"The small blood vessels that go to the penis can become diseased much earlier than the 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." Richard, a mechanic from upstate New York, is a muscular, athletic guy. He has a loving wife who has always enjoyed their sex life. But ever since he was a young boy, Richard couldn't get over the feeling that his penis was too small.

The vacuum draws blood into the penis and makes it swell. Vacuum devices are sometimes used in the short-term treatment of impotence. But overusing a penis pump can damage the tissue of the penis, leading to weaker erections. Male enhancement supplements work by increasing the amount of blood flow the genital region receives and the volume of blood that it can retain. In a flaccid state, the penis, like any other part of the body, receives a normal amount of blood flow.

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