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Hormone Networks and Your Erection: The I-75 of Your Body – Part 1

Posted on by Akash Kapadia, MD in ,

Man looking at smart watch after physical activity outdoors

Your body is running on a constant stream of information. Messages are sent, received, adjusted, and rerouted every second of every day, telling your body to breathe, eat, sleep, work, bathe, and yes, even have sex.

Hormones are the couriers of that system, the vehicles that get those messages across the body. They are a major part of the internal interstate that connects your brain, testes, adrenal glands, blood vessels, nerves, and tissues into a coordinated network. Just like I-75, there are downtown connectors and major interchanges along the way, some of which can become less than productive.

When you’re at the top of your game, and signals are flowing healthily, energy is steady, sleep is restorative, sex feels natural, muscles respond, and erections happen without negotiation. When one piece falters in this delicate system (signals are delayed, messages are distorted, or exits are missed altogether), a cascade can occur.

Predominant Hormones in Men’s Sexual Health

Erections are the result of precise coordination between hormones, blood flow, nerve signaling, and mental state. Testosterone, estrogen, cortisol, thyroid hormones, growth hormone, prolactin, and others alert various body systems of the intention to pursue sex and support the body’s ability to follow through.

These are some of the predominant male hormones involved with sexual health and what happens when their signals get scrambled.

Testosterone

Testosterone is the representative hormone of maleness. It’s fundamental for a healthy libido, sperm production, muscle mass, bone density, mood, and energy. Adequate testosterone helps prime the brain for sexual interest and supports the physical mechanisms required for erections.

When testosterone is too low, men may notice decreased sex drive, fewer spontaneous or morning erections, fatigue, loss of muscle, increased body fat, and mood changes. Excessively high testosterone (usually due to misaligned supplementation) can lead to acne, hair loss, mood changes, elevated blood pressure, and even increased cardiovascular risk.

Estrodial (Estrogen)

Yes, men have estrogen, and they need it. Estradiol is produced when testosterone is converted by an enzyme called aromatase. When balanced, estradiol supports libido, erectile function, sperm health, bone density, and mood.

High estradiol can contribute to low libido, erectile dysfunction, fatigue, breast tissue growth (gynecomastia), and mood changes. Low estradiol can cause bone loss, anxiety, and sexual dysfunction.

Elevated levels most commonly stem from increased conversion of testosterone to estrogen, which is frequently driven by obesity (fat tissue contains aromatase), aging, liver dysfunction, excessive alcohol use, and mismanaged testosterone supplementation. Low estradiol is usually seen alongside low testosterone or from over-suppression during hormone therapy, and can leave men feeling flat, fatigued, achy, and disconnected both physically and emotionally.

Prolactin

Prolactin levels are low in healthy men and non-pregnant women, as it’s usually associated with lactation. Made by the pituitary gland, prolactin mainly acts as a modulator in men by fine-tuning other systems; normal levels support male reproductive balance and proper signaling between the brain and testes. It fluctuates naturally throughout the day with stress, sleep, exercise, and orgasm, and appears to be involved with the neuroendocrine circuitry of ejaculation.¹

Too much prolactin interferes with the effects of testosterone, leading to low libido, erectile dysfunction, infertility, fatigue, and male breast enlargement. Certain medications (notably antidepressants, antipsychotics, and opioids), untreated hypothyroidism, chronic kidney or liver disease, and benign pituitary tumors called prolactinomas are common causes. Because prolactin is produced by the pituitary, persistently elevated levels are a red flag that warrants further evaluation rather than symptom-based treatment alone.

Cortisol

Most of us know cortisol as the “stress hormone.” In short bursts, it’s meant to be helpful – it sharpens focus, mobilizes energy, and gets the body ready to respond to immediate demands. It raises blood sugar, increases alertness, and temporarily suppresses non-essential functions so you can do what you need to do under duress.

However, when cortisol is chronically elevated, it becomes disruptive. It suppresses testosterone production, interferes with sleep, increases abdominal fat, and drains energy and libido. Men under constant stress from work, overtraining, or even untreated health conditions can experience a lag in the bedroom. High cortisol levels crowd the hormone highway and can make erections less reliable, desire dip, or both.

Thyroid Hormones

Thyroid hormones primarily regulate metabolism and energy. Both underactive and overactive thyroid states can mimic or worsen symptoms of low testosterone, including fatigue, mood changes, reduced libido, and erectile dysfunction.

Thyroid disorders disrupt the Hypothalamic-Pituitary-Gonadal (HPG) axis, which affects sex hormone levels. Thyroid hormones influence testicular tissue development and function, impacting sperm production and hormone release, and issues can affect the nerves and muscles essential for erection and ejaculation.

Symptoms of a thyroid disorder can appear subtle at first, and sometimes overlap with Low-T symptoms; when evaluations focus too narrowly on testosterone alone, other drivers can be missed. Correcting thyroid levels under an endocrinologist’s care typically resolves or improves these sexual dysfunctions. When additional support is needed, a urologist specializing in men’s health can help coordinate care and tailor treatment to restore sexual function.

SHBG (Sex hormone-binding globulin)

SHBG determines how much testosterone is actually available to your tissues.

High SHBG can leave you with “normal” total testosterone but low free testosterone: symptoms persist despite reassuring numbers on paper. That can seem confusing, so here’s an illustration to help explain how this works: SHGB binds to free testosterone, carrying it through the bloodstream and preventing it from being used immediately. Free testosterone is “free” to enter tissues, while SHBG-bound testosterone is largely inactive until released. Healthy SHBG levels maintain a balance between bound and free testosterone, ensuring there is enough to “go around.” If there is too much binding happening, tissues don’t get the testosterone they need.

Testosterone can look normal on lab results because most standard blood tests measure total testosterone, which includes both bound and free testosterone. If SHBG is high, total testosterone may appear within the normal range, but the fraction that is free and actually usable by the body is low.

Low SHGB levels do the opposite and allow for more free testosterone. On the surface, that can sound like a good thing. But even though there’s more available testosterone, it can be a marker for metabolic syndrome, a cluster of conditions that can include high blood pressure, elevated blood sugar, excess abdominal fat, and abnormal cholesterol levels. It also increases the risk of heart disease. Common causes of this kind of hormone shift include obesity and excess body fat, insulin resistance or diabetes, an underactive thyroid, excess androgen exposure (including testosterone therapy), and conditions such as Cushing’s disease.

DHEA (Dehydroepiandrosterone)

DHEA is a precursor hormone. Produced by the adrenal glands, DHEA also supports them, feeds into both testosterone and estrogen pathways, and acts in the central nervous system. Low levels are associated with fatigue, low libido, mood changes, and sexual dysfunction. DHEA levels drop in men primarily due to natural aging (a dip around 30), but they can also be reduced by adrenal gland issues (like Addison’s disease), pituitary dysfunction, severe stress or burnout, certain medications (like glucocorticoids), and other systemic illnesses that disrupt DHEA production.

High levels, often from unsupervised supplementation, can also cause problems and confuse the body’s natural hormone feedback loops, producing acne, oily skin, mood swings, hair loss, irritability, and gynecomastia.

Growth Hormone (GH)

Growth hormone has emerged in fitness and longevity circles for its perceived anti-aging, body-composition, and performance benefits. Its appeal is in its involvement in tissue repair, muscle recovery, fat metabolism, and overall vitality. Over-supplementation, however, can lead to joint pain, fluid retention, insulin resistance, abnormal facial or hand growth, and cardiovascular strain. Too much is also associated with certain cancers and can diminish athletic performance despite muscle growth.²

In adults, deficiencies can lead to fatigue, reduced muscle mass, increased abdominal fat, impaired exercise recovery, and reduced sexual interest. How does it become deficient? Usually from pituitary dysfunction, chronic poor sleep, untreated sleep apnea, head trauma, aging, or prior pituitary surgery or radiation.

GH works closely with other hormones, meaning disruptions here can ripple outward:

  • Testosterone availability: GH supports pituitary signaling that helps regulate testosterone production.
  • Energy and metabolism: GH interacts with thyroid hormones and insulin, and disruptions can lead to fatigue, altered blood sugar control, and reduced muscle performance.
  • Vascular health: GH promotes nitric oxide production and supports healthy blood flow. Trouble here can impair erections even if testosterone levels are adequate.
  • Body composition and fat distribution: GH works alongside cortisol and sex hormones to regulate fat and muscle mass. Interruptions in this network can shift fat to the abdomen, indirectly affecting testosterone-to-estrogen conversion and libido.

Every hormone has a specific job, but they also rely on one another to function. Sexual vitality is not governed by a single hormone; it’s regulated by a system. (And this is certainly not an exhaustive list of what’s at play.) Hence, changes in erections, libido, energy, or morning salutations aren’t just “performance issues.” Rather, they can be an indication of poorly regulated hormone traffic commonly caused by lifestyle interruptions and/or underlying health conditions.

Only 25% of men in the US who are prescribed treatment for Low-T undergo appropriate testing. I cannot stress enough how important it is to see the right doctor and undergo the right testing; other serious conditions can cause similar symptoms. Online clinics or pharmacies have their place and can seem convenient. But they can also overlook contributing factors such as sleep disorders, thyroid problems, adrenal dysfunction, medication interactions, or pituitary issues.

A full workup typically involves a detailed medical history, lab panels measuring total and free hormones, evaluation of thyroid, adrenal, and pituitary function, and sometimes imaging or specialized testing. Resulting therapies are targeted because they’re informed by your body’s unique chemical makeup.

Once you’ve been evaluated and discussed treatment options with Dr. Kapadia, it’s time to optimize your results. How, you might ask? Check out Part 2.

Dr. Kapadia is a distinguished member of a small, closely knit Reproductive Urology and Sexual Medicine community. He has published extensively in well-known medical journals and presented his research at both national and international meetings on male fertility and sexual medicine. His practice focuses on male fertility, sexual medicine, and hormone therapies, with an emphasis on personalized, system-wide care.

Resources:

  1. Valente, S., Marques, T., & Lima, S. Q. (2021). No evidence for prolactin’s involvement in the post-ejaculatory refractory period. Communications Biology, 4(10). https://doi.org/10.1038/s42003-020-01570-4.
  2. Australian Government Department of Health, Disability and Ageing Therapeutic Goods Administration. (2022, May 26). Too much of a good thing: the health risks of human growth hormone. Therapeutic Goods Administration (TGA). https://www.tga.gov.au/news/blog/too-much-good-thing-health-risks-human-growth-hormone.

 

Can You Still Get an Erection After Prostate Removal?

Posted on by Akash Kapadia, MD in ,

Man pondering, looking out window after prostate removal

One of a man’s biggest fears: what if I can’t get an erection? Few health concerns provoke as much anxiety for men. It’s an especially valid concern when discussing prostate removal, and one that is tactfully addressed in the clinic setting both before and after a prostate removal procedure.

Especially when you’re already processing a cancer diagnosis or another serious prostate condition, the information can feel overwhelming, technical, or rushed.

While no blog will ever take the place of the conversations you have with your doctor about your particular health situation, we thought a little background on a sensitive subject may help turn down the anxiety amperage.

Why is the Prostate Removed in the First Place?

The most common reason for prostate removal is the treatment of prostate cancer. Surgery is not always the first or only option; treatment decisions depend on several factors, including the cancer’s aggressiveness, location, size, and whether it has spread beyond the prostate. For men with low-risk prostate cancer, doctors may recommend active surveillance rather than immediate treatment.

Closely monitoring the cancer delays the potential side effects of surgery or radiation while keeping a careful eye on it. The goal isn’t to “wait and see” passively, but to avoid overtreatment. Many prostate cancers never become dangerous, and early treatment can permanently affect urinary and sexual function. Active surveillance allows men to maintain their quality of life while remaining safe. With frequent check-ups and ongoing communication with your practitioner, any signs of progression can be identified and treated early.

Some men with intermediate-risk prostate cancer may be candidates for focal therapy, also called partial prostate ablation. This technique uses targeted energy (such as heat, cold, sound, or electricity) to destroy only the cancerous portion of the prostate, potentially allowing men to stay on active surveillance longer while minimizing side effects.

For men with higher-risk prostate cancer, however, surgical removal may be the most effective means of controlling the disease, as long as the cancer is confined to the prostate and has not spread to surrounding tissues or organs.

Radical prostatectomy, the most common surgical approach, involves removing the entire prostate gland along with some surrounding tissue. It’s considered a complex operation. Because the prostate sits in a crowded and sensitive area of the body, it has potential risks and requires experienced technical precision. Surgeons take into account the tumor’s location, size, and relationship to nearby nerves when planning the operation. Because of the local anatomy and the uniqueness of each surgery, even the most exacting procedure still comes with risks, including problems with urinary control, erectile dysfunction, injury to the rectum, and scarring.

How Does Prostate Removal Affect the Penis?

The most direct answer is this: the prostate sits directly next to the nerves and blood vessels that control erections and urinary function. Tampering with the prostate includes the potential to disrupt the surrounding communication pathways. These structures are delicate, and even when surgeons use advanced nerve-sparing techniques, they can be temporarily (or sometimes even permanently) affected during surgery.

The nerves responsible for erections run immediately alongside the prostate, and a tumor can show up anywhere. When cancer is located close to or has extended beyond these nerves, preserving them may not be medically safe; prioritizing complete cancer removal can mean sacrificing some nerve tissue to avoid leaving cancer behind.

Recovery of erectile function after prostatectomy varies widely, in large part due to the anatomical location of the tumor and the surrounding structures it (or surgery) has affected. Other factors that help determine post-operative erectile function include how strong a man’s erections were before surgery and the skill and experience of the surgeon performing the operation.

Let’s go ahead and get this out: changes in erectile function are physical as well as emotional. Research shows that erectile dysfunction after prostate cancer treatment leads to significant psychological distress in men¹  – feelings of frustration, avoidance, embarrassment, or grief are common, and they can affect relationships, self-esteem, and overall quality of life. As part of your recovery, we want to restore optimal blood flow and nerve signaling, but we also want to help you rebuild confidence, intimacy, and a sense of normalcy. Both the physical mechanics and the emotional impact of these changes are critical parts of healing.

Most men experience some degree of urinary leakage and erectile dysfunction immediately after radical prostatectomy. For many, these effects are temporary and improve over time, but they are common in the early recovery period.

Erectile dysfunction after prostate removal does not automatically mean permanent loss of function. Nerves heal slowly, and recovery can take months or even more than a year; it just takes time. Some additional support along the way, including different treatments, rehabilitation strategies, and better management of other health conditions, can help bring men closer to their pre-surgery performance baseline.

What Can You Do?

Recovery is not passive. Even though tumor location, surgical factors, and other parts of the process feel out of your control, you still exercise quite a bit of influence when it comes to healing and improving your outcome.

Support Your Recovery Through Lifestyle Participation

Erections are fundamentally a vascular event. Hence, adequate blood flow is paramount. Habits that support cardiovascular health also support penile health.

Maintaining a healthy weight, staying physically active, and managing conditions like high blood pressure or diabetes improve circulation and hormone balance, and, therefore, libido and erectile function. Nutrient-dense diets support stamina and energy levels, while appropriate weight loss recalibrates hormonal disruptions that interfere with sexual function.

Being mindful of your overall health absolutely influences how well the body responds to rehabilitation and treatment.

Pelvic Floor Muscle Training

Pelvic floor muscles are also part of the intricate prostate neighborhood, supporting both urinary control and erectile function. After prostate surgery, these muscles can become weak or lose coordination.

Consistently performed Kegel exercises (that are also done correctly) are the easiest, most accessible practice you can adopt on the road to recovery. These movements help strengthen weak sphincters involved in post-surgical urinary incontinence, and they promote erectile rigidity via improved blood trapping in the penis.

Pelvic floor training is simple, noninvasive, and an important foundation of recovery, especially in the early months after surgery.

Medical Therapies to Support Erectile Function While Nerves Heal

The nerves usually take the longest to heal, taking many months or longer to “come back online.” In the meantime, many men benefit from therapies that help maintain erections during the healing process rather than waiting for spontaneous function to return.

Oral medications, such as daily tadalafil (Cialis) with sildenafil (Viagra) used early on in recovery and as needed, help improve blood flow and may support long-term outcomes, even if they do not immediately produce erections suitable for intercourse.

Intracavernosal Injection Therapy (ICI) is another great option. ICI uses injectable forms of medications similar to Viagra or Cialis that are delivered directly into the penis, bypassing the nerves – this can be especially effective while nerve tissue continues to heal.

Vacuum Erection Devices (VEDs) are another useful tool. By drawing blood into the penis, VEDs help maintain tissue health and allow for sexual activity during recovery. To preserve the erection VEDs can produce, many men use a constriction band (for no more than 30 minutes at a time).

Any combination of these methods can be utilized as part of a structured rehabilitation plan.

When More Support Is Needed

Recovery isn’t always linear, and progress can be uneven: sometimes it can feel like two steps forward and one step back. If early therapies are not providing the desired results, further evaluation and ongoing discussions with your practitioner will guide the next steps. Conversations and unique circumstances may drive the approach toward additional imaging, such as a penile Doppler ultrasound, or even surgical interventions.

For men with persistent erectile dysfunction despite rehabilitation, penile implants can be a reliable and highly effective long-term solution. Modern implants are discreet, safe, and designed to closely mimic natural erections.

Staying Positive and Moving Forward

You arrived at prostate removal due to a serious health condition – that wasn’t easy. And it’s normal to grieve the changes that come along with that course of action. The field of urologic care has come a long way, and Dr. Kapadia is here to help you find solutions. Advances in surgical techniques, rehabilitation strategies, and erectile dysfunction treatments mean that most men have options and real hope for restoration and recovery.

If you’re navigating sexual or urinary changes after prostate surgery, work with a specialist who understands the full recovery process. Dr. Kapadia and the team at Georgia Urology focus on individualized, stepwise care to regain function, confidence, intimacy, and quality of life at every stage of recovery.

Resource:
  1. Emanu, J. C., Avildsen, I. K., & Nelson, C. J. (2016). Erectile dysfunction after radical prostatectomy: prevalence, medical treatments, and psychosocial interventions. Current opinion in supportive and palliative care, 10(1), 102–107. https://doi.org/10.1097/SPC.0000000000000195.

 

Do Oysters Really Heighten Libido? (And Tales of Other Kitchen Aphrodisiacs)

Posted on by Akash Kapadia, MD in , ,

Man at restaurant eating oyster

Passed down from ancient civilizations and reconfigured by modern social media trends, there are dozens of “real” libido boost solutions hiding in our kitchens: oysters, honey, peppers, garlic, walnuts, ginseng, asparagus, figs, and a sizable list of others from across the globe.

Over many years and many regions, specific foods earned reputations as sexual fuel. Rare or expensive consumables were considered exotic or luxurious and equated with potency. Spicy foods induce physical sensations that mimic the cues of arousal. Some were even valued for their shape resemblance or animal symbolism.

Those are fun facts and all, but do they work? Maybe! What we know of food nutrient profiles suggests there isn’t really a direct biological connection between these foods and sexual prowess. However, there could be some indirect connections: nutrition, mood, energy, and confidence absolutely influence how people feel, which, in turn, shape perceived sexual performance.

Across history, lots of foods were believed to increase libido or sexual vitality, and we’re ranking them from the most believable to pure myth. Here’s a culture-by-culture tour of classic “aphrodisiacs” and why people believed in them.

Oysters

Verdict: Most believable.

Oysters: the quintessential aphrodisiac. The lore dates back to Aphrodite and classical antiquity, where oysters were associated with love and sensuality. Their texture, presentation, and the intimate act of eating them with a partner amplify their psychological effect.

And there might be some nutritional basis for this reputation. Oysters are rich in the mineral zinc, which is essential for testosterone production, sperm health, and metabolic function. Zinc deficiency can impair sexual function, so we would probably see the biggest turnaround in sexual performance in someone who was zinc-deficient. Suffice to say, if you already have adequate zinc intake, eating oysters is unlikely to trigger a dramatic physiologically-based sexual boost.

Aphrodisiac or not, oysters are a healthy food choice: high in protein, low in fat, and packed with minerals, they support general metabolic and reproductive health. Zinc and oysters aren’t necessarily sexual super-chargers, but the texture and sensuousness of eating them with another might be all you need to kick it into high gear.

Beets & Watermelon

Verdict: Possible nitric oxide boosters.

Ancient cultures revered beets for their ability to produce “amorous” emotions. In Greek mythology, Aphrodite’s allure was intensified by eating beets.¹ And there might be some nutritional evidence for this amplification of her virility. Beets contain compounds like tryptophan and betaine, which can promote a sense of well-being, and boron, a trace mineral that supports healthy sex hormone levels.

Seeds found at a 5000-year-old settlement in Libya and wall paintings in King Tut’s tomb suggest people have been eating watermelon (or at least a near relative of the species we know today) for millennia.² Hydrating and restorative, desert cultures around the Mediterranean Sea valued watermelon’s cooling and diuretic properties, voluminous water content, and storage longevity.

Both foods contain compounds that support vascular function. Beetroot has been touted for its ability to boost nitric oxide, a molecule that helps relax blood vessels. Watermelon contains L-citrulline, a precursor to nitric oxide. The healthy bump in nitric oxide can improve blood flow, including to the penis. Also, as we mentioned, watermelon is hydrating: tissues become nourished, toxins are pushed out, and the diuretic property removes fluid volume that could improve slightly elevated blood pressure.

Plausible contributors to sexual function – but the effect is modest. Also, dietary intake alone is unlikely to replace medical treatments for more serious urologic concerns and libido setbacks.

All in all, these are healthy, whole foods that belong on the menu – they’re not going to hurt, and they may even help! (Special note: Beets have a strong coloring to them. Don’t be surprised if they tint your urine pink or red. It’s harmless, but call us if you feel alarmed or notice anything else unusual.)

Ginseng

Verdict: Plausible.

The “root of vitality,” ginseng, has been used for thousands of years in Eastern and Chinese medicine to restore Qi (the life energy that methodically flows throughout our bodies). Sexual vigor is almost synonymous with stamina, resilience, and longevity. With the energetic property to revive Qi, including intimate horsepower, ginseng’s reputation evolved into that of an aphrodisiac.

There might be some factual basis to that. Erectile function relies heavily on healthy vascular and smooth muscle activity in the penis, which is mediated by nitric oxide (NO) signaling. NO relaxes the smooth muscle, allowing blood to fill the penile tissue and create an erection. Red ginseng, in particular, appears to enhance this process: experimental studies suggest it can increase endothelial relaxation and NO production, improving blood flow to erectile tissue.³

Ginseng also has promising antioxidant power. Wait. Let’s back up so we can go forward.

Oxidative stress happens when harmful, unstable free radicals, called Reactive Oxygen Species (ROS), overwhelm the body’s antioxidants, damaging cells, proteins, lipids, and DNA and contributing to aging and diseases like cancer, diabetes, and neurodegenerative conditions. Controlled levels of ROS are necessary for cell signaling, but excess production from pollutants, poor diet, or stress can harm cells.

Ginseng might be responsible for reducing markers of oxidative stress, preserving cellular structure, and improving smooth muscle health in experimental models, which can indirectly impact sexual performance and stamina.³ Incorporating ginseng as part of a balanced diet, combined with good sleep, exercise, overall healthy living, and advice from a knowledgeable practitioner, may help some people feel more energetic and engaged, even if it doesn’t dramatically “flip the switch.”

Chocolate

Verdict: A romantic, mood-lifting, endorphin trigger.

What list of food-based aphrodisiacs is complete without Valentine’s hottest commodity: chocolate? This ultimate love potion, cacao, was referred to as “the food of the gods” by the Aztecs and consumed in bitter, spiced beverages that were thought to enhance vitality and sexual prowess. The association of chocolate with romance and seduction carried on in European aristocratic society, and even into modern cultures around the world. The act of sharing chocolate, its luxurious texture, and its association with indulgence created a psychological association with pleasure and intimacy.

And good news – chocolate has a favorable, nutritious side. Dark chocolate, in particular, has compounds with antioxidant properties that, you guessed it, support cardiovascular health. It also contains small amounts of phenylethylamine and serotonin precursors that elevate mood and alertness – that endorphin release can definitely set off some libido vibes!

The all-around effect of chocolate can make sex a much more pleasurable activity to engage in. In practical terms, dark chocolate is heart-healthier than, say, a slice of cake, so enjoy it in moderation!

Adaptogens

Verdict: Can put you in the mood… via stress reduction.

Adaptogens are the wellness world’s little darlings right now, and they’re everywhere: teas, tinctures, smoothies, and “shots.” Maca root, ashwagandha, mushrooms like Turkey Tail and Reishi, astragalus, and other adaptogenic plants don’t act like stimulants or hormones, but they do help regulate the stress response, reduce fatigue, and improve overall resilience.

Many of these plants come from traditional medicine systems that focus less on sexual performance itself and more on restoring balance, which is really the root of any illness, according to these philosophies. In Ayurvedic and traditional Eastern practices, adaptogens are used to help the body respond to stress, fatigue, and illness.

Chronic stress elevates cortisol, disrupts sleep, drains energy, and interferes with sex hormone signaling. By default, this state of imbalance in the body suppresses the libido. The stress-buffering effect of adaptogens can help remove some of the barriers to “turning something on.” If the body can handle stress more effectively, conditions are such that the libido and an interest in sex have room to return.

Always talk to your prescribing physician before adding herbal supplements to your diet. Their effects vary widely depending on the person, the specific compound, dosage, and overall health context.

Peppers

Verdict: Can create a rush of sensation.

Heat can be equated with vitality and sexual energy, and peppers have long been associated with passion, fire, and desire. Intuitively and sensually, it makes sense: spicy foods cause warmth, sweating, flushing, and a racing heart, all sensations that can accompany physical arousal and prime the body and brain for intimacy. But there is a psychological force also driving this; just because we eat peppers doesn’t mean we’ll automatically be “in the mood.”

The compound responsible for the burn or sting we feel from eating a hot pepper, capsaicin, temporarily increases circulation and triggers the release of endorphins. That short-lived “rush” can feel energizing, exciting, and even euphoric. The effect is a momentary sensory illusion that sounds crazy at first, but again, has cardiovascular effects that might lend credence to spicing things up in the bedroom.

Peppers are also rich in vitamin C, antioxidants, and anti-inflammatory compounds. Capsaicin may protect against arterial calcification by encouraging normal arterial cell behavior and slowing down the harmful changes that cause arteries to stiffen and harden over time.⁴ Flexible arteries mean better blood flow, and better blood flow leads to stronger erections and sexual function.

Figs and Dates

Verdict: Nutritionally supportive, at best.

Figs and dates have been associated with sexuality and fertility for thousands of years. In many ancient Mediterranean cultures, figs symbolized fertility, abundance, and sexual vitality. In Ancient Egypt, Greece, and across the Middle East, sweet foods in general symbolized abundance, pleasure, and reproductive success.

In a practical sense, figs and dates are calorie-dense, rich in natural sugars, and provide quick energy along with small amounts of minerals and antioxidants. In populations where food scarcity or physical exhaustion was common, this rapid energy delivery may have translated into improved stamina, including reproductive capability.

Another commonality in these foods: they’re whole and healthy. They’re great at providing quick carbohydrates (energy) and delivering small amounts of minerals and antioxidants. The aphrodisiac status is mostly cultural and symbolic, and perhaps a splash of biological due to nutritive value.

Walnuts, Almonds, and “Shaped-Like It” Foods

Verdict: The Doctrine of Signatures…

… states that foods resembling body parts must benefit those body parts. It’s an ancient, pseudoscientific theory that plants and other consumables have characteristics that determine what they’re good for. Walnuts look like brains, so they were thought to improve cognition. (Turns out, they actually do!) Asparagus resembles male anatomy, so it must enhance virility. Nuts, seeds, and certain roots all found themselves folded into the aphrodisiac category through this “like affects like” logic.

Regardless of the myth around these “shaped-like it” foods, evidence suggests nuts were part of our species’ diet almost 800,000 years ago. Nuts and the tools to crack them have been found in bogs and archaeological sites throughout the Middle East, Europe, and the Americas.⁵

And nuts actually do support sexual health – but not just because they resemble, well, the corresponding anatomy. Walnuts and almonds are rich in healthy fats, antioxidants, and minerals that support cardiovascular health and help regulate cholesterol and triglycerides – and your erection depends on all of that being in healthy ranges.

Honey

Verdict: It’s the symbolism.

Love. Fertility. Sexuality. The very word honeymoon comes from a tradition of newlyweds consuming honey-based drinks to promote fertility and happiness in early marriage. In pockets of the world, and throughout history, its sweetness has symbolized pleasure and abundance, and its rarity made it a luxury.

Besides sharing sweets in a moment of closeness and intimacy, honey might accidentally work to “get the juices flowing” due to the quick-energy release from glucose and fructose and the extra kick of antioxidants and minerals.

Caveat: sipping honey throughout the night isn’t going to maintain an erection or otherwise keep you alert in the bedroom. Count on your urologist and clinically guided treatments for that part.

Outside the bedroom, honey earns its keep in other ways: it has mild antimicrobial properties, can soothe sore throats and coughs, supports gut health when used in moderation, and serves as a gentler alternative to refined sugar for people trying to stabilize energy and blood sugar levels. As an ancillary player, honey might be part of broader lifestyle changes that make intimacy easier.

What We Know Works

Not to take the magic out of it, but many classic “aphrodisiacs” probably worked because people expected them to; sort of a placebo effect. The psychology of it can be just as powerful as the physiology of desire and intimacy. If you believe something will help you feel more self-assured, it often does – in this case, the expectation or perception of a food to invite arousal. And there’s nothing wrong with that!

Oysters, beets, dark chocolate, nuts – they’re all genuinely healthy. And if you’re interested in the long game, they support cumulative, positive effects on cardiovascular, metabolic, and emotional well-being. Just don’t expect direct, immediate, or knee-knocking effects on libido.

If you really want to move the needle, we know a balanced diet, regular physical activity, and a consistent, healthy weight are always in style. Keeping underlying health conditions in check, like diabetes, high blood pressure, or sleep disorders, also affects sexual function. Even when physical health looks good on paper, mental health, stress, anxiety, depression, and relationship strain can undermine desire, performance, and overall health.

If you’re experimenting with dietary changes, supplements, or wellness trends, it’s wise to loop in your healthcare provider, especially if you have underlying conditions, take medications, or are trying to correct a specific sexual health concern. When lifestyle changes aren’t enough to turn your sexual health around, it might be time for a chat about medication, hormone evaluation and replacement therapy, or advanced urologic treatments designed to address the underlying cause directly.

Modern sexual medicine offers real, evidence-based solutions, and help is closer than you think. Dr. Kapadia believes curiosity is a good thing in medicine. If you have questions, even the ones that feel awkward or off-limits, he welcomes them. Based in the Atlanta area with Georgia Urology, Dr. Kapadia specializes in men’s sexual and reproductive health and remains actively involved in advancing the field through ongoing research and education.

Whether you want to learn more about our blog content or talk through your own concerns, we encourage you to schedule a visit.

Resouces:

  1. Avey, T. (2014, October 8). Discover the History of Beets. PBS Food. https://www.pbs.org/food/stories/history-beets.
  2. Strauss, M. (2015, August 21). The 5,000-Year Secret History of the Watermelon. National Geographic. https://www.nationalgeographic.com/history/article/150821-watermelon-fruit-history-agriculture.
  3. Wang, H., Zhang, J., Ma, D., Zhao, Z., Yan, B., & Wang, F. (2023). The role of red ginseng in men’s reproductive health: a literature review. Basic and clinical andrology, 33(1), 27. https://doi.org/10.1186/s12610-023-00203-0.
  4. Luo, D., Li, W., Xie, C., Yin, L., Su, X., Chen, J., & Huang, H. (2022). Capsaicin Attenuates Arterial Calcification Through Promoting SIRT6-Mediated Deacetylation and Degradation of Hif1α (Hypoxic-Inducible Factor-1 Alpha). Hypertension, 79(5), 906–917. https://doi.org/10.1161/hypertensionaha.121.18778.
  5. The History of Nuts. (2026). Www.nutcrackermuseum.com; Leavenworth Nutcracker Museum. https://www.nutcrackermuseum.com/history_nuts.htm.

When Your Diet Goes Head-to-Head

Posted on by Akash Kapadia, MD in ,

Man smiling while eating healthy lunch, putting fork to mouth

Erectile dysfunction (ED) is more common than many realize, affecting millions of men, as well as their partners, worldwide. Modern medicine has developed wildly impressive and effective solutions, ranging from medication to penile implants.

What modern medicine can’t change is how you treat your body. In other words, what you eat, how you move, and how you manage stress can all influence your sexual function.

Foods That Can Help

You are what you eat has more truth to it than many realize. A diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats not only nourishes your body but also your sexual health. Leafy greens, beets, and berries are particularly helpful because they contain nitrates and antioxidants, compounds that support the ability of your blood vessels to expand and increase blood flow. Healthy blood flow to the penile arteries results in strong, consistent erections.

Whole grains and legumes, packed with fiber, help regulate blood sugar and cholesterol, which also protects vascular health. And healthy fat isn’t your enemy – unsaturated fats from olive oil, nuts, and fatty fish support cardiovascular function and, indirectly, sexual performance.

Lean proteins from poultry, fish, or plant sources help maintain muscle mass and overall metabolism, contributing to hormone balance. Some studies suggest that men who follow Mediterranean-style diets, which are high in fruits, vegetables, whole grains, healthy fats, and fish, experience lower rates of erectile dysfunction than men who follow typical Western diets high in processed and fried foods.1

Foods That Can Hinder

Not all “healthy” foods are created equal – even foods with labels such as natural, diet, or zero-calorie can contain hidden sweeteners and other undesirable ingredients that aren’t so helpful. Processed foods with refined carbohydrates, saturated fats, and excess sodium can also sabotage sexual performance.

Refined carbohydrates, such as white bread, pastries, and sugary snacks, spike blood sugar and can worsen insulin resistance over time. This creates vascular stress and may reduce blood flow to the penis. Saturated and trans fats, commonly found in fried foods, fast food, and many baked goods, contribute to the development of atherosclerosis, which narrows arteries and impedes circulation – everywhere. High sodium intake can raise blood pressure, again negatively affecting vascular health.

Even moderate levels of unhealthy eating, when repeated daily and over time, can gradually compromise metabolic health and erectile function. On the flip side, the occasional indulgence alongside otherwise healthy dietary habits promotes physical health, reduces stress, boosts mood, and creates enjoyable social experiences that actually enhance sexual wellbeing.

Creating better habits like replacing processed snacks with whole foods, cooking with olive oil instead of margarine, and moderating caffeine intake can drastically improve blood flow, energy levels, and hormone balance. What hinders vascular and endocrine health can hinder erections.

There’s More: Exercise and Metabolic Health

We’ve mentioned it a few times, and we’ll say it again: erectile function depends heavily on cardiovascular and metabolic health. Regular physical activity improves circulation, lowers blood pressure, helps stabilize healthy body weight, and reduces stress, all of which can impact the ability to obtain and maintain an erection.

Aerobic exercise (including activities like walking, jogging, swimming, or cycling that get your heart rate up) strengthens the heart and blood vessels, increasing the availability of nitric oxide – a compound necessary for smooth muscle relaxation and adequate blood volume to the penis. Resistance training (as in push-ups, curls, deadlifts, and planks) helps regulate testosterone production, preserves muscle mass, and improves metabolic function. Pelvic floor exercises (such as Kegels, bridge pose, and squats) directly strengthen the muscles involved with erections and ejaculation, augmenting rigidity and control.

Obesity is also linked to erectile dysfunction – excess body fat, particularly around the abdomen, creates inflammation, insulin resistance, and lower testosterone levels. Fortunately, even modest weight loss can yield noticeable improvements in sexual function.

Moderating all of these aspects of lifestyle creates a positive feedback loop: improved circulation and hormonal balance support sexual performance; increased confidence and energy encourage continued healthy behaviors.

That’s Not All: Smoking, Alcohol, Stress, and Sleep

Yes, all of these factors can affect sexual performance. Poor sleep, particularly obstructive sleep apnea, insomnia, and nighttime shift work, is strongly associated with low testosterone and impaired vascular function. Research indicates that short sleep duration itself may negatively influence erectile function – men who consistently get insufficient sleep are at higher risk for developing ED, even after accounting for age and other medical conditions.2

Not getting regular quality Z’s has also been linked to a wide range of other disorders, including diabetes, hypertension, and major depressive disorder, all of which can further contribute to sexual dysfunction. Studies suggest that sleep-related disruptions in neuroendocrine systems, molecular signaling pathways, and vascular regulation can all lead to ED.2 Establishing consistent sleep habits not only supports better erectile function, but it can also enhance responsiveness to medical treatment.

Smoking damages blood vessels and reduces nitric oxide availability, making erections more difficult. Chronic alcohol use, on the other hand, can impair testosterone production and cause nerve damage. Chronic psychological stress elevates cortisol, which can decrease testosterone and interfere with the nervous system pathways involved in erections. Anxiety, depression, and performance pressure further compound the problem.

Oftentimes, smoking, alcohol consumption, and mental health go hand-in-hand, making this one of the most challenging lifestyle aspects to tackle. If you or someone you know is struggling with substance dependency or emotional well-being, please reach out to a healthcare provider for additional support and guidance.

Get Your Head in the Game

Erectile dysfunction is rarely just a bedroom issue – it’s often a signal indicating your body needs cardiovascular, metabolic, hormonal, and even mental health support.

Diet and lifestyle have a dynamic impact within the body, sometimes rivaling medication in effectiveness. When healthy habits are combined with medical intervention, these strategies provide the most comprehensive approach to ED and your overall physical mojo.

If you’re struggling with ED and want personalized guidance, schedule a consultation with Dr. Kapadia. With a few adjustments and solid medical advice, you can regain sexual confidence and peak performance.

Resources:

  1. Di Francesco, S., & Tenaglia, R. L. (2017). Mediterranean diet and erectile dysfunction: a current perspective. Central European journal of urology, 70(2), 185–187. https://doi.org/10.5173/ceju.2017.1356.
  2. Zhang, F., Xiong, Y., Qin, F., & Yuan, J. (2022). Short Sleep Duration and Erectile Dysfunction: A Review of the Literature. Nature and science of sleep, 14, 1945–1961. https://doi.org/10.2147/NSS.S375571.

Do Penile Implants Need a Tune-Up?

Posted on by Akash Kapadia, MD in ,

Happy couple hugging and laughing

“When can I have sex with it?”

“How long does it last?”

“What happens if I use it too much?”

“What happens if I don’t use it enough?”

“How often should I see my doctor?”

Penile implants are a game-changer for men with erectile dysfunction, and these are common questions that come up. Curiosity is a good thing, and implants perform best when you understand the basics. To keep your game fresh, it helps to pay attention to proper use, catch problems early, and keep your tune-ups in check.

Time to Activate

If you think you’ll be able to jump back into your nighttime extracurriculars right after surgery, your expectations will need an adjustment. After surgery, the soft tissues and incision areas need time to heal. Usually, about four to six weeks after surgery, you’ll be allowed to “activate.” Activation refers to the first intentional inflation of the prosthesis after the surgical site has healed and swelling has resolved.

The initial activation often happens in the surgeon’s office, allowing the patient (and partner) to learn proper pump technique and ensure the device works as intended. During the activation session, the surgeon demonstrates how to operate the pump-deflation mechanism and addresses any questions you may have to make sure you’re comfortable with the process. This education is pretty important, since proper technique can prevent mechanical issues and early mishaps that could stress the device or tissue.

Once you’ve been cleared for activation, it’s important to cycle the device regularly. Cycling refers to inflating and deflating the implant to keep the internal components moving. Regular cycling also helps maintain the health and elasticity of penile tissue.

Resuming sexual activity is an exciting milestone, and as soon as your healthcare provider has cleared you, game on. The timeline varies based on individual healing and comfort levels, but it’s usually around the same time as activation. A month or more may seem like a long time to wait, but be patient – jumping the gun could increase the risk of infection, wound dehiscence (rupture), or cylinder migration.

Whatever you come to them with, your provider has likely heard it before, so communicate openly about any concerns or questions during this period.

Know the Limits

You’ve gotten through surgery, you’ve been cleared for resuming activity, and now the fun begins. Is it possible to have too much fun with a prosthesis?

Not really…. If you’re using it properly. An inflatable penile prosthesis (IPP) is designed to withstand sexual activity without damage, and the concept of “overuse” is more about misuse than frequency. Behaviors such as forcing the cylinders against resistance during inflation, bending the device at extreme angles, or using it before complete healing can lead to mechanical issues or injury to the penis.

Underuse also occurs, and yes, it can be problematic in more ways than one, but we’ll focus on just one. If the inflatable cylinders remain deflated for extended periods, especially in the early months post-surgery, the surrounding tissue may contract, making future inflation more challenging. We often recommend scheduled early cycling, inflating and deflating the device regularly after activation. This keeps the cylinders flexible and maintains a healthy range of motion.

After the healing period, occasional use is fine – most patients don’t need to inflate daily once comfortable with the device and satisfied with their sexual routine.

Maintaining

IPPs don’t require routine tune-ups like a car, but some practical steps help keep the device working well:

  • Proper use: Learn pump mechanics and avoid unnecessary stress on the device.
  • Early cycling: Being consistent helps the device settle and prevents corporal contraction (the tightening of smooth muscle cells in the penis).
  • Monitoring: Watch for signs of complications, such as pain, swelling, or malfunction.

Regular follow-up appointments with your healthcare provider can also minimize long-term complications and ensure the implant functions reliably.

Even after healing, IPPs can encounter issues. And while many implants function well for years, revision surgery could become necessary. Potential complications and reasons for revision include:

  • Infection: Persistent redness, swelling, drainage, or fever signals urgent evaluation. Although rare, infections can occur and may require device removal.
  • Mechanical problems: Cylinder leaks or pump malfunction may require replacement, and sometimes parts just wear out over time.
  • Erosion or migration: The implant may shift or move through surrounding tissue, but proper sizing and avoiding early trauma usually prevent this; treatment usually involves explantation (surgical removal of the implant).
  • Fibrosis: A lack of early cycling can lead to scarring that limits the expansion of the cylinder.

The Weeks and Years Post-Op

Routine follow-ups help catch potential issues early, ensuring the IPP continues to function optimally. Follow-up schedules vary, but a typical timeline includes:

  • 1 Week Post-Op: Initial check-up to assess the surgical site.
  • 4-6 Weeks Post-Op: Activation session and functional assessment.
  • 3-6 Months Post-Op: Evaluate implant function and patient satisfaction.
  • Annually: Long-term follow-up to monitor implant condition and address any concerns.

These visits are also a chance to review technique, ask questions about changes in your sexual routine, and talk through any new symptoms. Even years after surgery, most patients benefit from maintaining contact with their provider to ensure a smooth operation.

Managing chronic health conditions such as diabetes, high blood pressure, or cardiovascular disease also plays a significant role in long-term implant success. Good control of these conditions supports proper blood flow and healing, reducing the chance of complications. Lifestyle factors, such as maintaining a healthy weight, staying physically active, and not smoking, further support overall penile and vascular health.

It’s worth noting that most inflatable penile implants last well over a decade, with high satisfaction rates among patients and their partners. Knowing that your device has a strong track record of durability can provide peace of mind as you return to normal life.

If you’re considering a penile implant or want long-term guidance with your device, consult with an experienced specialist. Dr. Kapadia has been designated as a Coloplast Titan and Boston Scientific AMS 700 Center of Excellence surgeon for penile implants – one of the few surgeons in the nation to achieve this dual designation. His expertise ensures patients receive the highest level of care from surgery through long-term follow-up.

Rebuilding Connection: Penile Implants & Quality of Life for Patients and Their Partners

Posted on by Akash Kapadia, MD in ,

Couple embracing outdoors during sunset

Sex isn’t just about sex. It’s about closeness, confidence, desire, and feeling like yourself. When erectile dysfunction (ED) enters the picture, it can take a toll far beyond the bedroom. Patients often describe a quiet erosion of connection, marked by less eye contact, increased distance, and fewer shared moments. Partners feel it too – frustrated, concerned, or unsure how to help.

For couples dealing with ED, the strain is both physical and emotional. Research shows ED can significantly impact mental and emotional well-being, not just for the individual, but for their partner, too. Many patients experience a dip in self-esteem, confidence, and even depression. Partners often report feeling unwanted, rejected, or isolated in response.¹ And when pills or pumps don’t work (or stop working), it’s easy to feel like hope is off the table.

But it’s not.

Inflatable penile prostheses (IPPs), also known as penile implants, are a highly effective, discreet, and long-lasting solution that’s helping men restore their sexual function and reclaim their quality of life. And research shows that both patients and their partners are overwhelmingly satisfied with the results.

Information about the mechanics of penile implants is widely available. But let’s focus on what really matters: how people feel afterward.

What the Numbers Say

Psychological factors such as stress, negative self-talk, or fear of failure in the moment are almost the worst part about ED – what researchers call “cognitive interference.” A penile implant eliminates the need to mentally manage the timing and success of medication, removing a significant source of anxiety.¹

In one study, more than 83% of patients were satisfied with their implant a year or more after surgery and said that they’d recommend it to a friend.² Another review noted satisfaction rates as high as 90%, putting penile implants on par with other life-enhancing surgeries like knee replacements and breast augmentation.³

Why so high? There’s the obvious reason, of course – regaining an erection. But it also brought people back to a place of comfort, connection, and spontaneity. For many couples, the implant removes the performance anxiety and pressure that often comes with ED. Intimacy becomes possible again, without the clock ticking on medication or external devices.

Men, as well as women, just want to be close to their partner again, and 85% of partners reported satisfaction with the results, alongside the men themselves.⁴ The better the partner feels, the more satisfied the patient is, and vice versa. Restoring erectile function helps restore emotional equilibrium for both partners.

Partners play a huge role in recovery, communication, and emotional healing. That’s why more urologists now encourage couples to come to consultations together to ask questions, express concerns, and start rebuilding trust as a team.

More Than an Erection

Sure, regaining sexual function is important. But the benefits of a penile implant often reach well beyond the bedroom. Patients frequently report improved confidence, reduced stress and anxiety, increased relationship satisfaction, and a return to physical closeness that had been absent for months or even years.

And while not every couple discusses these feelings out loud, many describe a quiet shift in their relationship – hand-holding comes back, affectionate jokes return, and emotional intimacy starts to feel easier again.

Some men worry the implant will “feel fake” or that their partner won’t accept it. In reality, most partners are grateful to regain intimacy and connection. Many couples report that once they adjust, the experience feels natural and emotionally freeing. And while the idea of surgery can seem daunting, the procedure itself is straightforward. Most patients return to light activity within a few days, and sexual activity within 4 to 6 weeks – just a brief recovery when you consider the months or even years of frustration that came before. Even better? Most implants last 10 to 15 years or more, making them a long-lasting solution to a long-standing challenge.

Most implants today are inflatable, discreet, and completely concealed within the body. Once healed, there’s no visible sign, and the function is entirely under your control. That means no waiting for pills to kick in or worrying about timing. It’s there when you want it, and completely undetectable when you don’t.

And with satisfaction rates this high, you’re investing in so much more than a medical device – you’re investing in quality of life, for yourself, and your partner.

Penile implants offer men and their partners a chance to reclaim something deeper. Whether ED has been a lingering issue or a recent frustration, you deserve to know your options and to have a partner in that conversation.

If you’re ready to talk about what life after ED could look like, Dr. Kapadia is here to help. He is a Coloplast Titan and Boston Scientific AMS 700 Center of Excellence for penile implants, and one of the few centers in the nation to achieve this dual designation.

He can offer expert guidance to patients and couples exploring treatment options, and has helped many people find their way back to a satisfying, connected life.

The earlier the ED is addressed, the less emotional distance builds between partners. Don’t wait until things feel unmanageable – many couples say they wish they’d explored treatment sooner.

References:

  1. Allen, M. S., Wood, A. M., & Sheffield, D. (2023). The Psychology of Erectile Dysfunction. Current Directions in Psychological Science, 32(6), 487–493. https://doi.org/10.1177/09637214231192269.
  2. Jorissen, C., De Bruyna, H., Baten, E., & Van Renterghem, K. (2019). Clinical Outcome: Patient and Partner Satisfaction after Penile Implant Surgery. Current Urology, 13(2), 94–100. https://doi.org/10.1159/000499286.
  3. Barton, G. J., Carlos, E. C., & Lentz, A. C. (2019). Sexual Quality of Life and Satisfaction With Penile Prostheses. Sexual Medicine Reviews, 7(1), 178–188. https://doi.org/10.1016/j.sxmr.2018.10.003.
  4. Jorissen, C., De Bruyna, H., Baten, E., & Van Renterghem, K. (2019). Clinical Outcome: Patient and Partner Satisfaction after Penile Implant Surgery. Current Urology, 13(2), 94–100. https://doi.org/10.1159/000499286.

Penile Implant as A Fix for Both Peyronie’s Disease and Erectile Dysfunction

Posted on by Akash Kapadia, MD in ,

Older couple smiling and laughing, woman laughing into older man with beard shoulder

The sex life of a middle-aged man is under threat from any number of urological conditions. One of the most psychologically and physically debilitating is erectile dysfunction. And while we have excellent first-line options in the form of medications like Viagra and Cialis or their generic versions, Sildenafil and Tadalafil, as well as penile injections, eventually, patients with erectile dysfunction, will not be able to achieve the erection they want, even with these arrows in their quiver.

Unrelated in cause but certainly related in function is a curvature or deformity of the penis known as Peyronie’s disease. There are several possible causes of Peyronie’s curvature, many of which we don’t understand fully. However, the general consensus, or at least a going theory, is that micro-traumas to the penis over time can cause the buildup of penile plaque that ultimately underlies the curvature of the penis. Penile plaque can accumulate anywhere around the penis, and therefore the curvature is not necessarily upward but can also be downward or even to the sides.

Peyronie’s disease has several potential treatments and options. About 5-10% of cases will improve independently. This leaves most patients needing some intervention for relief. The only FDA approved medical treatment for Peyronie’s is a medication known as Xiaflex that can be injected into the penile plaque and, along with manual traction, can soften the plaque and help remodel the penis to a more normal state. Xiaflex can be effective in nearly 75% of patients that undergo treatments, leaving some needing more invasive intervention. Penile plication to straighten the penis with a counter-suture or plaque removal and grafting, which allows the surgeon to remove the penile plaque mechanically, are a couple of options for more significant diseases.

However, if patients are suffering from severe erectile dysfunction as well that does not respond to medications, then they must consider a penile implant. A penile implant can be used to straighten Peyronie’s curvature. Call it a 2-for-1 curative option. This surgical option is, of course, a very personal decision that must be made in consultation with an expert in both conditions, like Dr. Kapadia.

When a Penile Implant Is Indicated

It is worth understanding that a penile implant may not be performed on patients who are responding to ED medications. On the other hand, patients with severe erectile dysfunction need not have severe Peyronie’s to benefit from an implant to address both conditions. In other words, erectile dysfunction is the primary diagnosis and justification for an implant.

The Bottom Line

In the case of both Peyronie’s Disease and Erectile Dysfunction, the most significant limiting factor in men finding the proper treatment is fear and embarrassment. However, it’s essential to know that Dr. Kapadia works with men of all ages and all severity levels to treat both disorders. So, the first step is making an appointment with Dr. Kapadia to learn more about this and other potential treatment options.

Comparing Viagra/Sildenafil to Cialis/Tadalafil

Posted on by Akash Kapadia, MD in ,

When patients find that they need erectile dysfunction/ED medication, their mind often goes straight to which medication is best. This decision can be challenging with all of the marketing swirling around ED treatment. Ultimately, however, the two most commonly known medications on the market are Sildenafil, the generic version of Viagra, and Tadalafil, the generic version of Cialis. Other than the dosages – 100 mg maximum for sildenafil and 20 mg maximum for Tadalafil, the two drugs have similarities and differences that every patient should know and understand.

For one, both are PDE5 inhibitors, which relax and widen blood vessels to allow for increased blood flow. This is the primary mechanism of their effectiveness, and it’s why they are so good for mild to moderate ED.

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Eroxon Topical Erectile Gel

Posted on by Akash Kapadia, MD in

Man squeezing gel out of tube into hand

You may have heard of a new erectile dysfunction therapy known as Eroxon (MED 3000) that the FDA recently approved for over-the-counter use. It is a topical gel marketed in Europe and the UK as a faster way to gain an erection versus Viagra or Cialis, and their generic forms sildenafil and tadalafil, respectively. However, while this sounds like a fantastic erectile dysfunction therapy, does it work?

Before determining whether this particular gel works, we should discuss the history of topical erectile dysfunction gels and formulations. This very short discussion centers around the fact that we have tried to create topical versions of several medical therapies, including, for example, trimix, which is otherwise used as an injection into the penis, without any success – the simple fact is that, to date, we do not have a reliable therapy that functions topically.

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P-Shots for Erectile Health. Legit?

Posted on by Akash Kapadia, MD in

Doctor with gloves filling injection

You may have heard of the term biohacking. It’s a colloquialism now used for a practice that is centuries, if not millennia, old – fine-tuning the body to extract the highest and best performance. A favorite therapy of Biohackers is known as platelet-rich plasma therapy, posited as a rejuvenation therapy, and is used in several applications. Orthopedic surgeons use it to help rejuvenate joints. Hair loss specialists claim it may assist with regrowth, especially in those with androgenic alopecia or male pattern baldness. Plastic surgeons use it for facial skin rejuvenation – the list goes on.
Continue reading “P-Shots for Erectile Health. Legit?” →