According to a survey of more than 25,000 heterosexual men, nearly half (45 percent) said they wanted a bigger penis.

Given that so many guys are anxious about the size of their junk, it’s not surprising that the penis enlargement industry is growing. From pills to pumps to stretching devices to surgeries, a range of products and services that promise to give you the length and girth you’ve always dreamed of are now available.

But do any of them actually work?

Let’s take a look at the evidence.

There are a lot of pills and supplements on the market advertised as “natural male enhancement,” which is just another way of saying that they’re designed to increase your penis size—and maybe improve your sexual performance, too. One of the most famous such products is ExtenZe, which you may remember from the infamous late-night infomercials hosted by porn star Ron Jeremy.

Despite lofty promises and money-back guarantees, there are no penis enlargement pills backed by any real scientific evidence, and none are FDA-approved. There’s simply no such thing as a pill that can enlarge your penis, so don’t believe anything you hear otherwise.

In fact, some companies have been taken to task for false advertising, including ExtenZe, which paid a $6 million settlement after a class-action lawsuit was filed against it.

Penis pumps have been sold as a treatment for erectile dysfunction for decades, and when used for this purpose, they do indeed work. Increasingly, though, they’re also being marketed as a penis enlargement tool—however, the evidence for this application is lacking.

In a 2006 study in which men used a vacuum pump three times per week for six months, the average increase in length was just 1/10 of one inch—a difference that was not statistically significant.

However, 30 percent of the men in this study reported being satisfied with the treatment. While penis pumps don’t do much to change actual size, they may offer psychological benefits to some users, perhaps in the form of a placebo effect.

Penile extenders (see an example here) are also an increasingly popular enlargement tool. These devices aim to increase penis length through progressive mechanical traction.

A 12" 8 Rod Premium Extender Kit

A 12" 8 Rod Premium Extender Kit

In other words, they basically stretch out the penis more and more over time.

Research has found that extenders do indeed work to some degree. For instance, a small 2008 study reported an increase of nine-tenths of one inch in length—but no change in girth—among men who used it for four hours per day over a six-month period. No major complications or side effects were observed.

Other studies have yielded similar but somewhat smaller results.

Obviously, making gains with an extender requires a LOT of dedication. In addition, many guys have reported that these devices aren’t very comfortable to wear. You can’t just wear them at night while your sleeping.

So, while it seems that extenders can provide some limited gains, this might not be a realistic or desirable option for every guy.

Penis enlargement surgery is on the rise worldwide. There are a number of different techniques available, including procedures for increasing length, girth and the size of the glans or “head” of the penis (you can read more about each of these procedures here).

We don’t have a lot of data yet on the outcomes of these surgeries, but what little we do know paints a pretty mixed picture. One of the major problems is that there’s no standard surgical technique, which means you don’t necessarily know what you’re going to get when you go under the knife.

Several cases of penile deformities have been documented following these procedures, with some requiring follow-up reconstructive surgeries. To add insult to injury, penis enlargement surgery is extremely expensive (the lengthening and widening procedures can cost about $6,000 each).

These surgeries are considered to be risky and should therefore be approached with great caution.

With the exception of penile extenders, most products and procedures advertised to enhance penis size are unlikely to work as promised.

The best approach is to learn to be happy with what you have. You can also take some comfort in knowing that the penis size women say is ideal is actually pretty close to average, which means that, in all likelihood, you’re probably just fine the way you are.

The other thing you can do is change your lifestyle. Specifically, quit smoking, improve your diet, cut back on the booze, and—above all else—get some exercise. These changes will not only help to maximize the size of your manhood by creating fuller erections, but the loss in abdominal fat will also make your penis look bigger.

Justin Lehmiller, PhD is a sex educator and researcher at Ball State University and author of the blog Sex and Psychology. Follow him on Twitter @JustinLehmiller.

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