What if waiting to treat erectile dysfunction after prostate surgery is the real mistake?

This randomized clinical trial followed 120 men in South Korea who had good erections before nerve-sparing robotic prostate surgery. Researchers compared two approaches using the same medication and dose: sildenafil 100 mg twice weekly for 3 months, started immediately after surgery, versus the same regimen delayed until 3 months after surgery.

By 12 months, 41% of men who started sildenafil early regained full erectile function, compared with only 18% in the delayed group. Starting treatment early made men nearly three times more likely to recover erections strong enough for sex. Importantly, early treatment also improved real-world outcomes, like the ability to get and maintain erections during partnered sex, without increasing side effects.

Why does timing matter? The early weeks after surgery are when penile tissue is most vulnerable to low oxygen and scarring. Early sildenafil appears to protect that tissue during nerve recovery, while waiting may allow lasting damage to set in. The takeaway is clear and clinically meaningful: the same drug, at the same dose, works far better when started earlier. For men facing prostate surgery, timing might make or break your long-term sexual recovery.

What actually happens when women are given testosterone—and who truly benefits?

This paper closely examined the safety and effectiveness of testosterone therapy in women, reviewing clinical trial data focused on sexual health outcomes and side effects. The study primarily evaluated postmenopausal women, including those who had undergone surgical menopause, and assessed low-dose testosterone therapy, most often delivered transdermally, as a gel. The main outcome measured was improvement in sexual desire, arousal, and satisfaction, alongside careful tracking of adverse effects.

The most consistent finding was clear: testosterone modestly but meaningfully improved sexual desire in women with low libido, especially those diagnosed with hypoactive sexual desire disorder. Women receiving testosterone reported more satisfying sexual experiences and increased sexual thoughts compared to placebo. Importantly, low-dose testosterone gel showed benefit without major short-term safety concerns. Higher doses or non-physiologic formulations did not show added benefit and raised more side effect concerns.

Clinically, this matters because it supports a narrow, targeted use of testosterone—not as a general wellness hormone, but as a specific treatment for carefully selected women. One caveat: long-term safety data are still lacking, especially for cardiovascular and breast health.

Bottom line: testosterone can help—but only when used cautiously, at the right dose, and for the right reason.

This week, someone asked me, “My partner has had a radical prostatectomy and suffers from ED. We have been using a vacuum pump to obtain erections in order to have intercourse. I am wondering how effective Cialis is for post prostatectomy patients. Can it be used in addition to the vacuum pump? Thank you for your consideration”. After a radical prostatectomy, erectile dysfunction is common, and it’s perfectly reasonable to combine Cialis (tadalafil) with a vacuum erection device—doing so can improve the chances of success, as both work differently to support erections. Many men find this combination helpful, and Cialis is safe to use post-surgery if prescribed, unless there are specific health issues that may contraindicate it. It’s important that your partner discusses dosing and timing with his urologist to ensure safety and the best results for both of you.

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’m genuinely excited to share something from my good friend Dr. Gabrielle Lyon. Her new book, The Forever Strong PLABOOK, reframes health through a Muscle-Centric lens. It’s not about punishment or perfection. It’s about understanding how building and maintaining muscle changes how you feel, how you think, and how your body responds to effort over time.

What I appreciate most is how practical and grounded this book is. It doesn’t just explain what to do. Her 6-week plan helps you apply these principles in real life, especially when things aren’t ideal.

The book is currently available for pre-order, and she’s offering over $400 in additional bonuses, including a six-week group challenge starting February 15 to help people actually implement what they’re learning. Learn more at https://drgabriellelyon.com/playbook/

I sat down to talk about why so many men struggle with finishing too soon in bed and shared simple, proven ways to help improve sexual stamina. "Doing breathing exercises can help you last longer by 900%."

Here are some quick takeaways:

Just know, "This isn’t just about how long you last, it is about how this affects your mental health." Consistency and patience really matter, and you absolutely deserve to feel confident and in control.

Check out the full episode for more tips and encouragement!

I had a really enlightening conversation with Dr. Frankie Bashan about modern dating, relationships, and why love is more complicated than ever. As Dr. Frankie put it “It’s because we have these unrealistic ideals…and we think we know what we want because social media and society tells us you deserve it. You deserve the best. Don’t settle for anything less.”

Here are three quick takeaways:

We even got into topics like attachment styles, honest communication, and tips for spicing things up in the bedroom. If you’re dating or in a relationship, this one’s for you!

So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “This was incredibly interesting. I almost scrolled past it because of the duration. Thank you.”

Struggling to “finish” even when everything else seems fine? Check out my new Substack: Why Can’t I Finish? Demystifying Delayed Ejaculation—and How to Reclaim Your Sex Life

In this article, I break down the real reasons delayed ejaculation happens—psychological, hormonal, and neurological—and share practical, evidence-based strategies for men and their partners to restore intimacy and confidence.