Rachel S. Rubin,醫學博士 / 2023 11 10 / Medscape


我是雷切爾·魯賓 (Rachel Rubin) 醫生,一位接受過性醫學專科培訓的泌尿科醫生。


陰莖的動脈直徑只有1毫米,它們早在 3 毫米心臟動脈形成斑塊並阻塞循環之前就已形成。因此,初級保健醫生與患者談論勃起健康非常重要。老實說:與患者談論其生活方式如何影響他們的陰莖健康要比討論生活方式如何影響其壽命或預防癌症更加容易。我讓很多男人戒菸,因為我告訴他們吸菸對他們的陰莖有什麼影響。

對於醫生和患者來說,談論陰莖可能是一項挑戰。對我們許多人來說,這並不太自然。如果一個 20 歲的年輕人和他 85 歲的祖父一起來到我的辦公室,他們都說他們的陰莖不能運作,你要如何去想像到底發生了什麼問題?難道他們也有同樣的毛病嗎?

這是我在辦公室使用的一個有趣且有用的工具。它稱為勃起硬度評分 (EHS)它是在 1998 年威而鋼問世前後開發的。讓患者更輕鬆地談論他們的勃起問題對我來說改變了遊戲規則。


我告訴他們這是一個 4 位數的秤。1」表示根本沒有勃起。2」是當它逐漸變得較硬較大,但無法插入。3」可插入,但非常不穩定。4」是完美的小黃瓜每個人都在尋求的如色情明星般的勃起。我請病人跟我講一個故事。他們可能會說,「當我早上醒來時,我的成績是 2。當我激勵自己時,我可以達到 3。當我和我的伴侶在一起時,有時我可以達到 4」。

這真的很有幫助,因為他們可以用數字說話。在我給他們改變生活方式、性治療、睪固酮、PDE5 抑制劑(如威而鋼或犀利士)或注射等治療後,他們可以回來告訴我情況發生了怎樣的變化。我有一個客觀的衡量標準,可以顯示治療如何影響他們的勃起。我不僅對這些客觀措施更有信心,而且我的患者對他們所獲得的照護也更有信心,並且他們更願意與我談論這些變化。因此,我鼓勵大家將 EHS 工具帶入辦公室。向患者展示它,讓他們更輕鬆地談論勃起。

引用此內容:談論陰莖的簡單方法 – Medscape – 2023 11 10 日。

The Easy Way to Talk About Penises

Rachel S. Rubin, MD / November 10, 2023 / Medscape


I’m Dr Rachel Rubin, a urologist with fellowship training in sexual medicine.

It’s important for doctors to ask about erections. Not only do our patients and their partners care about them, but they are a marker for overall health. I mean it. Penis problems are very common and are an early sign that patients could have a cardiac event. Think about it: Clogging the arteries of the heart is called a heart attack; clogging the arteries to the penis is a penis attack, or as doctors like to call it, erectile dysfunction.

The arteries to the penis are only 1 mm in diameter. They develop plaque and clog the circulation long before the 3-mm cardiac arteries. So, it’s very important for primary care doctors to talk to their patients about erection health. And I’ll be honest: It’s easier to talk to patients about how lifestyle is affecting their penis health than it is to discuss how lifestyle affects longevity or prevents cancer. I get a lot of men to quit smoking because I tell them what it’s doing to their penises.

It can be challenging for doctors and patients to talk about penises. It doesn’t come naturally for many of us. If a 20-year-old comes in to my office with his 85-year-old grandfather and they both say their penises aren’t working, how do you figure out what’s going on? Do they even have the same thing wrong with them?

Here’s a fun and helpful tool that I use in my office. It’s called the Erection Hardness Score (EHS). It was developed around the time that Viagra came out, in 1998. It’s been game-changing for me to get patients more comfortable talking about their erection issues.

I tell them it’s a 4-number scale. A “1” is no erection at all. A “2” is when it gets harder and larger, but it’s not going to penetrate. A “3” will penetrate, but it’s pretty wobbly. A “4” is that perfect cucumber–porn star erection that everyone is seeking. I have the patient tell me a story. They may say, “When I wake up in the morning, I’m at a 2. When I stimulate myself, I can get up to a 3. When I’m with my partner, sometimes I can get up to a 4.”

This is really helpful because they can talk in numbers. And after I give them treatments such as lifestyle changes, sex therapy, testosterone, a PDE5 inhibitor such as Viagra or Cialis, or an injection, they can come back and tell me how the story has changed. I have an objective measure that shows me how the treatment is affecting their erections. Not only do I feel more confident having those objective measures, but my patients feel more confident in the care that they’re getting, and they feel more comfortable talking to me about the changes. So, I encourage all of you to bring that EHS tool into your office. Show it to patients and get them more comfortable talking about erections.

Cite this: The Easy Way to Talk About Penises – Medscape – Nov 10, 2023.


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