MEN’S YOUROLOGY

Did you know that urinary issues in older men may be more closely tied to their sex life than we thought? This massive study surveyed over 12,000 men aged 50–80 across the US and Europe to understand the link between lower urinary tract symptoms (LUTS) and sexual dysfunction. The results were striking: 90% of men reported urinary problems, but only a small fraction had sought help. Also, having more severe urinary symptoms was a risk factor for more frequent sexual problems like erectile difficulties and painful ejaculation. Even after accounting for other health issues like diabetes or heart disease!

Urinary symptoms and sexual dysfunction are connected because they share the same anatomy, nerves, and blood vessels in the pelvic area. Basically, when the prostate enlarges with age or other health problems develop, it can disrupt multiple systems at once, affecting both bathroom and bedroom function. Changes in urination might not just be annoying, they might be a sign that sexual problems may follow.

WOMEN’S YOUROLOGY

Have you ever wondered why some women struggle with low sexual desire even when everything else seems “normal”? This review dug into the science and found that serotonin (the brain chemical we usually link to happiness) can actually dampen sexual interest by overactivating inhibitory pathways and muting dopamine’s excitatory effects. Researchers reviewed multiple drugs designed to rebalance these signals, but so far only flibanserin has been approved to treat hypoactive sexual desire disorder (HSDD). Its unique approach works by dialing down serotonin’s brakes while boosting dopamine and norepinephrine, restoring sexual motivation.

Why does this matter?

Because low desire isn’t always “in your head”, it can be deeply tied to brain chemistry, and this research shows us just how important neurotransmitters are in women’s sexual health.

This week, someone asked me, “I'm 48 and had a stroke back in February 2025. I'm also a type one diabetic. My problem is when I ejaculation there isn't any semen. One of my medcations is clomid and the was prescribed by an urologist. When will I able to start seeing semen again? Thank you.”. Given your age, history of type 1diabetes, and recent stroke, it’s not uncommon to see changes with ejaculation, including little or no semen coming out. Medical issues like this can affect the nerves and muscles involved in ejaculation, sometimes causing what’s called retrograde ejaculation, where semen goes into the bladder instead of out, or even a complete lack of ejaculation (anejaculation). Medications like clomid generally don’t cause this issue, but other medications or the underlying health conditions might play a role. There’s no guaranteed recovery, especially with combined neurologic and metabolic issues.

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 Dr. Mike Israetel on his channel for a thought-provoking episode, The Rise of Modern Porn – Is It a Real Problem? We dug into the impact of modern porn, shifting cultural norms, and how technology is shaping conversations around sex and relationships. This is the first in a series of interviews we’ll be doing together on his channel, so stay tuned for more deep dives on important topics.

Also lately, I’ve been working on creating lots of new short-form videos you’ll soon see on YouTube, Facebook, Instagram, TikTok, X, and LinkedIn! I even filmed some fun content with my 9-year-old son, so keep an eye out for that.

If you come across a video you’d like me to react to, you can share it with me here.

HIGHLIGHTS FROM MY CHANNEL

Here's a quick and easy breakdown for anyone struggling to last longer in bed—or supporting someone who is! “Doing diaphragmatic breathing is likely going to help men last longer in bed, specifically if you incorporate doing these behavioral exercises as well as potentially pelvic floor muscle strengthening at the same time.”

Here are some key takeaways:

• Simple breathing exercises can help you last minutes longer in bed—no pills or sprays needed.

• Adding breathing to pelvic floor exercises and behavioral methods works even better.

• You have more control over your sexual health than you think, and these tips are free and easy to try at home.

Remember, your confidence and enjoyment matter! Check out the full episode for all the details and step-by-step tips.

HIGHLIGHTS FROM MY PODCAST

I break down the real science behind female pleasure—honestly, it was eye-opening and super easy to follow! “The clitoris has more nerve endings dedicated purely to pleasure than any part of your body… It’s actually the main event.”

Practical tips:

• Focus more on the clitoris—it's designed only for pleasure!

• Foreplay and communication are key (aim for 30–45 minutes together).

• Don’t stress about chasing the “G spot” or squirting—what matters most is enjoying the moment.

Give it a listen if you want to feel confident and actually understand female anatomy! So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “Best sexual advice i needed 20 years ago, tg for the internet. Love your work, Doc ❤”.

NEW MEDIA

Noticing changes ‘down there’? Wondering if penises really shrink with age? Check out my NEW Substack: Are Penises Really Shrinking? What Every Man Needs to Know About Aging and Sexual Health.

In this article, I break down the science of penile changes over time, what’s normal, what’s not, and the smart habits every man can adopt to protect his sexual health.