Urologist Rena Malik, who has more than 2 million subscribers on YouTube, discusses how to care for your mental and sexual health while experiencing urological conditions.
Rena Malik
Founder, Rena Malik, MD; Urologist, Long Beach Veterans Affairs Medical Center
How do urological conditions, such as urinary incontinence or erectile dysfunction, impact a patient’s overall sexual health and quality of life, and what holistic approaches do you employ in managing these issues?
These conditions can have a dramatic impact on quality of life. People tend to minimize them because they’re not life-threatening, but the psychological impact of living with sexual dysfunction or urinary and bladder issues can be dramatic. It can lead to anxiety, depression, isolation, decreased work productivity, and even financial implications due to the cost of products like pads or diapers. My approach to managing these issues focuses on evaluating the patient’s goals and their level of motivation. There are certainly lifestyle changes one can make that can lead to dramatic impacts, and there are also effective and more invasive options like medications and procedures. Ultimately, it boils down to what the patient wants and what they are willing to do.
In your practice, what are some common challenges faced by patients when discussing sexual health concerns, and how do you create a supportive environment to address these sensitive topics?
The most common challenges faced by patients are related to discussing these issues with their intimate partners. They are often embarrassed and devastated by their sexual dysfunction and they’re worried about how their partner might deal with it or even losing their partner. I give patients advice on how to communicate with their partner, or I ask them to bring their partner into the office. It may offer an opportunity for their partner to learn. Lastly, therapy — whether it’s with a psychiatrist, psychologist, or sex therapist — can be extremely helpful in these cases.
Could you share some insights into the interplay between mental health and sexual function in patients with urological conditions? How do you integrate psychological support into your treatment plans?
Sexual health is biopsychosocial. There are no biological issues that cause sexual dysfunction that don’t have an interplay with psychology, so it’s important to look at patients in that framework. While they’re dealing with this biological issue, it’s creating havoc on their mental health in some capacity, whether it’s anxiety, rumination, or frustration. I look at patients as a whole individual and not just one system. I think it’s important to work in a team; very often I refer patients to sex therapy so they can have someone with appropriate expertise, knowledge, and time to spend with the patient to improve the psychological component. Sometimes that’s not accessible to patients or they don’t want to, so I counsel patients on some basic techniques that may help them work through some of the psychological issues as well.
With the rise of telemedicine and digital health platforms, how do you see these technologies transforming the delivery of sexual healthcare and enhancing accessibility to specialized services for patients with urological concerns?
Telemedicine has transformed the way we deliver care and led to a much-needed increase in accessibility to sexual health services. While I firmly believe that a physical examination is helpful for many conditions, a lot of things can be managed without a physical exam. Having access to the knowledge and care of experts in the comfort of your own home can allow people to open up in a way that maybe they wouldn’t have done otherwise, and I think it’s so valuable.
In your experience, what role do you see content creators like yourself playing in shaping the future of online health information?
I like to think of physician content creators as digital opinion leaders. We are taking scientific knowledge and translating it into education that’s accessible to the everyday person. As a physician, I can only reach so many patients in my clinic in a single day, but by allowing access to people through online platforms, we can reach millions of individuals who can learn and access information that they would not normally have had access to, which is so powerful. I get approached all the time by people who say I’ve changed their lives for the better without ever having met them in person.
