Since the month of February brings us Valentine’s Day and expectations of love, romance, and sex, now is a good time to discuss the epidemic of penis weakness—and how to avoid it.

I have witnessed an increased development of penis weakness over the last forty years. It is worth analyzing the social conditions that have created this outbreak. One could argue that men have always struggled with this condition. It could also be argued that the increase in penis weakness in recent years is only because men today feel more comfortable talking about their sexual problems. This is not the case. Powerful social and historical factors have contributed to, and continue to create, penis weakness among men today. Each individual case must have an independent evaluation.

One factor that plays a major role in penis weakness is the increased level of stress found in modern society. Men in today’s business world work long hours without enough sleep, exercise, or relaxation. They are often psychologically drained and physically exhausted when they get home. Add financial anxiety, societal pressure, nervousness caused by the rapid-fire pace of modern life, traffic jams, conflicts with bosses, coworkers, or clients, and problems with spouses and children and one can see a picture of conditions that are not conducive to either maximum sexual performance or maximum happiness!

These effects are compounded by the media’s highly romanticized image of marriage and family life—an image that creates impossible expectations. Being at your best at anything, especially sex, is difficult when you feel out of sorts physically or your mind is someplace else, preoccupied by other problems.

Few issues have a more chilling effect on sex than anxiety. Stress, tension, and anxiety exact a heavy toll on an intimate relationship. These forces pollute the atmosphere and fill the bedroom with emotional toxins.

Stress has definite medical consequences that work against normal sexual function. During the stress response, blood moves away from the genitals to supply the large muscle groups of the arms and legs. Anxiety, including performance anxiety, can increase the activity of the sympathetic nervous system. Anxiety can boost the flow of norepinephrine, a chemical that constricts blood vessels. This condition is precisely the opposite of what is necessary for an erection—a smooth flow of blood to the penis through open vascular channels.

This problem is compounded when men use alcohol and drugs in an attempt to cope with stress. As Shakespeare wisely observed, alcohol “provokes the desire, but it takes away the performance.” The same is true of drugs, including nicotine and prescription medications. The drugging of the American male is a major factor in the decline of penis power. The new craze over “Vitamin V” (Viagra) is hardly the solution.

To men who suffer from penis weakness, the Women’s movement, for all its welcome advances, has also contributed to the problem. With increased awareness of female sexuality, female orgasm, and the generally open discussion of women’s sexual needs (by way of women’s magazines, the Internet, television, and films), men now have the added pressure of having to know all of the intricate secrecies of female sexuality. They are expected to perform with the expertise of a twenty-four-year-old pornography star. For some men, this might not be a problem. Sex in general may still be smooth sailing. For most men, however, sex is an obstacle course—a track filled with snares and hurdles in which one scores points for technique as well as for getting to the finish line. The goal is not just to satisfy yourself, it is also all about satisfying your partner. And, in many minds, the man has a responsibility not just to bring a woman to orgasm but to multiple, ecstatic, earth-shattering orgasms. Now that’s pressure!

Both men and women expect sexual satisfaction. Partners also have a responsibility to work together through communication and understanding in order to meet one another’s expectations and to achieve mutual satisfaction. Every man should cater to his partner’s pleasure if for no other reason than to enhance his own. It is important to acknowledge that both genders have been insensitive to the high level of performance anxiety brought on by the new rules. The situation is made even more complicated by the enormous range of variation in female sexuality.

Millions of relationships turn into no-win situations when people aim for some imaginary standard of satisfaction instead of attending to the unique nuances and preferences of their partners. From my clinical observations, the single biggest sexual worry of contemporary men is that they will not provide their partners with orgasms of spectacular quantity and quality. If a man has even one humiliating encounter with a dissatisfied partner, he can succumb to the vicious cycle that begins in self-doubt and ends in penis failure.

Another media-related factor is the idealized image of the sex act itself. And what happens when reality doesn’t measure up to the imagined ideal?

Men blame themselves. They assume something is wrong with them. They think they are failures. And what is the focal point of their disappointment? Their penises, of course. “What’s wrong with it? Why can’t it be bigger and harder? Why doesn’t it do what the throbbing pistons do on the big screen or in books?”

You might not hear men asking those questions, but I do almost every day. Men think they should have a two-foot-long shaft of solid steel between their legs—a shaft that can pump and pound for hours on end.

That’s not a penis. That’s a Home Depot pneumatic drill from aisle six!

Most men measure themselves against standards built on fantasy, not reality. They interpret normal, commonplace experiences as signs of personal failure. There is enormous variety among men with respect to sex drive, capacity, preferences, and standards of satisfaction. Yet men assume there is a state of being called “normal.” They worry that every little sexual idiosyncrasy they have is a sign of abnormality. Worse, if sex doesn’t go as desired, or if they have a disappointing or embarrassing experience, they usually panic. This experience can result in significant self-doubt. Self-doubt creates fear, anxiety, and inhibition. These feelings are bigger obstacles to sexual happiness than having a construction crew in your bedroom (maybe even bigger obstacles than having your mother-in-law in your bedroom!).

Every man I have ever known has, at one time or another, lost an erection or ejaculated sooner than he would have liked.

Every man is, at times, not interested in sex.

Every man has failed to satisfy a partner.

Men who take such events in stride know that they are perfectly normal. They march without hesitation to their next sexual encounter.

These are the men who have penis power.

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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