Most men told they have “chronic prostatitis” do not have an infection, which is why round after round of antibiotics so often achieves nothing. Here is what chronic pelvic pain syndrome actually is, why the pelvic floor and nervous system matter more than the prostate in many cases, and where focused shockwave therapy fits.
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Most heel and Achilles pain settles with time and sensible loading. This is about the cases that do not — why “tendinitis” is the wrong word, why rest and anti-inflammatories so often disappoint, what a proper loading programme actually involves, and where focused shockwave therapy genuinely fits.
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Men with diabetes respond to Viagra and Cialis at noticeably lower rates than other men — and there are clear physiological reasons why. Here is what diabetes does to the erectile mechanism, what to check before assuming the medication has failed, and what realistically helps when pills alone fall short.
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Low testosterone and erectile dysfunction get treated as the same problem, but they are usually not. One is a hormone issue that blunts desire; the other is a blood flow issue that affects the mechanics of an erection. Here is how to tell which one you are dealing with — and why testosterone therapy often disappoints men who expected it to fix their erections.
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Here’s how the Mayo Clinic defines Peyronie’s Disease (PD):
“Peyronie’s Disease (PD) involves formation of fibrous scar tissue (plaque) in the tunica albuginea of the penis, leading to curvature, pain, shortening, or other deformities during erection. The exact trigger is often unclear, but the process centers on injury followed by abnormal wound healing.”
https://www.mayoclinic.org/diseases-conditions/peyronies-disease/symptoms-causes/syc-20353468
In my experience in dealing with thousands of PD patients, here’s 4 key questions and discussions about this very challenging condition.
Let’s just get a bit of science out of the way: The core mechanism of PD is improper healing and susceptibility to scar formation. PD is fundamentally a disorder of disordered wound healing rather than simple injury. After trauma or microtrauma causes bleeding and inflammation in the tunica, genetically or biologically susceptible individuals (sometimes linked to conditions like Dupuytren’s contracture) produce excess collagen, persistent myofibroblast activity, and inelastic plaque instead of normal remodeling. In short, PD most often begins with penile trauma in a susceptible person, followed by faulty scar-tissue formation. Symptoms of PD are painful erections, curved erections, difficulty in penetration, indentations or hourglass shaping, palpable fibrotic anomalies, loss of length and girth, erectile dysfunction, anxiety & depression. Patients will experience one or more of these symptoms, and the disease progresses from an acute phase (< 12 months) to a chronic phase (> 12 months).
Most cases have no clear recalled trigger; 75% of my guys don’t know why or how their PD started. 25%, however, are certain; they injured it during sex or masturbation, they got a puck or a foot in the groin, or they snapped a branch off on the head of their cock when they were clearing some brush, or post unrelated surgery (catheter insertion or removal?).
Don’t worry bro – you aren’t alone.
In fact it happens a lot, to a lot of guys over the course of their lives – PD prevalence is estimated as high as 9%.
For comparison sake – Diabetes has a similar prevalence – and everyone knows what diabetes is.
Most people don’t know what the F&%# PD is. And it’s very likely to be underreported.
So 25% for sure know HOW it happened, but for the remaining 3/4 of men, who just WAKE UP one morning – and it’s curved, or in pain – they have no idea what caused their condition.
I have my own theory.
I estimate that most of these men, specifically those who, prior to their injury, had normal erectile function, simply turned over on their boners during sleep, and boom, there’s your trauma. If you are a guy with healthy erectile function, you may be having 3-5 nighttime erections (nocturnal penile tumescence) every night! Accidents happen when you have a boner!
Simple preventative solution? Sleep on your back as much as you can!!! DICK UP!
Ultimately, being the detective in this scenario isn’t really relevant to you.
The question becomes – HOW DO I FIX THIS?
I’ve heard from several patients that when presenting to a urologists with PD, often later during the acute phase (because how long does it take to get a urologist appointment?), the advice for the patient was to ‘just wait it out’.
Whoa – yeah, don’t do that.
“See ya in a year!” said one urologist, without even completing a physical exam. Patient complained to me: “I just waited 10 months to be told there’s nothing that can be done?” Brutal. BS.
PD is a disease – meaning it progresses and usually worsens without intervention – and you should do what you can to halt it in its tracks early.
I’m not saying you need to have surgery or start injections – but you should be considering non-pharmaceutical, natural, non-invasive solutions now. I understand why most doctors opt to do nothing. In about 10% of PD patients, they will see a return to relative normalcy WITHOUT any intervention.
Following the Voltaire logic (“the art of medicine consists of amusing the patient while nature cures the disease”)
It just heals. And I’m sure, for a very small number of people – it does.
But for most, it won’t. And so being proactive is really important.
My advice is to throw the kitchen sink at the problem.
Here’s your list – Do all of them if you can:
Focused Shockwave Therapy. It’s powerful and painless for most people. It is expensive and there is no guarantee for success. But the data is very promising.
Traction Device and/or a vacuum pump. I recommend the RestoreX, the Penimaster, and the Active 3 Medintim Electric Pump. But don’t just buy it to let it sit under your bathroom sink. USE IT.
Nightly massages and jelquing. 5 minutes in a warm shower is all you need. These are somewhat controversial but I believe they can be done safely. Be careful! You CAN hurt yourself.
Apply Castor Oil to fibrotic plaque area. Purchase the very highest quality organic castor oil for topical use you can find. There’s none that I can specifically recommend. Go to a local Health Food Store. The data on castor oil is generally poor, but the side effects are so low that it’s generally worth a shot.
Bang & Masturbate (Carefully). Don’t let the blood flow to the area stop. USE IT.
Don’t do one, and ‘see what happens’. If you CAN – do them all. Do you think when Aaron Rodgers’ achilles exploded, he did the surgery and then was like ‘ahhh, I’m not gonna use the walking boot?’
Of course not – Throw the Kitchen Sink at the Problem.
Unfortunately, PD is like the achilles heel injury of the cock. PD, like an achilles rupture, is very difficult to fix, even with the best of care. How can such a small injury cause such a giant, and difficult to fix problem?
Often times you will never fully heal exactly, and If you do, prepare for a long recovery. The healing process takes time.
But if you DO NOTHING – I think you set yourself up for long term failure.
It’s important to note that there is a strong association of PD with mental health disorders. Many men develop significant emotional distress, clinical depression (rates often cited around 48% or higher in clinic samples), anxiety, relationship strain, and reduced quality of life. This is totally understandable given the impact PD can have on sexual function and body image.
https://pubmed.ncbi.nlm.nih.gov/40684259/
PD can often result in erectile dysfunction. While many guys who come to see me report no issues with ‘getting’ the erection, over time, it’s well defined that PD can result in early onset ED. In a retrospective analysis of 309 men with active-phase PD, ED was present in 37.5% of cases; in ALL of these, ED occurred during the course of PD. https://pmc.ncbi.nlm.nih.gov/articles/PMC4958366/
Again – it’s a disease.
Do what you can to halt its progression.
Clinical Presentation of Peyronie’s Disease: A Retrospective Study of 564 Cases (2024) — Found ED in 39.8% of PD patients.
https://www.mdpi.com/2075-4418/14/11/1125
Peyronie’s disease in the United States: A real-world, 13-year nationwide analysis of demographics, clinical characteristics, and treatment trends (2025) — ED present at diagnosis in 28.2% of patients; additional de novo ED developed in 14.8% within one year of PD diagnosis.
https://onlinelibrary.wiley.com/doi/10.1111/andr.70029
Premature ejaculation (PE) is often linked to physiological factors like pelvic floor dysfunction, poor penile blood flow, hypersensitivity of the penis, or chronic pelvic pain syndrome (CPPS). The combination of Focused Shockwave Therapy (FST), Pelvic Floor Physiotherapy (PFP), and pelvic floor muscle training addresses these root causes, offering a synergistic approach to improve intravaginal ejaculation latency time (IELT) and reverse PE symptoms.
How It Works:
Scientific Evidence:
Why It Helps: By targeting physiological causes like poor blood flow or pelvic inflammation, and in the neuromodulation of the penile nerves, FST creates a foundation for longer-lasting sexual performance, particularly in younger men with acquired PE.
How It Works:
Scientific Evidence:
Why It Helps: The PFP exam pinpoints the exact pelvic floor issues contributing to PE, enabling targeted training and ensuring shockwave therapy is optimized for the patient’s physiology.
How It Works:
Scientific Evidence:
Why It Helps: Pelvic floor training empowers patients to actively improve ejaculation control, building on the physiological improvements from shockwave therapy and the diagnostic insights from the PFP exam.
Men over 40 in Ottawa, Waterloo, Kitchener, and Gatineau searching for a non-surgical Peyronie’s disease treatment now have a proven solution: shockwave therapy. At FocusWave Clinic, low-intensity extracorporeal shockwave therapy (LI-ESWT) safely breaks down penile plaque, reduces painful curvature, and often improves erectile function—without surgery or injections.
Peyronie’s disease affects many men over 40, causing penile curvature, pain, and sometimes erectile dysfunction due to scar tissue (plaque) in the penis. For men in Ottawa and Waterloo seeking non-surgical solutions, FocusWave Clinic offers shockwave therapy—a safe, effective treatment to reduce symptoms and improve quality of life.
Shockwave therapy, or low-intensity extracorporeal shockwave therapy (LI-ESWT), uses focused or linear shockwaves (true shockwave!) to break down scar tissue, improve blood flow, and promote tissue regeneration. For Peyronie’s disease, it targets the fibrous plaque causing curvature, reducing pain and improving penile function. Clinical studies show that shockwave therapy can reduce curvature by 20-40% in many cases, often within 6-12 sessions.
At our Ottawa and Waterloo clinics, shockwave therapy for Peyronie’s disease is simple and discreet:
Men over 40 with Peyronie’s disease, especially those with painful erections or curvature affecting intimacy, are ideal candidates. If you’re in Ottawa or Waterloo and seeking a discreet, effective solution, shockwave therapy could be the answer.
Peyronie’s disease doesn’t have to define your life. FocusWave Clinic in Ottawa and Waterloo offers advanced shockwave therapy to reduce curvature and restore confidence. Schedule your private consultation today to learn how we can help.
Visit www.focuswaveclinic.com or call 888-558-9283 to book your appointment at our Ottawa or Waterloo clinic.
Take control of your men’s health now.
I’ve spoken with thousands of men over the last few years about their sexual dysfunction and performance issues.
Here’s what I’ve learned:
When it comes to Erectile Dysfunction (ED) – you aren’t alone. The inability to get or keep an erection is a very common problem.
Who is dealing with ED? The average age of our patient is 55 years old and ED is highly correlated with age.
Generally speaking, ED affects 20% of men over the age of 20, 30% of men over 30, and so on.
The older you get, the more likely you are to be dealing with it.
For most men, ED is highly treatable.
But like most health problems, it won’t go away on its own.
You have to be proactive and DO SOMETHING about it.
Causes of ED:
Psychological – this is the most common issue amongst younger men. Performance anxiety is much more prevalent amongst guys under the age of 30, but it can also affect older guys as well. Stress, bad sexual experiences, sexless marriages, porn addiction, excess masturbation, loss of libido and limited attraction to your partner – all can play a role in your inability to get or maintain an erection. SEX STARTS IN THE BRAIN. If you aren’t in the mood, or you are afraid that you won’t be able to perform, you can enter a vicious circle of sexual performance failure. Don’t let that happen. Get your mental game on point. Visit a sex therapist or sexologist who can help get you back on track.
Hormonal – if you are suffering from ED, a good place to start is with a visit to your doctor or naturopathic physician to check your testosterone levels. Low testosterone (aka Low T) is often viewed as the critical predisposition for andropause (male menopause). A decline in the body’s free levels of the male sex hormone may be the key to unlocking your ED mystery. The other key hormones to measure for are prolactin and cortisol. High concentrations of cortisol (the stress hormone) works inversely with testosterone, as they are both made from the same precursor molecule. The more stressed you are – the less testosterone you produce, the more cortisol you reproduce. Increased prolactin hormone (produced by the pituitary gland) may also bring about erectile disorder. Similar to cortisol, an increase in prolactin production can result in decreased testosterone secretion. Hypothyroidism or less active thyroid hormones may be the cause. Get your levels checked!
Vasculogenic – this is the most common cause of erectile dysfunction, especially in men over the age of 40. The connection between vasculogenic ED and cardiovascular disease is well established. ED is often called a harbinger of heart illness – as the arteries and veins that carry blood to and from the penis are some of the smallest in the body, and they are often the first affected by potential cardiovascular issues. A buildup of plaque in the arteries, or a possible venous leak (inflow of blood to the penis is sufficient but outflow is too rapid) may be the cause of a weak or nonexistent erection. Focused Shockwave therapy is the most effective, non-invasive, non-pharmaceutical option for patients looking to reverse vasculogenic ED. Combining with changes in lifestyle is critical to your success.
ED is a complex and frustrating medical condition.
Lifestyle, prescription drugs, low Nitric Oxide levels, and a host of other factors can contribute to your waning erectile function.
Call FocusWave Clinic in #ottawa and #kwregion for a free discovery call, and come in for a consultation with our trained nurses and health professionals.
888-558-9283 and visit www.focuswaveclinic.com to learn more.
Let’s get you back on the hobby horse!
Anxiety, Depression & Men’s Sexual Health
Depression and/or anxiety disorders in men is much more common than the statistics suggest.
Although only 5% of adult men annually report clinical depression in the Western world, approximately 20% admit to experiencing some form of anxiety disorder each year.
These numbers are rising, and alarmingly so.
In recent polling, the percentage of U.S. adults who report having been diagnosed with depression at some point in their lifetime reached 29% in 2023, nearly 10 percentage points higher than in 2015.
In fact, all of these datapoints are likely to be vastly underreported due to social stigma associated with these disorders.
Weakness
Without getting too deep into the clinical definitions and biopsychology of these conditions, we can confidently say that both depression and anxiety are weaknesses.
And EVERY SINGLE ONE OF US have moments of weakness.
Some moments of weakness can last minutes.
Some can last days and weeks.
No one is immune.
Acknowledging this is CRITICAL.
So….
What’s eating at you?
What’s your problem?
WHAT IS YOUR WEAKNESS?
These are rhetorical questions because, here’s the thing:
It doesn’t really matter.
It doesn’t matter if your environment is toxic (bad partner, crap boss, shitty job, no friends),
And it doesn’t matter if you are not motivated to do what you NEED to do (exercise, eating well, sleeping well, etc)…,
And it doesn’t matter if you are blowing it with your lifestyle (Smoking, drinking, being a lazy fuck).
What matters is: you are feeling weak now.
And THAT is what needs to change.
Take it Easy
It’s OK if you are feeling down and struggling.
EVERYONE SUFFERS.
The pain you experience, however, is OPTIONAL.
So when I see a patient coming in with anxiety, or stress, or extreme sadness, the first thing I do is to put my hands up and tell them: “Take it Easy!”
And I often repeat it “….Take it Easy….”.
I know ‘taking it easy’ is sometimes easier said than done, but this is the simplest advice you can receive when it’s clear you are mentally exhausting yourself.
You need to REST and TAKE IT EASY.
I’m not telling you to lay down and quit.
I’m telling you to STOP, BREATHE, REST and TAKE IT EASY…so you can come back stronger and carry on.
Sex Starts in the Brain
Men take a lot of shit – we are expected to have more agency and control than women.
The former are usually seen as victimizer while the latter is often seen as a victim.
Nowadays, we hear more about the downsides of the ‘Patriarchy’ than we do the ills of ‘Feminism’.
When it comes to our health, unfortunately, we aren’t very good at admitting, or working to repair, what is ailing us.
It’s different for everyone as to the what, and the why; but generally speaking, men struggle to take charge and make changes to both their physical and mental health (as compared to women)
The effect of mental health issues on a man’s sexual wellness is significant.
And in like manner, a man’s sexual wellness can directly affect his mental health.
It’s a 2-way street filled with potholes, pedestrians and peril.
Here are 5 ways your depression or anxiety can impact your sexual wellness:
1. **Erectile Dysfunction (ED):** Men with depression or anxiety are at a higher risk of experiencing erectile dysfunction. The psychological stress associated with these conditions can interfere with the brain’s ability to send the necessary signals to trigger an erection. Sex ALWAYS starts in the brain.
2. **Reduced Libido:** Both depression and anxiety can lead to a decrease in sexual desire or libido. The emotional and physical fatigue associated with these mental health conditions often dampens sexual interest and enthusiasm.
3. **Premature Ejaculation (PE):** Anxiety, particularly performance anxiety, can contribute to premature ejaculation. The pressure to perform well can create a cycle of anxiety and rapid ejaculation.
4. **Difficulty Achieving Orgasm:** Depression and certain antidepressant medications can make it challenging to reach orgasm, contributing to sexual dissatisfaction.
5. **Relationship Strain:** Mental health issues can strain intimate relationships, leading to decreased emotional and physical intimacy. This strain can further exacerbate sexual health problems.
Addressing the Connection
Given the strong link between mental health and sexual wellness, it is crucial to address both aspects in treatment.
Men experiencing symptoms of depression or anxiety should consider seeking professional help, be it a therapist, sexologist, naturopath, or allopath.
Addressing these mental health issues can lead to improvements in sexual health and overall well-being.
At FocusWave Clinic, we are committed to providing comprehensive care that addresses both mental and sexual health. Our approach includes a combination of tailored treatment plans, where we can integrate mental health support, natural sexual health treatments, and a holistic solution to overall improve well-being and quality of life.
If you are experiencing symptoms of depression, anxiety, or sexual health issues, we encourage you to book a consultation with us.
Taking the first step towards treatment can significantly improve your mental and sexual wellness.
For more information or to schedule an appointment, visit www.focuswaveclinic.com or call us at 888-558-9283.
Prioritize your health and well-being this Men’s Health Awareness Month.
Warm regards,
Drew Klein, Certified Sexologist & Clinic Director
FocusWave Clinic
Book a FREE DISCOVERY CALL with me
888-558-9283
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