Platelet-Rich Plasma for Erectile Dysfunction: Does the Science Match the Hype?

PRP injections are widely marketed as a “restorative” treatment for erectile dysfunction—but do they actually work?

This study put that question to the test using a gold-standard design: a prospective, randomized, double-blind, placebo-controlled trial conducted at the University of Miami. Sixty-one men with mild to moderate erectile dysfunction received either two intracavernosal PRP injections or placebo injections, spaced one month apart, and were followed for up to six months.

While erectile function scores improved over time in both groups, PRP did not outperform placebo at any point. About 58% of men in the PRP group and 54% in the placebo group reached a clinically meaningful improvement one month after treatment—essentially the same outcome. Penile blood flow measurements also showed no meaningful changes with PRP compared to placebo, and no major safety concerns were identified.

Key takeaway: This specific PRP protocol—two injections of 5 mL, one month apart—was safe but offered no added benefit beyond placebo. For patients and clinicians, this study raises an urgent and important point: despite strong marketing claims, PRP for erectile dysfunction still doesn't clearly improve erections in a meaningful way. More research is needed.

Mirabegron for Overactive Bladder: Does It Actually Work—and Is It Safe Long Term?

For years, overactive bladder treatments called anticholinergic medications have worked, but often at the cost of dry mouth, constipation, and people simply quitting them. This large integrated analysis asked a simple but important question: Can mirabegron (a different type of bladder medication) improve bladder symptoms without those trade-offs?

Researchers pooled data from a large clinical trial database that included thousands of adults with overactive bladder, comparing mirabegron (a beta-3 agonist) with placebo and older drugs. Across studies, mirabegron consistently reduced urgency episodes, daily urination frequency, and urge incontinence, with improvements that were both statistically and clinically meaningful. Importantly, these benefits were seen without increasing classic side effects like dry mouth or constipation.

The most meaningful finding was safety. Even at the commonly used 50 mg dose, mirabegron showed a low rate of serious adverse events, minimal effects on heart rate and blood pressure, and good tolerability over time. This means more patients are likely to stay on treatment long enough to benefit.

This analysis supports mirabegron as an effective, better-tolerated option for overactive bladder—especially for patients who cannot tolerate or have failed traditional therapies.

This week, someone asked me, “Dr.Malik, With my 1.97-inch erect penis at the age of 50 years, do I have any hope of satisfying and satisfying sex with my girlfriend or wife? Are there any women who no problem, willing to accept and love me with my micropenis?After just 10 seconds of masturbation, I already ejaculated. Can my premature ejaculation be eliminated so I can enjoy sex as long as I want?”. Many men worry about penis size and lasting longer, but truly satisfying sex is about intimacy, communication, and finding what feels good for both partners. The clitoris is the most reliable route for orgasm for women, so if you can prioritize offering pleasure to women using other means like oral or manual stimulation, or even using toys in the bedroom. Many women value connection far more than size, and solutions for premature ejaculation exist—simple exercises, therapy, or medication can help you last longer. Check out my podcast on this topic here!

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’ve been cherishing quality time with my family over the holidays. We just celebrated my mother’s 75th birthday, and I’m so grateful for my parents’ health and happiness as they continue to age gracefully.

I had a super honest chat about everyday habits that could permanently shrink your penis—and how easy it is to protect yourself. "The top six things you have to stop doing to prevent penile shrinkage."

Here are some quick takeaways:

Check out the full episode to learn exactly what you can do to protect your health and feel confident!

In my latest AMA episode, I break down some intimidating topics in such a clear, approachable way! Whether it’s testosterone therapy, urinary leakage, or ED testing, “I think it’s very safe...but just like anything else, it needs careful monitoring and is very safe. It does not cause prostate cancer.”

A few quick takeaways:

Loved this episode! So listen on Apple Podcast, Spotify, or here and see why people are commenting, “15:03 I like the way you include the background info like this. Makes the videos so interesting and worth watching even when I don't have any of the conditions (yet...)”.

Ever wondered if foreskin restoration is actually possible—or just internet myth? Check out my new Substack: Can You Restore Your Foreskin? The Science & History Behind Modern Solutions

In this article, I explore the real history of foreskin restoration, what modern science actually supports, and the key facts every man should understand before considering surgical or non-surgical options.