Dr. Rachel Rubin, a urologist with fellowship training in sexual medicine, shared her advice in an online lecture titled “The Simple Way to Talk About Penises,” which was posted on Medscape Friday.
She takes a gentle approach to a difficult problem.
A urologist says she’s found the perfect way to get men to talk about their erections – and while it may seem deceptively simple, it’s surprisingly effective in helping flabby men regain some stiffness.
Dr. Rachel Rubin, a urologist with fellowship training in sexual medicine, shared her advice in an online lecture titled “The Easy Way to Talk About Penises,” which was posted on Medscape Friday.
The Washington DC doctor admitted that many doctors have difficulty talking to patients about penises, despite their professional training.
“It doesn’t come naturally to many of us,” Rubin said. “If a 20-year-old comes into my office with his 85-year-old grandfather and they both say their penis doesn’t work, how do I understand what’s going on? Do they even have the same problem with them?
The urologist said she uses the Erection Hardness Score (EHS), described by the National Institutes of Health as a “simple, validated, semi-quantitative, self-reported tool that assesses erection hardness on a scale of 4 points”.
The tool was developed in 1998 by a team of urologists studying the effects of the then recently marketed drug Viagra.
Rubin attached a visual of the four-point score for viewers at home, before explaining the meaning of each of the four points.
“A ‘1’ is not an erection at all,” she described. “A ‘2’ is when it gets harder and bigger, but it won’t penetrate. A ‘3’ will penetrate, but it’s quite wobbly. A ‘4’ is that perfect cucumber and porn star erection that everyone is looking for.
The doctor said she makes her male patients “talk in numbers” in order to effectively describe their erections.
“I ask the patient to tell me a story,” she said. “They can say, ‘When I wake up in the morning, I’m a 2. When I stimulate myself, I can go up to a 3. When I’m with my partner, sometimes I can go up to a 4.’ .’”
If one of his patients fails to achieve optimal erection, Rubin prescribes treatments based on their specific situation. These may include lifestyle changes and sex therapy, as well as testosterone or Viagra.
She then asks them to return to her office to take stock and see if their numbers on the four-point scale have changed.
“I have an objective measurement that shows me how the treatment affects their erections,” she said.
Erectile dysfunction affects 40% of men by age 40 and 70% of men by age 70, according to the Cleveland Clinic. More than 50% of men will suffer from some form of erectile dysfunction.