Pelvic Health
Tibial Nerve Stimulation for Premature Ejaculation and Erectile Dysfunction
Tibial nerve stimulation is a form of neuromodulation that uses electrical stimulation near the ankle to influence nerve pathways that connect back to the sacral nervous system.
Treating Overactive Bladder, Incontinence, and Pelvic Pain with Tibial Nerve Stimulation
Tibial nerve stimulation is a form of neuromodulation used to influence the bladder and pelvic floor through the nervous system.
Type 2 Diabetes and Erectile Dysfunction
Erectile dysfunction (ED) is one of the most common complications of type 2 diabetes, and it is rarely "just a plumbing problem." Diabetes impacts erections through reduced nitric oxide signaling and endothelial function, accelerated atherosclerosis, and diabetic neuropathy, often years before someone develops obvious cardiovascular symptoms.
Different Types of Testosterone: Cypionate, Enanthate and Undecanoate
Testosterone replacement therapy (TRT) is not a one size fits all treatment. Even when two products deliver the same hormone, the ester attached to testosterone changes how quickly it is released from the injection site, how smooth levels feel between doses, and how often you need to dose.
Inhibin B: A Reliable Marker of Sperm Production
Inhibin B is a peptide hormone secreted primarily by Sertoli cells in the seminiferous tubules of the testes. It plays a critical role in the regulation of the hypothalamic-pituitary-gonadal (HPG) axis and serves as a negative feedback signal to the anterior pituitary to suppress follicle-stimulating hormone (FSH) secretion. Clinically, inhibin B has emerged as a valuable biomarker for assessing spermatogenic activity and testicular function in men.
Anal Trauma in Men: A Restorative and Trauma-Informed Approach
Anal trauma in men is an often hidden and under-discussed issue, yet it can have profound impacts on physical function, sexual health, and psychological well-being. Whether the result of consensual sexual activity, a medical procedure, an athletic injury, or assault, anal trauma can lead to long-term symptoms such as rectal pain, bleeding, bowel dysfunction, and pelvic floor dysfunction. Men may avoid seeking care due to embarrassment, fear of judgment, or previous dismissive experiences in healthcare settings.
Resolving Chronic Scrotal Pain: A Comprehensive, Non-Surgical Strategy
Scrotal pain, also known as orchialgia, is a distressing and often misunderstood condition that affects men of all ages. While acute causes such as testicular torsion or infection require urgent evaluation, many men suffer from chronic or intermittent scrotal pain that has no clear surgical target. In these cases, the pain may persist for months or even years, impacting physical comfort, emotional well-being, and sexual function.
Phimosis: A Non-Surgical Approach to Promote Retraction and Restore Function
Phimosis is a condition in which the foreskin cannot be fully retracted over the glans penis. While this is common in children and typically resolves naturally by adolescence, in adults it can cause pain with erections, hygiene problems, and recurring inflammation. In more severe cases, phimosis may progress to paraphimosis, a urologic emergency where the retracted foreskin becomes stuck behind the glans, restricting blood flow and risking permanent injury.
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.
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.