What if erectile dysfunction is one of the first signs of deeper health problems—not the problem itself?

This study analyzed over 12,000 men and found that 41% reported some level of ED, including nearly 1 in 3 men under 40. That alone is striking. But what stands out more is what ED is connected to. Men with ED were far more likely to have underlying conditions like high blood pressure (31%), high cholesterol (27%), diabetes (15%), depression (24%), and anxiety (23%)—often without proper treatment. In fact, nearly half were not receiving care for these conditions at all. Lifestyle patterns also mattered. Smoking, alcohol use, low physical activity, and higher body weight were all more common in men with ED.

The key takeaway: ED is not just a sexual issue—it’s often a signal of cardiovascular and mental health risk. The most meaningful “intervention” here isn’t a single medication, but a combination of treating underlying conditions and improving lifestyle habits. This matters because catching ED early could mean catching serious disease early, too.

Is sexual dysfunction after menopause the exception—or actually the norm?

This review analyzed 37 studies with almost 10,000 postmenopausal women across multiple countries, and the findings are hard to ignore. About 75% of studies reported sexual dysfunction, and when data were pooled, around 65% of women were affected. The average sexual function score also fell below the clinical cutoff, meaning most women were in the “dysfunction” range.

The most affected areas were desire, arousal, and orgasm, not pain or satisfaction. Age showed a clear pattern—sexual function declined as women got older—while higher education levels were linked to better outcomes.

What stands out most is what actually helped: structured educational and counseling-based interventions. These programs showed a significant improvement (effect size ~3.08) compared to usual care, suggesting that knowledge, communication, and guided support may be as important as medical treatment.

That said, many intervention studies were small and varied in quality, so results should be interpreted carefully.

This week, someone asked me, “Hello Dr In recent times, I have a strange dilemma. I am a nicotine addict and I have realised that if I replace nicotine with porn, it's going to be much more healthier and better. But my therapist tells me to continue with nicotine and leave porn but I think she is wrong. What do you suggest?? Is replacing nicotine with porn a good idea??”. I’m really glad you’re thinking about your health this thoughtfully. Nicotine, associated with smoking, impacts blood flow and erections. Pornography in and of itself is not inherently bad; however, if you are using it to escape negative feelings or boredom, it can lead to compulsive use and problems. A better approach is figuring out what triggers your use and working with your doctor to utilize tools to help you quit nicotine.

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!

You will be the first to know that I recorded an episode with Steven Bartlett for the Diary of a CEO Podcast last week!

It was so much fun, and I showed Steven how to use a traction device, explained anatomy, and even showed off some sex toys… We’ll see what makes it into the final edit, but I think you all will really enjoy it!

Recently, I tackled the common issue of losing erections during sex and why it happens to so many men. "Erections are a window into your health or a biomarker. If something has changed, it is so, so important to see a physician."

Here are some quick takeaways:

Remember, understanding the cause can help you fix it and prevent things from getting worse. You deserve a real evaluation and care. Check out the full episode for more insights and practical tips!

I had an eye-opening conversation with Dr. Heather Howard about how money troubles can sneak into our relationships and even impact our sex lives. She put it so well: “It’s very hard for sex to be desired if it feels performative or it feels like it’s a requirement.”

Dr. Heather broke down some key truths:

Seriously, whether you’re budgeting together or feeling the tension, it’s all about teamwork, honest chats, and remembering you’re both on the same side. You’re not alone if this sounds familiar! So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “Woo, this is beyond helpful. Should be payed for”.

Sex shouldn’t hurt—but for many women, it does. Check out my new Substack: 7 Reasons Sex Hurts And How to Fix It.

In this article, I break down the most common (and often overlooked) causes of painful sex—from hormonal changes to pelvic floor dysfunction—and share practical, science-backed steps to help you find relief and feel confident again.