Many women visit their primary care physician for a physical and their gynecologist for an annual exam at least once a year. “This is a person who, if you get a good one, takes your overall health as a woman into consideration – it’s not just a ‘vag’ doctor,'” Megyn said. “She’s checking out the whole woman, [including] your energy levels, your sleep, the breasts, yes, down south and Rio and all the stuff… my blood pressure… Whenever I leave my GYN, I feel like, ‘Okay, I’m well looked after.'”
This type of check-in and check-up does not necessarily exist for the opposite sex. “Men don’t really have that… extra on top of the primary care physician,” she noted. “I think they do the ‘turn your head and cough’ when they go to the primary care physician and, for most men, that’s about it.” But is that enough to adequately address the sexual health and wellness concerns that men deal with? The answer is most likely no.
On Wednesday’s show, Megyn was joined by Mohit Khera, MD, a board certified urologist and professor of urology at Baylor School of Medicine, to discuss the most common sexual health concerns men face and what kind of care they require.
Male Sexual Health Concerns
According to a study of 1,500 men between the ages of 18 and 80 that was released last year, 40 percent of men have some sort of sexual dysfunction, including erectile dysfunction (ED), Peyronie’s disease (PD), and premature ejaculation (PE). Of that group, Dr. Khera said 70 percent said they want help and 50 percent said they don’t know where to get it. Perhaps most telling, 44 percent of respondents did not tell their partner and 53 percent didn’t tell their physician about their concerns.
Dr. Khera believes these findings show both a “patient embarrassment” and a “physicians aren’t asking about it” problem. He gave the example of his own wife. “My wife is a primary care physician and she says, ‘Look, I have about 15 minutes to go through diabetes, hypertension, obesity – erectile dysfunction tends to be at the bottom of the list,” he said. So, while patients may not be self-reporting, there is also a very good chance that providers aren’t even asking the questions.
It can be a dangerous blindspot. “I think that one of the best barometers of a man’s health is his sexual health because it not only encompasses your physical health, but it also encompasses your mental health,” Dr. Khera said. He pointed to a 2005 study that showed 15 percent of men who have ED will have a heart attack within seven years.
There is an anatomical explanation for this. “The penile arteries are much smaller – one to two millimeters – compared to the coronary arteries,” he explained. “So, if you’re going to block an artery, you’re more likely to block the penile artery before you block the coronary arteries.”
And then there is the mental health part of the equation. As Dr. Khera explained, 33 percent of men who have erectile dysfunction are severely depressed and 37 percent have severe anxiety. If that man is in a relationship, the effects are not limited to him alone. “ED has a devastating impact not only on the patient but on the couple,” Dr. Khera emphasized.
When a man experiences sexual dysfunction, Dr. Khera said he will usually start to avoid sex. “We call this ‘subconscious aversion,’” he noted. The partner then interprets the behavior as rejection and the situation can spiral from there. “We know that couples that engage in sexual activity have significant improvement in the quality of their relationships… and those that do not engage in sexual activity have a significant decrease in the quality relationship,” he shared. “So, again, sexuality is really important for the couple.”
Perhaps unsurprisingly, Dr. Khera said erectile dysfunction is among the most common sexual health concerns men face. As he explained it, the percentage of men experiencing ED increases with age (i.e. 30 percent of men in their thirties, 40 percent of men in their forties, and so on). “You live long enough, a man is gonna get erectile dysfunction,” Dr. Khera said. “As men get older and they start developing more and more sexual dysfunction, and our job is to try to find out why.”
Depending on your age and overall health, ED can be the result of a variety of things. “As we get older… we start taking new medications that can make a significant impairment on erectile function and we started getting more conditions that are associated with ED,” Dr. Khera shared. Diabetes, obesity, and metabolic syndrome are just a few comorbidities, while medications like beta blockers to treat hypertension are “notorious for causing erectile dysfunction,” he adds.
Viagra and Cialis, penile injections, and even penile prosthesis can all help treat ED, but Dr. Khera said there are preventative measures men can take as well. “Diet, exercise, sleep, and stress reduction are very powerful tools and can prevent a man from ever developing erectile dysfunction,” he concluded. “So, to me, that’s a form of prevention.”
You can check out Megyn’s full conversation with Dr. Khera by tuning in to episode 604 on YouTube, Apple Podcasts, or wherever you like to listen. And don’t forget that you can catch The Megyn Kelly Show live on SiriusXM’s Triumph (channel 111) weekdays from 12pm to 2pm ET.