How Men Can Boost Their Fertility For Better Odds Of Conception – Exclusive

By Brynna Standen/Updated: Oct. 7, 2022 12:49 pm EDT

This article is a repost which originally appeared on Health Digest.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Our Takeaways:

· Only 30% of fertility complications are due to complications in the woman alone.

· There’s a cultural stigma against infertility in men.

· Male fertility can be caused by a number of factors.

While in theory, the idea of trying to get pregnant sounds like a whole lot of fun (wink, wink), for some couples it can start feeling a little more like one of the Sphinx’s riddles — difficult to navigate and laden with pressure and high stakes. In the U.S., one in eight couples have difficulty conceiving (per Fertility Answers). While fertility experts agree that only 30% of these cases can be attributed to a complication in the woman alone, society often seems to be in silent agreement that fertility issues start and end with women.

This unspoken consensus seems to point toward a gender bias within the medical field. A 2006 review published in Medical Anthropology Quarterly found that out of 157 articles published on the topic of fertility, only one was centered around men. Adding to this, a 2016 study published in the American Journal of Preventive Medicine reports that in federally funded clinics that offer family planning services, 81% of them educate women on preconception care, while only 38% of them provide the same education opportunities to men.

Health Digest sat down for an exclusive interview with Dr. Justin Dubin — a urologist and men’s health specialist practicing in South Florida, and co-host of the men’s health podcast “Man Up: A Doctor’s Guide to Men’s Health” — who gave us the scoop on the stigma surrounding male fertility and offered advice on how men can boost their fertility, giving them and their families the best chance at conception.

Shifting the focus

Well aware of the societal bias surrounding fertility struggles, Dr. Dubin wants men to understand their role in family planning. “When it comes to fertility and family planning, it’s important for guys to remember that it takes two to tango,” he asserts. While there are certainly times that fertility issues solely fall on the female, Dr. Dubin points out, “In couples struggling with fertility, 50% of the time there is a male factor component to the couple’s fertility problems. In fact, 30% of the time, a couple’s fertility issues are strictly due to the male! Despite these statistics, there continues to be an unfair focus and pressure on female partners when it comes to family planning issues.”

When it comes to examining why a couple is having trouble conceiving, Dr. Dubin notes, “Women are often the only ones to see a doctor for a fertility workup. Guys need to know that if their partner is getting evaluated for fertility, they should too. Not only does it take some pressure off your partner, there is a chance that getting evaluated by a urologist can help you achieve your family planning goals. It’s time we shift the focus of fertility away from women and back to the couple as a whole,” he declares, adding with encouragement, “Guys, see a doctor!”

The stigma of infertility in men and how to get tested

Women aren’t the only ones who face stigmas surrounding infertility. “Most men don’t like seeing a doctor, especially when it comes to discussing topics like fertility that they often associate with masculinity,” says Dubin. “Fortunately, the fertility workup is fairly straightforward. Typically, when you see your doctor there are three components to a male fertility workup.” He explains that it starts with semen analysis. “A semen analysis is a test in which you provide a semen sample. It is the gold standard for a male fertility evaluation. Basically, we look at the amount and quality of the sperm in your sample to assess your fertility status.” For men still intimidated by the process, Dr. Dubin offers, “Based on both your comfort level and access to facilities, the sample can be collected either at home or in a lab.”

Next, Dr. Dubin explains that blood work is useful. “Like female fertility, there are certain sex hormones that play a role in male fertility and sperm creation. Testosterone is an example of a common hormone we look at.” Men should also get a physical exam, and give their doctors a detailed medical history, while they’re at it. “Male fertility can be impacted by so many different things that it is important for your doctor to hear your story,” Dr. Dubin says. “In addition to a good history, getting a physical exam helps with the big picture of what is going on.”

Expert tips on boosting male fertility

When it comes to male fertility, it’s not as simple as playing with the cards you were dealt. “Male fertility is interesting because lifestyle choices can actually make a big difference on some men’s fertility. When it comes to overall health, it is important to remember: what’s good for your heart is good for your parts. Men who smoke cigarettes, are overweight, inactive, and eat poorly are more likely to have low testosterone and fertility issues. Eating healthy, exercising, and losing weight can help improve fertility.” While low testosterone can play a role in the struggle toward conception, Dr. Dubin reveals, “One important medication that can compromise your fertility is taking testosterone. If you are considering having kids at any point, I would not recommend starting without talking with a doctor.”

While we may have assumed this one was an old wives’ tale, Dr. Dubin clarifies, “If you are actively trying to conceive, you should avoid exposure to wet heat, [like] saunas and hot tubs. The heat can create a less favorable environment for sperm and temporarily cause a decline in sperm numbers.” Last but not least, let’s talk lube. “If you are a couple who uses lubrication during intercourse, the kind of lubricant that you use can make a difference. Most lubricants do not provide favorable environments for sperm and can potentially compromise fertility. When it comes to lubricants that are good for family planning, we recommend using Pre-Seed.”

Finding support at home

Because of the sensitive nature of fertility — especially when it is proving to be an issue — Dr. Dubin stresses the importance of communication between couples. “Fertility is a sensitive topic for men to discuss as most guys associate it with their masculinity and what they consider makes them a man. At the same time, conception and family planning is a two-way street and if there are concerns about their sexual health or fertility status, it is important that their partner talks with them about it. Communication is key for couples struggling with fertility.” Offering one final tip to couples who may be having a hard time, Dr. Dubin says, “Focusing on the fact that this is a couple’s issue, not a male or female issue, should help relieve specific pressures and should motivate both partners to be active in the process and hopefully each get evaluated.” Teamwork makes the baby-dream work!

 

 

 

 

 

 

 

 

 

 

 

 

A Doctor with Hard Flaccid – Updates and Advice

A Doctor with Hard Flaccid – Updates and Advice

by Romero MD

Original post: A Doctor with Hard Flaccid – Updates and Advice

Hi everyone I am 26 years old and I recently developed this mythical problem called Hard Flaccid.
I am a medical doctor. I finished medical school a few months ago, and I am currently applying for Obstetrics-Gynecology.

First, my story. I have been practicing PE, intermittently, for the past 4-5 years. Basically, only manual stretches (I am satisfied with my girth), but, like many others, I think my injury was caused by Edging and excessive Kegeling, which I have been practicing for over 10 years, for stamina training and erection quality.

And without knowing the extreme importance of Reverse Kegeling. Every time I have sex, I also do intense kegels, in order to last 60-90 minutes of penetration. I know, I know… maybe it’s a little too much… But my girlfriend and I have always liked long love sessions Almost 2 months ago, while I was having sex with my girlfriend, I started to lose my erection suddenly, after performing an intense Kegel, during a sex position that placed my penis at a downward angle (so, I did a “very weighted Kegel”).

I thought I might have torn a muscle or ligament, and we stopped at that moment. The next day, I woke up with a hyper contracted and cold penis. As it didn’t seem to be a penile fracture, nor did I have any skin lesions, hemorrhages or bruises, I decided to simply rest. Because I thought that any fellow urologist would tell me to simply do the same – to rest.

After two weeks of online research, I discovered my diagnosis – Hard Flaccid/CPPS. However, I only have/had symptoms related to the anterior/superficial pelvic floor (Ischiocavernosus and Bulbocavernosus Muscles). I don’t have pelvic pain, difficulty passing stools or other posterior/deep pelvic floor symptoms. But I have/had:

– Sudden erectile dysfunction (9-10/10 to 4/10)
– Sudden premature ejaculation (90min to 3-5min)
– Hyper contracted penis (Hard Flaccid). Which improves sitting, lying down, with Reverse Kegels and with heat; and worsens standing, with physical activity, with Kegels and with Involuntary Kegels
– Cold and soft glans (sometimes scrotum and penis too)
– Mild urinary retention
– Loss of morning and spontaneous erections
– Slight bend of the penis to the left, from the base of the shaft. (IC injury?)
– Slight downward curvature of the penis, from the middle of the penis (BC injury?)
– And a slight twist of the entire shaft, clockwise (IC injury?)

The next day, I visited the Urology Department at my hospital. I was observed by 4 urologists. As expected, none of them had ever heard of Hard Flaccid… After explaining the whole story, situation and symptoms, I was medicated with:

– Ibuprofen (anti-inflammatory), for 7 days
– Cyclobenzaprine (muscle relaxant), for 30 days
– Tamsulosin (alpha blocker, to decrease all sympathetic nervous activity, stressful or non-stressful, to the pelvic floor), for 30 days
– Total sexual abstinence (masturbation and sex), for 30 days, which I was already doing for 2 weeks.
After these 30 days, I will have an appointment with one of the best Andrologist in my country, which will be on August 27

So, after 3 weeks, I have been doing a lot of research (books, websites, forums) … And, according to my symptoms, I am almost sure that I had/have a strain of the Left IC Muscle (and maybe the Left and/or Right BC), which is, consequently, contracting the anterior/superficial pelvic floor and the penile smooth muscle (giving rise to the Hard Flaccid and the shortening of the penis, while it is erect) and, consequently, compressing the pudendal nerve, dorsal nerve and pudendal arteries, giving rise to all the other symptoms.

And that’s why REVERSE KEGELS are so important for the progressive relief of all the symptoms.

Treatments. What I have done to recover:
– Ibuprofen, Cyclobenzaprine, Tamsulosin
– Extraordinary healthy eating (Proteins, vegetables and fruits. Very important in the recovery of any injury) and supplementation (Ginkgo Biloba, Ginseng, L-Arginine, Fish Oils, Vitamins E, D, C, B complex and Zinc)
– No masturbation, no sex, NO PORN. And no pictures, no Instagram girls, nothing. Just hugs and kisses from the girlfriend. (Alright… We make love, but only with my hands and mouth. I don’t let her touch my penis… I was in this hardmode for 4 weeks. In the last week, I have been trying very light Edging (5 minutes of very light massage, very soft touches, always with REVERSE KEGEL), every other day, to give a little physiotherapeutic stimulation to the tissues. But without ejaculation (to avoid the Involuntary Kegels associated with orgasm, to keep my libido high and to increase the likelihood of spontaneous erections)

– Lots of REVERSE KEGELS/Front Reverse Kegels, throughout the day.
– Very light and Soft Squeezes (“massages”) of the flaccid penis, while Reverse Kegeling, to help relax tissues, throughout the day.
– Belly Breath Combos, Hindi Squats and Happy Baby, along with Reverse Kegeling.
– Light external massages, on the anterior/superficial pelvic floor
– 1 hour of STRETCHING (flexibility training) every other day – Pelvic Floor, Hamstrings, Psoas, Piriformis, Quadriceps, Adductors and Abs. (All along with Reverse Kegeling and Belly Breaths). Again, hardmode – Static, Dynamic and Weighted Stretches. I’m literally training to do the front and side splits.

– HEAT. Heat relaxes muscles and dilates arteries, increasing blood flow and, consequently, relieving symptoms. I wear shorts, under my pants, during the day. When I get home, I wrap my lower body in a blanket and I use a hot rice sock sometimes. And I place a big and soft pillow under my buttocks, when I am sitting in my chair.

– Sleep. A lot. (Very important in the recovery of any injury)
– I am a very active person (running and weighted calisthenics), but I stopped this type of physical activity since the day of the injury (to avoid Involuntary Kegels). However, I am doing some bodyweight Squats and Hip Thrusts (along with Reverse Kegels) before stretching. I read somewhere that gluteal and posterior chain strength is also important.

– ABSOLUTELY NO STRESS (!!!). I have always been a very calm and peaceful person, in all situations of my life. But, after reading that Hard Flaccid was highly influenced by stress and anxiety, I am now completely in a “ZEN state with the Universe” Buddhist monk style.

Not only to avoid any nerve discharge from the Sympathetic Nervous System to the pelvic floor (and, consequently, Involuntary Kegeling, which prolongs the contraction of the pelvic floor muscles, which worsens the compression of nerves and arteries), but also to prevent the rise of Cortisol and Adrenaline and, consequently, the drop in testosterone levels. And (as many of you claim) this is absolutely essential.

I was a little stressed during the first week (before I knew the real diagnosis) and my penis was terrible… Hard Flaccid like a rock, with a loss of 1.5inches in BPFL. After knowing that I really have to relax completely, I immediately felt the first improvements in 3-4 days.

However, on the other hand, I am very convinced that I did a muscle strain, at least, of the Left IC. Those left curvature and left twist… Hmmm… On August 27, I will ask for an MRI. If the radiologist tells me it is normal, I will try to take the images to more doctors.

So… after almost 2 months, I have improved a lot – Now, I only have hard flaccid if I’m standing. A few times, I don’t even have it standing. It happens when I get up after doing Reverse Kegels for a few minutes (or sitting for a while in a more comfortable position) and continue to do Reverse Kegeling while I’m standing. This was impossible 1 month ago.
– The morning erections are progressively coming back
– 3 days ago, I’ve managed to have a 8-9/10 erection during the mini Edging sessions.
– However, I still have a slight bend to the left and the clockwise twist, during erection (I no longer have the downward curve), and I lost about 0.5 inches in BPEL…

1- Now, I would like to ask Pegym’s brightest minds and everyone in this group who is still recovering from Hard Flaccid, what are the most recent updates on this disease/symptom? Regarding physical treatment, exercises, medications and supplements. What am I missing? Where can I improve to speed up recovery?

2- I have been thinking about starting to do a small daily session of Kegels/Front Kegels/IC kegels… In order to give a physiotherapeutic stimulus, just like any other muscle injury. But I’m afraid it could get worse… What’s your opinion? (See post 26)

3- What do you think about adding very light and soft manual penile stretches? (along with Reverse Kegeling) I feel a lot of relief with the soft squeezes. But, in these, the applied force is perpendicular to the penis. I’m not sure if extra parallel force will be beneficial for the tissues. (See post 26)

4- Okay, the last question might be a little funny, but I think it might be relevant. I think I have an injury mostly on the left side. So, is it more advisable to rest the penis in the left groin or in the right groin? It tends to get softer on the right, but naturally falls to the left. (See post 26)

Thanks a lot for reading my story Best regards to the entire PEGym community
And thank you so much, for saving me during the past 2 months UPDATES: post 21, post 23 (stress management), post 26, post 29, post 63, post 66 (HF & Stretching)