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Host: Dr. Melanie Carminati, PT, DPT, GTS, NCPT BrooklynPhysicalTherapy.com Guest: Dr. Michael A. Werner, M.D., FACS MazeHealth.com @mazewerner Disclaimer: The medical information in this podcast is for informational purposes only, not individualized medical advice. For personalized care, consult your healthcare provider. About Dr. Michael A. Werner Dr. Michael A. Werner, Founder and Medical Director at Maze Health, is a board-certified urologist who received specialized Fellowship training in male infertility, surgery, and male sexual dysfunction at Boston University Medical Center. His private practice in Midtown Manhattan and Westchester, New York, is limited to two areas of specialization: male infertility and male and female sexual dysfunction. He's a frequent lecturer and author in medical journals and books on these topics. Exploring Men's Health After 70 In this episode, we'll discuss a crucial aspect of men's health after age 70, focusing on sexual health. Our previous podcast episode, "Sex After 70," primarily centered around female sexual health concerns with Dr. Dena Harrison, a gynecologist. However, we received numerous comments asking about men's sexual health and what can be done for men over 70 to maintain a fulfilling sex life. Dr. Werner, could you please share your clinical experience with male patients aged 70 and above? What are some common complaints they come in with in terms of sexual intimacy and sexual function? Dr. Werner explains that as people live longer, sexual issues in older men become more prevalent. The two primary age-related concerns he encounters are erectile dysfunction and difficulties with ejaculation. The discussion delves into the treatment options for these issues, such as penile implants, penile injections, oral medications, and more. Pelvic Pain and its Connection with Erectile Dysfunction The conversation shifts to discussing chronic pelvic pain syndrome in men, which is often not well understood. Dr. Werner elaborates on the different symptoms and their varied manifestations. Dr. Carminati, as a pelvic floor therapist, adds to the discussion by emphasizing the importance of pelvic floor physical therapy and how it can assist in managing pelvic pain and other related issues. Incorporating Radiofrequency Therapy (Winback Tecar): Dr. Carminati shares her experiences with radiofrequency therapy, specifically the Winback Tecar system, which she finds beneficial for treating various pelvic conditions. The therapy is described as a warming sensation, and it explains how it helps facilitate deep tissue work for male pelvic pain patients. Premature Ejaculation and Its Treatment Dr. Werner addresses premature ejaculation, emphasizing that it's not always a psychological issue but can be physical and, in some cases, lifelong. He discusses treatment options, including the use of selective serotonin reuptake inhibitors (SSRIs) to delay ejaculation and topical numbing agents. Addressing Low Libido The conversation then touches on low libido in older men, often related to declining testosterone levels. Dr. Werner highlights the importance of hormone replacement therapy and discusses how it can significantly improve libido in men. The Impact of Prostate Cancer Treatments on Sexual Function When it comes to patients who have undergone prostate cancer treatments, Dr. Werner explains the common effects on sexual function and discusses potential treatments. He highlights the importance of early intervention to address post-treatment erection issues and emphasizes the effectiveness of penile injections in these cases. The podcast concludes with discussions about reducing the stigma around discussing sexual health after the age of 70 and the importance of seeking help for sexual concerns. Dr. Werner and Dr. Carminati stress the value of collaborative efforts between urologists, pelvic floor therapists, and other medical professionals in providing holistic patient care. This informative conversation shows the importance of open dialogue and a multidisciplinary approach to addressing sexual health challenges in older adults, providing hope and solutions for individuals seeking to improve their quality of life.

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In this episode of "Why Do Men Want to Use a Condom?", we explore the multifaceted reasons behind why many men choose to use condoms. This topic encompasses a range of considerations from health and safety to personal preferences and relationship dynamics. Join us as we delve into: Health and Safety: STI Prevention: Understanding how condoms play a critical role in reducing the risk of sexually transmitted infections (STIs) and ensuring both partners' health. Pregnancy Prevention: Examining the effectiveness of condoms in preventing unintended pregnancies and how they contribute to family planning. Personal Preferences: Comfort and Control: Discussing how some men feel more comfortable and in control when using condoms, and how this affects their overall sexual experience. Performance and Pleasure: Exploring the impact of condom use on sexual pleasure and performance, including common misconceptions and solutions. Relationship Dynamics: Trust and Communication: Analyzing how condom use can be a matter of trust and communication between partners, and how discussing contraception can strengthen relationships. Respect and Responsibility: Examining the role of condoms in showing respect for a partner's wishes and taking responsibility for sexual health. Cultural and Social Factors: Societal Expectations: Investigating how societal norms and cultural expectations influence attitudes towards condom use. Education and Awareness: Highlighting the importance of sexual education in shaping informed decisions about contraception. Challenges and Solutions: Addressing Common Concerns: Tackling common issues men face with condom use, such as discomfort or decreased sensation, and offering practical solutions. Innovations and Alternatives: Looking at new advancements in condom technology and alternative methods of contraception. Expert Opinions: Interviews with Healthcare Professionals: Gaining insights from doctors, sexual health experts, and relationship counselors on the importance of condom use and how to address common concerns. ⚠️ FAIR USE COPYRIGHT NOTICE: The Copyright Laws of the United States recognizes a "fair use" of copyrighted content. The videos and this Youtube channel in general may contain certain copyrighted works that were not specifically authorized to be used by the copyright holder(s), but which we believe in good faith are protected by federal law and the fair use doctrine for purposes such as criticism, comment, news reporting, teaching, parody, or research, is not an infringement of copyright. All video is for educational purposes only. We believe this constitutes a fair use of any such copyrighted material as provided for in section 107 of the US Copyright Law.

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Around 16% of Indian population suffer from different forms of sexual dysfunction with people suffering from this vascular dysfunction resorting to Phosphodiesterase type 5 (PDE5) inhibitors such as Viagra. In fact, it has been found that the sales of this drugs has increased many fold. But is this really a disease? Sexual Dysfunction both in men & women is a vascular dysfunction, it is endothelial dysfunction. In fact, it is an early sign of cardiovascular disease. Sexual dysfunction is a problem of lack of blood flow. For erectile, our sexual organs needs increase in blood flow. When there is stimulation of sexual activity, there is a signalling cascade that tells there is need for increase in blood flow for engorgement that allows for erection & penetration. It is no brainer that our body, endothelial cells need to produce nitric oxide that stimulates blood flow. Endothelial cells lines our blood vessels & when coupled with endothelial nitric oxide synthase converts semi essential amino acid- L-Argnine into nitric oxide. Our oral microbiome synthesise nitrate into nitrite which mixes with stomach acid to produce nitric oxide. Nitric oxide binds to a receptor on enzyme called guanylyl cyclase This activates a message called cyclic GMP which dialates the blood vessels of sex organs & allows for increase of blood flow of sex organs, leading to erection. However, if you are experiencing inflammation or oxidative stress, it could lead to endothelial dysfunction, disrupt the blood flow, causing sexual dysfunction. Even if your oral microbiome is imbalanced or you are consuming foods high in glyphosates, it could disrupt nitric oxide. Endothelial dysfunction in the vascular bed of sex organs is the same as Endothelial dysfunction in cerebral arteries in brain, Endothelial dysfunction in coronary arteries & more. The effectiveness of PDE-5 inhibitors & other supplements for sexual dysfunction depends upon Nitric oxide. Nitric Oxide activates Cyclic GMP while PDE-5 inhibitors prevents the breakdown of Cycle GMP. If you are experiencing functional loss of nitric oxide production, there is no activation of cycle GMP & these drugs are not equipped to do their job. Citations https://pmc.ncbi.nlm.nih.gov/articles/PMC8109295/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4806684/ #erectiledysfunctiontreatment #erectiledysfuntion #erectile_dysfunction #erectile #erectiledysfunctioncure #erectilehealth #reproductivemedicine #reproductivehealth #reproductiveissues #reproductive_health #reproductivesystem #health #viralreels #viralvideos #viral_video

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