MEN’S YOUROLOGY

Does taking a pill every day make intimacy more satisfying than “on-demand” use?

This randomized, placebo-controlled trial followed 623 men (average age 58) with mild to moderate erectile dysfunction who had only a partial response to on-demand PDE5 inhibitors like sildenafil. After switching to tadalafil 5 mg once daily for 12 weeks, both men and their partners reported significantly higher treatment satisfaction across every domain, including erection quality, orgasm, pleasure, and confidence, compared with placebo.

What’s striking is that satisfaction levels with daily tadalafil were comparable to the maximum doses of on-demand therapy, but without the timing pressures of “planning” sex. This matters because satisfaction, both for patients and their partners is a critical factor in whether treatment works long term. The study suggests daily tadalafil may offer couples a more natural, spontaneous, and fulfilling sexual experience.

WOMEN’S YOUROLOGY

When men struggle with erectile dysfunction, do their partners’ sexual experiences suffer too? This study explored that question by surveying 65 female partners of men newly diagnosed with ED, comparing their responses to 65 age-matched women whose partners had no sexual dysfunction. Women whose partners had ED reported significantly lower satisfaction across multiple domains, including desire, arousal, orgasm, and overall sexual fulfillment.

In fact, nearly 70% of partners of men with ED reported difficulty reaching orgasm, compared to less than 30% in the control group. Sexual desire was also lower, and relationship intimacy was often negatively affected.

This just shows that ED is not just an individual issue, but a shared experience that can deeply affect couples’ intimacy.

This week, someone asked me, “I'm 46, and for the last three years, my ejaculation has been like water and really low volume at that, sometimes hardly anything comes out. I've seen my local urologist but they say everything is normal except slight prostatitis. What would you recommend for finding out what changed and how to get my ejaculate back to a normal consistency?”. It’s completely understandable to notice these changes and feel concerned, ejaculate volume and consistency can be affected by many factors, including age, hydration, medications, prostate health, health conditions, and even stress. Make sure to review your medications with your doctor and ask if your medical conditions might be causing retrograde ejaculation. Otherwise, it could be due to weak pelvic floor muscles that are just not propelling out the ejaculate forcefully. That can be improved by Kegel exercises.

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!

WHAT I’VE BEEN UP TO LATELY

Big News — My Book Is Officially Submitted!

I just turned in my book to my publishers! Coming October 20, 2026, my book dives deep into men’s sexual health, breaking down how to optimize and maintain a healthy sex life throughout your life. I’ve poured my heart, expertise, and years of experience into this one, and I can’t wait for you all to read it!

HIGHLIGHTS FROM MY CHANNEL

I dove into the popular question: Are buff guys really better in bed? Let’s break down the science in super simple terms. "Men who reported having no loss in muscle strength were 60 to 65% less likely to lose their morning erections, have a decline in sexual desire, and lose erection quality compared to those who noticed that they had a loss of muscle strength."

Here are some quick takeaways:

• More muscle means a lower risk of erectile problems and better sexual health.

• Hand grip strength is an easy way to check your overall muscle health at home.

• Simple lifestyle changes, like strength training and eating enough protein, can really help!

Basically, keeping your muscles strong does more for you than looking good, it helps keep things working well in the bedroom too! Check out the full episode if you want to learn easy tips to boost both your health and your confidence.

HIGHLIGHTS FROM MY PODCAST

I had an amazing conversation with Dr. Will Bulsiewicz all about fiber—how it can improve not just our digestive health, but also our mood and even help with weight loss. Dr. Bulsiewicz had some great tips for making fiber easy to add to your routine, “To me, fiber is the potential opportunity because fiber activates these satiety hormones… to make us feel full.”

Here are a few simple takeaways:

• Soluble fiber dissolves in drinks and is easier on your gut.

• Fiber helps both constipation and diarrhea by bringing your system to balance.

• Start with real foods (like legumes and greens) before jumping to fiber supplements.

Give this episode a listen if you’re curious how a little more fiber can make a big difference! So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “Amazing. No one ever talks about a Fiber diet . Protein , Carbs, Fats when we should be focusing on a high fiber diet first”.

NEW MEDIA

Noticing changes in your morning erections or losing them altogether? Check out my new Substack: Morning Wood & Men’s Health: What Your Erections Reveal About Blood Flow, Hormones, and Wellness.

In this article, I explain why morning erections are your body’s built-in health check, what it means if they disappear, and the steps you can take to protect both sexual and overall health.