Penn Primary Care Podcast Men's Sexual Health
Dec 22, 2025
Dr. Kathleen Hwang, a leading urologist and men's health expert, discusses vital aspects of male sexual health. She shares insights into differentiating between physiological and psychogenic erectile dysfunction and emphasizes the importance of taking a focused sexual history. Dr. Hwang clarifies testosterone's role in libido versus erections, explores common causes of erectile dysfunction, and offers practical tips on PDE5 inhibitors. She also addresses age-related sexual function and surgical options for those needing advanced interventions.
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SHBG And Estradiol Alter Testosterone Effects
- Total testosterone can be misleading when SHBG is high because free testosterone drops.
- Check SHBG and estradiol if symptoms don't match the total testosterone number.
Use Doppler Over Rigiscan For Vascular Testing
- Use penile Doppler ultrasound to assess arterial and venous function when needed.
- Home nocturnal tests exist but Rigiscan use has declined due to cost and availability.
Counsel Patients On PDE5 Practicalities
- Explain practical differences: sildenafil works best on an empty stomach and tadalafil tolerates food and offers long duration.
- Start with home trials alone to build confidence before introducing a partner.