Does BDSM harm relationships—or could it actually strengthen them?

This study examined whether people who engage in BDSM differ in sexual satisfaction, relationship satisfaction, and emotional closeness compared with those who don't. Using survey data from adults in romantic relationships, researchers found that people who reported engaging in BDSM did not show lower relationship satisfaction or closeness. In fact, many reported equal or higher levels of sexual satisfaction and felt just as emotionally connected to their partners as those in non-BDSM relationships. The study highlighted the role of communication, trust, and consent—core features of BDSM practice—as likely contributors to these outcomes.

This suggests that sexual practices alone do not predict relationship health. What matters more is how partners communicate and agree on boundaries. This research reframes BDSM from something assumed to be risky or damaging into something that, when consensual and mutual, can coexist with strong emotional bonds.

How common is female sexual dysfunction—and why are we missing it?

This large review pulled together results from dozens of studies in primary care settings to answer a basic but overlooked question: how many women are struggling with sexual problems? A substantial portion of women reported at least one sexual difficulty, including low desire, trouble with arousal, pain during sex, or difficulty reaching orgasm. In many studies, more than 1 in 3 women had symptoms that met criteria for sexual dysfunction.

The most common problems were low sexual desire and arousal difficulties, followed by pain with sex. Rates increased with age and were higher in women with chronic health conditions, menopause, or mental health concerns. Yet despite how common these issues were, the review showed that sexual concerns were rarely discussed or diagnosed in routine care.

These findings suggest that female sexual dysfunction is not rare or “niche”—it is a common health issue hiding in plain sight.

This week, someone asked me, “I had an enlarged prostate treated with microwave energy. It was a huge mistake. I endured intense pain for 28 point five minutes. I am unable to get an erection at all. Do you have any suggestions for me?”. Prostate treatments should improve your quality of life, not leave you suffering. Loss of erections after a procedure can feel devastating, but please know there are options to help. Treatments like oral medications, vacuum devices, or even injections can restore erectile function for many men. It’s important to talk openly with your urologist so they can assess your unique situation and recommend solutions tailored to you. You can also check out my new erectile mastery course for 20% off with the code yourology.

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!

I have some really exciting news—and you’re the first to hear it! We’ve officially finalized the title of my upcoming book: The Hard Truth, and it will be released on September 1st. I can’t wait for you to read it!

I tackled the intriguing topic of why testicle pain can sometimes feel good, and how our bodies and brains process these intense sensations. "Your brain doesn't have like two separate filing systems, one for pain and one for pleasure. Both... activate similar brain regions, and both can trigger a dopamine release."

Here are some quick takeaways:

Remember, "cock and ball torture or ballbusting is adult sexual expression, and as long as it's done consensually, safely, and you know the risks, it is okay to continue."

Check out the full episode for practical tips and safety advice!

I had an eye-opening conversation with Dr. Scott Eggener all about prostate cancer—how to prevent it, understanding screening, and what really matters when you hear the word “cancer.” His goal? To make it less scary and more manageable for everyone. "The great news is almost everyone diagnosed with prostate cancer, it will not be a long-term problem for them."

Some quick takeaways:

If you want more peace of mind about prostate health, definitely give this episode a listen!

So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “I normally don't comment on your podcasts but this one was really interesting and informative. I really enjoyed the conversation, depite the scary topic.”

Curious whether an ancient herb can really boost libido and testosterone? Check out my new Substack: Ashwagandha and Sexual Health: Does This Herbal Remedy Really Boost Libido and Testosterone?

In this article, I outline what the science actually says about ashwagandha’s effects on stress, testosterone, and sexual function—and who should (and shouldn’t) consider using it—based on the research and my experience as a urologist.