Can your mind alone improve erectile dysfunction—even without real medication?

This large meta-analysis reviewed 63 randomized trials with over 12,000 men taking PDE5 inhibitors (like sildenafil) or placebo. Surprisingly, men in the placebo groups still showed real, measurable improvement in erectile function, with a small-to-moderate effect size.

The effect was even stronger in men with PTSD-related ED, suggesting psychological factors play a major role. Medications still worked best overall, but this study highlights something critical: expectation, mindset, and context can significantly influence sexual function.

Key takeaway: PDE5 inhibitors remain effective, but their benefit is not purely physical. In certain groups—especially psychologically driven ED—belief and mental state may be just as powerful as the drug itself. This challenges how we approach treatment and suggests we may be underestimating the role of the brain in sexual health.

Why is female sexual dysfunction still so misunderstood—even in healthy women?

This paper set out to answer a basic but overlooked question: how common is female sexual dysfunction (FSD), and who is most at risk? Instead of focusing only on patients with illness, the researchers designed a large systematic review of studies from general populations across multiple countries.

What stands out is how inconsistent the field still is. Earlier studies showed wide ranges—for example, sexual arousal issues alone varied from 11% to 48%—largely because definitions and measurement tools were not standardized. At the same time, several key predictors repeatedly appeared: age, relationship status, physical health, mental health, and socioeconomic factors all play a role.

The most meaningful takeaway isn’t a single “cause,” but a pattern: FSD is multifactorial, shaped by both body and life context—not just biology.

In real-world terms, this means treating sexual dysfunction isn’t about one pill or fix. It requires looking at overall health, emotional well-being, and relationships together. The urgency? Even now, we still lack consistent tools to fully understand how many women are affected—and why.

This week, someone asked me, “Is there such a thing as too sexually active? I'm 63, have seen symptoms of enlarging prostate both in bladder retention and in occasional pains, which I've had tested extensively, I'm now on prostate shrinking medicine one tab a week. My question is, could my over active sex drive (ok , five times a day) be harmful to my prostate?”. Being sexually active—even frequently—is generally not harmful to the prostate; in fact, regular ejaculation may reduce your risk of prostate cancer. Your prostate symptoms are more likely related to enlargement, not activity level. Listen to your body, stay well hydrated, and continue working with your urologist to manage symptoms comfortably.

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!

This last week has been quite a challenge for me! I got incredibly sick last weekend and spent most of the week recovering. Thankfully, I’m on the mend now and back at it! All of you, my community, keep inspiring me to continue creating educational content for all of you!

Also, I don’t often tell you to pre-order a book. But I’m telling you to pre-order this one. Cynthia Thurlow, NP just released her new book The Menopause Gut, and I genuinely believe this is one of the most important women’s health books to read this year. If you’re in perimenopause or menopause — or approaching it — this book gives you real clarity about what is actually happening in your body and what to do about it.

Cynthia is a nurse practitioner, 2x TEDx speaker with over 15 million views on her second talk, and host of the Everyday Wellness™ podcast. She’s been featured on Good Morning America, Good Day New York, USA Today, ABC, and The Megyn Kelly Show.

What makes this book different is that she doesn’t just describe symptoms. She explains the mechanism: how declining estrogen reshapes the gut microbiome, drives inflammation, and causes the cascading symptoms most women blame on everything but the real root cause.

Inside, she breaks down:

Pre-order your copy of The Menopause Gut and secure your $338 bonus stack — including the Video Masterclass Series, Why the Gut Matters in Midlife Guide, and Gut Health Symptom Checklist.

If your health is even slightly on your radar this year, this book belongs in your hands.

P.S. The pre-order bonuses disappear once the book officially releases on April 28.

I dove into some really weird and unexpected things that can happen during orgasm—stuff like sneezing, crying, foot pain, or even suddenly laughing! "Orgasm is like hijacking your entire involuntary nervous system for a short period of time."

Here are some quick takeaways:

If you’ve ever thought you were alone or worried about these strange sensations, know that you’re not. Check out the full episode if you want to understand the science behind it and feel reassured!

I had the best conversation with Sue Goldstein about sex, aging, and why women shouldn’t be embarrassed to talk about pleasure—or get help when things change. At 76, Sue’s living proof that good sex doesn’t have an age limit! She explained “It is your choice whether you want to have sex or not. It is our jobs to help people who want to have sex who can’t be able to have sex.”

Here’s what stuck with me:

Let’s keep breaking the silence—our bodies, our pleasure! So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “I really enjoyed this conversation with Dr. Sue Goldstein. Over 50 yrs of marriage & still enjoying sex at 76 yrs old. Keep up your great work sexual education videos”.

Why does the skin ‘down there’ look darker—and should you be worried? Check out my new Substack: Why Your Genitals Are Darker Than the Rest of Your Skin—and Why That’s Totally Normal.

In this article, I break down the real reasons behind genital skin changes—from hormones to everyday friction—when it’s completely normal, when to get it checked, and how to care for your body without chasing unrealistic standards.