Archive for June, 2013

No More Dirty Ol’ Men-Testosterone May Just Be The Answer

June 29, 2013

Testosterone, the hormone made in a man’s testicles declines with age. The symptoms of low testosterone include lethargy, falling asleep after meals, irritability, loss of sex drive or libido, and loss of muscle mass. Most of these symptoms can be reversed by hormone replacement therapy.

Men over age 65 who have a low testosterone level and symptoms of low testosterone have shown marked improvement in their symptoms with testosterone replacement therapy. Older men who receive testosterone replacement have reported a decrease in their waist circumference, a decrease in their blood pressure and a decrease the total cholesterol level.
Testosterone replacement therapy can be administered by an injection every 7-14 days, daily application of a gel to the skin each morning, or the insertion of testosterone pellets under the skin using a local anesthetic. These pellets will last 4-6 months and need to have follow up pellets 2-3 times a year.

Bottom Line: Testosterone replacement therapy is effective in older men and helps them restore their energy level, their libido or sex drive, and improve their cardiovascular health.

Vasectomy-The Prime Cut, Most Men Are Satisfied With The Decision and the Procedure

June 22, 2013

I have performed nearly 6000 vasectomies in my career and I have found very few men are disappointed with the procedure or the results. The majority of men don’t have any reservations after the procedure.
Often men will ask if the procedure is reversible and the answer is that the vasectomy can be reversed. However, men should make the decision to have a vasectomy only if their family is complete or they don’t plan to ever have children. The cost of the vasectomy is less than $1000 but the cost of the reversal can be north of $20,000. The vasectomy is done with a local anesthetic only takes 10-15 minutes and a reversal requires a general anesthesia and can take 2-3 hours to complete.

A study conducted at the University of Iowa reported half of the men said they considered a vasectomy for a year or less before having the procedure; 85 percent had a high level of certainty they made the right decision. The most common reason for the sterilization was that a man didn’t want additional children and felt a vasectomy was the best birth-control option. Over 90 percent were married, and had two or more children.

Almost a third of the men had some anxiety about the procedure, primarily concern about possible pain and “fear of the unknown.”
Bottom Line: Vasectomy remains one of the best forms of permanent sterilization. Most men are satisfied with the procedure and the results and would do it again and recommend it to others.

Shocking New Treatment For Impotence-Shock Waves Found Effective In Treating ED

June 16, 2013

Shock wave has been successfully used for over twenty years for the treatment of kidney stones. Now a modified shock wave has been used to treat impotence or erectile dysfunction.

A study of twenty men with an average of 50 and who had ED for more than three years were selected to participate. The men had ED on the basis of cardiovascular disease. The treatment consists of using low-intensity shock waves twice a week for three weeks. The men were tested one month later and 15 of the 20 men had significant improvement in their ability to engage in sexual intimacy with their partner.

The men were found to have an increased in blood flow to the penis when comparing the pre-treatment to the post treatment period.

Bottom Line: Yes, drugs such as Viagra, Levitra, and Cialis are effective in the treatment of ED however they only work when the man consumes the medication. Shock waves may be therapeutic and may result in such significant improvement that the man once treated no longer needs to take any medication for his ED. Stay tuned as shock wave to the penis may be just what the doctor orders!

The Skinny On Water-A Convenient Diet Aid

June 16, 2013

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Would you believe that drinking plain water, good ol’ H-2-O can produce a significant weight loss?  It’s as easy as drinking two glasses of water before each meal.  If you drink two glasses of water, it is likely that you will consume 75 less calories at each meal compared to those who do not drink water. 

How does it work?

Water fills the stomach before you start the meal and gives you a feeling of satiety even before you start consuming any food. 

Water also boosts metabolism because your body has to work to bring the ingested liquid to your core temperature.  Those who drink 8-12 glasses of water a day had a higher metabolic rate than those who just drank four glasses a day. 

Bottom Line:  Water is a calorie free appetizer.  It’s also free and it does work and you can expect to lose an additional 6.6 pounds a year.  So drink up…..water that is!

Cunnilingus And Throat Cancer-Fact vs. Fiction

June 4, 2013

Mike Douglas

Mike Douglas

First it was Angelina Jolie getting top media billing with her revelation that she had double mastectomy because she tested positive for BRCA gene and was at great risk for developing breast cancer. Now Michael Douglas raised eyebrows when he cited oral sex as the cause of his throat cancer. We do know that Mr. Douglas has a history of smoking, which is known risk factor for developing throat cancer.

The tonsil and base of tongue area are areas of concern for cancer caused by a strain of HPV, or human papillomavirus. This virus can be transmitted through oral sex. However, it doesn’t mean that everyone who engages in oral sex is going to get this type of cancer. It’s actually a small percentage of people who contract the virus and don’t have an immune system that can kill the virus.

HPV does cause many cases of cervical cancer in women and is also associated with penile, anal and vaginal cancers.

Help is available to prevent these infections with a vaccine.
The three series vaccination is most effective in people up to the age of 26. It is best to have young boys and girls vaccinated before they have become sexually active. But the most important thing you can do is to be careful. The same way you would act to avoid contracting HIV. The more promiscuous you are, and the more partners you have, the more at risk you are. Use common sense and don’t take sexual risks.

Impotence: When You Can’t Get It Up is Getting You Down

June 3, 2013

Probably nothing devastates a man more than having a failure in the bedroom. Impotence or erectile dysfunction affects nearly 33 million men in the United States. You are not alone. Help is available for nearly every man who has erectile dysfunction.
According to the Urology Channel’s “Erectile Dysfunction: Natural/Alternative Treatments,” erectile dysfunction can be treated by eating right, drinking plenty of water and avoiding sugar, dairy and caffeine. They recommend to eat whole, fresh, unrefined and unprocessed foods, including vegetables, whole grains, soy, beans, seeds, nuts, olive oil and cold-water fish such as salmon and tuna.
Taking your vitamins can also help; the Urology Channel suggests supplements such as flaxseed, and in particular vitamins C, E and the mineral zinc. These vitamins and supplements help bolster the vascular system, which is an important part of good sexual health.

Since sexual health relies on the vascular system, a strong heart plays an important part in treating erectile dysfunction. Aerobic exercises such as power walking, running, bicycling or dancing strengthen the cardiovascular system. A stronger cardiovascular system gives stronger support to the vascular system that supports a healthy erection.
 Kegel exercises–exercises that flex the pelvic muscle– which are helpful in strengthening the ligaments that support an erection. These exercises can also increase blood flow in the pelvic area, which can aid in achieving a strong erection.

Herbs which are used in Traditional Chinese Medicine to support healthy erectile function include ginseng, ginger and ginkgo biloba.
 Ginseng helps increase blood circulation, and is typically taken as a dried powder, often as a paste mixed with honey. Ginkgo biloba also increases blood flow in the arteries, which help support the vascular functions that enable a healthy erection.
 Another non-medical option is garlic but the treatment can be tough to take: the trick to getting the most out of garlic is to chew fresh, uncooked garlic very thoroughly. Though it is unpleasant and can be downright painful, this allows your body to absorb powerful natural nutrients through the blood vessels in the mouth. Some of the most powerful ingredients in garlic are destroyed as they travel through the digestive system, and these erectile dysfunction-fighting nutrients are only absorbed while chewing.
One out of two men over age 40 have had difficulty attaining and maintaining an erection sufficient for sexual intercourse, doctors say. And while the numbers are smaller, even some younger men may have difficulty developing an erection.
However, more than at any other time in history, erectile dysfunction is a problem with a solution. Medications and external and internal treatments have improved dramatically, allowing thousands of men to return to healthy sexual functioning. Likewise the stigma has decreased with public awareness.
Over the past 20 years, increased media attention, scores of television ads for medications like Viagra, Levitra and Cialis and starring roles in movies and television shows have moved erectile dysfunction out of the shadows and onto the list of common health concerns.
Erectile dysfunction is often caused by a lack of adequate blood flow, which can be an indicator of a potentially life-threatening health problem such as heart disease, high cholesterol, or diabetes.
Surgeries for prostate cancer, bladder and certain colorectal cancers may result in erectile dysfunction.
Regardless of age or cause, treatment options are the same, depending on the individual.

Men with heart problems and some other health conditions cannot take Viagra, Levitra, or Cialis. These drugs can be fatal for men taking nitroglycerine or any nitrates.
The next level of treatment includes injections and vacuum pumps, both of which can be effective. While the thought of injections is less than appealing to most men, the results are excellent.
If pill and external treatments are not effective, doctors say an internal prosthetic device is an option.
An implant gives the spontaneity and quality of erection that they can’t get with many of the other treatments including pills, injections or vacuum pump. Internal devices or a penile prosthesis are effective continuously on demand, which means a man and his partner can achieve a full erection on demand and within seconds that contains itself as long as they want to have sex.
While these surgeries have been performed since the 1950s improvements in surgical technique and devices are dramatic.
The 30-minute procedure is minimally invasive and usually does not require hospital admission. Men may experience some discomfort for 1-2 days after the procedure.

Men who have the prosthesis have by far the best satisfaction rate for any treatment for erection problems, up into the 99 percent range.

Bottom Line: Erectile dysfunction affections millions of American men. There are solutions both medical and surgical that can help men restore their ability to successfully engage in sexual intimacy with their partners.

Incontinence-Deep Six The Depends

June 3, 2013

You Don't Have to Depend On Depends!

You Don’t Have to Depend On Depends!

Urinary incontinence affects millions of American women. The involuntary loss of urine is one of life’s most embarrassing events. The best solution is not diapers or panty liners. Help is available and you can donate the diapers to the grandchildren.
Urinary incontinence isn’t an inevitable result of aging. Most women who have it can be helped or cured.
The best treatment depends on the cause of your incontinence and your personal preferences. Treatments include:

Recommended Related to Urinary Incontinence/OAB

Overactive Bladder (OAB)
Urinary incontinence, the involuntary loss of urine, affects an estimated 25 million Americans, mostly women. For most, incontinence is the result of problems controlling the bladder. For people with a type called functional incontinence, however, the problem lies in getting to and using the toilet when the need arises.

Behavioral training, such as bladder training and timed urination.
Bladder training (also called bladder retraining). This is used to treat urge incontinence. With bladder training, you slowly increase how long you can wait before having to urinate by trying to delay urination after you get the urge to go.
Timed urination. It can be used to treat both urge and stress incontinence. With timed urination, your doctor has you urinate on a schedule, even if you don’t have to go.
Prompted urination. It requires a caregiver to prompt the person to urinate. This technique is used mostly for people with a disability that gets in the way of using the bathroom on their own (functional incontinence).
Lifestyle changes and pelvic floor (Kegel) exercises.
Medicines. There are medications used to relax the bladder muscle. These are referred to as smooth muscle relaxants. Examples include Ditropan, Toviaz, Enablex, Detrol, and Vesicare
Medical devices. An example is a pessary which is helpful for pelvic organ prolapse
Surgery. For more information. This is intended for women with stress incontinence or loss of urine with coughing and sneezing.

Behavioral training, exercises and lifestyle changes, and medicines are usually tried first. If the problem does not get better, your doctor may try another treatment or do more tests.
When there is more than one cause for incontinence, the most significant cause is treated first, followed by treatment for the secondary cause, if needed.

Bottom Line: Incontinence is one of life’s greatest embarrassments. Treatment is available. You don’t have to depend on Depends!

Dr. Neil Baum is one of the authors of What’s Going On Down There-Improve Your Pelvic Health, which is available from

Book on Pelvic Health By Drs. Siddighi and Baum

Book on Pelvic Health By Drs. Siddighi and Baum

The Enlarged Prostate-Spending Too Much Time On the Toilet

June 1, 2013

Normal prostate (L) vs. Prostate gland enlargement (R)

Normal prostate (L) vs. Prostate gland enlargement (R)

Prostate enlargement affects million of American men over age 50 who have symptoms of frequency and urgency of urination, poor force and caliber of the urine stream and getting up multiple times a night to go to the restroom to urinate. The enlarged prostate gland can impact a man’s quality of life. Nearly all men can achieve relief from this common medical problem.

There are several effective treatments for prostate gland enlargement. In deciding the best option for you, you and your doctor will consider your particular symptoms, the size of your prostate, other health problems you may have and your preferences. Your choices may also depend on what treatments are available in your area. Treatments for prostate gland enlargement include medications, lifestyle changes and surgery.

Medications are the most common treatment for moderate symptoms of prostate enlargement. Medications used to relieve symptoms of enlarged prostate include:
Alpha blockers. These medications relax bladder neck muscles and muscle fibers in the prostate itself and make it easier to urinate. These medications include terazosin, doxazosin (Cardura), tamsulosin (Flomax), alfuzosin (Uroxatral) and silodosin (Rapaflo). Alpha blockers work quickly. Within a day or two, you’ll probably have increased urinary flow and need to urinate less often. These may cause a harmless condition called retrograde ejaculation — semen going back into the bladder rather than out the tip of the penis.
5 alpha reductase inhibitors. These medications shrink your prostate by preventing hormonal changes that cause prostate growth. They include finasteride (Proscar) and dutasteride (Avodart). They generally work best for very enlarged prostates. It may be several weeks or even months before you notice improvement. While you’re taking them, these medications may cause sexual side effects including impotence (erectile dysfunction), decreased sexual desire or retrograde ejaculation.
Combination drug therapy. Taking an alpha blocker and a 5 alpha reductase inhibitor at the same time is generally more effective than taking just one or the other by itself.
Tadalafil (Cialis). This medication, from a class of drugs called phosphodiesterase inhibitors, is often used to treat impotence (erectile dysfunction). It also can be used as a treatment for prostate enlargement. Tadalafil can’t be used in combination with alpha blockers. It also can’t be taken with medications called nitrates, such as nitroglycerin.

Laser surgeries use high-energy lasers to destroy or remove overgrown prostate tissue. Laser surgeries generally relieve symptoms right away and have a lower risk of side effects than older surgical procedures such as the TURP or transurethral resection of the prostate that require 3-4 days of hospitalization and requires a catheter for several days after the procedure. Some laser surgeries can be used in men who shouldn’t have other prostate procedures because they take blood-thinning medications.

The laser used in my practice is the green light laser (GLL). It is performed in the hospital or a one-day surgery center. Men go home after the 30 minute procedure with a catheter which is usually removed the day after the procedure.

Less than 1% of patient will experience erectile dysfunction after the procedure, and 1/3 of the patients have retrograde ejaculation after the procedure. Some of the common side effects include mild burning with urination. Although incontinence can occur with this procedure, it is very uncommon, especially when it is performed by an experienced urologist.

For more information on managing the enlarged prostate gland with the green light laser, please view my video on YouTube:

The Prime Cut: the No Needle, No-Scalpel Vasectomy

June 1, 2013
Procedure Can Be Accomplished Without a Scalpel

Procedure Can Be Accomplished Without a Scalpel

Family planning is an important concern for all couples. An unwanted pregnancy in the United States is not as critical as an unwanted pregnancy in China, which has a two-child policy. Nonetheless, permanent contraception is an issue that most couples need to be concerned about. A vasectomy is a permanent form of sterilization and is the most reliable, inexpensive and effective method of contraception currently available with over a 99.9% success rate.

The procedure takes about 20 to 30 minutes and can be done in an office or clinic. It is usually done by a urologist.

No-scalpel vasectomy is a technique that uses a small clamp with pointed ends. Instead of using a scalpel to make a small opening of the scrotal skin, a special clamp is inserted through the tiny opening and separates the vas from the blood vessels and other structures along the spermatic cord. The benefits of this procedure include less bleeding, a smaller opening of about 1\4 inch in the skin, and fewer complications. No-scalpel vasectomy is as effective as traditional vasectomy.

Bottom Line: Vasectomy is a permanent method of birth control. Once your semen does not contain sperm, you do not need to worry about using other birth control methods.
Vasectomy is a safer, cheaper procedure that causes fewer complications than a tubal ligation in women. So if your family is complete, a no-scalpel, no-needle vasectomy as one of the best methods of contraception.

Hormone Headaches-You Don’t Need To Suffer Every Month

June 1, 2013

Menstrual Migraine

Menstrual Migraine

So Many Of Our Patients Are Plagued By Headaches during their menstrual periods. These headaches can be debilitating and are usually related to changing levels of estrogens that occur each month. Let us give you some suggestions that can relieve these hormonal headaches.

Entice the endorphins
If you exercise you can reduce the risk of menstrual migraines. This can be as easy as walking, jogging, biking, or swimming. These exercises increase the release of endorphins, which are nature’s most powerful pain relievers even more powerful than morphine.

Eliminate food triggers
The most common triggers are aged cheeses, processed meats with nitrites, chocolate, excessive caffeine, alcohol (especially red wine), citrus fruits, bananas, onions, and foods containing MSG.

Have a routine
Don’t skip meals, sleeping late on weekends, or any changes in your usual schedule can lead to menstrual headaches.

Rest and relax leads to relief
Yoga, meditation, or biofeedback teaches you how to control the muscle contractions and swelling of the blood vessels around your brain.

Put a little magnesium in your diet
We suggest 400-600 mg of chelated magnesium a day.

Pain pills.
At the first sing of a headache take a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen. Also over the counter aspirin and acetaminophen may be helpful. If you know the day you are going to experience a headache, take a pain reliever two days before your anticipate your headache.

It may be helpful to increase your estrogen levels by taking 1mg of estrogen (17 beta-estradiol) twice a day7 2-3 days prior to your period and continue for 2-3 days during your period.

This is the latest and best medication according to headache experts. Triptans, such as Imitrex, Maxalt, Zomig, stop the pain within hours after the pain starts and you can start the medication at the first sign of a migraine.

Bottom Line: Menstrual migraines are very common and can be debilitating for women who have these monthly headaches. Most of these headaches can be controlled by without medications but if the headaches are severe, speak to your doctor and he\she can help with medication.

for more information on pelvic pain, triggers of hormonal headaches, and menopause, please see our book, What’s Going On Down There-Improve Your Pelvic Health, available from

Book on Pelvic Health By Drs. Siddighi and Baum

Book on Pelvic Health By Drs. Siddighi and Baum