. Withdrawal before ejaculation is a good method of birth control.

This “pullout” method, also known as the rhythm method, is a very poor form of birth control. As a man approaches a climax, ejaculatory fluid, which contains a considerable number of sperm, will seep preceding orgasm. The sperm can easily come in contact with the uterus and result in pregnancy. One in five couples who use the pullout method as their only form of birth control over the course of a year will conceive a child.

Myth #3. Premature ejaculation affects only younger men.

Although premature ejaculation is quite common in younger men at the outset of sexual maturity, many older men also find it to be an issue. Premature ejaculation affects about 30 percent of men at some time in their life. It can often be related to sexual inactivity for long periods of time or psychological factors. On the other hand, the ability to delay ejaculation can be learned. A number of treatments for premature ejaculation are readily available. Early ejaculation in men who are in their 30s or older may be a symptom of erectile dysfunction or fatigue. In older men, premature ejaculation can be a function of poor cardiovascular conditioning, depression, or neurologic symptoms. In younger men, it can be a symptom of anxiety. Early ejaculation is correctable and treatable in all age brackets.

Myth #4. A real headache is a good reason to avoid sex.

While many women, and some men, have feigned a headache to get out of sex, intercourse actually relieves minor aches and pains, including headaches. Oxytocin and other good endorphins released during sexual activity and orgasm are responsible for pain relief and general mood elevation.

Myth #5. Most men don’t last long in bed.

Surveying my patients revealed that the optimal length of sex is 3 to 13 minutes, not including foreplay. Each couple has its own time averages, which depend on each individual and, of course, other factors, including energy levels and sexual desire. Many of my patients think that everyone else is having better, longer, and more sex than they are, when in reality this belief is generally untrue. The key factor for most of my patients is mutual sexual satisfaction, unrelated to the clock at the bedside.

Myth #6. Great sex comes naturally!

Great sex is not an Olympic sport. It is not a contest. It does not come with an instruction manual. The key to great sex is mutual communication. Each partner must show a willingness to try new techniques and positions. The key is agreeing on what both partners find pleasurable. The physical chemistry often seen on television shows or in a movie suggests that when two lovers meet, sparks fly and mind-blowing sex naturally flows. But in the real world, great sex is not always that easy.

Myth #7. Sexually transmitted diseases (STDs) can be contracted from a public toilet seat.

Organisms that cause the most common STDs, like gonorrhea and Chlamydia, can survive only for a very short time, and the toilet seat is a highly unlikely transmitter. Public restrooms are undoubtedly a host to a number of germs, from those that cause the common cold to hepatitis A. But catching an STD in a public restroom is extremely rare. To contract an STD, the organism would have to come in direct contact with the urethra or enter through an open wound, a circumstance that is certainly possible but highly unlikely.

Myth #8. Viagra and similar drugs are the holy grail for men with erectile dysfunction.

The class of drugs known as PDE5 inhibitors, which include Viagra, Cialis, Levitra, and Staxyn, make up a billion-dollar industry in the United States alone. These drugs increase blood flow to the penis and create a firm erection, particularly in men who have diminished blood flow or an inability to sustain an erection long enough to complete intercourse. While many men benefit greatly from the use of these drugs, many younger men abuse them to enhance performance. This practice is a dangerous precedent. These drugs are drugs of performance, not drugs of desire. Many older men with serious cardiovascular conditions require a more aggressive form of treatment, which might include injection therapy or perhaps even a penile prosthesis. The “little blue pill” is not the answer for everyone. Although safe in most instances, these drugs are not without serious side effects or dire consequences if used inappropriately.

Myth #9. Certain foods or substances are aphrodisiacs.

Aphrodisiacs, named for the Greek goddess of sensuality and love, theoretically increase libido and put people in the mood for love. Oysters, dark chocolate, strawberries, rhinoceros horn, and tiger penis have been touted as aphrodisiacs for decades. No scientific evidence supports the validity of claims that foods or herbs can actually cause arousal. It is possible that certain foods, fragrances, or visual stimuli can trigger an erotic memory and thus increase desire. These substances may appear to be aphrodisiacs, but arousal would occur only on an individual basis.

Myth #10. Men care less about birth control responsibility than women do.

A large number of fertile men see me for an elective vasectomy. Men have often taken the brunt of women’s complaints regarding whose responsibility birth control is. The real issue is that women have several options available to them—patches, implants, diaphragms, the pill, the injection, IUDs, female condoms, and tubal ligation—while men have only vasectomy, condoms, withdrawal, and possibly (on the horizon) the male pill to choose from. Therefore, in the majority of cases, responsibility for birth control nearly always falls on a woman by default. Among my patients, condom use is still the main form of contraception, followed closely by the pill. My experience indicates that equal responsibility should be and usually is operative in matters of birth control

Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).

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