HolSpan MD

09/02/2026

Be aware. Be HOL

09/02/2026

Prostate cancer screening can feel more complicated than simply “getting a PSA.”

When should you start screening? How often should it be checked? What does an elevated PSA actually mean? And when does an abnormal result warrant additional testing?

These decisions are increasingly individualized. Current urologic guidance emphasizes shared decision-making and considers factors such as age, family history, ancestry, overall health, PSA history, and personal preferences when developing a screening strategy. [1]

The Urology Care Foundation offers prostate cancer information and resources here:

https://www.urologyhealth.org/media-center/prostate-cancer-info-center

At my urology practice/HolSpanMD, helping men sort through these sometimes complex questions is an important part of what we do. Our goal is not simply to order a test, but to help each man understand his individual prostate health and risk and develop a thoughtful screening strategy that makes sense for him.

Prostate health deserves an individualized conversation.

Be aware
Be HOL

Sources:

1. https://pubmed.ncbi.nlm.nih.gov/41744286/. The Journal of Urology, 2026

09/02/2026

Be aware
Be HOL

🚨 What do you know about your prostate cancer risk?

Most people expect cancer to come with warning signs, but when it comes to prostate cancer, one of the most common cancers diagnosed in people with prostates, early disease often causes no symptoms at all.

This , take a moment to learn your risk factors, understand your screening options, and make informed decisions about your health. Because when it comes to prostate cancer, awareness is one of the most powerful tools you have.

🔗 Click to access our FREE Info Center: https://bit.ly/4dVZPjf

09/02/2026

Be HOL

09/02/2026

MOVEMENT + ERECTILE FUNCTION

Erectile health can tell us something about overall health.

Erectile dysfunction (ED) is a urologic condition, and we have effective conventional treatments for it. But er****ons are also a window into overall vascular health.

An er****on depends on healthy blood flow. Diabetes, high blood pressure, obesity, inactivity, smoking, and other cardiometabolic factors can affect the blood vessels throughout the body (including those involved in erectile function. ED and cardiovascular disease share many of the same risk factors and underlying vascular pathways). [1]

That is why treating ED does not have to end with treating the er****on.

It can also be an opportunity to take a closer look at the bigger picture: blood pressure, blood sugar, cholesterol, weight, activity level, sleep, stress, and other factors that influence cardiovascular and metabolic health.

What is good for your heart tends to be good for your parts.

Movement is a crucial input for cardiovascular health. Regular physical activity supports blood flow, endothelial function, metabolism, energy, and weight management. Research also shows that aerobic exercise can improve erectile function for many men. [2]

Lifestyle intervention is not a replacement for appropriate medical evaluation or conventional ED treatment. It is a complementary part of a more complete approach. The American Urological Association recommends counseling appropriate men with ED that diet and increased physical activity improve overall health and may improve erectile function. [3]

Urology: Erectile Dysfunction
Lifestyle Foundation: Movement
Men’s Health Intersection: Vascular and metabolic health

Sometimes a urologic symptom is an opportunity to have a much bigger health conversation.

That is the intersection of conventional urology and HolSpanMD.

Be well
Be HOL



Sources:

1. https://pubmed.ncbi.nlm.nih.gov/38938256/. JACC: Advances, 2023
2. https://pubmed.ncbi.nlm.nih.gov/37814532/. The Journal of Sexual Medicine, 2023
3. https://pubmed.ncbi.nlm.nih.gov/29746858/. The Journal of Urology, 2018

09/01/2026

Be rested.
Be HOL.

09/01/2026

Be rested. Be HOL.

09/01/2026

SLEEP + NOCTURIA + TESTOSTERONE

What does waking up to urinate have to do with men's wellness?

More than you might think.

Nocturia — waking during the night to urinate — is a urologic symptom, but it is not always just a prostate problem.

Sleep and nocturia can be deeply intertwined. Nocturia fragments sleep, but sleep disorders and other medical conditions can also contribute to nighttime urination. Poor sleep can then show up the next day as fatigue, impaired concentration, reduced motivation, and poor recovery. [1]

One important condition to consider is obstructive sleep apnea.

Sleep apnea is a condition in which breathing repeatedly pauses or becomes restricted during sleep. It can cause snoring, gasping or witnessed pauses in breathing, unrefreshing sleep, and daytime fatigue. It can also be associated with nocturia. In some men, sleep apnea contributes to more nighttime urine production and more frequent trips to the bathroom. [2]

Sleep is also when the body recovers and regenerates.

During sleep, the body engages in tissue repair, muscle growth, and immune system restoration. Growth hormone is released predominantly during deep sleep stages, supporting cellular regeneration and metabolic health. [3]

Sleep is fundamental to hormonal health.

Testosterone secretion follows a circadian rhythm, with the majority of daily testosterone release occurring during sleep. Sleep restriction (even just one week of reduced sleep) has been shown to decrease morning testosterone levels by 10–15% in healthy young men. [4] Chronic sleep debt and obstructive sleep apnea are associated with lower testosterone levels, potentially affecting energy, libido, muscle mass, and overall vitality. [5]

The relationship between sleep and hormones is bidirectional: poor sleep reduces testosterone, and low testosterone or testosterone therapy can influence sleep architecture and breathing patterns. [6]

So if you are waking up multiple times to urinate (especially if you also snore loudly, wake up gasping, feel exhausted despite a full night in bed, or struggle with daytime sleepiness) the answer may involve more than the bladder or prostate alone.

Those same symptoms can overlap with concerns that bring men in asking about testosterone. When a patient tells me:

" I'm tired, I'm not sleeping, and I'm getting up three times a night,"

I do not see three isolated complaints.

I see a reason to ask why.

Urology: Nocturia
Lifestyle Foundation: Sleep
Men's Health Intersection: Recovery, regeneration, hormonal balance, energy, and overall wellness

Treat the urologic problem.
Understand the bigger picture.

Be rested/ restored
Be HOL



Sources:

1. https://pubmed.ncbi.nlm.nih.gov/41106987/. The Urologic Clinics of North America, 2025
2. https://www.nature.com/articles/s41585-024-00887-7. Nature, 2024
3. https://www.nature.com/articles/s41591-025-03529-6. Nature, 2025
4. https://pubmed.ncbi.nlm.nih.gov/21632481/. JAMA, 2011
5. https://pubmed.ncbi.nlm.nih.gov/41862783/. Reviews in Endocrine & Metabolic Disorders, 2026
6. https://pubmed.ncbi.nlm.nih.gov/31042277/. The Journal of Clinical Endocrinology and Metabolism, 2019

08/31/2026

08/31/2026

Be well. Be HOL