Below are some of the questions people like you have sent us about sexual health.
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Almost all men have a normal size penis – although many young men are concerned that their penis is too short or too small. Sometimes they believe this because they have compared themselves with friends or classmates in a common shower or locker room, or maybe someone teased them or made a hurtful comment. Or they might have seen pornographic pictures or movies and compared themselves with the porno “stars” (many of whom have unusually large genitalia).
The penis reaches adult size over a number of years during puberty (the years during adolescence when boys and girls grow and change to become adult men and women). A boy who matures more slowly than his friends will not get an adult-size penis until late in adolescence – and this may cause anxiety or make him feel as though he has an abnormally small penis.
It is also worth noting that a man’s penis may change size considerably depending on time of day, temperature, and factors other than sexual stimulation or excitement. During sexual stimulation or excitement, the penis becomes engorged with blood and stands erect – but there is a wide variation in normal size and shape and angle for an erect penis also. In some men, the erect penis is almost the same size as the flaccid (soft or non-erect) penis, while in other men the erect penis is much longer and wider than the flaccid penis. You cannot tell by looking at a man’s flaccid penis what size it will be when erect.
As a general rule, the size of the penis does not determine a sexual partner’s satisfaction with a sexual experience. That usually depends much more on the relationship between the two people and on both partners trying to make each sexual experience mutually pleasurable and satisfying for both of them.
Because many young men are concerned about the size of their penis and would like it larger, there are many unethical people or businesses that offer lotions or pills or other types of non-medical treatment to enlarge or lengthen the penis. None of these methods have been fully tested in clinical trials and approved for medical use – and none of them are recommended by reputable physicians. They are taking advantage of a man’s concerns about his penis size (despite the fact that most men have a normal size penis) and seeking to get his money for treatments that are worthless at best. Some can be dangerous or may even damage the penis. None of these methods or products can be recommended or should be used.
Finally, there are a few uncommon medical conditions of the penis that a man should talk about with his doctor (especially a urologist). The first is an extremely small penis, a condition called micropenis in which the penis does not develop to a normal size. Occasionally a boy will also have a penis that does not develop normally even before birth; usually these conditions are recognized shortly after the baby boy is born and given the necessary medical attention. Another medical condition occurring most commonly in middle-aged men is Peyronie’s Disease. In this problem the penis develops scar tissue that may cause it to be smaller or curve abnormally – but this is not a cause of concern about a small or short penis in young men.
The exact reason isn’t known for an association between young men’s condom use and masturbation. One simple possibility is that masturbation allows young men to become more familiar with their own penis when it is erect. Using condoms is pretty easy, but knowing what to expect, and some practice, can make it really easy.
Another possibility is that young men who masturbate may be more comfortable with their sexuality. We’ve begun to learn in the past few years that young people who are comfortable with their sexuality are often more careful in protecting themselves and others. It may be that masturbation and condom use are both ways by which people express their sexual health.
A final important point about the study you read is that it shows that people still masturbate even after they’ve started having sex with others. In fact, we know that many men and women continue to masturbate even into their 60’s and 70’s. Even if masturbation isn’t for everyone (isn’t it nice to be able to choose?), it certainly seems that masturbation is a part of people’s expression of their sexuality, no matter how old.
--J. Dennis Fortenberry, MD, MS
Ask the experts about sexual health and STIs
A: The short answer to your question is that there are no negative effects of masturbation. That means in terms of mental health, physical health, sexual health.
The first question to ask is whether or not you are actually ejaculating. It may possible that the wetness in your pants is a generous amount of pre-ejaculate or "pre-cum," the natural, clear lubrication secreted into the urethra and out through the tip when a man is aroused. Some men produce very little pre-ejaculate, while others can produce around a teaspoon, certainly enough to make your underwear feel wet. You cannot control the amount of pre-cum, but you take comfort in the fact that all men secrete pre-ejaculate and that your body is doing its job well.
If you are ejaculating prematurely—before you want to—you should know that this is quite common as well. Is there anything wrong with you? Probably not, though I certainly recommend talking with your healthcare provider. Certain anti-depressants can inhibit sexual arousal, and your healthcare provider will know whether this option might be appropriate for you. Will you grow out of it? Probably so. Most estimates suggest that about a third of men have some challenges with ejaculatory control, and that most of those men grow out of the difficulty as they age.
The ability to control ejaculation is not a skill anyone is born with; it is one every man has to learn. When you were a young child you learned to control urination. You have probably also learned how to control sneezing, or at least to moderate how loudly you sneeze when you are in a quiet environment. Ejaculation, like urination and sneezing, is a physical reflex, and learning to control it takes practice, experimentation and experience, along with a willingness to make mistakes along the way.
The fact that you recognize the difference between orgasm and ejaculation means you already have a high level of body-awareness. The techniques that are most often suggested for increasing ejaculatory control simply build on this strength you already possess: awareness of your physical reactions.
I caution you against trying to think about a non-sexual topic in order to avoid feeling sexual. Distracting yourself during physical contact with someone you care about is a hard habit to break and ultimately tends to create more problems than it fixes. If your goal is to be able to focus on your girlfriend and your own physical pleasures while also controlling ejaculation, then distracting your mind takes you further away from that goal rather than toward it.
I suggest that first you practice controlling ejaculation on your own while masturbating, using the "squeeze" technique or the "stop/start" technique, both which will give you practice in recognizing signals from your body, allowing you to enjoy sexual sensations and get close to ejaculation without going past the "point of no return," when ejaculation becomes inevitable. Resources to help you learn about these techniques are listed below.
In addition, masturbate to orgasm and ejaculation (once or more) before your dates with your girlfriend. Having already experienced sexual release may slow down your responses once the two of you are together.
I also suggest you talk to your girlfriend about what’s happening for you if you feel you can trust that she will keep this information in confidence. It may be flattering for her to learn that she turns you on so much, and simply sharing this information might help you decrease your anxiety and embarrassment. Anxiety about ejaculatory control may actually make it more difficult to moderate ejaculation. Once your difficulty is out in the open, you can work together modify the techniques you’ve been practicing on your own. The DVD and most descriptions of the practice techniques assume couples are having intercourse, but you can modify the same principles to fit your relationship.
For example, the two of you might experiment this way: See how close you can sit to each other before you get an erection. Slowly practice moving closer to each other and touching each other—first holding hands, then wrapping an arm around her, then allowing her to put her head on your chest. How long and in what ways can you touch before you feel like you are close to ejaculating? At that point, before you reach the "point of no return," move further apart or stop touching until you are ready to try again. With practice, you will likely be able to hold her more closely for longer periods of time.
If you ejaculate before you are ready, don’t worry. Just laugh, go change your underwear (keep several pairs on hand for such occasions), and return to snuggling, knowing that controlling ejaculation will most likely get easier over time as you practice with patience and self-acceptance.
- Scarleteen’s resource on male sexual anatomy, which includes information about pre-ejaculate and the gland which produces it
- The Mayo Clinic describes the “squeeze” technique as well as other treatments for premature ejaculation such as talk therapy and antidepressants
- Sex educator Cory Silverberg describes the "stop/start" technique
- The DVD You Can Last Longer from the Sinclair Institute demonstrates both the "squeeze" and "stop/start" techniques in a sexually explicit manner. Though the video is dated, the techniques have remained the same
- The book, The New Male Sexuality, by Bernie Zilbergeld, Ph.D., has an entire chapter devoted to developing ejaculatory control, and the book is filled with other useful information on male sexuality.
- To find a certified sex therapist in your area, visit the directory of the American Association for Sexual Educators, Counselors and Therapists (AASECT). A therapist may be able to help you develop other techniques to decrease anxiety and increase ejaculatory control
--Amy Stapleford, M.Ed.
"Foreplay" is generally defined as any sexual or romantic activity that prepares someone for intercourse. Kissing, hugging, petting, oral sex, manual stimulation (such as fingering), bondage/discipline/S&M (such as spanking), a romantic dinner, dating, sexual teasing, watching or reading porn/erotica, and talking all can be “foreplay” if partners become aroused (“turned on”).
For intercourse to be comfortable, a man’s penis needs to be engorged with blood (“hard”), and a woman’s vagina needs to be self-lubricated (“wet”). Often people get aroused at different rates, so you should have enough foreplay before intercourse to make sure everyone’s ready. If a woman tries to have intercourse when her vagina is not lubricated, for example, it can be uncomfortable or even painful for her.
If you have anal intercourse, foreplay should involve both getting turned on and relaxing the muscles of the anus of the person(s) who will be receptive. Because the anus does not self-lubricate, you’ll need to use lubricant any time that you have anal intercourse (or insert fingers).
Sometimes men or women do not become erect or lubricated, even when they feel good and are enjoying sex. A person’s age, physical health, hormone levels, monthly cycles, drug use, emotions, recent sexual activity, and comfort level with a particular partner can all affect blood flow to the genitals, and therefore may affect erections and lubrication. It is possible to add extra lubrication (water-based lubricant, silicone-based lube, saliva [spit], or vegetable oil [NOT with latex condoms]) if needed, and fortunately there are many fun sexual activities which are not focused on the genitals (penis, vagina) at all.
The word “foreplay” implies that intercourse is the “main event,” the ultimate goal of sex. It’s not, or it doesn’t have to be. We can have hot, steamy sex with or without intercourse. Scientists who study sexuality have learned that many of us can have orgasms from stimulation to almost any place on our bodies—breasts, necks, noses, feet, ears, knees—anywhere!
Some have suggested replacing the term “foreplay” with “outercourse.” Whatever you call it, I’d suggest that you can think of all of those fabulous activities I listed (and more) as part of—rather than simply a prelude to—sex.
--Amy Stapleford, M.Ed.
Ask the experts about sexual health and STIs
Men of any age can sometimes find it difficult to get or maintain erections. Few of us have bodies that always “perform” exactly as we want them to, and it is perfectly normal for erections to come and go during any period of sexual play.
If you’re concerned about your ability to get an erection, I would suggest that you first see a physician to rule out medical problems. Your doctor will likely ask you questions such as:
- Do you get erections in your sleep? When masturbating alone? With a partner?
- Do you drink alcohol, use recreational drugs, or take prescription medications?
Alcohol and other drugs sometimes make people feel less nervous about sex, but they can get in the way of being able to get and maintain erections. Some prescription drugs have sexual side-effects, and some medical conditions affect erections, as well.
If your doctor rules out medical causes, you might want to explore mental or emotional reasons that you are having trouble getting and maintaining erections.
- Are you attracted to your partner(s)?
- Do you feel nervous, anxious, or guilty about sex? About getting an erection? About pleasing your partner(s)?
- Do you know and trust your partner(s) well enough so that you feel comfortable around him or her?
If you are anxious, nervous, or feel guilty about getting an erection or having sex, this can make it more difficult to get turned on physically. Your penis might be "shy," even when your mind is aroused, especially if you feel pressure to "perform" sexually, you don't know your partner(s) well, or if something happened in the past which left you feeling that an erection was unsafe or morally unacceptable.
Because our culture tends to have narrow ideas about what it means to be attractive, you may need to take some time to figure out what it is that attracts you. Do you enjoy looking at, smelling, touching and talking to this person, whether or not s/he looks like the ideal in your head? Would you prefer to be having sex with someone of another gender? Do you like and respect your partner(s)? Do they like and respect you? Many men find that they need to know, trust, and feel very attracted to their partner(s) before they can maintain erections with them.
I would also suggest you explore ways of giving and receiving sexual pleasure without an erection. Your hands and mouth can give someone a lot of pleasure, and every inch of our skin is sensitive to touch. (See more on foreplay on this page)
You may consider talking with a counselor or therapist who specializes in sexual issues, such as those at:
The short and easy answer is, no: enjoying looking at breasts or lesbian erotica does not mean you are a lesbian. Someone is a lesbian if she calls herself a lesbian, and usually that means she is primarily attracted sexually, romantically and emotionally to women and rarely if ever attracted to men.
In fact, many other self-identified heterosexual women enjoy looking at other women’s bodies. I once heard a woman refer to herself jokingly as a "boob-isexual." She has always been attracted romantically, emotionally and sexually to men. She finds breasts arousing and attractive but has never wanted to be in a sexual or romantic relationship with a woman.
Most sexologists and psychologists agree that few people are exclusively heterosexual or homosexual. Most people, they say, fall somewhere on a continuum between gay and straight, and most people’s "sexual orientation" is fluid (changeable) over a lifetime. We humans are marvelously complex, and simple labels like "straight" and "gay" don’t account for our infinite diversity.
Alfred Kinsey is one scientist whose research suggested that people do not typically fall into the neat and easy categories of "heterosexual" and "homosexual." He developed a scale from 0 (exclusively heterosexual) to 6 (exclusively homosexual) with which to describe one’s sexual orientation. You can read more about the "Kinsey Scale" online.
Similarly, many people don’t think of attraction as a simple "either/or": "I am either attracted to someone or I am not." Instead they think of the many different ways they might be attracted to someone—whether for going on a hike, looking at someone, having a conversation, having non-genital sex, having genital sex, having children, or sharing a home. By asking themselves "the ways in which" they are attracted to someone instead of "whether or not" they are attracted to someone, they find they are "attracted" to many people in different ways and for different types of activities: some sexual, others not.
Using an expanded idea about what it means to be attracted to someone, it sounds like you may be "attracted to" looking at breasts and watching girls having sex with each other, but not attracted to having sex with girls yourself--a perfectly valid set of interests.
--Amy Stapleford, M.Ed.