Male Enhancement: Is It Worth a Try? (cont.)

The FastSize Extender, though not extensively tested, has received some validation from mainstream medical sources. But that makes it a true rarity among the nonprescription methods of male enhancement. Most are a waste of money, and some are downright dangerous, doctors say.

Instead of furtively turning to untested methods, men with persistent concerns should consider opening up about them with their doctors. That's because performance problems sometimes act as an early warning signal for serious health problems. 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.

Links Between Sexual and Overall Health

Sexual performance declines naturally as men age, doctors say. But a rapid or severe decrease in performance or libido can be a red flag. Most importantly, erectile dysfunction may be an early predictor of heart disease.

Atherosclerosis, a condition in which fatty deposits build up inside arteries, may restrict blood flow to the penis and cause erection difficulties. "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. "In younger or younger middle-aged men, ED is often the first sign of atherosclerosis."

For men with ED who are at risk of heart disease, prescribing Viagra or its cousins isn't enough, Boyle says. These men should be also be controlling their weight and cholesterol level, limiting their alcohol intake, and quitting smoking. Evidence shows that these changes in themselves can have a positive effect on sexual function, Boyle says.

Sometimes men with erection problems or a diminished libido have low levels of testosterone, Boyle says. Testosterone deficiencies can also affect mood and energy levels. 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. Nonprescription testosterone, such as the kind used by some bodybuilders, is dangerous, she warns.

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. 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. "They need reassurance from a physician that everything is OK," she says.