Articles & Education
Straight answers. No hype. Just information you can use.
What You Should Know About Perimenopause and Menopause Hormone Therapy
A single study in 2002 changed how a generation of women were treated. What it actually found, what we understand now, and why waiting until after menopause is usually the wrong advice.
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Perimenopause: The Years Nobody Warned You About
Your labs came back normal and you still feel wrong. Here is why perimenopause is so often missed, and what is actually happening.
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Men and Women Run on the Same Hormones
Estrogen, progesterone and testosterone are not his and hers. What differs is the amounts, the ratios, the timing, and how tissues respond.
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Gaslighting in Medicine, I’m Sorry - Recurrent UTI. (originally posted 9/27/21)
Women with recurrent UTI symptoms are routinely told nothing is wrong. Why standard urine cultures miss real infections, and what testing can find them.
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The Menopause Connection to Recurrent UTIs
If your urinary infections started after menopause, the reason is usually estrogen. Vaginal estrogen is one of the most effective and most underused preventions we have.
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Low Testosterone: When a Number Actually Matters
Symptomatic men get told they are normal for one reason: someone read a single testosterone number without context. What the number does and does not tell you, and why treatment is on the table more often than men hear.
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Peptides: What They Are, and Why the Rules Keep Changing
Peptides are oversold and misunderstood in roughly equal measure. What they actually are, why so few are FDA approved, and how to tell the well-supported ones from the rest.
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Preventing Recurrent UTIs: Tips and Strategies for Urinary Tract Health
Practical steps that reduce recurrent urinary tract infections, and an honest look at where the prevention evidence is strong and where it is weaker than people assume.
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Erectile Dysfunction Is a Warning Sign, Not Just a Bedroom Problem
The arteries in the penis are small, which means they clog first. New erectile dysfunction in a man under 60 deserves a cardiovascular workup, not just a prescription.
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The Bliss Point: Why You Cannot Stop at One
The food industry has a name for the exact mix of sugar, salt and fat that maximizes craving, and companies spend years of testing to hit it. What the bliss point is, the NIH trial that proved the effect, and why fighting science with science is nothing to be ashamed of.
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The Scale Is Measuring the Wrong Thing
Two people at the same weight can be in completely different metabolic shape. And a good deal of what gets blamed on aging turns out to be weight.
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What are the Different Types of Urinary Incontinence?
Stress, urge, overflow, and mixed incontinence are different problems with different treatments. How to tell them apart and what actually helps each one.
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Smoking Does Not Stop at Your Lungs
Everyone knows what smoking does to lungs. Almost nobody knows it is the biggest cause of bladder cancer, or that it shows up in the bedroom years before it reaches the heart. A urologist's case for quitting, and how to actually do it.
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Kidney Stone Size: What Passes on Its Own and What Doesn't
A 6 mm stone and a 6 cm stone are not the same problem. What your report actually says, the odds a stone passes, how long it takes, and the one symptom that means go to the ER tonight.
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UroLift Center of Excellence, and What It Actually Means for an Enlarged Prostate
Dr. Roscoe Nelson was designated a UroLift Center of Excellence. More useful than the award: where minimally invasive options actually fit for an enlarged prostate.
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Preventing ED during Prostate Cancer Treatment
Can Viagra during radiation help preserve erections? What penile rehabilitation is trying to accomplish, and what the evidence actually supports.
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Is the PSA Test Right for You?
PSA is the most argued-over test in urology. What an elevated result means, why overtreatment was a real problem, and what changed to fix it.
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Understanding the PSA Test
A single PSA number rarely settles anything. How age, free PSA, density, and velocity each add to the picture, and what actually happens after an elevated result.
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What Happens if My PSA is Elevated?
An elevated PSA is a starting point, not a diagnosis. What happens at the follow-up visit, and how the decision to biopsy actually gets made.
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Treatment Options for Prostate Cancer
You've been diagnosed with prostate cancer. How grade, stage, and your own health shape the decision, and what each option actually involves.
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Treatment for Advanced Prostate Cancer
What we can do for prostate cancer that has spread, and how treating earlier and harder changed the outlook.
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Thirty Years of Technology in Urology: What Worked and What Didn't
A urologist looks back at three decades of new technology, what actually changed how patients do, and what quietly disappeared.
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The Government’s War Against Men’s Health is About to Get Much Worse (by Benjamin Davies, MD)
Guest commentary from Benjamin Davies, MD, on how changes to prostate cancer screening policy affect men's health.
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Can a person survive on 1 kidney that is not failing but not in perfect condition?
Can you live with one kidney that is not in perfect condition? Usually yes, but carefully. How diabetes, blood pressure, and ordinary aging change the math.
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Patient Question: My kidney stone is 6 cm, is there an option to try and dissolve?
Most kidney stones are calcium-based, and once they form they are nearly impossible to dissolve. What actually works for a large stone, and when surgery is the answer.
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Patient Question: Where is kidney pain referred to?
Kidney pain shows up in the mid back, the abdomen, or the groin depending on the cause. How to tell it apart from an ordinary muscle strain.
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Patient Question: Can you overdose on potassium?
You can overdose on potassium, but for most people it takes far more than bananas. When kidney problems and certain blood pressure medications make it a real risk.
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Patient Question - Fish Oil and the Prostate
Does fish oil raise PSA or prostate cancer risk? A look at the omega-3 study that worried a lot of patients, and what it does and does not actually show.
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Patient Question: Why do bladders fall in the first place?
Pelvic organ prolapse happens because the pelvic floor carries real weight. Why pregnancy, aging, and tissue change make bladders drop, and what can be done.
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