Greater Boston Urology Blog

How Mental Health Can Affect Urologic Health

Our mental health—or as the CDC describes it, our emotional, psychological, and social well-being—can affect our physical health. Anyone who's ever lost sleep because of a stressful situation has certainly experienced this first-hand.

Given the sensitive nature of so many urologic conditions—from erectile dysfunction to incontinence to prolapse—it's no wonder that a person's mental health can be a crucial component to diagnosis and treatment.

Today, one of our urologists, Dr. Jonathan Brajtbord, joins us to discuss the role mental health plays in urologic health and his approach when navigating these delicate discussions with patients.

As with all content on our blog, the information provided in this article is meant to be educational in nature, not medical advice. Always consult a physician regarding your specific health needs.

Discuss some of the common urologic conditions you treat—and how mental health (both positive and negative) can affect the patient's life.

DR. BRAJTBORD: So much of our psyche can affect our physiology and therefore our bodies. Take for example urinary frequency and urgency. The more that we are nervous, anxious, or stressed, the tighter our pelvic floor can get and the greater sense we have that we need to urinate. Stress and anxiety can contribute to erectile dysfunction as well as pelvic pain in both men and women.

Are there certain urologic conditions that are especially impacted by someone struggling with emotional and psychological problems?

DR. BRAJTBORD: Absolutely. We can carry stress and anxiety in different parts of our bodies. For example, our pelvis is a hammock or bowl of muscles and tendons. Some men and women will carry stress in their pelvis. This can then lead to symptoms of a urinary tract infection (UTI) in women and men. Symptoms include feelings of urinary urgency, frequency, pain, and pressure.

Some women dealing with these symptoms will have been treated numerous times for infections despite no evidence that there is actually an infection. In these cases, the issue and their symptoms can be due to dysfunction or tightness in the muscles of the pelvic floor. For men, they will often complain of similar symptoms, and some will even complain of testicular pain.

Erectile dysfunction is another common condition that is impacted by anxiety and stress. Quite often, nothing is anatomically wrong with men in their 20s, 30s, or even 40s who are dealing with erectile dysfunction. These men will simply be under significant stress. This can lead to physiological changes in their body—a sympathetic nervous system imbalance that can then make it harder for the body to achieve and sustain an erection.

Of course, stress is not the only emotion that can cause these symptoms—anxiety, anger, frustration, and depression can all lead to physiological changes that impact a man's ability to achieve an erection.

What's your approach to mental health when developing treatment plans for patients?

DR. BRAJTBORD: The most important thing I can do is simply ask patients about their stress, anxiety, and lives. Allowing patients the space to speak about what is going on in their lives can be incredibly powerful. Often, patients have never had a physician ask about their life or stress.

I allow and hold space for patients to share their stories—what is going in their lives, their relationships, family dynamics, and work stress. I then help patients make the connection between their stress and their physical symptoms. I help them realize that their symptoms are often a physical manifestation of their inner emotions or stress.  

I can't help them solve all their stress or anxiety, but I emphasize the importance of handling stress, and we begin talking about some strategies to help manage their stress.

What are some things for our readers to think about as they look for connections between their own mental health and urologic symptoms they may be experiencing?

DR. BRAJTBORD: I believe that the body is trying to communicate with you. I believe that symptoms can be a physical manifestation of our underlying emotional or mental state.

I think it's important to remember the mind-body connection. These two things are not separate despite what we are often taught in medical schools. Before looking to medications or surgery to try and solve your symptoms, it's important to evaluate your life and consider how your lifestyle choices are impacting your health and symptoms.

Is there anything else you'd like to share with readers?

DR. BRAJTBORD: Please join me on Instagram where I discuss a lot of these topics. I'd love to hear from you! 

Interested in making an appointment with Dr. Brajtbord?

Dr. Brajtbord is accepting new patients in our North Easton Care Center. Make an appointment with him or one of our other world-class urologists or urogynecologists.

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