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Writer's picture Michael Kaplan MD

The Year Of The Golden Penis Couldn't Come At A Worse Time!


First some great news for men. It seems that men on college campuses have never had it better. On many college quads the ratio of women to men has become lopsided, with many more available cis females than cis males. There is a "gender divide" which has created a dream scenario for want-to-be studs. With odds stacked heavily in their favor some lotharios learn to take their new-found popularity for granted. They can't help but feel that they don't have to work quite so hard in a relationship, since their next conquest is waiting around the corner. Understandably, some of the suddenly desperate females have grown resentful, and termed the phenomenon the golden penis syndrome.


"It was the best of times, it was the worst of times." Charles Dickens


Just when the odds finally seemed to be working in the favor of male college students, the incidence of erectile dysfunction has never been higher in young men. According to a large multinational studies the incidence of ED in young men is now as high as 30%! https://pubmed.ncbi.nlm.nih.gov/28642047/


The incidence of ED increases with each decade of life due to a reduction of the flow of blood into the penis (vascular insufficiency.) Endothelial dysfunction is a term that is used to describe pathology in the cells which make up blood vessels. The same processes that account for cardiovascular disease also causes occlusion of the blood vessels that supply the penis. Most of these processes are cumulative and older men are naturally more likely to have cardiovascular disease than young men. In fact, historically urologists believed that young men who suffered from ED usually has a psychogenic problem. While psychologic factors can still play a role it is now believed that even in young men there is a higher probability of an organic, or physical problem.


Things were already bad, and the pandemic made everything worse!



The cornerstone of a great erection is vigorous, luxuriant blood flow through patent blood vessels. A young healthy man with cardiovascular endurance is superbly suited to meet this requirement. Even before the pandemic many men under the age of 40 were struggling with erections because of a lack of exercise, borderline testosterone levels, inadequate sleep, and stress. The pandemic resulted in over 7,500,000 confirmed cases, and countless other subclinical victims.


Covid-19 results in hyperinflammation and a phenomenon termed cytokine storm. This in turn results in endothelial dysfunction and may also lower testosterone levels. This two pronged attack can kill erections. The duration of the damage is still not fully known. At least one team of investigators found evidence of Covid-19 in the tissue of penises at the time of implantation of penile prosthetics. https://pubmed.ncbi.nlm.nih.gov/33988001/


Erectile dysfunction is almost always treatable!


There have never been more options available for the treatment of erectile dysfunction. Obviously, for many years pde5 inhibitors such as Viagra and Cialis have been available and are now more affordable than ever.


It's true! Most patients initially respond favorably to Viagra. While Viagra, Cialis, Levitra and Stendra are highly effective, many patients experience side effects, and eventually the drugs usually stop working. The reason for this is that they just don't cure the root problem which is usually vascular insufficiency.


Most recently low intensity shock wave therapy has gained popularity and acceptance among urologists. Shock waves can reverse endothelial dysfunction and result in improved blood flow to the penis. Treatments have proven to be safe and well tolerated. Most recently, with the advent of rapidly advancing technology patients have been able to treat themselves at home, without embarrassing and expensive doctor visits.

While low intensity shock wave treatments don't work for everybody, patients who are just starting to notice a decline in function, or those who respond to medication but would prefer a more natural approach seem to be the most likely to benefit. Most patients who do benefit will ultimately require additional treatments, but by owning their own unit this becomes much less of an issue. If a patient notices a decline in function he can simply administer additional treatments at home with his own Uroshock.

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