Happy Down Below: Everything You Want to Know About the Penis and Other Bits

September 10th, 2018

I spent an awful lot of time learning — and teaching about — female genitalia. I talk about where it is, what it does, how it works, and how to interact with the various bits and bobbles. Like most aspects of human sexuality, a (cis) woman’s sexuality, is ignored. So I feel there’s a good reason for me to harp about vulvas and vagina, clitorises and cervixes, and everything in between.

Despite more attention being paid to the penis, its testicular friends, and the neighboring prostate, there’s a wealth of knowledge that is unknown (perhaps forgotten), and I came face to face with it in Happy Down Below, a book about the penis by German urologist Dr. Oliver Gralla. I was continually surprised by what I learned in this book. It was the type of knowledge you can only glean through an active career in your field, and the good doctor shares the knowledge-through-experience he’s had treating UTIs, infertility, erectile dysfunction, foreskin, and other topics.

Happy Down Below starts strong, with Dr. Gralla writing about how little most (cis) men know about their penises. Phew, at least it’s not just me.

However, the book slowed down a bit as the doctor introduced the reader to the penis, which included information about average sized (old news pour moi), the definition of and possible solutions to having a micropenis, and a rundown of all the parts. Toward the end of the chapter are sections on spots, warts, and other unwanted conditions of the penis. This first chapter is somewhat confusingly arranged, and it left me wondering what the actual point of it was. At nearly 50 pages, the first chapter is lengthy, and it could easily have been split up for clarity of theme.

Peppered throughout this book are stories from Dr. Gralla’s career or his colleagues’. The stories range from unbelievable (patients inserting ball bearings into their urethra until they fill the bladder) to grotesque (doctors using parts of corpses to enlarge the penis and patients injecting caulk into their penises). These stories appear almost immediately in Happy Down Below, which help to break up some of the older information or drive home a point that the author is making.

These anecdotes weren’t enough to keep me enthralled through the confusing first chapter; although, things perked up as Dr. Gralla discussed prostate issues that are often kept in the dark. I was especially struck by the fact that most elderly men will die with prostate cancer that has never been detected or interfered in their lives. The doctor makes pragmatic arguments about when and how to treat prostate issues, and his pragmatic nature plays a large role in his work and this book. For example, there are times when he admits to treating patients suffering from psychological issues about their sexual performance with drugs that have no effect, beneficial or otherwise, to facilitate the placebo effect. This sort of thing seems bizarre to someone raised in litigious America, but I cannot help but give his doctor credence.

This book picks up in the third chapter, which focuses on women’s urology. Dr. Gralla sees few women, but the ones he does see have typically struggled with consistent UTIs. The book continues to pick up traction as Galla writes about infertility and the couples with whom he has worked. This chapter offers insight into the mistakes people make (steaming your penis multiple times daily will not help you conceive) that decrease fertility how often patients misunderstand doctors and instructions. There was a brief tip about how sex closer to ovulation is more likely to conceive a boy child, which I found interesting.

Of course, it only makes sense that a book like this includes information about male contraception, but Dr. Gralla only discusses current options such as condoms and vasectomies. It’s interesting to learn about the efficacy of vasectomy reversal, but it would be nice to know what the future might hold, too.

Dr. Gralla does make some good points as he discusses erectile dysfunction, which has an appearance of being on the rise, especially in young men. But this may not be the truth. It’s perhaps easy to forget about the ways that men struggle, but Dr. Gralla has dealt with patients as young as 14 who wanted to better please their lovers. And while I wouldn’t call sexual curiosity a struggle, it certainly leads to problems that were entertaining enough to read (some complete with hydraulic pliers or bolt cutters).

Gralla does due diligence to various methods for dealing with ED before launching into a chapter on premature ejaculation where he similarly relays solutions. By now, the formula is apparent enough that you get a feel for how the chapter on hormones and testosterone will read; explanatory and interesting with a few entertaining tales and a couple of lackluster moments.

If you’re not sold on the educational merits of Happy Down Below, you might like the final chapter, in which Dr. Gralla discusses things that wound up in the orifices of his patients. Lost dildos, tree boughs, matches, and a bladder full of ball bearings all make an appearance here. This chapter is so bad you can’t look away.. if that’s how you react to that sort of thing. It doesn’t follow the formula of the preceding chapters, which I didn’t mind. Dr. Gralla tackles the subject with humor, so Happy Down Below does end on a lighthearted note.

As I read Happy Down Below, I couldn’t help but detect something a bit old-fashioned about Dr. Gralla., especially in his humor He is noticeably from a generation older than mine, and some of his comments highlight over mindsets or reflect cliches and stereotypes that are no longer readily accepted. This bothered me more toward the beginning of the book, but either I became accustomed to it, or it lessened as the book went on. Likely both.

It’s difficult to say who the target audience of this book is. At some parts in Happy Down Below, Dr. Gralla offers advice to readers who might be struggling with the specific issues he’s encountered during his career. At others, his advice is better targeted at medical practitioners. There were points when I simply enjoyed learning new things the way I do when I read any medical/science book. While I think it’s good for books to have a wide audience, sometimes a niche makes it easier to market or just recommend.

I did it enjoy this book for the most part and felt like I learned quite a bit. It was a quick and easy read even if you don’t.

I wouldn’t use it as an encyclopedia, but it wouldn’t hurt to pick up this book if you like books by doctors/professionals about their careers, want to know more about urological health in laymen’s terms than medical jargon, and want to be prepared for possible future complications with your genitals. Happy Down Below would likely be a good book for many (cis) men to pick up; although, I cannot help but wonder whether they would.

You can buy this book on Amazon. At the time of writing this review, there’s a coupon that will automatically be added to your cart!


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