MEN’S YOUROLOGY

Nearly 4 in 10 young men had erectile dysfunction, is anyone talking about this?

I reviewed this 12-page cross-sectional study of almost 200 men aged 20-40 in Saudi Arabia, and the findings were pretty surprising. Almost 40% met criteria for erectile dysfunction, a prevalence much higher than what has been reported in similar age groups worldwide. And this wasn’t just mild difficulty, the study captured the full spectrum, from mild to severe ED. What stood out most was how strongly psychosocial factors shaped sexual function. Men who screened positive for depression had dramatically lower erectile function scores, an average IIEF drop of 12.6 points, even after adjusting for age, BMI, income, and health status. Lower income and unemployment also showed clear associations with worse sexual function.

This study is a reminder that erectile dysfunction in younger men is both common and deeply intertwined with emotional and socioeconomic stressors. It raises an uncomfortable but important question: Are we paying enough attention to the mental and social drivers of sexual health in young men?

WOMEN’S YOUROLOGY

Can mindfulness really change sexual functioning?

This systematic review takes a careful look at 11 clinical studies, spanning women with low desire, arousal problems, pain disorders like provoked vestibulodynia, and even men with situational erectile dysfunction or compulsive sexual behavior. Across these diverse groups, a consistent pattern emerged: mindfulness-based treatments often led to meaningful improvements in sexual symptoms.

In women, several studies reported increases in sexual desire, arousal, lubrication, satisfaction, and overall sexual function after just a few sessions of mindfulness-based cognitive-behavioral therapy. It seems that being mentally aroused while being physically aroused was an important marker for women who feel disconnected from their bodies during sex.

Benefits were not limited to women. Men with situational erectile dysfunction reported better erectile function and higher sexual satisfaction six months after a mindfulness-integrated program. And in a small pilot group of men with compulsive sexual behavior disorder, mindfulness-based relapse prevention significantly reduced problematic pornography use and emotional distress. This data suggests mindfulness may be a powerful, underused tool for improving sexual wellbeing by helping individuals reconnect with their bodies in safer, more attuned ways.

This week, someone asked me, “Hello Dr Malik, You do great work, thank you! I have a question regarding oral sex (on a man) followed by intercourse for a heterosexual couple. Since we have lots of bacteria in our mouths, does this practice cause any concerns or risks with regards to women's sexual health? Sincerely, Georges”. Performing oral sex on a man followed by vaginal intercourse is generally safe, but it can carry a small risk of transferring any sexually trasmitted infections from the mouth to the genitals. If you're using barrier protection or in a monogomous relationship where both partners have been tested, nothing to worry about.

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

I recently joined Holly Randall on Holly Randall Unfiltered for a truly honest, sex-positive conversation about one of the biggest questions men have: “Is my penis normal?” We talk about what real erections, libido, orgasms, and penis size look like—far beyond what you see online.

We also clear up common myths around “porn addiction,” blue balls, semen retention, and more, all in a judgment-free, educational way. If you want straightforward answers about your body and your sexual health, watch it now here.

HIGHLIGHTS FROM MY CHANNEL

I had a really interesting chat about how often you ejaculate can actually lower your risk of prostate cancer, it’s more important than you might think! “Guys who ejaculated 21 times or more per month had a lower risk of prostate cancer compared to those who ejaculated four to seven times per month.”

Here are some quick takeaways:

• Ejaculating more often may help reduce your risk for prostate cancer.

• Cleaning out the pipes (your prostate) regularly could lower inflammation and cancer risk.

• This is just one piece of the puzzle; diet, exercise, and screenings still matter!

Remember, this isn’t a magic fix, but it’s an easy habit that could support your health. For even more tips, check out the full episode!

HIGHLIGHTS FROM MY PODCAST

In my latest AMA, I tackled some really common questions about sexual health, wet dreams, and even how to stay fresh “down there.” “Sex is supposed to be fun. If you want to explore different parts of your body, by all means you should do it safely, do it consensually, and use lots of lubricant.”

Here’s what stood out:

• Anal play? Start slow, use proper toys, and communicate.

• Wet dreams are totally normal for teens (nothing to worry about!).

• Stay fresh by wearing cotton underwear and using safe powders.

In this conversation, I keep everything simple and real—don’t miss this episode. So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “Need a doctor like her to help out..❤❤❤❤”.

NEW MEDIA

Worried sex could trigger a heart attack? Check out my new Substack: Can Sex Give You a Heart Attack? What You Need to Know—From a Urologist’s Perspective

In this article, I break down the science behind sex and heart risk, explain who really needs caution, and share practical tips to stay safe, so you can enjoy intimacy without unnecessary fear.