Will Preston
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The ED Treatment Evidence Card
Every treatment in the AUA erectile dysfunction guideline, with the recommendation strength and evidence grade it actually carries. Zero statements rest on Grade A evidence.
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Half of ED Treatment Pages Leave Out That the Treatment Is Investigational
We coded 137 claims across 90 pages against the AUA guideline. Half omitted that shockwave, PRP and stem cell therapy are investigational, and commercial clinics omitted it four times as often as publishers.
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Testosterone Injections vs Gel vs Pellets: What Actually Separates Them
Eight approved routes, side by side: dosing schedules, how flat each keeps your levels, which carries a boxed warning about your family, and which one may spare your sperm count.
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Suicide in Men: The Numbers, the Warning Signs, and What Helps
Men account for close to four in five suicide deaths. Why the gap exists, what it looks like from the outside, whether asking makes things worse, and what the evidence says actually helps.
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Heat and Sperm: Saunas, Laptops and What the Evidence Shows
Heat suppresses sperm production in experiments and the effect fully reverses. But in 3,041 couples, laptops, tight underwear and saunas showed no measurable effect on how quickly they conceived.
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Varicocele: The Most Common Correctable Cause of Male Infertility
Present in 15 percent of men and up to 44 percent of those with primary infertility. Repair reliably improves semen parameters. Whether it produces more babies is a genuinely open question.
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Testicular Lumps: What Is Worth Checking, and What Happens Next
The most common solid cancer in young men, and the one where waiting costs the most. Five-year survival runs 99 percent localised and 72 percent once it has spread.
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Which Cholesterol Number Actually Predicts a Heart Attack
LDL-C measures cholesterol mass. ApoB counts particles. They usually agree, but one adult in five is discordant, and three independent methods say the particle count is the one that causes events.
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PRP, Microneedling and Laser Caps: What the Evidence Actually Supports
Everything sold for hair loss beyond finasteride and minoxidil, sorted by what the trials support. Including why FDA cleared and FDA approved are not the same thing.
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Dutasteride for Hair Loss: Stronger Than Finasteride, and Off-Label
Dutasteride blocks both forms of the enzyme that makes DHT. In the one large head-to-head trial it beat finasteride on hair count and width. In the United States it is approved for enlarged prostate,…
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When the Pills Do Not Work: Injections, Vacuum Devices and Implants
Around a third of men do not respond to PDE5 inhibitors, but most of them were taking the drug wrong. For those who genuinely fail, injections, vacuum devices and implants all have real numbers…
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Erectile Dysfunction Is a Cardiovascular Symptom, and It Arrives First
The arteries that fail first are the smallest ones. In men with confirmed coronary disease, two thirds developed erectile dysfunction first, a mean of 38.8 months before any cardiac symptom.
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Semen Analysis: What Each Number on the Report Actually Means
The WHO reference limits are not a line between healthy and unhealthy. They are the fifth percentile of men who conceived naturally within a year, which changes how every number on the report should…
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Exercise for Depression: What 218 Trials Found, and What They Did Not
A BMJ network meta-analysis ranked walking, yoga, strength training and antidepressants against each other across 218 trials. Here are the effect sizes, what worked better in men, and why the authors rated their own…
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Do Penis Enlargement Pills Work? No, and Two Thirds Contain Prescription Drugs
No supplement has ever been shown to change penis size, and no mechanism exists by which one could. When researchers tested 102 products off the shelf, 67 percent contained undeclared prescription ED drugs.
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Doxy-PEP: It Works, and the CDC Does Not Recommend It for Most Men
A single 200 mg doxycycline dose within 72 hours of sex cut chlamydia and syphilis by 70 to 90 percent in randomised trials. Here is what the evidence shows, who the CDC recommends it…
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Oral Minoxidil for Hair Loss: As Good as the Foam, With Different Problems
The only head-to-head trial in men found oral minoxidil 5 mg roughly equivalent to 5% topical over 24 weeks. Unwanted hair growth elsewhere ran at 49% against 25%. It is off-label everywhere, and a…
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Testosterone Replacement: The Warning the FDA Removed, and the One It Added
TRAVERSE found no increase in heart attacks or strokes, and small real increases in atrial fibrillation, kidney injury and pulmonary embolism. In February 2025 the FDA dropped the cardiovascular boxed warning and added one…
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Shockwave Therapy for ED: A Real Effect, Just Below What You Would Notice
Twenty-one randomised trials found a 3.89-point improvement in erectile function. The smallest change men actually notice is about 4 points. Nine of the trials were funded by the device makers, and the average course…
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Viagra, Cialis and the Rest: You Are Choosing a Duration, Not a Strength
Sixteen randomised trials in 5,189 men found no difference in how well tadalafil and sildenafil work. What separates the four PDE5 inhibitors is half-life, food, and which side effect you would rather have.