April 15, 2009 -- When it comes to health-related solutions to better sex, there seem to be few secrets, at least at first glance.
No doubt you've heard by now of the little blue pill, Viagra. Your inbox has likely been flooded at one time or another with questionable advertisements for libido enhancers and diets to increase your sex drive. You may have even done a Kegel exercise or two.
But even aside from these well-known options, there are a host of everyday activities, products and procedures that some say have the potential to spice up your sex life.
Granted, some are more myth than sensual magic. But experts in the field of sexual performance say that some of them could actually go a long way in terms of improving your bedroom performance and libido.
The following pages represent a few of the examples of products, practices and preconceptions that some look to in an effort to augment their intimate experiences. Will they work for you?
Longer-Lasting Sex -- In a Spray
Men with premature ejaculation problems may find a solution in a new formula from the United Kingdom that the British press has dubbed "liquid Viagra."
The formula, which recently completed testing in Europe, does not actually contain Viagra, but instead uses the local anesthetics lidocaine and prilocaine to numb the penis and allow men to "last longer" during intercourse.
The drug, known as PSD502, is applied topically five minutes before intercourse and was reportedly rated by two-thirds of patients as "good" or "excellent." Men applying the drug also reported intercourse lasted more than six times longer than before.
According to the researchers, among the 300 men in the study and their female partners, there were few instances of any side effects.
Although erectile dysfunction makes more headlines, experts in sexual health say premature ejaculation is much more common, especially among younger men.
"This is a bona fide company trying to develop a bona fide care for a bona fide problem," Irwin Goldstein, director of San Diego Sexual Medicine at Alvarado Hospital, said of the spray.
Goldstein said ejaculation is normally a reflex that can be controlled to a degree, similar to urination. But in premature ejaculation, "That fires without the person's permission."
Could It Help Your Sex Life?
Daniel Watter, a clinical psychologist, board certified sex therapist based in Parsippany, N.J., said that the spray was probably safe. But he added that the numbing properties of the treatment could have some drawbacks. Specifically, he said, taking the sensation away from a crucial part of the penis could hurt some men's ability to control their ejaculation.
"If you want good ejaculatory control, you have to pay attention to what's going on in your body," he said. "You have to pay attention to where your arousal is."
Linda De Villers, a Los Angeles-based sex therapist and author of "Love Skills," agreed. "I think most of us think it's a bad idea," she said. "It's sort of anti-pleasure focused, saying, 'Let's numb you out and dumb you down.'"
Still, the U.K. proprietors of the formula note in their research that since the solution is applied only to a small part of the penis, men who use it properly should be able to maintain most of the sensation that they would normally experience.
When it comes to condoms, most of the discussion revolves around the prevention of pregnancy and sexually-transmitted disease, rather than fun.
But with the increasing array of condoms on the market with pleasure-enhancing properties -- including twisted and ribbed textures -- some sexual health experts hope that these prophylactics will be able to adopt a more recreational image.
The issue of fun condoms has even worked its way into the scientific literature. In a 2006 issue of the U.K. medical journal Lancet, authors of a "Viewpoint" article said that campaigns promoting condom use should emphasize how they can enhance the "fun factor" of sex.
"Since pursuit of pleasure is one of the main reasons that people have sex, this factor must be addressed when motivating people to use condoms and participate in safer sexual behavior," the authors say in the "Viewpoint."
Could It Help Your Sex Life?
De Villers said that the idea may indeed be catching on with at least some people.
"I have known a few women to say they've actually noticed a difference," she said. "I'd say it's in the different strokes for different folks category. ... If you believe it feels good, maybe it feels good."
The other advantage to pleasure-producing condoms? They tend to be far less expensive and complex than other health-related strategies to boost your sex life.
"Try them, you might like them," De Villers said. "How can they be harmful?"
At the time the Lancet article was published, Suzie Heumann, president of Tantra.com Inc. and author of "The Everything Great Sex Book," said, "Condoms could actually be the new sex toys of the future -- and without batteries -- with design changes, additions, and a new advert campaign."
To some, it may seem extreme. But some women are willing to go under the knife for so-called "vaginal rejuvenation" -- a variety of surgical procedures designed to either improve the aesthetic appearance of the vagina or improve sensations during sex.
The American College of Obstetricians and Gynecologists has already taken a stance against such procedures; in August 2007, the organization issued a statement urging women to stay away.
Such procedures are not "accepted and routine surgical practices," the opinion reads. "Absence of data supporting the safety and efficacy of these procedures makes their recommendation untenable."
Still, some doctors stand behind the methods as needed surgery for some women whose vaginal structure causes them pain or difficulty during sex.
"I think people should get to make their own decisions about their bodies as long as doctors are making them informed consumers," Dr. John Miklos, director of the Atlanta Urogynecology Associates, Laser Vaginal Rejuvenation Institute of Atlanta Medical Research Institute, said at the time the College of Obstetricians released its statement. "It's a woman's right to say, 'I don't like the way my labia look.'"
Vaginal rejuvenation also refers to such procedures as revirginization, which seeks to create the effect of a restored hymen, and G-spot amplification, in which a filling agent is injected into the front inner wall of the vagina in order to increase sensation.
Could It Help Your Sex Life?
Watter said he is not surprised that vaginal rejuvenation procedures have become popular in certain circles.
"People go for plastic surgery all the time, so it's just a matter of time before the vagina is a part of that," he said. But, he added, "The effect they have on sexual performance is minimal."
For this and other reasons, De Villers said she could not advocate the procedure under most circumstances.
"It's really radical, and most women have perfectly normal vaginas," De Villers said. "I do not recommend it."
The exception, she said, is when a doctor might suggest restructuring after a woman gives birth if there is a high degree of stretching and incontinence.
Penile Enhancement Surgery
Women are not the only ones to look for a surgical solution to better sex. Some men seek a surgeon's help when it comes to getting a longer or thicker penis.
Dr. Darius Paduch, a urologist at the New York Presbyterian Hospital-Weill Cornell Medical Center, who is an expert in male sexual function, said the idea that a larger penis may lead to more pleasurable sex is not an unfounded one, as past research has shown that length and thickness plays a part in the orgasm of a female partner.
"From the female perspective, penis size and girth matters," Paduch said.
But the surgical procedures that lead to a larger penis are not without risks. Paduch said that if improperly done, serious injury can result. He noted that while some of these injuries come from botched surgery at the hands of an untrained practitioner, others are the result of a man using a device or technique in an attempt to lengthen his penis on his own.
In the latter category, he said he has seen men who have come in with serious damage to the nerves and blood vessels in their penises.
The surgery to lengthen a penis also involves the cutting of the suspensory ligament, a tough band of tissue that anchors the penis to the pubic bone. Severing this connection does allow for greater length, but it can also mean less control and a decrease in erection angle.
Likewise, surgical procedures to increase the thickness of the penis also have their potential complications. One approach, which involves removing fat from one part of the body and injecting it into the shaft of the penis, has already been branded with a strong contraindication by the American Society for Aesthetic Plastic Surgery.
"Enlargement of the penis by fat injection is considered an experimental high-risk procedure, and there is currently insufficient data to establish its safety and effectiveness," the society states on its Web site.
Could It Help Your Sex Life?
For men with certain medical conditions that affect the size of their penis, it is likely that such surgical interventions could have some positive effect. But for most men, Paduch said, the need for such surgery exists only in their minds.
"The problem is that a lot of men have this gym locker room complex," he said. "The overall message is that there is definitely something about length and girth, but most men are of average size when erect -- about 5¼ to 5½ inches in length.
"I have never had a male patient who, after the reassurance that they are of a normal size, tells me that they still want to have something done."
The idea is, for lack of a better term, seductive. Implant a few electrodes close to your spinal nerves, turn a dial on a box, and sit back while you experience an intense orgasm.
Such a device was what Dr. Stuart Meloy, a pain specialist in Winston-Salem, N.C., accidentally devised while using a spinal stimulator to treat chronic pain. While the idea behind the device was to feed an electrical current into spinal nerves to override pain signals, the device had an unintended side effect on female patients.
"When we turned on the power in this case, she let out a moan and began hyperventilating," Meloy said on ABC News' "Good Morning America" in 2004. "Of course, we cut the power and I looked around the drapes and asked her what was going on. Once she caught her breath, she said, 'You're going to have to teach my husband how to do that.'"
The technique, which Meloy termed Neurally Augmented Sexual Function, led to hopes that thousands of women who have trouble achieving orgasm would one day be able to take advantage of the device, which has since earned the moniker "orgasmatron" in the popular media.
But since Meloy began work on the technique in 1998, a number of barriers have kept it off the market. For now, Meloy said, development has stalled.
"'Hiatus' is the best way to put it," he said.
Not that the technique doesn't work, or that the patients who have tried it have had much to complain about. Meloy said that the few studies he has completed have yielded overall positive results.
But for most people, even those diagnosed with sexual dysfunction, the idea of surgery to improve their sex lives is too extreme. The fact that the equipment currently carries a $25,000 to $30,000 price tag has also contributed to a slow adoption of the technology.
Meloy said he eventually hopes to scale down the size and power of the device to make it both more manageable and less costly. But this, he said, could take time.
"I'm now on year 11 of this odyssey," Meloy said. "Luckily, I have a day job I like."
Application solely for the purpose of sexual function appears to still be a ways off. Add to that the idea that surgery is necessary to reap the benefits of the device, and the barriers to widespread use of this treatment today become apparent.
"Few people are so far willing to spend that kind of money," Meloy said. And, as for the surgery, he added, "I don't like the phrase minor surgery. If it was by body and a knife, it's a big deal to me."
Still, it's hard to say what buttons society may be able to push in the future to help give stalling sex lives a much-needed jolt.
For those who think high heels are sexy, there may be one more reason to support this opinion, at least according to an Italian study published last year.
Dr. Maria Angela Cerruto, a urologist at the University of Verona, Italy, published research that suggests that the posture that women adopt while wearing heels can tone the muscles in her abdomen and pelvic floor.
The small study of 66 women was published last spring in the journal European Urology.
"We now hope to prove that wearing heels during daily activity may reduce the need for pelvic exercises," Cerruto told ABC News' Ann Wise shortly before the study was published.
Could It Help Your Sex Life?
Cerruto said the research would be great news for women who not only struggle with regular exercising, but who are also supposed to remember to do the pelvic floor exercises known as Kegels.
But De Villers said she remained skeptical. She said that she has never heard of benefits of high-heeled shoes, other than that they can make you more body conscious so that you suck it in.
And Watter expressed his own concerns about the finding.
"I don't think I've ever heard a woman who likes wearing high heels," Watter said, adding that he has "never been told by women that heels are helpful for their sex life."
Could adding a bit more physical activity to your schedule help you get more physical in the bedroom?
It's a much-touted link that has more than a few purported celebrity adherents. Recently, it was reported that even French President Nicolas Sarkozy had adopted an exercise regimen that his personal trainer Julie Imperiali told the U.K. paper The Telegraph helped him reap fringe benefits in the form of improved sex, thanks to her Tectonic method of exercise that targets muscles in the pelvic floor.
When contacted by ABCNews.com, Imperiali declined to comment further. But past research is chock full of other data that seem to indicate a link between exercise and an improved sex life.
One example of such research is a study published in the August 2003 issue of the Annals of Internal Medicine, which found that exercise improved erections and reduced the risk of impotence in men older than 50.
This finding was supported in another small study published in the June 23, 2004, issue of the Journal of the American Medical Association, which found that exercise and a reduced-calorie diet could help correct erectile dysfunction in obese men.
And other research points to the benefits of improved circulation from regular exercise that can enhance sexual performance.
Could It Help Your Sex Life?
De Villers said she believes there is little doubt that feeling the burn in the gym also leads to more heat in bed.
"I am a huge fan of exercise and that should truly be promoted," she said. "I would encourage couples to take a walk or play tennis and come home and hop in the sack."
Aside from the immediate effects of exercise, she noted that over the long term an exercise regimen can enhance circulation, reduce cholesterol and increase flexibility -- all good news for sexual performance.
"People who have clogged arteries and diabetes don't have a good sex life," she said, adding that "getting into fun positions requires muscle strength and flexibility."
While Watter said that to his knowledge there exists direct correlation between sex drive or performance and exercise, he said being in better shape certainly won't hurt your sex life, and it may even help.
"If you are in good physical shape and you exercise regularly, there's a chance exercise makes sex better, like it makes every other activity better," he said.
ABC News' Radha Chitale, John Berman and Ann Wise contributed to this report.