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At the end of the six-month study, which was funded by the maker of the FastSize Extender, Levine found increased penile length and reduced curvature in every man and increased girth in seven of the men.

"In younger or younger middle-aged men, ED is often the first sign of atherosclerosis.

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Levine, MD, director of the male fertility program at Rush University Medical Center, tested the FastSize Extender on 10 men afflicted with Peyronie's disease, which can cause bending and shrinkage of the penis.

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Boyle tests for testosterone levels and prescribes it as a topical gel, though she warns it is only safe when prescribed and monitored by a physician.

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The American Urological Association says a common form of lengthening surgery (involving cutting the suspensory ligament of the penis) has not been shown to be safe or effective.

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Most are a waste of money, and some are downright dangerous, doctors say.

"Penis-lengthening surgery is also an option for men, but it is a highly controversial procedure.

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But Lamm says these remedies may be appropriate for men who have experienced a decline in sexual performance but do not suffer from a diagnosable sexual problem.

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Evidence shows that these changes in themselves can have a positive effect on sexual function, Boyle says.

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He felt embarrassed in gym locker rooms and when standing naked before his wife.

WebMD Medical News: "Penis-Lengthening Surgery Questioned," "Small-Penis Syndrome Questioned.

Calling the results "remarkable," Levine now prescribes the device to many of his Peyronie's patients and reports no significant complications.

"I was afraid my girlfriend would think I was a freak, but she was supportive because she felt a difference in her satisfaction and I felt more confident in myself," Bob tells WebMD.

Many men would clearly rather spend $20, $50, $100 on the Internet than go to the doctor and get real information.

All it took was 25 months and over 2,600 hours wearing the device, typically five hours a day, seven days a week.

The remedies persist for men who can't get their hands on prescription drugs like Viagra or who prefer "natural" cures.

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Thousands of years before Viagra, men were consuming everything from horny goat weed to powdered rhino horn in hopes of boosting sexual performance.

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A recent study found that 85% of women are pleased with their partner's penis proportions, but 45% of men say they want a larger penis.

A 2006 study found that only 35% of men were satisfied with the outcome of surgery, which added only half an inch, on average, to length.

She also says the lengthening has enhanced their sex life, though she had no complaints before.

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No herbal remedy can restore erections like Viagra and its prescription counterparts, says Steven Lamm, MD, an assistant professor of medicine at New York University and author of The Hardness Factor.

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"I didn't feel manly enough," he tells WebMD.

Atherosclerosis, a condition in which fatty deposits build up inside arteries, may restrict blood flow to the penis and cause erection difficulties.

These men should be also be controlling their weight and cholesterol level, limiting their alcohol intake, and quitting smoking.

For men with performance issues who are physically healthy, Boyle often prescribes counseling, such as marriage counseling for men with relationship issues or psychiatric help for men who are preoccupied with a problem in penile appearance.

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He says he's gained over 2 inches of erect length.

When Boyle's patients come to her with bottles of herbal supplements, she tells them she cannot vouch for their safety or effectiveness unless the FDA has reviewed the claims on the label.

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Richard, the mechanic from New York, got results faster than Bob, but still wore the device under his clothes for about eight hours a day.

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) SOURCES: Karen Boyle, MD, assistant professor of urology and director of reproductive medicine and surgery, Johns Hopkins University School of Medicine.

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Levine, MD, professor, Rush University Medical Center and director of male sexual function and fertility, Chicago.

But ever since he was a young boy, Richard couldn't get over the feeling that his penis was too small.

And there's plenty of debate on whether size matters at all.

The FastSize Extender device promises results, but it's far from quick and easy.

"If a woman can have a breast enlargement and it makes them psychologically feel better," he reasons, "then perhaps we should have the same thing for men.

Sexual performance declines naturally as men age, doctors say.

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"The small blood vessels that go to the penis can become diseased much earlier than the [larger vessels that go to the heart," Karen Boyle, MD, a urologist at Johns Hopkins School of Medicine, tells WebMD.

But a rapid or severe decrease in performance or libido can be a red flag.

The group also refuses to endorse surgeries that inject fat cells in the penis with the goal of increasing penile girth.

Men who are overly preoccupied with penis length tend to have unrealistic expectations of surgery and should seek counseling instead, the authors wrote.

"The FastSize Extender, though not extensively tested, has received some validation from mainstream medical sources.

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