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He felt embarrassed in gym locker rooms and when standing naked before his wife.
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Your doctor might be able to prescribe something that can really help, or least provide a valuable dose of perspective about what constitutes "normal" sexual performance.
)Could FastSize work on men of normal penile length? Levine says it might.
And there's plenty of debate on whether size matters at all.
WebMD Medical News: "Penis-Lengthening Surgery Questioned," "Small-Penis Syndrome Questioned.
(Have you tried or considered trying a male enhancement product? Talk about it on the Men's Health: Man to Man message board.
Nonpresciption methods of male enhancement and male enlargement range from the possibly effective to the downright dangerous.
So there should be plenty of ways to satisfy your partner that have nothing to do with pills, creams, surgery, or devices.
Steven Lamm, MD, assistant professor of medicine, New York University and author, The Hardness Factor.
Most are a waste of money, and some are downright dangerous, doctors say.
For young men with sexual performance problems and no signs of physical problems, Boyle may prescribe counseling and a low dose of Viagra as they work out issues of insecurity.
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Many men would clearly rather spend $20, $50, $100 on the Internet than go to the doctor and get real information.
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"All the pills, topical creams, and gels are worthless.
He has a loving wife who has always enjoyed their sex life.
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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"In some cases, men are harming themselves in the pursuit of a bigger penis.
Testosterone deficiencies can also affect mood and energy levels.
All it took was 25 months and over 2,600 hours wearing the device, typically five hours a day, seven days a week.
WebMD does not provide medical advice, diagnosis or treatment.
(Levine has also worked as a paid consultant to FastSize Extender.
That's because performance problems sometimes act as an early warning signal for serious health problems.
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.
The most sensitive nerves in the vagina are found close to the surface, Lamm notes, and the clitoris is found on the vagina's outside.
Atherosclerosis, a condition in which fatty deposits build up inside arteries, may restrict blood flow to the penis and cause erection difficulties.
Levine cites "jelqing," a technique involving hours and hours of intense stroking.
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.
The device cost $298, but Richard says the effect on his self-confidence has been priceless: "It made a world of difference to me.
Men who are overly preoccupied with penis length tend to have unrealistic expectations of surgery and should seek counseling instead, the authors wrote.
Just ask Bob, a retail manager from New Jersey.
She also says the lengthening has enhanced their sex life, though she had no complaints before.
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"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.
"For men with ED who are at risk of heart disease, prescribing Viagra or its cousins isn't enough, Boyle says.
"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.
The remedies persist for men who can't get their hands on prescription drugs like Viagra or who prefer "natural" cures.
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.
See additional information.
He was shocked to notice a difference within a few days.
"Penis-lengthening surgery is also an option for men, but it is a highly controversial procedure.
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.
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It's a testimony to men's abiding insecurities about sexual performance.
He says he has patients who have developed Peyronie's disease due to violent stretching of the penis through jelqing.
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It's ironic that the male preoccupation with enhancement seems to be independent of the needs of women, the supposed benefactors of improved sexual performance.
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.
Evidence shows that these changes in themselves can have a positive effect on sexual function, Boyle says.
Instead of furtively turning to untested methods, men with persistent concerns should consider opening up about them with their doctors.
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Many doctors question whether the benefits of lengthening surgery outweigh the risks.
He says he's gained over 2 inches of erect length.
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The question is, do any of these "male enhancement" techniques really work?Richard, a mechanic from upstate New York, is a muscular, athletic guy.
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Bob, New Jersey.
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.
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.
Richard, New York.
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.
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.