the guy’s guide to maintaining sexual health by paul j. turek, md

Sexual  Health  

Sexual  health  issues  are  in)mately  related  to  overall  health    

         Blog  Post:  “The  Sound  and  the  Fury”  

0%   50%   100%  

70  65  60  55  50  45  40  

Age  

None   Mild   Moderate   Severe  

Source:  Massachuse9s  Male  Aging  Study   Probability  

“Anybody  who  believes  that  the  way  to  a  man’s  heart  is  through  his  stomach  flunked  geography.”  

-­‐  Robert  Byrne  

The  usual  suspects…  

Source:  NaIonal  Sleep  FoundaIon  Sleep  in  America  Poll    

Album  cover,  Ben  Lee  

Low  Desire  

Obesity  

Stress  MedicaEons  

Heart  Disease  

Diabetes  

ProlacEn  

Depression  

Low  Testosterone  

Sleep  

ErecEons  Thyroid  

InferElity  

Obesity  

Stress  MedicaEons  

Heart  Disease  

Diabetes  

Cholesterol  

ProlacEn  

Surgery  

Injury  

Organ    Failure  

Low  Testosterone  

High  Blood  Pressure  

Sleep  

The  Usual  Suspects…  

Alcohol  &  

Drugs  

Source:  Nudell  D  et  al.  Hum  Reprod.15:  1289,  2000.    

TesEcular  Cancer  A.er  InferElity  

FerElity  Status     No.  of  Men     SIR  (95%  CI)    All  Men   22,562     1.3  (0.9,  1.9)    Male  Factor  InferIlity    

4,549     2.8  (1.5,  4.8)*    

No  Male  Factor  InferIlity    

14,557     1.1  (0.6,  1.7)    

*P<0.05    

Male  InferIlity:  A  Biomarker    Of  Overall  Future  Health  

InferIlity  

?  

?   etc  

Facts:    •  Risk  factors:  family  history,

 undescended  tesIs,  pot  use  •   Curable  if  caught  early  •   TesIcular  self-­‐examinaIon    

 can  catch  it  

Blog  post:  “Weed  worries”  

Issues  in  your  body,    not  “in  your  head!”

Source:  www.Ne9ers.com  

•  Early  (premature)  ejaculaIon  

•  Late  (delayed)  ejaculaIon    

•  Dry  (retrograde)  ejaculaIon  

•  Absent  or  anejaculaIon  

•  EjaculaEon  is  a  spinal  reflex  (just  like  sneezing)  •  Completely  clinically  treatable  

ContracepEon  

Guys,  here  are  your  choices:                                                          

Blog  Posts:  “Pulling  Out  is  In”  and  “The  Ailing  Male  Pill”    

Condoms   #1  for  STD  protecIon  

Rhythm  

Withdrawal   Not  as  bad  as  was  thought  

AbsInence  

Vasectomy   #1  for  ease  and  compliance  

“Male  Pill”     Compliance,  effecIveness    and  trust  issues  

STDs  The  STD  “Most  Unwanted”  list  in  the  U.S.:    

Source:  www.cdc.gov/std  *Has  a  vaccine:  Gardasil  

Frequency   Perpetrator   Trend  

#1   Genital  Warts  (HPV)*   ?  

#2   Herpes  Virus  (HSV)   ?  

#3   Chlamydia   Rise  

#4   N.  Gonorrhea   Decline  

#5   HIV   Decline  

#6   Syphilis   Rise  

STDs:  Syphilis  in  California  

ReproducIve  Age  Men   Who  Live  in  the  Bay  Area  

Source:  www.cdc.gov/std  

STDs:  The  Best  Advice  

PracEce  safe  sex.  

The  Male  Hormone  Testosterone  

Body  hair  

Bone  marrow-­‐stem  cells  

Behavior  /  mood  

 Bone-­‐growth,  density  

Blood-­‐clojng,  HDL  

Heart-­‐vasodilaIon  

Fat-­‐reducIon  

Kidney-­‐erythropoieIn  Liver-­‐serum  proteins  

Muscle-­‐anabolic  

Male  sex  organs-­‐      maintenance  

MaseraI  Ghibli  

Sexual  Health  

Obesity  

Stress  MedicaEons  

Heart  Disease  

Diabetes  

ProlacEn  

Depression  

Low  Testosterone  Sleep  

ErecEons   Thyroid  

Alcohol  &  

Drugs  

Does  it  do  a  body  good?      Yes,  some  call  it  the  “elixir  of  life”…  

Is  it  the  “root  cause”  of  your  sexual  problems?    

 Unlikely…  

Is  testosterone  replacement  the  “holy  grail”  for  men?    

 No…    

Blog  post:  ”Testosterone:  A  sword  with  two  edges”  

“More  is  be9er”    curve  

Testosterone  Level    

Outcome  

“Here’s  the  truth”    curve