MEN’S YOUROLOGY

Have you ever thought about how sexual dysfunction impacts relationships? This study looked at 723 men with partners and found that more than half felt their condition was hurting their relationship, especially those dealing with premature ejaculation (83%), followed by erectile dysfunction, low testosterone, and Peyronie’s disease. Surprisingly, men in longer relationships and those with better sexual function were more likely to say their relationship was suffering. Basically, the more sudden the change the bigger the emotional toll.

Sexual health issues can deeply affect intimacy and connection. If you’re struggling, you owe it to yourself and your partner to get help.

WOMEN’S YOUROLOGY

Did you know that not all women with low desire, arousal difficulties, or even pain during sex feel bothered by it? This systematic review of 19 studies found that distress is more likely when these issues are severe, paired with anxiety or depression, sexual dissatisfaction, poor communication, or when a partner is also unhappy or distressed about sex.

Why does this matter? Because sexual problems aren’t always “problems” unless they cause distress.

This week, someone asked me, “What's symptoms do you experience with tight kegel muscles?”. When your pelvic floor muscles are too tight, sometimes called pelvic floor dysfunction, you might notice symptoms like pain or pressure in your pelvis, difficulty starting or fully emptying your bladder, constipation, or even pain during sex or erections. Some people also feel a constant urge to urinate or experience lower back, hip, or groin discomfort because those muscles are always “on.” It can be frustrating because it often gets mistaken for urinary or prostate issues, but really, your muscles are just holding too much tension, like a knot in your shoulder. The good news is that this is treatable, and pelvic floor physical therapy can make a huge difference by teaching you how to relax and retrain those muscles so you can feel better. I actually made a video called How to Properly Do Kegels for Men: Last Longer & Improve Erection Strength, featuring a pelvic floor therapist. It’s a great place to start if you want clear guidance and expert tips you can follow right at home. I've also interviewed Dr. Julie Sarton and Dr. Sara Reardon, two pelvic floor physical therapists on the podcast where you can learn more.

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’m 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.

HIGHLIGHTS FROM MY CHANNEL

I dove into the top “testosterone killers” that might be sneaking into your daily routine—especially important for men over 40. "If you're a man over 40, there's a 40% chance your testosterone is already low, putting you at higher risk for heart disease, diabetes, and even premature death."

Here are some quick takeaways:

• Processed foods, lack of sleep, and stress can all drag down your testosterone.

• Skipping weights or focusing only on cardio won’t give you the boost you want.

• Avoid plastics (like BPA) and make sure you keep healthy fats in your diet.

Staying on top of these simple factors can make a big difference in your energy, mood, and long-term health.

HIGHLIGHTS FROM MY PODCAST

I had a informative conversation with Dr. Aaron Fischman about a lesser-known treatment for enlarged prostate called prostate artery embolization (PAE). This is a minimally-invasive option that lets you avoid major surgery. Dr. Fischman summed it up perfectly: “The best thing about embolization... is that they can be completely awake, they can walk out of the procedure room. They typically go home an hour after the procedure.”

Here are a few quick takeaways:

• PAE treats enlarged prostate without surgery or long hospital stays.

• It offers symptom relief with a low risk of sexual side effects.

• The procedure is fast, safe, and most men recover quickly.

Curious if PAE is right for you? Be sure to talk to a qualified doctor for a full evaluation and listen on Apple Podcasts, Spotify, or here and see why people are commenting, “Dr. Fischman was amazing. He would be great at anything he tries. Thank you Dr. Malkin I feel like I am prepared for what may come in my aging process and will stay glued to your media”.

NEW MEDIA

Ever wondered if female ejaculation is real—or just a myth? Check out my NEW substack: Female Ejaculation vs. Squirting: A Urologist Explains the Science and Myths.

In this article, I break down the science behind female ejaculation and squirting, explain their key differences, and bust common myths to help you feel more confident and informed.