Use Your X or Lose It

Andrew Siegel, MD

Use X or lose it…X can be anything–you fill in the blank–your muscles, your brain, your bones, your sexual function.

The cells and tissues of our bodies—including muscles, bones, brains, and every other organ—are endowed with a remarkable capacity for “plasticity,” the quality of being able to be shaped and molded in an adaptive response to the environment they are exposed to. What it comes down to is that our human body is an “adaptation machine.”   Our composition is “fluid” as opposed to “static,” and our tissues are constantly being remodeled, restructured and refashioned in adaptive responses that occur in accordance to the forces, stresses, resistances and demands placed upon them. This plasticity is an amazing phenomenon that can be tapped into by purposely challenging our tissues with the appropriate resistances to enable them to perform at extreme high levels of function.

Today’s blog is a discussion of use X or lose it in the context of male sexual function.

Hard Fact: If you go for too long without an erection, smooth muscle and other tissues within the penis may be damaged, resulting in a loss of penile length and girth and negatively affecting your ability to achieve an erection.

Your penis needs to be utilized the way nature intended, just like every other body component…and that means not just to direct your urinary stream with laser-like precision! Your penis is a marvel of engineering, uniquely capable of increasing its blood flow by a factor of 40-50 times over baseline, this surge of blood flow happening within seconds and accomplished by relaxation of the smooth muscle within your penile arteries and erectile tissues. When your penis is erect, not only is rigidity achieved, but the erection also serves to keep your penile muscles and tissues richly oxygenated, elastic and functioning well. The dramatic increase in penile blood flow that occurs with an erection enhances subsequent erectile performance via the release of nitric oxide, one of the important chemical mediators of erections.

In the absence of regular sexual activity, disuse atrophy (wasting away with a decline in anatomy and function) of your penile smooth muscle and erectile tissues can occur. In a vicious cycle, the poor blood flow resulting from lack of use produces a state of poor oxygen levels in the penile tissues, that, in turn, can induce scarring, which can further compound sexual dysfunction.

Scientific studies have found that sexual intercourse on a regular basis protects against ED and that the risk of ED is inversely related to the frequency of intercourse. Men reporting intercourse less than once weekly had a two fold higher incidence of ED as compared to men reporting intercourse once weekly.  (Am J Med 2008 July;121(7): 592-596).

Radical prostatectomy, the surgical removal of the prostate gland for treatment of prostate cancer, can cause penile shortening. The gap in the urethra (because of the removed prostate) is bridged by sewing the bladder neck to the urethral stump, with a consequent loss of length thought to be on the basis of a telescoping phenomenon. Erectile dysfunction associated with damage to the nerves that are responsible for erections further compounds the shortening by causing disuse atrophy and scarring. For this reason, getting back in the saddle as soon as possible after surgery will help “rehabilitate” the penis by preventing disuse atrophy.

A Few Words on Adaptation

Your muscles and other tissues are capable of hypertrophy (growth) or atrophy (shrinkage), depending upon the environment to which they are subject to. Exposure to a stimulating and active “environment” on a long-term basis can positively affect not only your external appearance, but also more importantly, your internal health. Conversely, exposure to a non-stimulating, sedentary environment on a long-term basis can negatively affect your external appearance and internal health.

Every cell, tissue and organ of your body is endowed with a remarkable capacity for “plasticity,” the quality of being able to be shaped and molded in an adaptive response to environmental changes. It deserves repeating that your body and its parts are “fluid” as opposed to “static” and are constantly being remodeled, restructured and refashioned in adaptive responses occurring in accordance to the forces, stresses, resistances and demands placed upon it.

Use It or Lose It

Our bodies demand physical activity in order to function optimally. For example, our bones require weight bearing and biomechanical stresses in order to stay well mineralized and in peak functional condition, as bone mineralization is stimulated by the stresses brought on by a variety of movements. The same holds true for every organ in our body—to maintain maximal functioning they need to be put into the service for which they were designed. As much as our bodies adapt positively to resistance, so they will adapt negatively to a lack of resistance. For example, after wearing a cast on one’s arm for 6 weeks, there is noticeable wasting of the arm muscles, nothing other than disuse atrophy. This phenomenon will occur to any body part not used in the manner for which it was designed.

Beyond Using It

The magic of plasticity and adaptability can be tapped into by challenging your body to adapt to resistances to enable it to perform at extreme levels of function. Exercise is about the adaptation—in neuromuscular, mechanical, and metabolic terms—to the specific demands that are placed on it. As your body is subjected to gradual and progressive “overload,” adaptation occurs and a “new normal” level of fitness is achieved.

Your pelvic floor muscles play an important role during erections, activating and engaging to help maintain penile rigidity and a skyward angling erection. There is good reason that the 1909 Gray’s Anatomy labeled one of the pelvic floor muscles the “erector penis.” Numerous studies have documented the benefits of male Kegel exercises in the management of ED.

Participating in a pelvic floor muscle training program can be a very useful tool to improve ED. It will sharpen your awareness of your pelvic floor muscles and enable you to isolate them and increase their strength, tone, and endurance. As your pelvic floor muscles become more robust, erections will improve accordingly. A comprehensive program such as the Private Gym includes a basic series of progressive male Kegel exercises without resistance followed by the use of resistance equipment to maximize pelvic floor muscle strengthening and performance. The pelvic muscles—like any other muscle in your body—will gradually and progressively adapt to the load placed upon them and will strengthen in accordance with the resistance.



Elston Howard was a New York Yankee who invented the batting “donut,” a circular lead weight that slides onto baseball bats and is used by on-deck batters. This added weight during practice swings is useful for stretching, enhancing bat speed and strength training; additionally, it makes the bat feel very light once it comes time to step up to the plate and remove the weight. Howard employed the resistance principle to heighten power—use the weighted bat in practice and when it comes time to step up to the plate, you’re going to perform better.


batting donut on bat


This principle will work on your “bat,” too—utilize resistance training in practice and when it comes time to “step up to the plate,” you’re going to perform better. Resistance training turns conditioning into a weapon that is capable of producing “outstanding” erections, maximizing endurance, and  boosting one’s confidence.

Bottom line: You can lose it, maintain it, or optimize it by not using it, using it, or subjecting it to exercise and resistance training, respectively. You are bestowed with an amazing and magical capacity for plasticity and adaptation, which can be transformative when used to your advantage and benefit.

Wishing you the best of health,

2014-04-23 20:16:29

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Note: As Arnold Kegel popularized pelvic floor muscle exercises in females in the late 1940’s, so I am working towards the goal of popularizing pelvic floor muscle exercises in males. This year I published a review article in the Gold Journal of Urology entitled Pelvic Floor Muscle Training in Men: Practical Applications to disseminate the importance and applications of these exercises to my urology colleagues. I wrote Male Pelvic Fitness: Optimizing Sexual and Urinary Health, a book intended to educate the non-medical population. I, along with my partner David Mandell and our superb pelvic floor team, co-created the Private Gym male pelvic floor exercise DVD and resistance program.

For more info on the book:

For more info on the Private Gym:


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3 Responses to “Use Your X or Lose It”

  1. 5 Reasons Your Penis May Be Shrinking | Our Greatest Wealth Is Health Says:

    […] Disuse atrophy: Use it or lose it […]

  2. The Quest for A Mightier Penis: What You Should Know | Our Greatest Wealth Is Health Says:

    […] adapt to not being used, with tissue wasting, shrinkage and weakness of the pelvic floor muscles. Use it or lose it! My vote: A Resounding  […]

  3. Overcoming Penile Insecurity | Our Greatest Wealth Is Health Says:

    […] Weight gain causes the pubic fat pad to be more prominent, the male equivalent of the female mons pubis. As the penis becomes buried in pubic fat, the penis will appear shorter. However, penile length is usually intact, with the penis merely hiding behind the fat pad, the “turtle effect.”  For every 35 pounds of weight gain, it is estimated that there will be a one-inch loss in apparent penile length. Lose the fat and the penis reemerges.  Fitness (particularly cardiac and core fitness) will substantially help penile function, since the penis is an extension of the cardiovascular system and some of the core muscles strongly contribute to erectile rigidity. […]

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