How reliable is MRI alone when monitoring prostate cancer? Two new studies shed light on this. Johns Hopkins researchers found that men with positive MRI results often can be reclassified as higher risk, suggesting that biopsies targeting MRI lesions with systematic biopsies targeting 12 distinct regions of the prostate are important for accurate risk assessment. Meanwhile, UCSF researchers argue that MRI-targeted biopsies alone may suffice, as systematic biopsies rarely detect anything major that MRI misses.

What’s the takeaway?

MRI of the prostate is important and useful for helping find and target suspicious lesions to diagnose and provide the most accurate risk assessment. Talk to your doctor about MRI if you have an elevated PSA.

This week, someone asked me “Why do I not have sperm but can orgasm ?”. It sounds like you're discussing retrograde ejaculation. Retrograde ejaculation is a condition where the semen, instead of being expelled out through the penis during ejaculation, flows backward into the bladder. This happens due to the malfunction of the bladder neck muscles. This can happen due to:

1. Medications: Certain medications, particularly those used to reduce the size of the prostate, are common culprits.

2. Surgical Procedures: Surgeries like transurethral resection of the prostate (TURP) can affect the bladder neck mechanism.

3. Diabetes: This condition can affect the nerves that control the bladder neck, leading to retrograde ejaculation.

4. Neurologic Conditions: Conditions like spinal cord injuries can impact the nerve function necessary for normal ejaculation.

Good news is retrograde ejaculation is not dangerous, but can be a problem if you're trying to get your partner pregnant.

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

The Los Angeles fires have been incredibly frightening and difficult to control. Fortunately, my family and I are safe but this has been a trying time for people living in Los Angeles. If you'd like to support check out this list of ways to donate from my Instagram page.

HIGHLIGHTS FROM MY CHANNEL

In my latest video, I tackled what to do when your erectile dysfunction (ED) meds aren’t cutting it. It's a super common issue, but we've got some strategies to explore together.

Quote: "Treating the underlying issue is the most important part of this process."

Some quick takeaways are

• Adding daily medication to your on-demand ED meds can help increase blood flow and improve your results.

• Testosterone replacement and antioxidants like l-arginine might offer additional benefits.

• Shockwave therapy has shown promise, especially in conjunction with ED meds.

In the episode, I emphasized that "Adding daily tadalafil with your on-demand medication can continuously increase blood flow and prevent tissue damage."

Check out the full episode to dive deeper into these solutions and find what might work best for you. Let's improve your quality of life together!

HIGHLIGHTS FROM MY PODCAST

I had an incredible conversation with Dr. Karen Tang about understanding women's health, misconceptions around periods, and the importance of open communication in relationships. Dr. Tang really knows her stuff as she emphasized, “Open communication is crucial in addressing sexual and relational needs.”

During our chat, we dived into

• Open conversations about sexual discomfort can significantly improve relationship dynamics.

• Common menstrual symptoms like cramps and digestive changes shouldn’t be dismissed but discussed with a doctor.

• Hormonal changes throughout the cycle can affect mood and libido, so understanding them can help manage symptoms better.

Listen on Apple Podcasts, Spotify, or here to hear Dr. Tang’s perspective on why talking openly about gynecologic health is vital, and see why listeners are commenting "I would love to see more Post-menopause content, it great to have more specific content that seems to change before and after menopause."