Education Articles
How Blood Sugar Damages Tendons: The Hidden Role of AGEs
Tendons are resilient structures, built to transmit force from muscle to bone. But like other tissues in the body, they are vulnerable to the damaging effects of elevated blood sugar. One of the most important biochemical contributors to tendon degeneration in metabolic disease is the formation of advanced glycation end products, or AGEs.
Prescription Preworkout: Tadalafil and L-Citrulline for Vascular Performance, Increased Strength and Muscle Pump
Traditional preworkout supplements often rely on stimulants like caffeine or yohimbine to deliver short-term energy and vascular effects. While these ingredients may enhance alertness and temporary vasodilation, they often come with side effects like anxiety, rapid heart rate, and crashes. At the Performance Medicine Institute, we offer a prescription alternative grounded in vascular physiology: a combination of daily tadalafil (5mg) and L-citrulline (750-1500mg) to safely and sustainably enhance performance, blood flow, and muscle pump without overstimulation.
A Comprehensive, Integrative Approach for Chronic Migraines
Chronic migraines are more than just frequent headaches. They represent a complex neurological disorder that often resists conventional pharmacologic treatments. Many patients are prescribed medications or receive Botox injections, yet continue to struggle with persistent pain, tension, fatigue, and reduced quality of life. At the Performance Medicine Institute, we take an integrative, multimodal approach that targets the root causes of migraine, not just the symptoms.
TriMix Therapy: A Temporary Tool for Long-Term Erectile Function
Erectile dysfunction (ED) is a multifactorial condition that can result from hormonal imbalance, vascular insufficiency, nerve injury, or chronic illness. While many patients respond to first-line oral medications like tadalafil or sildenafil, others require more direct interventions. TriMix, an intracavernosal injection therapy, is a powerful short-term solution used in select cases. At the Performance Medicine Institute, we view TriMix not as a lifelong therapy, but as a transitional tool, one used to restore penile tissue responsiveness while working to correct the underlying causes of ED.
Testosterone Therapy for Women: A Critical Hormone for Energy, Libido, and Wellbeing
While testosterone is typically associated with men’s health, it also plays a critical role in the wellbeing of women. Produced in the ovaries and adrenal glands, testosterone contributes to libido, energy, muscle mass, bone density, and mood regulation. For many women, especially those approaching menopause or who have undergone surgical oophorectomy, testosterone levels decline significantly which leads to a constellation of symptoms that can be addressed with carefully monitored hormone replacement therapy.
Oral vs Topical Minoxidil for Hair Loss: A Closer Look at Effectiveness and Safety
Minoxidil is one of the most widely used medications for androgenic alopecia (male and female pattern hair loss). While most patients are familiar with the over-the-counter topical version, oral minoxidil has recently gained attention for its superior efficacy and ease of use. Originally developed as an antihypertensive, oral minoxidil has been repurposed at low doses to stimulate robust hair regrowth across the scalp with a favorable safety profile. Understanding the differences between oral and topical delivery can help patients and providers choose the right strategy for hair restoration.
Understanding Post-Finasteride Syndrome: Causes, Symptoms, and Treatment Approaches
Post-finasteride syndrome (PFS) is a poorly understood but increasingly recognized condition characterized by persistent physical, neurological, and sexual symptoms that continue long after discontinuing finasteride. Finasteride is a 5-alpha reductase inhibitor commonly prescribed for androgenic alopecia and benign prostatic hyperplasia. Although effective in reducing dihydrotestosterone (DHT) levels, its systemic effects can disrupt hormonal and neurosteroid balance, resulting in long-term adverse outcomes in a subset of users.
Comparing Biological Therapies for the Treatment of Knee Osteoarthritis
Knee osteoarthritis (OA) is a degenerative joint disease that leads to cartilage loss, pain, stiffness, and functional decline. While joint replacement remains a final option for severe cases, many patients seek less invasive solutions that can relieve symptoms and delay or prevent surgery. Regenerative and orthobiologic therapies have emerged as promising options, offering tissue-supportive and anti-inflammatory effects. This article compares four common injectable treatments, hyaluronic acid (HA), platelet-rich plasma (PRP), microfragmented adipose tissue (MFAT), and bone marrow aspirate concentrate (BMAC), in the management of knee OA.
Innovative Treatment for Hard Flaccid Syndrome: A Multimodal, Regenerative Approach
Hard flaccid syndrome is a distressing and poorly understood condition that primarily affects men between the ages of 20 and 40. It is characterized by persistent penile discomfort, a semi-rigid flaccid state, perineal tension, and erectile dysfunction that cannot be attributed to typical organic or psychological causes alone. Because it overlaps with both pelvic floor dysfunction and neurovascular dysregulation, treatment requires a nuanced, multidisciplinary approach. At the Performance Medicine Institute, we combine pelvic rehabilitation with regenerative therapies and metabolic support to offer a comprehensive strategy for recovery.
Rehabilitation After Prostate Cancer Surgery: Optimizing Recovery and Long-Term Outcomes
Prostate cancer surgery, most commonly a radical prostatectomy, is a critical intervention for treating localized prostate cancer. However, it can lead to substantial changes in urinary, sexual, and pelvic function. Many patients are unprepared for the downstream effects of surgery, which may include incontinence, erectile dysfunction, pelvic pain, and impaired core strength. Rehabilitation is not just supportive care, it is a proactive, evidence-based approach that improves quality of life and accelerates functional recovery.