The Armor Men's Health Show

EP 655: Should I Give Up On Getting It Up? A Listener Wonders If It's Too Late To Treat His ED

• Dr. Sandeep Mistry and Donna Lee

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In this segment, Dr. Mistry and Donna Lee answer a listener's question about ED in his seventies. Although he wants to be sexually active, his urologist dismissed his concerns and failed to diagnose or treat him. He wonders if he should give up or find another urologist who will help him pursue treatment. Dr. Mistry famously loves the topic of sexually active older men and finds great fulfillment in helping to preserve their sexual function. He strongly suggests this listener find a new urologist who will take his concerns seriously. He also points out that there can be many causes of ED, so the treatments offered should reflect a careful diagnosis. At NAU Urology Specialists, we provide thorough testing and diagnostic screenings to determine the origin of the dysfunction. Once a cause is identified, we offer a range of state of the art treatments ranging from medications and surgeries to sex therapy and pelvic floor physical therapy--all of which can be key parts of restoring sexual function for different patients with differing issues. To learn more about the options available to you if you suffer from ED, or to make an appointment, call us today!

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Speaker 1:

Welcome to the Armor Men's Health Hour with Dr. Mystery and Donna Lee. Hello and welcome to the Armor Men's Health Hour. This is Dr. Mystery , your host here, as always with my awesome and really talented co-host, Donna Lee.

Speaker 2:

That's right. That is me, Donna Lee wearing a hat today,

Speaker 1:

Donna. It's really a stylish view . <laugh> . Um , this is a men's health show. Uh , I'm board certified urologist and , uh, we've been doing this show for a couple of years, really trying to give , uh, the listeners , uh, both in our immediate radio listening zone here in Austin, as well as listeners all over the world through our podcast, some important information regarding men's health issues, the little itty-bitty parts of your life that are really big parts of your life, like the sexual parts and the urinary parts that we can give you some insight on, and hopefully add a little humor into that.

Speaker 2:

That's right. We're always talking about those parts,

Speaker 1:

The nipples to the knees,

Speaker 2:

Trying to improve your parts.

Speaker 1:

Uh, the show is brought to you by N a u urology specialist. That's the , uh, specialty urology group , uh, that I started in 2007. Uh, we're no longer just one person and one person at the front desk. We are four physicians, a five physician assistants. Mm-hmm . <affirmative> . We have , uh, three pelvic floor physical therapists. We have a sleep medicine program because we know the importance of sleep hygiene and , uh, sleep wellness in terms of your overall health. We have sex therapy , uh, in the office. So when you are a man or a woman with a complex sexual dysfunction or even a simple sexual dysfunction , uh, this is a place that you can land and get really good care.

Speaker 2:

That's right. You can , um, catch us all over Austin, too. We're in Round Rock, north Austin, south Austin and Dripping Springs, Texas.

Speaker 1:

Well , how do people get ahold of us? Donna, you

Speaker 2:

Can call us during the week. You can even call my mobile phone because apparently it's out there. 5 1 2 2 3 8 0 7 6 2. That's not my mobile. That's the office number. Um, our website's, armor men's health.com. Or you can send us your questions to Armor men's health@gmail.com. I forgot people can't see me and I'm making hand motions. And Dr. Mystery's shaking his head no,

Speaker 1:

That's right, <laugh>. We're trying out , we're trying out introducing ourselves to the video audience and , uh, Donna's making a poor transition. I might add <laugh>.

Speaker 2:

I can hardly get the equipment connected, so I'm glad to just be here and be heard.

Speaker 1:

Your questions and the topics that you bring to us are what drive this show. Uh, Donna, do we have a question?

Speaker 2:

We do. We have a couple of topics, both from one's from a 73 year old, one's from a 77 year old, both the 73 year old I spoke with on the phone, and I thought this was fascinating. He has another urologist and he's leaving that particular urologist because in his opinion , uh, for the quality of care, he felt like the other urologist kind of just gave up on him because he is in his seventies. He's still sexually active or wants to be , um, and he has erectile dysfunction, but he said the other urologist really was kind of dismissive. And so , um, he wanted to get your thoughts on that, but I absolutely assured him over the phone we can help as much as we can possibly help. And Dr. Mystery's favorite thing is to give an erection to an older man.

Speaker 1:

That's right. I say it all the time on the show. If I can help a man in his eighties , uh, stay sexually active, that it's a really good day for me <laugh> because it's , uh, one of these goals for myself that we hope to kind of achieve as well. Right . Uh , my poor wily. So when it comes to the older man with erectile dysfunction on this, on this show, we often talk about what kind of, kind of puzzle a young man with erectile dysfunction can be for a urologist. And the 50 to 60 year old man is kind of bread and butter for most of us, right ? But, but what are the approaches you take for the man over 70? And what are you really worried about? So sometimes physicians can be worried about the cardiovascular impact that , uh, sex can have on them, but that's not really what drives most people to be , uh, a little hesitant to take care of it. It's that a lot of the treatments that we have simply don't work. Then you're kind of limited by the, how we would say the, the motivation of the individual to get an erection. So taking pills, doing shockwave, taking testosterone, these are things that a lot of patients are willing to do and easy to do. When we talk about more advanced ways to treat erectile dysfunction, whether they be injections into the penis or , uh, a penile prosthetic device, they require more conversation and sometimes it can , uh, be offputting for the provider more than the patient. Hmm . Uh , it reminds me of an interesting statistic. Uh, when it comes to women with sexual dysfunction, a lot of times women don't bring it up because their concerns are gonna embarrass the doctor. Really?

Speaker 2:

Hmm .

Speaker 1:

I know. I know. And so it's really hard

Speaker 2:

To embarrassing my doctor

Speaker 1:

To , to try to make sure that they <laugh> , uh, feel comfortable bringing them up. Look at this . A lot of our doctor , a lot of our , uh, patients , um, are really thankful that they can finally talk about these very sensitive sexual issues with the physician. But that's what we're here for. And we would hope that if , uh, you've been made to feel uncomfortable talking about these things in the past, now it's not just about whether you get , uh, an erection or not an erection. Sometimes , um, uh, men will have problems with delayed or premature. There are patients who have pain with , uh, difficulty with urination after. There can be some men who , um, uh, really complain of pain in the penis during intercourse. All of these things require a different approach. So if you're a man and in our practice, or a woman who are having sexual pain, sexual difficulty, low libido, we have so many great treatments , uh, that are available , uh, that go beyond just kind of, you know, Viagra and testosterone.

Speaker 2:

Gotcha. Well, we'll certainly let him know, 'cause I'm sure we'll see him soon. But don't give up in your seventies, guys.

Speaker 1:

No. Uh, you know, the, the things that cause erectile dysfunction, we usually , uh, discuss , um, with our patients in several different , um, uh, kind of silos. The first silo is the psychological things that can happen that cause you to lose your erection. That can be anxiety, that can be , uh, like performance anxiety. It could be , um, depression , uh, and depression meds, even. Uh, then there can be vascular issues. The blood float , the penis can be impaired. Uh, it may cause , um, uh, it may be associated with cardiovascular issues like your heart or your lower extremities , uh, or even , uh, the blood vessels to your brain , uh, can similarly be impacted by the same , uh, blocking effects. Neurologically, we see that a lot in diabetic men or even in spinal cord injury patients. And then there's hormonal, so testosterone being the obvious one, but there's other hormones like prolactin and thyroid hormone that if they're off, they will , uh, negatively impact your ability to get an erection as well. So if you're , uh, suffering from erectile dysfunction and people aren't giving you a deeper answer, they're just kind of throwing a pill at you, and that's not satisfactory to you. If you'd like to have a better understanding, we have all sorts of tests that we can do , uh, in the clinic. Donna, have you seen that little vibration machine that we have in room one?

Speaker 2:

Mm . It's big <laugh> .

Speaker 1:

It's a big machine <laugh> , and so it's

Speaker 2:

Intimidating. Yeah .

Speaker 1:

So this is , uh, this is the machine that's designed for the , uh, detection of diabetic neuropathy, but we've used it as many , uh, you know, advanced sexual health providers to examine the , uh, the vibratory sensation as well as the temperature sensation of the genital area. We do it in both men and women because sometimes people don't get an orgasm or people don't keep an erection because their sensation is diminished. Mm-hmm. <affirmative> . And so , um, although I don't have a way to regenerate the nerves , uh, more than supplements and better health , um, you know, and tighter control of your diabetes , uh, at least it gives the patient some closure, some understanding of why , uh, they're having the problem. Uh, similarly, we offer something called a penile doppler. Dr. Yang here in our office does penile doppler studies. So that , uh, is , uh, oftentimes we'll inject a medicine into the penis and make sure that the arteries are , uh, responding appropriately to the , uh, to the medication, or that you're not leaking blood out of the penis called venous leakage. Um , because all of these different , uh, causes are treated differently, and , uh, we want to be here to make sure that your treatment and your , um, uh, uh, you know, that your cause are, are aligned.

Speaker 2:

What does venous mean? What does that

Speaker 1:

Venus means? The vein. So , uh, when it comes to holding an erection,

Speaker 2:

Stop Venice Venus

Speaker 1:

<laugh> , I think your Italian dreams are coming through <laugh> . I remember, I remember floating on the canals of Venice drainage, Venice , the Ven , uh, when you have an erection, there's two parts. One is the artery brings blood flow into the penis, and second, the veins have to close off so the blood gets trapped in the penis. Hmm . So sometimes people have difficulty because the artery isn't strong enough, or not enough blood flows through the artery to give you an erection, but sometimes it's because the veins don't clamp off properly. And that's , uh, one of the proposed mechanisms of how patients with Peyronie's disease can have , um, uh, uh, venous leakage causing their erectile dysfunction. So when you come to our clinic, it's definitely one of the things that we're gonna be looking at , uh, uh, to, to get the , to the underlying reason for your erectile dysfunction,

Speaker 2:

Right? So, in a nutshell, your doctor should offer you a whole tools shed full of options. Is that right? Right.

Speaker 1:

And if you're, and if you're bringing tool shed, but if you're bringing up your erectile dysfunction at the last minute, right? When they're trying to walk out , walking

Speaker 2:

Out <laugh> , and

Speaker 1:

They're just gonna throw some Viagra at you and walk out the door , uh, but if you make a dedicated visit for erectile dysfunction, for example, in our clinic , uh, we're gonna go through a more advanced , uh, mechanism of trying to diagnose you. And so that, and that's what you should expect. So , uh, Donna, if people wanna get their , um, jive back on

Speaker 2:

Or their Venice and Venus questions answered, <laugh> ,

Speaker 1:

Please, how do people get ahold of us and how do people make an appointment?

Speaker 2:

You can call us about your veins and Venice, Italy at 5 1 2 2 3 8 0 7 6 2. Our website is armor men's health.com. Our email address for your amazing questions at Keep us fueled and ready to go is Armor Men's health@gmail.com. And you can listen to our podcast wherever you listen to podcasts. We are officially award-winning in men's wellness and sexual health. So take that, Dr . Mistry . Hmm . Thank you, <laugh> . The Armor Men's Health Hour will be right back. If you have questions for Dr . Mystery , email him at Armor Men's health@gmail.com.