Looking Back On 2024: 6 Milestones

By: Erica Williams, CEO

In the state of Florida, the ratio of urologists to patients is higher than the national average. In fact, Florida ranks third in the country for the number of practicing urologists, just behind California and New York, according to the American Urological Association.

There’s a reason for this: Our state has a high demand for all urologic care, from bladder infections and erectile dysfunction to overactive bladder and prostate cancer, and we aim to meet it.

It’s why Advanced Urology Institute operates more than 30 offices in six regions, with 115 providers throughout Florida. Our cross-Florida footprint is comprised of the top urologic experts in the country.

In 2024, our AUI team – along with our patients and community – helped us complete a number of important milestones. We want to share these achievements with you.

6 Milestones From 2024 To Celebrate Into 2025

A smarter, faster check-in experience.

Waiting in line can be frustrating – it’s why millions of people use self-checkout at the store. So, we’ve implemented self-check-in. It’s called Phreesia and it’s designed to get you in front of your doctor sooner. Prior to your visit, you will receive a reminder about your appointment. You’ll also have the ability to review and update your health information. If you haven’t completed the information when you arrive for your appointment, no worries – we will give you an iPad to do so there. Our staff will happily help if you need it.

New practice management and electronic medical records system.

On September 30, we converted to a new scheduling and billing computer system across AUI. Panama City transitioned to a new electronic medical system (EMR) at the same time, with our other offices converting throughout the first half of 2025. We sincerely appreciate your patience as we navigate through converting to these new computer systems. We know it has temporarily impacted on your experience with our offices; however, these changes will provide an enhanced and efficient paperless experience for our patients.

The AUI in-house pharmacy.

While officially opened in late 2023, our in-house pharmacy proved its value to patients throughout 2024. The pharmacy is specifically dedicated to providing essential prescriptions to prostate cancer patients as well as certain medications for erectile dysfunction patients. Our pharmacy also offers home delivery service under qualifying insurance plans. If you need additional funding assistance, our resource department will apply for it on your behalf.

Our clinical research division.

In 2024, we officially opened our clinical trials research division at our Daytona, Largo, and Oxford regions (with Tallahassee coming soon). These trials carry out research into leading-edge treatments as well as conditions such as interstitial cystitis, bladder cancer, and prostate cancer. They also present opportunity because they offer qualifying patients early access to expert knowledge and promising care procedures. In time, we expect clinical trials will be offered throughout our remaining regions.

Our ever-expanding team.

We’re fortunate to continuously recruit leading providers to our practice. In 2024, the following physicians joined these AUI care centers:

• Daytona Care Center: We welcomed Dr. Robin Vasan, who specializes in uro-oncology, reconstructive surgery, and robotics; and Dr. Luke Fifer, who specializes in men’s and women’s health, robotics, and bladder and kidney issues.
• Oxford Care Center: Joining our staff are Dr. Aamir Hussain and Dr. Michael Sombeck, radiation oncologists who specialize in prostate cancer treatment; and Dr. Milton Williams, a specialist in men’s and women’s health, bladder problems, and kidney problems.
• SWFL Care Center:We welcomed  Dr. Joanna Chon, a longtime Naples urologist who specializes in urogynecology and reconstructive pelvic surgery as well as female voiding and pelvic floor disorders.
• Panama CityCare Center: In January 2025, Dr. Michael Corea will become a member of our team, bringing expertise in urinary conditions as well as kidney stone treatment.
• We have also added numerous Advanced Practice Providers (nurse practitioners and Physician assistants) throughout offices in AUI to provide additional opportunities for urologic care.

Our resilience.

Hurricanes Milton and Helene upended life for many of our patients and care teams throughout the state. As a result of the damage, AUI was forced to temporarily move our medical services from our Largo and Pasadena offices to other AUI offices. We also temporarily relocated our pharmacy to a separate location. We are thankful to our team members who seamlessly transitioned care in these locations and are grateful to our patients for their understanding. We hope to get back to our normal locations soon. If you and your family were deeply affected by the 2024 hurricanes, we hope that recovery is in your near future.

Expect Even More in 2025

In the coming year, our team plans to continue exploring new frontiers of treatment through our clinical research and by investing in leading technologies. We’ll share these updates with you in our six regional newsletters throughout the year, and you also can keep informed through our blog and webinars.

As long as Floridians need urological care, we’ll be there, where you need us.

Did you know your doctor can provide resources to improve your overall urinary health in addition to diagnosing and treating you? You can quickly request an appointment here, or search AUI’s convenient office locations here.

By: Umar Karaman, MD

One-third of Americans struggle with bladder control, including overactive bladder (OAB). If you’re one of them, don’t be discouraged. There are numerous treatment options which means you don’t have to live with it!

The best approach starts with knowing why your bladder isn’t functioning like it should.

What is OAB?

The term describes a group of urinary symptoms, including:

• Sudden, hard-to-control urge to urinate
• Accidental leakage (incontinence)
• Getting up to urinate two or more times a night

When you urinate, your bladder muscle contracts and forces out urine. Then it relaxes so your bladder can fill again. When that muscle weakens or becomes damaged, loss of bladder control can result. Researchers have linked OAB with:

• Alcohol, caffeine, and some medications. These dull your brain’s signals to the bladder.
• Obesity which puts pressure on your bladder
• Parkinson’s disease, multiple sclerosis, stroke
• Pregnancy and childbirth which can damage the bladder muscle
• Radiation therapy
• Urinary tract infections

How is OAB diagnosed?

These tests can confirm you have OAB and also help to determine the best treatment:

• Cystoscopy: a thin, flexible scope with camera is inserted into the urethra to examine for abnormalities
• Urinalysis: a urine sample is examined
• Urodynamics: measures pressure in your bladder and urine stream. Also determines how much urine remains in your bladder after you finish urinating.

What is the treatment pathway for OAB?

Step one is for you to keep a voiding diary to track what you drink and when you urinate. Based on the results, your urologist will recommend treatment beginning with the least costly and least invasive:

• Lifestyle changes will be recommended, including adjustments to your diet, managing your weight, pelvic floor exercises (Kegels), and bladder training.
• Medications that relax your bladder muscle so it can hold more urine.

At a one-month follow-up, your urologist may prescribe a second medication. If there is no improvement, a repeat evaluation may be needed including another cystoscopy and/or urodynamics.

The next line of treatment, if needed, may include one of the following:

• Sacral nerve stimulation: A tiny pacemaker-like devise is implanted to calm the nerve that controls the bladder. Before implantation, a test phase can determine if this is right for you.
• Percutaneous tibial nerve stimulation or Percutaneous tibial neuromodulation: Your tibial nerve is located just above your ankle. This procedure uses a slim needle electrode to stimulate the nerve for better bladder control.
• Botox: Injected into the bladder, it partially paralyzes the muscle to prevent overactivity. But you’ll still have enough control to empty your bladder.

If your urologist determines these approaches aren’t right for you, other options exist, including surgery. The goal is to get you back in control of your bladder and an improved quality of life.

Learn more about OAB here. Request an appointment with a urologist at AUI.

By: Greg LaMendola, PA-C

It’s true! Science supports the notion that oysters can enhance your libido. Which got us to wondering what other foods can boost male sexual health?

Contemporary research has found that several foods can improve sexual wellness and erectile function due to their vitamins, minerals, flavonoids (antioxidants and anti-inflammatories), and healthy fats.

These nutrients strengthen the heart so it can more effortlessly pump blood throughout your body and into the genitals, so you can more readily achieve and hold an erection. On top of that, a strong heart supports stamina.

6 Food Categories to Fall in Love With

Everyone’s body is different and therefore might respond to foods in varying ways, but research suggests the nutrients in the following foods could enhance your sex drive and erectile health.

1. Aw shucks, it’s not just oysters. Men and women have been slurping down oysters and clams to kindle sexual desire for centuries, but crab and lobster have similar powers, thanks to one common nutrient. Shellfish carry zinc, a mineral that increases blood flow and balances testosterone. Zinc might also support sperm function.
2. Love fruits. Consuming several daily servings of fruit, including apples, cherries, berries, citrus, grapes, and/or watermelon, can reduce erectile dysfunction (ED) by 14%, research has found. That’s because fruit flavonoids and amino acids improve circulation and therefore erections. (Diabetics should ask their doctors about fruit portions.)
3. Love veggies too. A bed of greens might improve your performance in the bedroom. Spinach, broccoli, asparagus, and beets are among veggies rich in blood-pumping nutrients. Vegetables are high in vitamin C, magnesium, and fiber, which stimulate metabolism and circulation. Magnesium also could boost testosterone levels, studies show.
4. Go nuts for healthy fats. Nuts and other foods are high in protein and “good” fats that have been linked to better sexual performance, right down to sperm quality. The omega-3 fatty acids in walnuts, almonds, and hazelnuts strengthen the heart, while pine nuts deliver zinc. Other healthy-fat foods: avocado and fish such as salmon, sardines, and mackerel.
5. Cocoa’s a go-go. Cocoa beans might be bitter, but the sweet truth is they’re filled with nutrients that add a spark to circulation and mood. Dark chocolate that’s 70% cocoa or more carries higher levels of antioxidants and anti-inflammatories (flavonoids) that fire up circulation and dopamine, the pleasure hormone.
6. Peppers that spice it up. If you can eat one chili pepper, then try for two or three. A study in Physiology & Behavior finds that men who eat hot peppers regularly have higher-than-average testosterone levels. When accompanied by the pepper chemical capsaicin, these hot flavonoids release endorphins, a natural mood enhancer.

Eat for Love, and Your Whole Health

Can certain foods act as anti-aphrodisiacs and reduce your sex drive? Research is ongoing, but several studies agree that too much alcohol can contribute to sexual and erectile dysfunction. You might want to keep it moderate.

Other sexual sideliners include some prostate cancer treatments, the side effects of kidney disease, and stress. If you suspect such conditions are getting in the way of your sex life, it might be time to talk to a specialist.

Don’t clam up! Our doctors train daily to better understand and treat male sexual wellness.

You can visit our Sexual Health page to learn more about conditions and treatment offerings.

Halloween is the time for ghosts, ghouls, and goblins. But you know what’s scarier than any Halloween horror flick? Kidney stones.

Kidney stones often cause pain so severe that they send their victims to the emergency room to find out what is wrong.

What are these malevolent maladies?

Kidney stones are hard masses that form in the kidneys because of an overabundance of minerals, salts, and other waste in the urine. The most common stones are from calcium or uric acid:

• Calcium stonescan have genetic or metabolic causes. They can also be linked to foods with oxalates (found in some nuts, legumes, and dark leafy greens) and sodium and animal proteins.
• Uric acid stonestypically form in people who eat a lot of animal proteins (red meat, poultry, eggs), those who are dehydrated or lose too much fluid due to diarrhea, and those with diabetes or metabolic syndrome.

Symptoms of kidney stones include severe pain on either side of the back, blood in the urine, and nausea due to the pain.

Why could trick-or-treat trigger stones?

What you eat and drink can trigger the formation of kidney stones. I hate to be the bearer of bad news, but recent research indicates that candy can contribute to kidney stones.

A study released by the National Health and Nutrition Examination Survey found that the more sugar we eat, the greater our chances of developing these painful little formations. How much sugar?

People who get more than 25% of their total calories from added sugars are at an 88% higher risk of developing kidney stones than those who take less than 5% of their calories from added sugars.

For context, the USDA’s Dietary Guidelines for Americans 2020-2025 advise that all added sugars should account for less than 10% of total calories.

Added sugars reduce the amount of urine our bodies produce, resulting in higher levels of urinary calcium. Added sugars can also lead to other health problems that are known contributors to stone formation – diabetes and obesity among them.

Kidney stones are a common condition in the U.S., affecting up to nine percent of the population and resulting in a half-million emergency room visits every year. Your risk of being among those could depend on various factors. Adult males are slightly more likely than women to develop stones. Health conditions, including chronic diarrhea, dehydration, inflammatory bowel disease, high blood pressure, and gout, also can raise chances.

When it comes to the effects of added sugar, the National Health and Nutrition Examination Survey indicated that Native Americans and Asians are more likely to develop kidney stones when eating large amounts, compared with Hispanic, non-Hispanic White, and non-Hispanic Black people.

Lastly, those who have had stones, even just one, are 50% more likely to develop more in the following five to seven years.

How many fun-sized candy bars should I eat this Halloween?  

So, how much sugar is safe to eat to avoid stones?

The American Heart Association recommends that adult males consume no more than 36 grams of sugar daily, or nine teaspoons, which equals about 150 calories. Women and children should strive for no more than 25 grams (6 teaspoons) or 100 calories.

For context, a 1.86-ounce Snickers candy bar contains 28 grams of sugar, and a bag of Skittles has 45 grams.

So, try to limit yourself to one fun-size candy bar daily. Better yet, balance that with an apple and a glass or two of water.

Advanced Urology Institute offers state-of-the-art outpatient treatments for the care of kidney stones. You can learn more about our treatments here.

The PSMA PET scan is quickly becoming the gold standard for diagnostic testing in cases of high-risk localized and metastatic prostate cancer. AUI patients on the Emerald Coast can now access this game-changing imaging technology at the Hope Regional Cancer Center in Panama City.

Advanced Urology Institute and Hope Regional Cancer Center merged in October 2023 to expand care and coordinate services to enhance the patient experience. Hope Regional Cancer Center provides imaging services for diagnosing nearly 30 different types of cancer, from breast to uterine.

The PSMA PET scan is essential in the treatment of prostate cancer because it shows the disease more accurately throughout the body.

“It shows us the disease at an earlier stage and allows us to be much more precise in our treatment planning,” said Dr. Hasan Murshed, a board-certified radiation oncologist with Hope Regional Cancer Center

PET stands for positron emission tomography, an imaging test that shows 3D images inside the body. PSMA stands for prostate-specific membrane antigen, a protein prostate cancer cells make.

The PSMA-PET test uses an FDA-approved radioactive tracing agent to pinpoint the location of cancer cells within the body. Patients are injected with the radiotracer before starting their PET scan. The tracer binds with the PSMA on the prostate cancer cells, so when your doctor reviews your PET images, any prostate cancer cells within the body are lit up by the radiotracer.

“October marks the first anniversary of our merger with Advanced Urology Institute, and being able to offer this potentially life-saving imaging service to our prostate cancer patients is a pretty great way to celebrate,” said Dr. Murshed.

Hope Regional Cancer Center was founded in 2012 by Dr. Murshed. It is a freestanding, comprehensive cancer treatment center that coordinates chemotherapy and immunotherapy infusion services, blood disorder treatments, and image-guided and intensity-modulated radiation therapy. It is among an exclusive group of freestanding cancer centers in Florida that has earned the prestigious American College of Radiology (ACR) accreditation, recognized as the gold standard in medical imaging.

By: Matthew Truesdale, M.D., F.A.C.S.

About 113 of every 100,000 Florida men get diagnosed with prostate cancer annually. You might think: Hey, those are good odds! Maybe I’ll hold off on getting tested.

But this is what you should think, instead: Hey, those are good odds! It’s probably because more men are getting tested earlier.

Early detection is a key reason for getting your prostate-specific antigen (PSA) test annually. Or, if you’ve never had one, for asking your doctor when you should get your first screening – even if you’re younger than 50.

What’s the point of asking about a PSA blood test early? Here’s what: One year can make the difference in establishing an accurate, healthy baseline. PSA blood tests look for changes in antigen levels, which can suggest cancer. If your PSA number rises by more than 0.75 in one year, it could indicate cancer cell growth. Your first screening establishes that baseline, which is measured in points, so you should get it when you are still at low risk of developing prostate cancer.

Here is another reason to schedule a prostate-specific antigen test for you or a loved one: September is Prostate Cancer Awareness month.

Do You Know Your Cancer Risk Factors?

True, the possibility of developing prostate cancer is more likely after you hit 50. However, 37% of prostate cancer cases occur in men between 45 and 64, the Centers for Disease Control reported in May 2024.

Your doctor could recommend you schedule your first blood screening at age 45 or even 40, depending on these risks:

• Your family matters – If your father and/or brother has a history of prostate cancer, then you carry a higher risk of the disease.
• Your race matters – African American men are more likely than any other race to develop prostate cancer, and at younger ages. Further, African American men are twice as likely to die from the disease.
• Your lifestyle matters – Tobacco smoke, obesity, and high proportions of fatty foods increase the chances of abnormal cell development.

A Life-Changing Point About PSA Tests

There’s a lot of information out there about what PSA tests can do, so here are the basic facts: All of your cells – both healthy and cancer cells – produce antigens. If cancerous prostate cells multiply uncontrollably, the level of those prostate-specific antigens will rise accordingly, raising your baseline.

This is why the timing of your first PSA test is so important. The earlier you get tested (at your doctor’s suggestion), the more likely you’ll establish a baseline that reflects good health.

Further, in addition to testing for cancer growth, annual PSA tests can indicate an enlarged prostate or inflammation.

Defining Your Healthy Baseline: Know Your Antigen Odds

When it comes to PSA readings, there isn’t one normal or abnormal figure. Of the 113 Floridians diagnosed annually, some can have a PSA level of 3, while others a reading of 9.

What matters is a change in your PSA level. If it rises by more than 0.75 in one year, it could indicate cancer cell growth.

Be aware that certain temporary events, including prostate infections, can cause your PSA levels to fluctuate. Even ejaculation and vigorous exercise can increase PSA production for a day or two, so schedule your test when such events won’t alter the reading.

What You Can Do To Manage PSA Production

Some studies indicate that diet and activity can lower PSA in your blood, which is generally preferable. Consider these tips:

Eat more produce – Fruits, veggies, and legumes carry nutrients that strengthen the immune system, which attacks cancer cells.

Walk on the sunny side of the street – Vitamin D, which comes naturally from the sun, supports immunity. Other sources of vitamin D include milk, orange juice, cereals, and supplements.

Exercise your strength – Aerobic activities and weight-lifting can help reduce PSA levels.

If your PSA reading does go up, even with these tips, ask your doctor about next steps. Our AUI physicians who specialize in prostate cancer can describe additional tests and treatment options for you.

Because even if you are one in 113, early detection puts the odds of curing cancer in your favor.

Want to learn more? Visit our prostate cancer page, which includes informative videos. To read about AUI’s Advanced Prostate Cancer Institute, click here.

By: Scott Sellinger, M.D., F.A.C.S.

Advanced prostate cancer is a more aggressive form of prostate cancer that requires an intensification of treatment efforts.

However, advanced prostate cancer does not always mean metastatic prostate cancer, which is prostate cancer that has spread to other parts of the body. We consider five categories advanced, and I’ll discuss them shortly.

First, you should know the frequency of prostate cancer. Approximately 1 in 8 men will be diagnosed with prostate cancer in their lifetime, and about 20-30% of these men will be diagnosed with advanced prostate cancer at the outset. With advanced prostate cancer cases on the rise for the first time in 20 years, according to the American Cancer Society, it’s essential to understand what this diagnosis means.

How Advanced Prostate Cancer Progresses

The prostate is a small gland below the bladder and in front of the rectum. Prostate cancer occurs when abnormal cells in the gland begin to divide uncontrollably, forming an invasive tumor.

Frequently, prostate cancer is slow-growing and unlikely to cause a man any harm during his lifetime. However, for some men, the cancer cells are more aggressive.

Whether your prostate cancer is advanced will be something your doctor will determine based on the results of tests such as a prostate biopsy, imaging and PSA tests, and your personal medical history. These are the five categories we define as advanced prostate cancer, requiring an intensification of treatment.

• Very High Risk, Clinically Localized: While this type of cancer has not spread beyond the prostate, it is categorized as advanced because your physician believes it has a very high risk of doing so or reoccurring following a primary treatment.
• High-risk, Biochemical Reoccurrence (BCR): This is when a measurable and increasing PSA occurs following previous treatments.
• Non-Metastatic Castration-Resistant Prostate Cancer (nmCRPC): This cancer no longer responds to hormone treatment. It keeps growing even though the body’s testosterone levels have been reduced to very low levels. Non-metastatic means it is still localized.
• Metastatic Castration-Sensitive Prostate Cancer (mCSPC): Cancer has spread from the prostate into other body regions. It remains responsive to hormone therapy.
• Metastatic Castration-Resistant Prostate Cancer (mCRPC): Metastatic prostate cancer that no longer responds to hormone therapy.

How is Advanced Prostate Cancer Treated?

The treatments for advanced prostate cancer are progressing all the time. Hormone therapy medication is frequently used to block the production of testosterone. When prostate cancer cells are denied testosterone, the cancer cells are starved of their fuel source. It’s not a cure for prostate cancer, but it can slow cancer growth. Hormone therapy is frequently used in men with high-risk prostate cancer pursuing radiation therapy.

Evolving therapies include chemotherapy and immunotherapy (which boosts the body’s immune system to destroy cancer cells), as well as new drugs such as Radium-223 (which delivers radiation particles directly to bone tumors) and lutetium Lu 177 vipivotide tetraxetan, which delivers radiation directly to cancer cells.

Clinical trials for experimental new therapies are also an option for patients to consider.

Advanced prostate cancer often is not curable, but today’s treatments can help keep it under control and manage symptoms.

Prostate Cancer Awareness Month

September is Prostate Cancer Awareness Month. This year, we are stressing an important point—0.75. If your PSA increases by 0.75 or more in one year, it could be prostate cancer.

We are encouraging men to know their PSA level and better understand it, aiming to empower them with prostate health knowledge.

If you have questions about your risk or treatments for advanced prostate cancer, we encourage you to schedule an appointment with a urologist today. Professional advice and early detection can significantly improve your chances of successful treatment.

By: Jamey Sarvis, M.D.

It’s all fun and games until someone gets a kidney stone.

During the hotter months, it’s essential to be mindful of our health, especially when it comes to preventing kidney stones. Kidney stones are a common issue that can be particularly prevalent during summer due to dehydration caused by hot weather. And as Floridians we experience summer-type temperatures much longer than most other Americans. However, proper precautions and healthy habits can reduce the risk of developing kidney stones.

What is a kidney stone?

A kidney stone is a small, hard growth that develops in the kidneys when urinary minerals and salts crystallize and bind together.

What are common kidney stone symptoms?

The most common sign of a kidney stone is pain in the back, sides, groin, and/or testicles (for men).

The pain can be acute enough to cause nausea and vomiting, and blood may be present in the urine. Someone experiencing these symptoms should see a urologist. Small kidney stones may pass through the body naturally within days or weeks of formation, with the help of lots of water. A doctor can provide guidance. However, a stone must be removed if it causes complications, such as an infection or blockage.

Why do kidney stones increase in the summer?

One of the most crucial factors in preventing kidney stones is staying well-hydrated. Dehydration can lead to the formation of kidney stones, so it’s essential to drink adequate water throughout the day. Experts recommend consuming at least 8-10 glasses of water daily, but this may vary depending on individual factors such as activity level and climate.

How else can you prevent kidney stones?

In addition to staying hydrated, maintaining a balanced diet plays a significant role in kidney stone prevention. Certain foods high in oxalates, such as chocolate, nuts, and certain fruits and vegetables, can contribute to the formation of kidney stones. By moderating the intake of these foods and incorporating a variety of nutrients into your diet, you can help reduce the risk of kidney stone development.

Regular physical activity is another vital aspect of kidney stone prevention. Exercise helps maintain a healthy weight, reduces the risk of kidney stones, and contributes to overall well-being. Engaging in regular exercise routines can promote better kidney health and decrease the likelihood of developing kidney stones.

By prioritizing hydration, adopting healthy eating habits, and incorporating regular exercise into your routine, you can take proactive steps to prevent kidney stones, especially during summer. Remember to consult a healthcare provider for personalized advice and recommendations based on your health needs.

If you are experiencing symptoms of kidney stones, visit your AUI urologist as soon as possible.

Safe and effective technologies are available at Advanced Urology Institute to help diagnose, treat, and manage kidney stones.

By: Jenna Hurley, P.A.

Nearly 4 million Floridian women are 35 and older, and – based on national statistics – up to one in three of them is not in the mood.

Low sex drive among women is common, so much so that an estimated 21 million experience it nationally. Yet just four in 10 women who have difficulty with their sexual function ask about treatment, compared with 62% of men.

If you are among these women, you may simply be too busy or it may feel uncomfortable to seek a remedy. Causes of low libido include stress, body image insecurity, breastfeeding, and even some forms of birth control, including the pill.

However, underlying medical issues can also interfere with your sex drive. Some medical changes involve your stage of life as a woman, but others can stem from common urologic disorders. So, if you notice you have a low sex drive and it troubles you, it could be time to consult a urologist or urogynecologist for overall health reasons.

Why the Low Libido? 4 Mood-Lifting Solutions

Changes in your hormone levels or urinary function can make sex painful. Researchers estimate that 40% of all women have experienced pain during sex at one point or another in their lives. This can make it difficult or impossible for women to enjoy sex and can lead to decreased libido.

Here are four common causes behind reduced sex drive, and how you can treat them.

1. Vaginal discomfort – Hormone levels as well as physical events can make intercourse hurt. A drop in the female hormone estrogen, which stimulates desire and lubricates the vagina, can cause vaginal dryness. This typically occurs during menopause, but also can be due to certain medications or breastfeeding. Chronic vaginal pain, however, is different. Signs of this include persistent burning, aches, and itching in the vaginal area which can occur secondary to nerve damage, pelvic inflammation, muscle spasms, or a reaction to yeast.
   Mood-lifting treatments: You can improve general discomfort with intercourse by using an appropriate lubricant during sex. Dryness can also be alleviated by regularly applying vaginal lubricants or estrogen creams, or by using doctor-recommended laser treatments designed to reinvigorate vaginal tissue. Vaginal pain might be relieved by Kegel exercises to strengthen the pelvic muscles or medications, including nerve blockers. If your pain persists, our urogynecologists can surgically treat the vagina.

2. Pelvic organ prolapse– The muscles in your pelvis hold your bladder, uterus, and upper vagina in place. If those muscles weaken, these body parts can slip, or prolapse, toward the vaginal canal causing a budge or sensation of something “falling out”. This occurs in nearly half of all women between 50 and 79 to some extent, with symptoms such as pelvic discomfort, numbness, and pressure. This can make intercourse painful or physically difficult.
   Mood-lifting treatments: Minimally invasive approaches include Kegels which are pelvic floor exercises and pessaries which are small disc shaped devices used to hold the tissue in place when inserted into the vagina. If you choose surgery, your pelvic musculature can be reinforced using your vaginal tissue or medical grade surgical materials to resuspend anatomy back into an appropriate position.

3. Urinary leakage (incontinence) – Childbearing, menopause and nerve abnormalities can make it harder to hold in urine. The fear of an accident can shut down the idea of sex. The two most common forms are urge incontinence and stress incontinence. Overactive bladder (OAB) commonly causes urinary urgency, or the immediate, hard-to-control need to pee. Stress incontinence is a sudden urine leak from pressure to your abdomen, such as coughing.
   Mood-lifting treatments: You can relieve symptoms of OAB with medications that block some of the excess nerve signals that cause bladder muscles to contract. These medications include oral pills and bladder injections with Botox. The nerves can also be stimulated with electrical nerve stimulation to reduce urge incontinence. Your path to treatment for stress incontinence can involve Kegel exercises, bladder training, pessaries, and urethra-strengthening drugs or procedures.

4. Pelvic pain – Interstitial cystitis(IC) occurs when irritating substances in your urine leak through a compromised bladder lining. It can be quite painful even without sex, which is why it’s often referred to as painful bladder syndrome. Bacterial urinary tract infections can also cause pain in the bladder.
   Mood-lifting treatments: For IC, symptom-based treatments include pelvic floor physical therapy, bladder washes, nerve stimulation, medications including both oral options and Botox, and stretching the bladder with fluids while under anesthesia (called hydrodistension). We can help you relieve both acute and chronic urinary infections with medications as well.

Interested In Learning More? Sex Education is for All Life Stages

The urological conditions above are among the most likely to hamper your sex drive and other enjoyable activities. But other causes also exist. It’s tempting to ignore the symptoms, but try not to, as they can worsen over time without intervention.

If lifting your mood and improving your sexual health is important to your quality of life, call a specialist today for an appointment. Acknowledging your medical needs as a woman by seeking professional help for sexual dysfunction is an important step in feeling empowered to live your best life — and your journey to getting back in the mood can begin with that simple step.

The healthcare providers at Advanced Urology Institute are your partners in good overall health. You can read about all the women’s health conditions we treat, with symptoms and treatment options, on our web site: advancedurologyinstitute.com.