MEN’S YOUROLOGY

Why do some men struggle to reach orgasm during partnered sex—even when everything seems fine physically?

This study takes a close, honest look at why some men have trouble reaching orgasm during partnered sex, and the results are surprisingly relatable. Among 351 men, the most common reasons weren’t medical problems at all, and they were the emotional ones. About 66% said stress, worry, or simply being too distracted played a major role, and more than 40% chose anxiety as their biggest reason. Nearly half also mentioned that the stimulation they got, whether physical or mental, just wasn’t enough to help them “build up” to orgasm.

Relationship and medical factors ranked surprisingly low. Only 19% pointed to relationship issues, and 17% to medical or medication-related causes. And interestingly, most men who struggled with a partner had no trouble reaching orgasm during masturbation. That gap raises important questions about comfort, pressure, and how different sexual settings affect the body. This study is a reminder that sexual difficulties are often rooted in everyday feelings and experiences, and understanding these patterns could help men and couples approach the issue with more clarity and less shame.

WOMEN’S YOUROLOGY

We often talk about how men’s sexual issues affect women—but what about the other way around?

This systematic review takes a deep look at how a woman’s sexual difficulties can affect her male partner, something many couples quietly experience but rarely talk about. After screening more than 8,000 studies, the researchers included 26 studies from 16 countries, covering over 15,000 participants. And the findings shows that men, partnered with women who have diagnosed female sexual dysfunction (FSD), were three times more likely to develop their own sexual difficulties.

The pattern was especially clear for erectile and ejaculatory concerns. The risk of erectile dysfunction increased almost 4x, while premature ejaculation was about twice as likely in men whose partners were experiencing issues such as pain, low desire, or problems with arousal or orgasm. Interestingly, not all sexual areas were consistently affected—desire and orgasm on the male side showed mixed results, suggesting these relationships are complex and influenced by many everyday emotional and relational factors.

What this review makes unmistakably clear is that sexual health is rarely an individual issue—it’s a shared experience. And recognizing these patterns may help couples and clinicians move toward more open, compassionate, and effective approaches to care.

This week, someone asked me, “I don't feel pleasure after orgasm i dont know why? I don't have ED or premature ejacultion issue but when i reach climax i dont feel that pleasure of orgasm How do i over come this? I am worried about it”. It’s completely understandable to feel worried when orgasm doesn’t bring the pleasure it should, and this happens more often than people realize. When climax feels “flat,” it can come from stress, medication side effects, low testosterone, pelvic floor tension that dampens sensation, emotional disconnection, or even focusing too much on performance. A good first step is getting your hormones checked, reviewing medications, and considering pelvic floor therapy. Also, try experimenting with new sensations or positions, and communicate openly with your partner. With the right evaluation, this is absolutely something we can improve.

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

✨ My New App Is Officially LIVE, and It’s 20% Off Until Black Friday only!

I’m so excited to finally share something I’ve been working on for over a year, The Better Sex App, your personalized, science-backed program for sexual health. It’s everything I teach in the clinic, on YouTube, and in my research… now in one place, with daily lessons, smart tracking, and an AI coach trained on my real clinical guidance.

Whether you’re looking to improve ED, boost libido, ease performance anxiety, or strengthen communication, the app creates a custom plan built just for you.

To celebrate launch week, you can get 20% OFF, but only until Black Friday. If you’ve been wanting structured, evidence-based support built by a board-certified urologist… now is the time.

Start your personalized plan here for 20% off!

HIGHLIGHTS FROM MY CHANNEL

In this video, I talked about a pretty surprising topic, using Botox (yes, the wrinkle treatment!) as a potential option for men struggling with tough-to-treat erectile dysfunction (ED). "Botox for erectile dysfunction is showing promise in clinical trials. Response rates range from 40 to 77%, depending on how severe your ED is to start."

Here are some quick takeaways:

• Botox works by relaxing the smooth muscle in the penis, which can help improve blood flow.

• It’s not FDA approved for ED yet and isn’t covered by insurance, it’s still considered experimental.

• It seems very safe, with minimal side effects, but you’ll need repeat treatments.

If you’ve tried everything else for ED, this could be worth discussing with your urologist as a possible option before more invasive procedures. Always talk to a doctor to see what’s best for you!

HIGHLIGHTS FROM MY PODCAST

This is a very eye-opening talk with Dr. Ken Hanson about sex dolls, AI chatbots, and how this new tech is quietly changing relationships and intimacy. You’d be surprised, Dr. Hanson points out these aren’t just for lonely single folks! He shared, “When that thing is able to return some semblance of emotional connection, romantic connection, sexual connection, it’s only going to further enhance those feelings.”

Here are a few things that stood out:

• Many sex doll users are actually married or in relationships.

• AI chatbots and dolls can help fight loneliness but aren’t a substitute for real-life connections.

• Most people use these technologies because they genuinely enjoy them.

Curious how this will shape the future of relationships? Give it a listen on Apple Podcasts, Spotify, or here and see why people are commenting, “Thanks for the video! It's good that YouTube videos like these open up on the taboo of Sex Dolls and hopefully make it something we can openly talk about; no matter if it is to support it or not support it.”.

NEW MEDIA

Curious if L-arginine can actually improve erections?

Check out my new Substack: Can L-Arginine Really Improve Erectile Dysfunction? Evidence-Based Insights from a Urologist. I break down what the science really says about this popular supplement, how it works, and why managing your overall health is the key to better sexual function.