Can being dominant or submissive in bed influence arousal and satisfaction?

This study explored how sexual roles, specifically dominant and submissive behaviors, relate to sexual function. Researchers surveyed adults about their sexual preferences and behaviors, then compared these with standard measures of sexual function, such as desire, arousal, lubrication, or erection, orgasm, and satisfaction. They looked at how behavior and role-taking during sex might connect to how well sex works physically and emotionally.

The pattern was clear and surprisingly consistent. People who reported more dominant or more submissive behaviors tended to report better sexual function overall. In women, stronger engagement in either role was linked to higher desire, better arousal, easier orgasm, and greater satisfaction. In men, these behaviors were associated with better erections, orgasm, and overall sexual performance. The relationship was strongest for people who actively identified with and practiced these roles, suggesting that comfort and confidence in one’s sexual style mattered more than the specific role itself.

This study suggests that sexual function is not only about hormones or blood flow, it’s also shaped by how people express themselves sexually. Feeling confident, intentional, and engaged in a role may help the body respond better during sex.

Is sexual decline with age really just about hormones?

This study looked at sexual function in women aged 40 and older by examining both biological and psychological factors at the same time. Instead of focusing only on estrogen or menopause status, researchers measured sexual desire, arousal, and satisfaction alongside mood, stress, and relationship factors. The goal was to understand how the body and the mind work together as women age.

The results showed a strong mind–body connection. Lower sexual function was linked not only to physical changes like menopause-related symptoms, but also to emotional and mental factors such as depression, anxiety, and negative body image. Women who reported better mental well-being and fewer distressing symptoms tended to report better sexual desire and satisfaction. Hormonal changes mattered, but they did not explain everything on their own.

This shows that sexual health in midlife and beyond is not just a hormone problem, it is also shaped by mental health and overall well-being. Treating hot flashes or vaginal dryness alone may not fully restore sexual function if stress, low mood, or relationship issues are also present. The findings highlight the need for care that addresses both physical symptoms and emotional health, showing why sexual well-being deserves attention as part of healthy aging.

This week, someone asked me, “I am on 18 ( Eighteen ) prescription Drugs, I have been seeing a Urologist for years now for bladder control and ED. Nothing has helped, he says that I an 76 years old and suggest I wear my Depends and just forget about EVER having normal sex again. I can't accept that .I can't take Viagra due to all my other meds. What can I do ?????”. I’m really sorry you were told to give up. Being 76 and on many medications makes treatment more complicated, but it does not mean options are gone. If pills like Viagra aren’t safe for you, there are other effective treatments, such as vacuum erection devices, intracavernosal injections, or a urethral suppository for ED, which usually don’t interact with other drugs. For bladder control, there are many options as well. A full medication review, hormone check, and seeing a urologist who specializes in sexual medicine could help you regain function and quality of life. You can learn more on my YouTube channel, podcast, or with my erectile mastery course.

I love hearing from you, so if there’s a question you’ve been wanting to ask, just let me know. Who knows? Your question might be the one I dive into next!

My kids have been off for “ski week,” so we’ve been enjoying a slow, cozy week at home—gym trips, movie theater outings, and lots of snuggling on the couch, watching shows and movies together. I honestly couldn’t ask for anything better.

I just talked all about why you might dribble after you pee—even when you think you’re done—and what you can do about it. "When this coordination breaks down, either because the bladder is not squeezing well or there's a blockage, you end up with what we call a post-void residual."

Here are some quick takeaways:

Check out the full episode for more simple tips to help you pee better and feel your best!

I had a super interesting conversation with Dr. Jordan Feigenbaum about the hype around peptides and how they’re marketed online. He broke down the basics and explained why a lot of these “miracle” solutions aren’t what they seem. For example, he said “It’s theoretical. It’d be nice if true, but that’s the big thing—if true.”

Here are a few quick takeaways:

If you’re curious about peptides, tune in to hear Dr. Feigenbaum’s honest perspective! So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “I listen to a ton of interviews and this is one of the most comprehensive health and fitness conversations I've ever heard. Great job! Will be sharing this one with all my friends and family”.

Worried about how early exposure to pornography affects kids’ brains? Check out my new Substack: How Pornography Impacts Kids’ Brains: A Urologist’s Guide for Parents.

In this article, I explain what the science says about how porn shapes young minds—and share practical, judgment-free ways parents can talk to their kids about sex, boundaries, and healthy relationships, based on both research and what I see in the clinic.