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1. Hello, Dr. Mayer. Thank you for sitting down with me today. Would you mind discussing the main issues that come up most often in your clinic?

Well, primarily, men come into the FullMast clinic for erectile issues and questions about testosterone therapy. When a man comes into our office, and he’s around 45 years old and he presents with erectile issues, the first thing I have to think about is cardiovascular illness. Men who present with early-onset erectile dysfunction will most often have cardiovascular issues such as hypertension and high cholesterol.

2. As FullMast’s Chief Medical Officer, what are some concerns you’ve noticed when patients come into your office? How have you been able to address these?

I’ve noticed that some patients are reticent to come into a clinic where there are other men who are sitting around in the waiting room. They’re not necessarily ashamed, but there is still stigma around sexual health and erectile issues. In order to combat this, we manage our consultations according to a specific protocol. The consultations are an hour long. When a patient comes in for his consultation, the previous patient has already left. We have one treatment room. Our main concern is the comfort of the patient. We want to ensure privacy and confidentiality as much as possible.

3. What are some questions men should ask their doctors during their annual physical?

Annual physicals are not recommended for men until they’re 50 years old. Before 50 years of age it should be once every two years. During these annual checkups, they should ask for a colonoscopy, a rectal (prostate) exam, which involves the detection of PSA, the prostate-specific antigen. Certainly as a man gets older, he should ask about exercise and weight loss, especially if he is overweight or obese. Most physicians don’t talk to men about those issues. Even a slightly overweight man who doesn’t get that much exercise will present with signs of erectile dysfunction. The most common manifestations of ED are cardiovascular issues, hypertension, high cholesterol, and high blood sugar.

4. Do issues of mental health ever arise during these consultations?

Yes, these issues come up quite often. Men who are low on testosterone often come in slightly blue and with less energy. Sometimes, we have a conversation about the use of antidepressants. As part of the assessment, we also evaluate psychogenic causes of erectile dysfunction especially if the man is in his early thirties. Often times the causes are not organic but psychogenic. But keep in mind, psychogenic causes may also occur in men in their fifties as well.

5. Does fitness or nutrition ever come up during a consultation?

One of the first things we talk about is exercise. I usually ask them, ‘Do you walk?’ Walking is a good way to start becoming active. I recommend they measure the steps they take every day. There are many phone apps out there to help them keep track of the number of steps they take. I would recommend 1,000 steps per day, or 100 steps per minute to get their heart rate up.

Vitamin D is also important especially in the wintertime: 5,000 units per day along with magnesium. A trick I tell them is when to start and when to stop: if they go outside at noontime, and their shadow is longer than their height, take the vitamin D, but if at noontime, their shadow is shorter than height, don’t take it that day. I would also recommend lots of unsaturated fats, which can be found in olive oil, avocado, and walnuts (which contain arginine, a precursor for nitric oxide, which assists in producing a fully erect penis).

6. Do most men who come into your office have some type of support network?

They do, but it’s mostly support from their partner, especially because their partner is equally affected by these erectile challenges. They often come into the clinic with their partners. Men usually don’t like to talk about these issues with other people like friends or family members. Hopefully over time people will see sexual health as being another facet of overall health, but today, many men are still worried about how people perceive their masculinity. They don’t want to be questioned by their buddies or their friends. I’ve noticed men don’t joke about these issues until they’re in their seventies. In the1990s when Viagra come out, men became more open to discussing sexual health. It opened up the lines of communication; the commercials were humorous, and men felt more comfortable talking about it.

7. What age group do you see most often at the clinic?

The range is anywhere between 20-80 years old. Usually, younger patients have erectile issues that stem from psychogenic issues rather than men in their fifties and beyond. Younger men also have concerns with premature ejaculation.

8. Dr. Mayer, thank you for your time today. Before we say goodbye, is there anything else you would like to add?

Oh, that’s not a problem at all. Thank you. Yes, so I have noticed that many therapies nowadays focus on medications such as Viagra and Cialis, but there are many non-medicinal therapies and procedures out there. In fact, medications tend to wear off over time. FullMast has pioneered the first new and Health Canada approved treatment for erectile dysfunction called SONICWAVE, which is a non-surgical, non-medicinal therapy that uses high-frequency vibrations to stimulate nerve function, cell regeneration, and increase blood flow to the penis.

If a man has diabetes or has had prostate surgery or who presents with neurogenic issues, we’re going to recommend both SONICWAVE and Viberect. Viberect is another vibration technology that helps the secretion of nitric oxide. We believe in multimodal therapies so we also recommend pelvic floor exercises to strengthen the muscles that are responsible for maintaining blood flow and rigidity in the penis.

Overall, we’re here to help men handle the sensitive issue of erectile challenges by providing the best care possible at our clinic. We also want to open up the conversation about men’s sexual health and about maintaining sexual activity as men age. Myself and sexologist Dr. Stephen de Wit will be presenting at an upcoming talk on August 2nd to discuss these key topics in men’s sexual health.