Can Regenerative Therapy Really Fix Erectile Dysfunction?

For years, ED treatments like pills and injections have only relieved symptoms without fixing the root problem. This global survey looked at something newer: regenerative therapy, which aims to repair damaged tissue. Researchers gathered answers from 479 doctors across 62 countries, making it the largest survey of its kind on this topic.

About one in three doctors said they already use regenerative therapy for their patients. The clear favorite was low-intensity shock wave therapy, used by over half of them, followed by platelet-rich plasma injections, with a combination of both coming in third. Doctors reported that patients with blood-flow-related ED and mild-to-moderate cases responded best, especially younger and middle-aged men.

So which treatment actually works best? Shockwave therapy came out ahead, with the most supporting evidence and doctors most confident in its safety. Platelet-rich plasma showed promise too, but experts stressed it should still be considered experimental and used mainly in clinical trials. Stem cell therapy was used the least, likely due to its high cost and limited availability, and remains firmly in the research stage.

Despite the encouraging results, most patients didn't reach dramatic improvement, and doctors still aren't sure how long the benefits last. We still need bigger, well-designed studies needed before regenerative therapy can become a standard, trusted option. The full paper breaks down even more surprising details about what's really driving doctors' decisions.

Can Treating Bladder Problems Also Improve Your Sex Life? A New Review Says Yes.

Millions of women silently struggle with both overactive bladder (OAB) and sexual problems—and new research shows these two issues are more connected than most people realize. This review found that about 1 in 4 women deal with both conditions at once, and the number is likely higher since many women don't speak up. Fear of leaking, embarrassment, and anxiety during intimacy were common reasons women struggled with arousal and orgasm. The problem also gets worse after menopause—86% of postmenopausal women with OAB were at risk for sexual dysfunction, compared to 66% of younger women.

Here's the encouraging part: every major OAB treatment reviewed, from pelvic floor exercises to medications to nerve stimulation, improved sexual function too, with no harmful side effects. One standout comparison found that beta-agonist medications outperformed anticholinergic drugs, which tended to dry out tissue and lower arousal.

The takeaway? Treating your bladder might do more for your bedroom than you'd expect. Curious which treatments made the biggest difference? Read the full study for the details.

This week, someone asked me, “Recently went to the urologist for a check up and ask for a testosterone gel subscription. He told me my testosterone level was 499 and he didn't want to write the script. Said I didn't need it. I told him I feel better and sleep better when I use it. He finally wrote the script. I am wrong about this?”. A testosterone level of 499 ng/dL is generally considered within the normal range, so based on current guidelines, testosterone therapy usually isn’t recommended unless you have both consistently low testosterone levels and symptoms of deficiency. Levels can be difficult to interpret as we don’t have personalized testing and we don’t know what your individual testosterone should be or what it was at its peak. Also, I would want to evaluate your free testosterone as well to get a better idea of your testosterone. It’s important to make sure you’re fully aware of the risks of testosterone replacement, including effects on fertility, red blood cell counts, and the prostate, and to fully look for other possible causes of your symptoms, such as sleep issues, stress, depression, or other medical conditions.

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 am back to work! Seeing patients and starting to get geared up for my big book launch in November. I start radiation next week, which I am not looking forward to, and my husband started chemotherapy, and he’s having a lot of side effects. It’s been hard but I’m trying to stay optimistic.

I talked to a patient yesterday who was lamenting that he wished he had picked a different treatment option for prostate cancer, and I told him something that I think everyone should know. When you are making difficult health decisions - you do the best you can with the information you have. You are in a stressful situation, and you can’t predict the future. If you had picked an alternative, you could have had a better or worse outcome, but there’s no way to know, so you have to give yourself grace.

Even for me, during this time, I second-guess myself and spend a lot of time thinking about whether I’m making the right decision for my future, my health, and my husband’s health. So I’m trying to give myself grace and trust that I’m making the best decisions I can with the information I have.

Let’s talk about some surprising ways you might be harming your penis without even realizing it! As I always say, "Your penis is a biomarker of your overall health," which means keeping it healthy goes way beyond just sex.

Here are some quick takeaways

Take care of your whole body, and your penis (and overall health) will thank you. For more simple tips you can use right now, give the episode a listen!

I had an eye-opening discussion with top kidney stone experts about what really causes kidney stones, how to prevent them, and the latest treatments. "If you can keep the urine dilute enough, those salts don’t crystallize out."

Some super simple takeaways:

And yes—common “remedies” like lemonade or crazy internet hacks? Most aren’t proven, so stick with what works and always talk to your doctor!

Curious about smart toilets for stone prevention? That might be the future. So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “finally a video on kidney stones”.

Want to last longer in bed? Check out my new Substack: Want to Last Longer in Bed? Here’s What Science Says.

In this article, I break down what really causes premature ejaculation and share evidence-based strategies that can help improve control, confidence, and sexual satisfaction.