Men's Sexual Health Urology Care Podcast (1) start 10m 18s

-Hello, and welcome back

to the Urology Care Podcast,

the official podcast
of the Urology Care Foundation.

We have two fantastic guests with us

to talk about men's sexual health.

Our first guest,
Doctor Denise Asafu-Adjei,

is the assistant professor of neurology
at Loyola University,

where she serves as the medical director

of male reproductive medicine.

She also holds a dual appointment

at the Parkinson School
of Health Sciences and Public Health.

She's a strong advocate
of equal healthcare access

for all patients.

Our second guest, Doctor Amar Rambhatla,

is the director of men's health

at the Henry Ford Urology Institute.

His specialty areas
include male infertility,

low testosterone, sexual dysfunction,

Peyronie's disease, and vasectomy.

So let's get started.

We are here
with Dr Rambhatla and Dr Asafu-Adjei

to join us on a discussion

about men's sexual health.

I'll have both of you
introduce yourselves.

So, Dr Rambhatla, let's start with you.

-Hi, my name is Amar Rambhatla

and I'm the director of men's health

at the Vattikuti Urology Institute
at Henry Ford.

-And I am Denise Asafu-Adjei.

I am at Loyola University
in Maywood, Illinois,

outside of Chicago,

and I'm the director
of male reproductive medicine here.

-Wonderful, well,
we are excited to have you both

here with us again
to talk about men's sexual health.

So I first wanted to kind of start

with the basics and talk about

why is it important to even be talking
about men's sexual health?

-Men's sexual health is--

it's important
for a man's overall well-being,

and, you know, sexual dysfunction

can sometimes
be a foreshadow of problems

to come later in life.

For example, erectile dysfunction,

especially in younger men,

can sometimes manifest
before other medical problems,

such as cardiac problems, later in life.

And so it's very important for us

to be able to
identify these issues early on

so we can get men treated

to help optimize
their overall health status early on.

-And I think, to piggyback off
of that a little bit,

I also think when we talk
about sexual health,

we're talking about quality of life.

I think oftentimes in medicine,

we're often dealing with conditions

like, you know, cancer
and, you know, other things that are,

you know, of course, very important.

But I do think that sexual health

tends to get sideswiped a little bit

as being sometimes less important
than other aspects of health.

Quality of life issues, as we know,
there's a lot of men

who don't even seek treatment
for certain conditions

because it can potentially affect
their sexual health.

Men who don't take certain medications

for other important conditions,
like cardiac issues,

because it could, you know,
affect sexual health.

So I do think
that it's a really important area

for us to focus on,
because I think when people feel

like their quality of life is optimized,

it often does influence their behaviors

with other, you know, with other
kind of health seeking measures.

So that's also a reason why
I think it's really important

for us to continue
and leveraging those conversations.

-Yeah, absolutely.

You guys both
made some really great points there.

Um, and so you kind of
touched a little bit

on some different conditions
in those responses.

But what are some of the
most common urologic conditions

regarding sexual health for men

that you see in your practices?

-Yeah. I mean, of course,
I'll probably take the easy one away.

Uh, erectile dysfunction, uh, you know,

which we know is like
the most common sexual dysfunction.

I think probably something
that a lot of people don't realize

is that erectile dysfunction
can affect men

across the age spectrum,

and so I often tell patients this is not

just a disease of, you know,
your dads and your grandpas.

I'm sure, you know, Dr Amar
also sees, you know, younger patients.

I see really young patients who, again,

this may be a harbinger
of other medical conditions,

but it's really common.

And, you know, I think people
just don't really recognize that.

I'd probably say my top two, you know,

between that, would also be--

you know, premature ejaculation
is also something that I think,

in a culture where we constantly
have this elevated view

of what our sex life should be,

I think a lot of people also
come in with the notion of,

should I be lasting this long,
and what this should be,

and so I think people's baselines

are quite skewed because of that.

So I'd say those are kind of my top two

on the kind of sexual function side.

-Yeah, absolutely, I mean, um,
you know, those are very common.

Uh, other things that we see

are Peyronie's disease.

Especially now it seems like, um,

with better treatments
for Peyronie's, um,

people are becoming more aware
of the disease process

and coming in and seeking help.

Um, other ejaculatory issues,

delayed ejaculation and anejaculation.

And I also see a lot of men
with low libido,

which may be, uh, a sign of,

um, erectile dysfunction,

but also, uh, hormonal issues,

um, such as low testosterone,
and so, um,

that's also something
that we commonly see.

-I think it's also so interesting,

and I think I'd also be curious
to-- to, you know,

hear your thoughts.

Um, I feel like there's--
I see a lot more men now

who are just like,
I don't feel like myself,

and a lot more people
are a little bit more sensitized to,

well, I think it must be
my testosterone, right?

Like, I just feel like there
has been this shift

and that more men have
become aware of

this could be a contributor
for the low libido,

for the low energy,

so I feel like that's
become a little more mainstream.

Are you seeing that as well
in kind of your practice?

-Yeah, absolutely, and so, you know,

and this whole low testosterone,

it's a very real condition, and--

but oftentimes we see that people

aren't being properly diagnosed

and properly treated,

and so I think, you know,

it's something
that we can't just overlook,

and I think patients
need to be aware of this

and come in
and get the appropriate workup.

Because, you know,
it's-- testosterone is very important

to not just sexual health,
but other organ systems in the body,

and it's important
for mental well-being,

for, you know,
musculoskeletal, uh, health.

And so there's a lot of systems

that testosterone can affect.

-Yeah, I wanted to
go a little bit deeper into that.

That's definitely I feel
like something you see more

like on social media and--
and people talking about testosterone.

So can you dive a little bit more deeper

into what it is, why it's so important,

and you know, how it contributes
to men's sexual health

and why talking to a doctor,

and Dr Rambhatla, like you said,

you know, getting the the test

and making sure that
you're getting the right information,

why that is so beneficial.

-Yeah, so testosterone
is basically a hormone,

uh, that's secreted by the testicles,

and it's mainly-- its main function

is to, um, help develop

male secondary sex characteristics,

and, you know,

it's also important
for other, uh, organ systems,

like there's testosterone receptors
in the brain,

in the kidney,
in, uh, skeletal muscle and bone.

And so it's important
throughout the body,

and even women have a low level

of circulating testosterone

that's made by a different gland

called the adrenal gland.

And so it's important
for both men and women,

but certainly in men, as you get older,

testosterone levels tend to decrease.

And, you know, we have
very good studies

that show that, you know,
there's a decline,

but there can
be a significant decline in some men

to the point where they
start exhibiting symptoms

of having low testosterone.

And, you know,
these can manifest as problems

with sexual function, low libido,

you know, uh, fatigue,
uh, loss of energy,

trouble sleeping, uh, memory function.

It could affect, uh, mental well-being.

And so, you know, it's important

for men experiencing symptoms like this

to come in, be properly evaluated,

because there
are very effective treatments for this,

and, you know,
testosterone replacement therapy

can help improve a lot of this function

and restore quality of life,

and it's not something
that you have to live with,

with this declining quality of life.

-And I think you also
brought up a good point

where it's a medical condition
that we treat.

I think it really has unfortunately
become quite a predatory market

with, you know,
people not properly diagnosing it,

inappropriately over-treating people,

and there are real side effects

from taking things like testosterone,

which is why you want to be
under the care of a urologist

or, you know,
someone who has the medical training

to manage this
so that you can get treated,

that you're getting
treated appropriately.

So I know
that a lot of us really advocate

for if you're feeling
like you have these symptoms,

try to get under the care
of an actual medical provider

who can really
guide your treatment appropriately.

Yeah, absolutely.

And, you know, it's important--

testosterone therapies
can have side effects also

that need to be monitored.

And so, you know,
it's especially important

to be getting appropriate care

for that as well.