The startling curve of how opioids deaths are increasing over two decades (Courtesy: CDC) The opioid epidemic is one of the most lethal and pressing health issues in America right now. Deaths from opioid overdose now surpass 80,000 annually. That’s more than the number of deaths due to colon and breast cancers combined! Sure, much of the problem rests in the streets where fentanyl runs rampant. But realize too that 88% of opioid abuse (not deaths) results from legally prescribed medications. So, it is incumbent on medical providers to seek alternative approaches to treating pain. To be fair, m ..read more

The soil is the thing… for good health and fertility (Courtesy: Unsplash) You may remember the movie Raising Arizona, the hyperactive Coen Brothers comedy in which Nicholas Cage and Holly Hunter, an unlikely and infertile couple (petty thief and policewoman), steal a baby to start their family. According to Cage, “Her insides were a rocky place where my seed could find no purchase.” This earthy analogy surfaced again recently at a workshop of holistic and Eastern medicine providers where I spoke. Providers of acupuncture and traditional Chinese medicine value and prioritize mind-body balance a ..read more

Lots of happy campers! Although a “no scalpel” anything is vastly more attractive than the alternative, is it really all it’s cracked up to be with a vasectomy? Or is it a marketing ploy to get men in the door? After all, who needs another bait and switch play when it comes to the family jewels? I have to say, in this instance, it’s no gimmick: the no scalpel vasectomy is the best thing to happen to men’s reproductive health since Viagra®. The Early Years The first vasectomy was performed in the UK almost 200 years ago. It gained notoriety in the roaring 20s as a male rejuvenation technique un ..read more

Starry, starry, night…great for ZZZZs (Courtesy Unsplash) Bedrooms are many things to many people. Usually, we view it as a place of rest, sleep and possibly sex. Lady Gaga called it her “stage,” albeit one that others aren’t allowed to see. Moby sees himself as a “weird, bald musician who makes records in the bedroom.” In many businesses, bedrooms are also boardrooms or, according to Theo Paphitis, a place where “you can have a worldwide shop.” Will Durst considers it a “place to laugh, so long as you don’t point.” Moon Unit Zappa thought of her bedroom as where she could be “miserable about ..read more

Stress: Now you know what it is, let’s gets control of it! (Courtesy G. Habeshaw, Unsplash.com) I never actually considered my practice to be an emergency room for men’s sexual health until a man in his mid-20s called and said: “I really need to see you…today! I had a problem down there last night!” Soon after, he sat in front of me, looking exhausted and beside himself and blurted out “I lost my erection during sex for the first time ever! Something’s definitely wrong with me; I hope it’s not serious.” I had him take a few deep breaths and began my investigation into his sexual conundrum. A T ..read more

A different, and mighty, drop of fluid (Courtesy: Alexander Gray, Unsplash) Pulling out is a very commonly used contraceptive. Officially called coitus interruptus, this ancient method of birth control is also an inexpensive, organic, and hormone-free. Pulling out defined as removing the erect penis from the vagina and vulva before ejaculation. Believe it or not, 60% of reproductive-aged women in the U.S. who have had intercourse have used withdrawal for contraception at some time. And, nearly 5% of women use pulling out as their primary method of birth control. Despite its worldwide ..read more

Lots of things in life are passed from father to son (Courtesy: Unsplash) It’s only been about a generation or so since we have come to realize that a significant chunk of male infertility is caused by subtle genetic changes in male DNA. Sure, syndromes based on larger, chromosomal alterations such as Klinefelter syndrome have been known for 60 years, but the finding of smaller DNA mutations causing male infertility is far more recent. Add to this the fact that assisted technology (IVF-ICSI) now offers the opportunity for biological fatherhood in many men with genetic infertility, and you can ..read more

Testosterone: good for your health or good for a healthy look? (Courtesy: Unsplash) Is testosterone therapy really all it’s cracked up to be? Does it really help your sex life? Does it actually help you live longer? Is testosterone the medicinal Holy Grail for men? And how, pray tell, have we come to believe that anabolic-suffused competitive bodybuilders, those (spray) tanned Adonis’ with ripped, ballooned muscles everywhere, are truly “healthy” when in fact they are not: their mortality rate as young men is unspeakably high. Yet there are those, including my patients, who swear by testostero ..read more

I have to say that I have led a truly privileged life in medicine. Throughout my long and storied education as a physician and caregiver, I have stood on the shoulders of many great mentors. In high school I had teachers who imbued biology and physics with wonder, awe, and hard-to-see logic. And then there were those Yale college professors who demanded critical and astute thinking in all things spoken and written. Finally, my mentors at Stanford Medical School taught me the sheer beauty and magnificence of human anatomy and physiology. Yes, they all shaped how I now think about medicine and ..read more

Creating knowledge from information is the key to Second Opinions (Courtesy: Leon Gao, Unsplash) Second opinions are commonplace in law, business, building and construction, and car repair. However, the idea that “two heads are better than one” really began in medicine. Second opinions should be considered when the diagnosis or treatment is unclear or when a treatment hasn’t worked. If the answer to “what should we do now?” is a shoulder shrug, consider another opinion. It may also have value when things just don’t sit right with you or when your gut feeling is off. Maybe your personal researc ..read more