Rena Malik, M.D. - Weak Erections at Night?! UTI after SEX?! | AMA
Dr. Reena Malik addresses erectile dysfunction (ED) and its potential causes, including hormonal fluctuations, vascular issues, nerve problems, medications, and psychological factors. She explains that testosterone levels peak in the morning, which may explain why some men experience better erections at that time. For prostatectomy, she outlines the prostate's role in urinary and sexual function, and discusses potential post-surgery outcomes like urinary incontinence and erectile dysfunction. She emphasizes the importance of nerve-sparing techniques and rehabilitation programs to maintain sexual function. Regarding recurrent UTIs, Dr. Malik explains that they are common in women due to anatomical factors and provides practical advice such as increasing fluid intake, urinating before and after sex, avoiding constipation, and considering cranberry supplements or post-coital antibiotics. She reassures that recurrent UTIs are not due to poor hygiene and advises against excessive cleaning.
Key Points:
- Testosterone peaks in the morning, affecting erection quality.
- Prostatectomy can lead to urinary incontinence and erectile dysfunction; nerve-sparing techniques help.
- Recurrent UTIs in women are common; increase fluid intake and consider cranberry supplements.
- Post-coital antibiotics can prevent UTIs; discuss with a doctor.
- Recurrent UTIs are not due to poor hygiene; avoid excessive cleaning.
Details:
1. 🎙️ Introduction: Ask Me Anything Episode
- Dr. Reena Malik introduces herself as a urologist and pelvic surgeon.
- The podcast is an 'Ask Me Anything' episode where Dr. Malik answers audience questions.
- Listeners can join her on renam malik. supercast.com to ask questions and access ad-free, early episodes.
2. 🕒 Erectile Dysfunction Timing
- Testosterone, a major sex hormone, is released in a pulsatile manner, peaking in the morning and decreasing throughout the day, potentially leading to erectile difficulties at night.
- Hormonal causes are not the primary cause of erectile dysfunction; vascular issues like high blood pressure, high cholesterol, and diabetes frequently impair blood flow to the penis.
- Neurological problems and surgeries affecting nerve function can also cause erectile issues.
- Certain medications, such as anti-depressants and high blood pressure drugs, may have side effects that impair erectile function.
- Psychological factors such as stress and anxiety can contribute to erectile difficulties.
- The timing of high testosterone levels in the morning aligns with better erectile function, while fatigue and accumulated stress at the end of the day may contribute to difficulties in achieving erections at night.
3. 🔍 Understanding Prostatectomy
3.1. Reasons for Prostatectomy
3.2. Post-Surgery Effects
3.3. Recovery and Rehabilitation
4. 🚺 UTIs After Sex: Causes and Tips
- Recurrent UTIs are common in women, with two or more UTIs in 6 months or three or more in a year being relatively common.
- The urethra in women is shorter, making it easier for bacteria to reach the bladder, especially during sexual activity.
- Drinking 1.5 liters more fluid daily can reduce UTI rates by 46% by diluting bacteria.
- 46% of UTIs resolve on their own due to the body's natural ability to clear bacteria.
- Urination before and potentially after sex can help some individuals, although there is no strong evidence supporting it as a preventive measure.
- Avoiding constipation is crucial as it reduces the bacterial load near the urethra.
- Proper pelvic floor relaxation during urination is important to prevent bladder dysfunction and bacterial growth.
- Cranberry supplements with 36 mg of proanthocyanidins can help prevent recurrent UTIs.
- 100% cranberry juice is effective in preventing recurrent UTIs.
- Consulting a doctor about post-sex antibiotic use can prevent UTIs, although chronic use has risks.
- Recurrent UTIs are not necessarily related to hygiene practices; excessive cleaning can cause irritation and mimic UTI symptoms.
5. 🔔 Conclusion and Membership Information
- Maintain hydration and address constipation for overall health benefits.
- Incorporate cranberry into your diet to support bladder health.
- Ensure regular and complete bladder emptying to prevent health issues.
- Become a member at renam malik.supercast.com for exclusive access to AMA episodes.
- Membership offers benefits such as participation in 'Ask Me Anything' sessions, ad-free and early episode releases.
- Members can access transcripts of episodes, providing enhanced accessibility.