MEN’S YOUROLOGY

What’s the emotional cost of finishing too soon? This large study looked at over 1,500 men and their partners—and specifically focused on those whose ejaculation happened in under 2 minutes. What they found was striking: men with premature ejaculation reported lower self-esteem, worse sexual satisfaction, and more relationship distress. Their partners felt it too. And overall? These men rated their quality of life lower than men without this condition.

Premature ejaculation isn’t just about performance—it deeply affects mental health, relationships, and how men see themselves.

WOMEN’S YOUROLOGY

Did you know that nearly half of women with type 2 diabetes experience urinary incontinence?

In this large study of nearly 10,000 women, researchers found that 48% had leaks at least once a month, and 29% had them weekly. Even among those who had no issues to begin with, new cases still developed over time. So what’s going on? The study identified several risk factors including higher BMI, having more kids, low physical activity, use of diuretics, and hormone therapy after menopause. Things like hysterectomy, vascular disease, and longer duration of diabetes also increased the odds.

Many of these risk factors are actually modifiable—and that means there are opportunities to prevent or reduce symptoms. If you have type 2 diabetes and experience leaks, know that you’re not alone—and there are ways to get support.

This week, someone asked me, “Does lower chronic back pain effect erection?”. Absolutely, chronic lower back pain can impact your erections, and it’s something I see more often than people realize. The nerves that help control erections run through the lower spine, so if there's compression, injury, or chronic inflammation in that area, it can interfere with the signals needed for an erection. On top of that, living with ongoing pain can cause stress, poor sleep, and lower testosterone levels—all of which can impact sexual function. If this sounds like your situation, it's worth discussing both with your urologist and a spine or pain specialist, because treating the underlying back issue and improving overall health can sometimes make a real difference in your erections too.

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 recently joined BigDeal by Codie Sanchez for a wide-ranging, no-holds-barred conversation on what everyone gets wrong about sex and libido. We unpacked the myths around female orgasm and male performance, the role of porn in shaping how young people learn about sex, and how AI might change intimacy as we know it. We also explored how better communication—especially between parents and kids—can reshape the way we approach sex education. This episode is packed with honest, eye-opening insights you won’t want to miss. Listen here: https://youtu.be/CwZWlZJeNhg?si=mFGXIiDznG8NFd3T

Also, I'm excited to share that I’ve launched my own Substack! If you’re interested in learning more about urologic and sexual health—from practical tips to deep dives on topics most people are too shy to talk about—you can now follow me there. I’ll be publishing thoughtful, evidence-based articles to help you take control of your health and stay informed. Subscribe here: https://renamalikmd.substack.com/

HIGHLIGHTS FROM MY CHANNEL

Today I broke down the big question everyone has: which pill actually works best for harder, longer-lasting erections? It turns out, there’s a lot of science behind the answer! Quote: “If you want to be as efficacious as possible, 50mg of sildenafil might be the best choice. However, if you’re worried about tolerating it or you’re having bad side effects, Tadalafil 10mg might be the better option.”

Here are some quick takeaways:

• Sildenafil (Viagra) 50mg works best for effectiveness, but can have more side effects.

• Tadalafil (Cialis) 10mg is gentler on side effects and still helps many men.

• There’s no one-size-fits-all—everyone responds differently, so talk to your doctor.

Ultimately, it’s about finding what works for you and your lifestyle. Share this with whoever might need to hear it, and remember, there’s help out there!

HIGHLIGHTS FROM MY PODCAST

I had an eye-opening conversation with Dr. Sara Reardon (a.k.a. the Vagina Whisperer!) all about pelvic floor health, and honestly, I think everyone should know this stuff. Dr. Reardon puts it so well “The pelvic floor is a basket of muscles that sits at the base of the pelvis…these muscles are working with every breath that we take. It contracts and relaxes. It’s a spinal muscle, so it actually helps support our core.”

Here are a few quick takeaways:

• Pee and poop properly—don’t rush or strain!

• Move your body and don’t sit all day.

• Learn to relax and strengthen your pelvic floor with breath and simple exercises.

Seriously, you don’t need to be a medical pro to take care of your pelvic floor, and making just a few small changes can have a huge impact. So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “As a person currently undergoing pelvic floor therapy, this was extremely helpful. Thanks doctors!”