MEN’S YOUROLOGY

Can something as simple as breathing help with premature ejaculation?

This study looked at 62 men with PE and compared two groups—both did behavioral therapy and pelvic floor exercises, but one group added daily diaphragmatic breathing (slow, deep belly breathing that activates the diaphragm). After 8 weeks, both groups improved—but the breathing group saw a 900% increase in ejaculation time, better pelvic floor strength, and improved nervous system regulation. And unlike the other group, their results actually lasted a full year.

This shows that adding a free, simple breathing technique to an existing routine can significantly improve premature ejaculation—and the benefits stick. Definitely worth a deep breath, don’t you think?

WOMEN’S YOUROLOGY

Is your body fat messing with your bladder?

This study looked at 157 participants to figure out if excess weight really causes overactive bladder (OAB)—and the answer isn’t as simple as BMI or waist size. Instead, they found that visceral fat (the kind wrapped around your organs), fat around the bladder wall, and a higher visceral adiposity index (VAI) were all linked to significantly higher OAB risk. In fact, visceral fat increased your chances by more than 9 times. Meanwhile, BMI and waist circumference? Not helpful at all.

It shows that where your fat is stored may matter more than how much you weigh—especially if you're dealing with urinary urgency or leaks. The challenge it's hard to measure how much of your fat is visceral vs stored underneath the skin. We know weight loss does significantly improves symptoms of overactive bladder, so do your best to maintain a healthy body weight.

This week, someone asked me, “Mam, i have a problem of ED. I am sugar patient for 10 years. My penis has shrink and curved downward. It happend arround 1 and half years before. I felt that there was change in my penis. 1st i was feeling my penis has spread on the top side of my penis. After some months, i face ED. So, i contacted to yourolgyst. He wrote come medicien but there is no effect. Can you please advise about it?”. I’m really glad you reached out because what you’re experiencing is actually quite common in men with long-standing diabetes, and it’s important to know you’re not alone in this. Diabetes can affect the blood vessels and nerves that are critical for erections, and over time, this can lead to erectile dysfunction (ED). The changes in the shape and size of the penis, sometimes causing it to curve is due to a condition known as Peyronie’s disease. If the medications you’ve tried haven’t helped, it may be because the diabetes has affected the tissues more than expected, or there could be scarring from Peyronie’s that needs to be specifically addressed. My advice is to continue managing your blood sugar as tightly as possible, since that’s the foundation for improving your overall health and slowing progression, but I also recommend seeing a urologist who specializes in sexual medicine. There are advanced treatments available beyond pills, like injections, vacuum devices, or even implants, as well as possible therapies for the curve, depending on its severity and how much it’s affecting your life. Most importantly, don’t lose hope—there are real solutions out there, and getting the right support can make a huge difference in your quality of life and confidence.

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, 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 whether those popular nitric oxide (NO) supplements actually help with erections. Quote: "Nitric oxide or NO, is a tiny molecule that I like to call the ignition for erections."

Here are some quick takeaways:

• The main ingredients with some evidence are L-arginine and L-citrulline, but they mostly help mild cases and need to be taken often.

• Foods like leafy greens and beets can boost nitric oxide naturally, but it’s not proven they directly improve erections.

• Most supplements have weak evidence, especially for more serious ED—so don’t waste time or money hoping for a magic fix.

The best way to keep erections and blood flow healthy? Focus on a heart-healthy lifestyle—get moving, eat well, and don’t smoke. If you want to dive deeper, check out the full episode for all the science and advice!

HIGHLIGHTS FROM MY PODCAST

I had an eye-opening conversation with Dr. Lauren Streicher all about perimenopause, menopause, and keeping your sex life—and your wellbeing—on track through it all. Dr. Streicher really gets it when she says “It is not unusual to have these perimenopausal fluctuations in the 40s. And so many women think that if they bring up that they need a vibrator to already have an orgasm, that somehow the guy is going to be insulted. And quite frankly, it’s the exact opposite.”

Here are the big takeaways:

• Perimenopause can start in your 40s (and it’s unpredictable!).

• Hot flashes, brain fog, and vaginal dryness are common—but treatable.

• Vibrators and topical estrogen can be real game changers for your sex life.

Don’t let the myths or fear hold you back—there are solutions, and you are not alone! Listen and learn more on Apple Podcasts, Spotify, or here and see why people are commenting, “I LOVE this guest!!! Very informative and has a great way of putting things! I literally laughed out loud multiple times while listening. 😂”