MEN’S YOUROLOGY

Ever wondered which premature ejaculation treatments actually work—and which ones are just hype?

This umbrella review looked at 65 randomized controlled trials and compared different meds like SSRIs (paroxetine, dapoxetine), tramadol, topical anesthetics, and even sildenafil. The best performer in prolonging ejaculation time? Paroxetine, which added over 5 minutes on average. But every treatment had side effects—topical anesthetics and paroxetine had the lowest risks, while others like tramadol and dapoxetine came with more. And here’s the catch: most of these studies were short-term and not high-quality.

If you're struggling with PE, knowing what’s actually effective (and safe) can help you talk to your doctor about better options. Not all treatments are created equal.

WOMEN’S YOUROLOGY

Did you know your pelvic floor might affect blood flow to your clitoris?

This study looked at sexually active women without any sexual dysfunction to see if clitoral blood flow changes when pelvic muscles contract. Using Doppler ultrasound, researchers found that clitoral blood flow significantly decreased during pelvic floor muscle contraction compared to a relaxed state. The stronger the pelvic pressure, the lower the blood flow velocity. This suggests your pelvic floor tone could directly impact arousal—even in women with no reported issues.

Why does this matter?

Because stronger pelvic floor muscles might mean more arousal, and ultimately more pleasure.

This week, someone asked me, “With over active bladder, does eating or drinking bladder irritants have a short or long term effect ie is it hours or days?”. Many people wonder if things like caffeine, alcohol, spicy foods, or citrus will set them off right away or create lasting issues with their bladder. The truth is, most bladder irritants act pretty quickly—often within a few hours of eating or drinking them, you might notice more urgency or the need to run to the bathroom more frequently. However, these effects are generally short-term and tied to recent intake, not something that builds up over days. If you cut out an irritant, your symptoms should improve within a day or so, and if you reintroduce it, they can flare up again just as quickly. The key is to pay attention to your own body and see which foods or drinks bother you, then limit or avoid them if you notice problems. Remember, everyone’s bladder is a little different, so it’s about finding what works for you—and don’t be too hard on yourself as you go through the process.

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

We’re working on something exciting: a brand-new course on Erectile Dysfunction and Testosterone – and we want you to help shape it!

Join the waitlist by answering these short survey forms:

• 👉 ED Course Survey Link

• 👉 Testosterone Course Survey Link

Your responses will help us create a course that’s not only informative and practical, but also tailored to exactly what you want to learn.

Also, if you haven’t seen it yet, I’ve started a Substack where I dive into the topics I’m most passionate about—urologic and sexual health, backed by science and delivered with clarity.

My latest post is live:

• 👉 5 Surprising Facts Every Man (and Woman) Should Know About the Prostate—From a Urologist

You can also subscribe to get future articles straight to your inbox: https://renamalikmd.substack.com/

HIGHLIGHTS FROM MY CHANNEL

Today, Eric Leckie and I tackled a really practical topic for men—how to actually do Kegel exercises to help with things like erections, lasting longer, and better bladder control. Quote: "You guys might have heard about Kegel exercises, but how exactly do you do one?... In this video, we're talking about Kegel exercises for men. Yep, you guessed it. They aren't just for women."

Here are some quick takeaways:

• Kegels strengthen your pelvic floor muscles—important for sexual health and bladder control.

• Consistency is key: it’s just like any other exercise, so stick with it even if results take time.

• They can help with erectile dysfunction, premature ejaculation, and post-prostate surgery issues.

If you want to learn the step-by-step basics and see how these simple exercises can make a big difference, be sure to check out the full episode!

HIGHLIGHTS FROM MY PODCAST

I had an amazing conversation with Dr. Ian Kerner all about what it really takes to have good sex and keep the spark alive in a relationship. Dr. Kerner is a nationally recognized sex therapist, and he brought so many practical tips to the table. For example, he shared “I like to say that foreplay can be core play. There have been studies that have shown that women can fantasize their way to orgasm without ever touching themselves and give themselves hand-free orgasms.”

Here are a few key takeaways:

• Talk honestly about sex—even if it feels awkward at first.

• Focus on turning off your thinking brain and really getting absorbed in the moment.

• Don’t underestimate the power of fantasy, psychological arousal, and foreplay.

Want to upgrade your sex life? Start by talking openly and embracing a little creativity! Listen on Apple Podcasts, Spotify, or here and see why people are commenting, “Great episode! I really enjoyed Rena’s questions and what Ian had to say.👏”