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January 08, 2024

A guy’s guide to sexual health

What every man should know

Men's Health Sexual Health

Content sponsored by MidLanticUrology-Native-010424-MensHealth

Limited - Man Looking out a window uncertain Jeff Bergen/istock

Most people know the fundamental sportsmanship rule: hitting below the belt is illegal. The groin is highly sensitive, and a strike here can cause severe injury. While a man’s sexuality is off-limits for low blows, that doesn’t mean it’s off-limits for discussion with your doctor.

Too bad most men don’t see it that way.

Stats About Guys and Sexual Health

It’s not that men aren’t concerned about sexual health. In a 2023 survey, the Cleveland Clinic reported:

• 44% of men are worried about erectile dysfunction.
• 39% of men are worried about loss of sex drive.
• 36% of men are worried about low testosterone.

But of men surveyed, while 37% reported having experienced issues related to sexual health, only two in five sought professional help.

So, guys, let’s have a frank discussion about your most common sexual health concerns. MidLantic Urology docs are here to help.

Dr. Laurence Belkoff – Talking About ED

Limited - MidLantic Urology - Laurence Belkoff

Dr. Laurence Belkoff

What is it?
Erectile dysfunction is the inability to get or maintain an erection firm enough to have sex. Many men think ED only occurs in older men, but ED is not exclusive to getting older. There are men in their 40s and 50s who experience ED and men in their 70s, 80s, and 90s with great sex lives.

What are the symptoms?
Failure to reach or sustain an erection more than half of the time, at any age, may indicate a condition that needs treatment. Other symptoms may include decreased sexual desire and less rigid erections.

Who is at risk?
ED has a wide range of causes, from vascular issues and nervous system issues to hormone or psychological issues. Chronic health conditions, which about 1 in 4 guys face in the U.S., also impact erectile function. These include diabetes, heart disease and hypertension, obesity, high cholesterol, and smoking. Many medications that treat these conditions have side effects that contribute to ED. Bottom line: ED is a complex, common medical condition and not one to treat lightly or feel self-conscious about.

What is the most common myth about ED?
That taking testosterone supplements will cure ED. Low testosterone may or may not be what is affecting your erections. Taking supplements with a normal testosterone level will not result in better erections and may cause side effects if not taken appropriately.

What treatments for ED are you most excited about?
Low-intensity shock wave lithotripsy and platelet-rich plasma (PRP) therapy injections. There are also new oral therapies in clinical trials. ED is very treatable. It all comes down to which treatment is right for your lifestyle. Our doctors can help you determine that.

Dr. Richard Harkaway – Talking About Low-T

Limited - MidLantic Urology - Dr. Richard Harkaway

Dr. Richard Harkaway

What is it?
Testosterone deficiency syndrome or Low-T means that a man’s body is not making enough testosterone, the primary male sex hormone that regulates fertility, muscle mass, fat distribution, and red blood cell production.

What are the symptoms?
Reduced sex drive, reduced erectile function, loss of body hair (including facial hair), loss of lean muscle mass, feeling tired all the time, obesity, and symptoms of depression are the specific symptoms most directly linked to Low-T.

Who is at risk?
Data suggests that about 2.1% of men (2 in every 100) may have clinically Low-T, which is a low blood testosterone level of less than 300 nanograms per deciliter (ng/dL). It is more common in men over the age of 80, who have diabetes, or who are overweight. Don’t just assume you have Low-T and start popping pills. Talk to your doctor.

What is one of the most common misconceptions about Low-T?
That it’s a normal part of aging, and nothing can be done about it. If you have clinically Low-T, it is essential to treat it. Testosterone is not just for sexual health. It aids in bone, cardiac, mental, and psychological health. Anyone whose testosterone is in the low-normal range may also benefit from treatment, but a physician should manage it.

What treatment for Low-T are you most excited about?
Bio T Pellets because they quickly get testosterone into the normal and high normal range for men.

Dr. Joceline Fuchs – Talking About Peyronie’s Disease (curvature of the penis)

Limited - MidLantic Urology - Joceline Fuchs

Dr. Joceline Fuchs

What is it?
Peyronie’s disease is a condition by which a small scar forms in the lining of the penis resulting in penile curvature, loss of penile strength, indentation, or pain.

What are the symptoms?
During the first 12 months of developing Peyronie’s disease, you may experience pain with erections, curvature of the penis, penile shortening, an abnormal shape to the penis, or a lump in the penis.

Many men are worried that Peyronie’s disease will cause issues with getting and maintaining erections. While there is some association between penile plaque and restriction of blood flow in the penis, this is not always the case.

Who is at risk?
Peyronie’s disease typically forms from microscopic trauma that occurs during intercourse. The trauma leads to inflammation and then a penile scar or lump. It is most common in men over the age of 40.

What is the most common misconception about Peyronie’s
That it is a rare condition. It can feel very isolating, since many men don’t talk about it or seek care because they find it embarrassing. In reality, it’s estimated that 6-10% of adult men have Peyronie's disease.

What treatments for Peyronie’s disease are you most excited about?
Introducing injectable collagenase into penile plaques has dramatically broadened the options for safe and effective office-based treatment of Peyronie’s. Surgery remains highly effective at correcting the curvature for more severe or bidirectional (S-shaped) curvatures.

The Physical/Mental/Sexual Health Connection

Men, your physical, mental, and sexual health are closely related. Changes in sexual health may indicate underlying medical conditions. Sexual health affects your quality of life and mental health.

A urologist can provide many management options, including observation, medication, injections, surgery, and more. Sexual health is a crucial component of overall health, so if you’re experiencing any issues, it’s time to consider seeking help from a physician at MidLantic Urology.

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