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As a urologist and a surgeon who specializes in male sexual dysfunction and infertility, men frequently turn to me for medical advice when suffering from issues surrounding their sex life. They often think that I may recommend some sort of surgical solution. However, there are many factors surrounding sex itself that can be addressed without surgical intervention.

Sex is profoundly interlaced with many psychological elements. It can be affected by issues of self-esteem, and it is clearly connected to one’s medical condition and overall mental health. Specifically, studies have found that testosterone levels play a key role in physical energy and emotional well-being, which themselves can have a direct impact on sexual desire and function, especially as men grow older. …

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Jacob and Rachel at the Well [c.168] Artist: Circle of Bartolomé Estéban Murillo. Source: Wikimedia

As a urologist and a surgeon who treats infertility and sexual dysfunction professionally, I have had ample opportunity to reflect deeply on the impact that fertility and sexual health issues can have on the marital relationship.

Over the years, I have often drawn on my Jewish heritage and faith for further insight, inspiration, and support, and I feel that has helped me to become a better doctor for my patients.

Biblical Inspiration

I frequently turn to books about Jewish spirituality for inspiration and insight, including the Garden of Emunah, the Garden of Wisdom, Living Emunah, and Maimonides: A Spiritual Biography. I make a habit of reading and studying the weekly Torah portion with scholarly experts and often listen to TED Talks about meditation and spirituality.

One of the stories from the Hebrew Bible that has always resonated with me is the story of Rachel, the bride whose hand Jacob sought for many years. After they were finally married, Rachel learned that she was infertile and informed Jacob. Anguished by her condition, Rachel told her husband that she felt that her life was all but worthless without the ability to bear children. Jacob’s immediate reaction was one of anger, telling her that he didn’t possess divine powers or any other way of changing her condition.

I have always been moved by this story from the Torah, which delicately sheds light on how infertility can lead to marital strain. Jewish commentators who reflected on the story have suggested that Jacob’s reaction to his wife’s distress was hardly ideal. Rather than showing compassion and inviting Rachel to join him in having faith, he lashed out at her in anger. Ultimately, the Bible recounts that Rachel successfully conceived more than one child, providing us with a beautiful and illuminating story about the power of prayer and compassion in marriage, while juxtaposed with the stresses of infertility. …

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As the COVID-19 pandemic continues to rage and lockdowns across the US and the world remain in place, I have encountered quite a number of recurring questions regarding sex and relationships at this unprecedented and often difficult time. I think it’s important to take this opportunity to address a few of them.

Can you become infected with COVID-19 by having sex?

There is no evidence that the novel coronavirus can be transmitted sexually, though it has been found in feces, which means that sexual activity involving the oral stimulation of the anus might spread the virus. Evidence shows that the virus is transmitted through the respiratory system and through respiratory droplets as well as through saliva and mucus. However, the nature of sexual activity is such that bodily fluids are so easily shared, and this can greatly increase the risk of the virus’s transmission. …

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It’s fairly safe to say that we have all been dealing with numerous uncertainties over the last few months in the wake of the coronavirus outbreak. While daily life in itself has changed significantly and has become filled with new quandaries surrounding that which was once mundane, such as transportation and family dinners, some face an even more complex reality.

Many of those who need to see a physician may be thinking twice about leaving the house, all the more so if they need to visit a hospital that has potential exposure to COVID-19 patients. Those who require vital ongoing monitoring for a condition may be left with few alternatives. Others may be somewhere in the middle — stuck at some point that is not quite at the extreme of requiring urgent medical care yet still necessitating important care and checkups that can only questionably be postponed, at best. …

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Photo by Dainis Graveris on SexualAlpha. Source

There is no denying it. There are a variety of natural and surgical approaches out there that claim to increase the size of your penis. A simple Google search of the term “penile enlargement” quickly reveals the number of methods available. Do they actually work? For the most part, unfortunately no. Other than the Penuma penile implant, the treatments on the market are largely ineffective at best and outright dangerous at worst. What are these methods all about, and how is Penuma different? Let’s have a look at them and understand their risks and complications.


Jelqing is a relatively simple method that does not require much other than your hand. The idea here is to prevent the blood from leaving the penis. To do so, you use your thumb and index finger to create a circle and place it around the base of the penis. You then squeeze the penis upwards, causing the blood to flow to the tip at a higher rate and having the tissues expand over time, supposedly increasing penile girth. …

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The swift spread of the coronavirus and its far-reaching repercussions have been stressful and disruptive, affecting our lives in unexpected ways. Most immediately, people are afraid for their own well-being and that of their loved ones, as they have been worried about infection, possible hospitalization, and worse. People are also extremely anxious about the economic impact of this pandemic, which has placed millions of people across America out of work. …

Introducing the Unique Penuma Penile Implant

The development of the Penuma implant is by far one of my proudest professional achievements. I developed Penuma, the first penile implant for aesthetic enhancement to receive FDA clearance, as a direct outgrowth of two of my greatest passions in life: surgery and urology.

Becoming a surgeon had always been a dream of mine ever since I was a child, and it quickly became one of my chief goals when I first began to study medicine. I was in awe of the immediacy of the results that could be achieved with surgery, an immediacy that simply could not be replicated in any other fields of medicine. When a doctor treats a patient with high blood pressure, diabetes, or other similar ailments, the courses of treatment generally tend to present themselves gradually. Alternatively, with surgery — most of the time — the results are in by the end of the proverbial day.

Applying my surgical training to urology has given me the unique opportunity to be able to treat male infertility and sexual dysfunction in a way that has improved the lives of thousands of men ever since I first opened my practice in 1982 in Beverly Hills. Nothing can be more rewarding for a doctor and a surgeon than to have former patients and their partners reach out to say how their lives were changed for the better thanks to the treatment they received at my clinic. …


Dr. James Elist, MD, FACS

Dr. James J. Elist is a world-renowned urologist, and expert in male infertility, impotency, and sexual dysfunction.

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