Men have difficult relationships with their penises. They’re like the best friend who you can’t truly rely upon to turn up to an occasion. You may wish he were bigger so you’d feel more confident when you’re with company, or you may wish he were smaller and not so bloody overbearing. But most of all you just wish he’d do what you say and looked presentable. Alas, with a fella who can’t take his drink like this one, you can never guarantee it.

So what have men always done? Look for remedies to willy anxiety. Penis pumps and rhino horn and the art of illusion.

Now though, things are getting serious. In a porn-steeped world where johnsons the size of jousts are being wanged about over every screen available, reality has got a bit distorted. Men want high performance big-uns so they can rock their partner’s world all night long, even though – guess what – the other person may not like LA porn star moves. And the pressure to perform as they think they should is causing sexual dysfunction in men both young and old. Erectile dysfunction is said to affect half of men over 45, commonly with vascular problems, but it is also on the rise amongst young men for these social and psychological reasons.

And the obsession with having some PornHub-ris is leading to a new rise of invasive and non-invasive techniques to improve the situation down there. The latest craze are fillers, injections of Botox-style liquid to improve girth.

This is Filler

Viagra is now over the counter and other erectile dysfunction pills are doing great business for firms like hims. Of course, they work by dilating the arteries that supply the penis and have to be taken prior to sexual intercourse, but a filler injection, on the other hand, is a more permanent solution, blocking signals in the nerves that supply muscles so they can no longer contract – in the same way that Botox is used to soften wrinkles and crow’s feet.

The word is already out on these treatments in the UK. Two of the largest cosmetic surgery firms have reported a 70-fold rise in enquiries from men about filler procedures. This week, the BBC’s Victoria Derbyshire programme featured a 36 year old man slapping his bits down on the operating table for the cameras. Hyaluronic acid is usually the filler used, a substance found naturally in the fluid surrounding your eyes, and it is injected into the tissue under the skin of the shaft and then massaged out for natural results. In this case, it resulted in the man’s penis girth increasing from 4.9 inches to 5.9 inches, at a cost of £3000. The result can last for 18 months. His girlfriend looked happy – however, Dr Asif Muneer from the British Association of Urological Surgeons told the BBC, “All these augmentation procedures are mainly to increase your flaccid girth and will have no benefit on your erect length…[and] it might lead to complications that will impair sexual function later on.”

What’s the point?

If it doesn’t make a difference in size when it’s erect, then why even bother? Because this is not about sexual performance, this can be considered locker room vanity. For all the sexual dysfunction going on, still it’s the fear of what other men may think that’s the worst of all. Even though the NHS says most men’s penises are around 3.75 inches long when not erect, men can’t see the wood for the trees, so to speak. A recent YouGov survey found 42% of 18-24 year old British men would like their penis to be bigger, with only 36% saying they were happy with their size.

There’s a good deal of tragedy in this. The mask of masculinity covering massive insecurities about our bodies. Distorted ideas of what’s normal and what isn’t, informed by porn and not by each other, particularly hetero men, because of course hetero men aren’t supposed to look at each other’s penises, lest you get a kicking. It’s absurd. Penises are beautiful. Maybe not scrotums, but penises certainly are, in all shapes and sizes. This is something we’ll be coming back to in our Get Real Project, which wants to reveal the truth about men’s bodily worries and support better self-belief.

Not that we won’t be showing an interest in a new trial in Cairo University in Egypt where they are trailing injections of botulinum toxin to treat men with erectile dysfunction. Botox for men – Bro-tox they’ll call it in the States, no doubt – well, let’s not rule it out. If you have a real sexual dysfunction problem, it’s good to know there’s help out there if you need it. But if it’s just pleasing your partner, or simple aesthetics you’re bothered about, don’t worry. Life isn’t one size fits all, and that applies to penises too. Celebrate difference. Celebrate yourself. Partners find that the sexiest thing of all.