Premature ejaculation (PE) is a common sexual dysfunction affecting in a significant percentage of men across the globe. Most often, its psychological factors like stress or anxiety related to performance. But one recent case published in the Archives of Sexual Behavior, has revealed an uncommon physiological cause, challenging the established paradigm and underscoring the value of thorough medical workups.

For years, a 32-year-old man struggled with premature ejaculation (PE), believing his performance anxiety to be the cause. Like many others with sexual dysfunction, he blamed his symptoms on stress and psychological issues. But when his symptoms intensified—along with unexplained symptoms such as pelvic pain and prolonged erections without stimulation—he knew there was something else going on.

His search for answers or a certain reason resulted in an unexpected diagnosis- a vanishingly rare spinal cyst was compressing nerves that controlled sexual function, impairing his body's normal reaction. This epiphany not only altered his treatment but enlightened an under-recognized physiological mechanism of PE.

When Anxiety Isn't the Cause of Premature Ejaculation?

PE is among the most prevalent sexual disorders in men, occurring in as many as 30% globally. Although psychological issues—performance anxiety, stress, and depression—are often culprits, new research indicates that physiological explanations cannot be ruled out.

Here, the patient's chronic symptoms, such as priapism (recurrent, throbbing erections) and pain on ejaculation, led physicians to consider other factors beyond anxiety. An MRI scan of his lower back uncovered an oval fluid sac called a Tarlov cyst compressing his sacral nerves—nerves responsible for sensation and function in the pelvic area.

What Are Tarlov Cysts?

Tarlov cysts, or perineural cysts, are cerebrospinal fluid-filled sacs that develop around nerve roots at the base of the spine. Most individuals with Tarlov cysts will never have any symptoms, but occasionally, when such cysts become large or compress nerves, they can create serious problems, such as:

• Lower back pain
• Sciatica-like symptoms
• Bladder and bowel dysfunction
• Sexual dysfunction, including premature ejaculation

The sacral nerves have a very important function in passing signals between the brain and pelvic organs. Compression of these nerves results in the misfiring of the nerves, which leads to involuntary or exaggerated responses upon ejaculation.

Once the underlying cause was determined, physicians advised surgery to excise the cyst and relieve pressure on the nerves. Post-surgery, the patient reported dramatic improvements—his premature ejaculation decreased, and he no longer suffered from priapism or pelvic pain. A check-up six months later confirmed the long-term efficacy of the treatment.

This case highlights a valuable lesson: sexual dysfunction is not always psychological. Most men with PE might never think to look for an underlying neurological reason, resulting in misdiagnoses and useless treatments.

For those with recurrent or worsening PE, particularly with other symptoms such as unexplained pain or irregular erectile function, a complete medical assessment—comprising imaging studies—can prove life-altering.

Low-dose CT chest scans could help detect pneumonia in at-risk patients while exposing them to only small amounts of radiation, a new study has found. The research, published in Radiology: Cardiothoracic Imaging, shows that ultra-low-dose scans can effectively detect pneumonia in patients with compromised immune systems, enabling doctors to treat the infection before it becomes life-threatening. According to the researchers, these scans expose patients to just 2% of the radiation dose used in a standard CT scan.

"This study paves the way for safer, AI-driven imaging that reduces radiation exposure while preserving diagnostic accuracy,” lead researcher Dr Maximiliano Klug, a radiologist with the Sheba Medical Center in Ramat Gan, Israel, said in a news release. He added that CT scans are the gold standard for detecting pneumonia but there are concerns regarding the risk posed by repeated exposure to radiation. There is a solution- ultra-low-dose CT scan. However, the problem is that these scans can be grainy and hard to read, researchers said.

Study Gives Solution To This

To overcome that, Klug's team developed an AI program that could help "de-noise" low-dose scans, making them sharper and easier to read. Between September 2020 and December 2022, 54 patients with compromised immune systems who had fevers underwent a pair of chest CT scans -- a normal dose scan and an ultra-low-dose scan. The AI program cleaned up the low-dose scan, and then both sets of images were given to a pair of radiologists for assessment. Radiologists had 100% accuracy in detecting pneumonia and other lung problems with the AI-cleaned low-dose scans, but 91% to 98% accuracy in examining the scans that hadn’t been improved through AI, results show.

"This pilot study identified infection with a fraction of the radiation dose," Klug said. "This approach could drive larger studies and ultimately reshape clinical guidelines, making denoised ultra-low dose CT the new standard for young immunocompromised patients.

How Can You Detect Pneumonia?

Pneumonia is a lung infection that causes the air sacs in the lungs to fill with fluid or pus and can be caused by bacteria, viruses, or fungi. The symptoms can range from milk to severe, which includes:

Coughing with or without cough

Fever

Chills

Trouble breathing

Chest pain, especially when breathing deeply or coughing

Sweating or chills

Rapid heart rate

Loss of appetite

Bluish skin, lips, and nails

Confusion.

How to detect Pneumonia in coughing newborns and toddlers?

Pneumonia can severely affect newborns and young children as their lungs are comparatively more sensitive. As per Dr Goyal, young children can cough for various reasons including seasonal infections and tonsillitis, which is very common in this age group. But if they look visibly irritable and have poor sleep patterns, then parents must reach out to an expert. "I am not saying that parents must visit a hospital but any local paediatrician would be able to detect pneumonia in your kid.

Once thought to be eradicated in the US, measles is making a concerning return. With rising cases and recent deaths in the US—the first since 2015—public health officials are on high alert. The Centers for Disease Control and Prevention (CDC) has been tracking the outbreak closely, exacerbated by decreased vaccination rates and increased international travel. The situation is not just in the US; in Australia and Canada, cases are rising, and health authorities across the globe are issuing warnings.

Measles is an extremely contagious and airborne illness that will result in severe complications, such as pneumonia, inflammation of the brain (encephalitis), and even death. The CDC states that nearly 1 of every 5 unvaccinated people who get the virus will need to be hospitalized, and as many as 3 of every 1,000 infected children can die from complications. As vaccination continues to spread, the question remains: Is it time for round two of vaccinations?

The US and global resurgence of measles can be traced to the following factors:

Declining Vaccination Rates

Routine immunization was disrupted during the COVID-19 pandemic, which resulted in declining vaccination rates in children. According to the CDC, the coverage of the MMR (measles, mumps, and rubella) vaccine in kindergarteners declined from 95.2% during 2019–2020 to 92.7% during 2023–2024, making about 280,000 children susceptible to measles.

International Travel

Outbreaks of measles in countries with lower vaccination rates, including some areas of Asia and Europe, risk unvaccinated travelers getting the illness overseas and transporting it back to their native countries. This was reflected in 2019 when imported cases of measles nearly led the US to lose its elimination status.

Misinformation and Hesitancy: Misinformation-driven vaccine hesitancy has been a key driver of decreased immunization coverage. Misconceptions regarding the safety and efficacy of vaccines have dissuaded parents from getting their children vaccinated, raising the threat of outbreaks.

Measles Outbreaks Outside the US

It is not only the US that is experiencing a measles crisis. Australia has witnessed an increase in cases, and health authorities issued warnings in Melbourne and Sydney. Five new cases were recently reported in Victoria, where some were associated with international travel. Residents are being called upon by health officials to watch out for symptoms and seek treatment if they believe they have been exposed to the virus. In New South Wales, a tourist infected with measles traveled to Sydney and attended several venues, and there are fears of community spread.

While measles is no longer endemic in Australia, it still appears as a result of travel-acquired infections. This emphasizes the importance of worldwide vigilance and collaborative public health action to avoid further outbreaks.

Should You Get a Measles Vaccine Booster?

For individuals immunized on the recommended schedule—two doses of the MMR vaccine—there is more than a 95% probability of lifelong immunity against measles. But some adults require a booster dose. People who were vaccinated prior to 1968 might have been given an earlier formulation of the measles vaccine that was derived from an inactivated virus, and not as effective as the current live attenuated vaccine. Adults in this group need to receive at least one dose of the new MMR vaccine. Moreover, the CDC also advises an additional dose of measles vaccine to adults with high-risk exposure, such as college students, healthcare personnel, and those who live with immunocompromised individuals. International travelers must also be fully vaccinated because outbreaks of measles continue to pose a threat in countries with poor immunization coverage. Precautions against these can prevent infection and check the resurgence of measles globally.

Why Is There a Urgent Need for High Vaccination Rates?

Measles is among the most infectious diseases, which can be spread in the air when an infected person coughs or sneezes. For this reason, there needs to be a high percentage of vaccination coverage so that outbreaks are prevented. Public health professionals emphasize that a minimum of 95% of a community should be vaccinated to ensure herd immunity.

In the US, vaccination rates have fallen below this level in recent years, and states such as Texas have had particularly severe outbreaks. This trend is echoed internationally, with several countries having declining immunization rates and following them, resurgence of disease.

What to Do If You've Been Exposed to Measles?

If you think you've been exposed to measles, it's important to move quickly:

1. Call your doctor/ a medical practitioner immediately who will be able to check your immunity, give post-exposure prophylaxis if needed, and advise on what to do next.
2. Symptoms of measles such as fever, cough, sore throat, and a characteristic rash usually develop 7 to 14 days following exposure.
3. Isolation for four days or more after the rash develops is advisable in case you have been diagnosed with measles in order to avoid further transmission.

Measles epidemic- once preventable disease, now poses communities with the risks of declining vaccine coverage and globalization. With cases of measles increasing on several continents, the response is obvious- Now is the time to put immunization first. If you are uncertain about your immunization history, see a health care provider and get another shot—because when it comes to measles, prevention is the best treatment.

It can be incredibly frustrating being constantly told that you have a drinking problem when you've never had a drop but for this 61-year-old Pennsylvania woman, each and every effort to become eligible for a life-saving liver transplant was thwarted by an insurmountable hurdle—she kept testing positive for alcohol. No matter how many times she asserted that she had not been drinking, her urine drug screens read otherwise. Accordingly, she was refused entry on the liver transplant waiting list numerous times, the doctors presuming she was struggling with alcohol addiction.

But the reality was much stranger than anyone might have dreamed. In what seems to be a first in medical history, physicians found that her own bladder was secreting alcohol—a process so unusual that it had not been given an official name yet. Her case sheds new light on how the human body, under abnormal circumstances, can simulate effects of alcohol use without ingestion.

The patient had severe liver cirrhosis, a scarring and liver function loss that requires a transplant to save her life. She also had diabetes that was uncontrolled, leading to high levels of glucose (sugar) in her urine.

Initially, physicians at one hospital brushed off her assertion that she was sober, believing that she was denying alcohol addiction. When she subsequently reported for assistance at the University of Pittsburgh Medical Center (UPMC) Presbyterian Hospital, the same problem persisted. Her urine samples consistently registered the presence of ethanol, the beverage type of alcohol, further increasing the medical staff's suspicion. Yet there was a critical discrepancy: whereas her urine tested positive for ethanol, it was free of the usual metabolic byproducts—ethyl glucuronide and ethyl sulfate—seen days after drinking.

This contradiction interested Dr. Kenichi Tamama, a senior researcher on the study and an associate professor of pathology and medical director of UPMC's Clinical Toxicology Laboratory. If the woman was consuming alcohol, the metabolites should have been found in her urine. Also, her blood alcohol tests were negative, and she never showed any symptoms of being intoxicated.

Following more research, the doctors discovered a surprising cause: yeast in the woman's bladder was fermenting sugar into alcohol. The process, normally related to making beer or wine, was occurring within her body. Consequently, they suggested calling her condition "urinary auto-brewery syndrome" or "bladder fermentation syndrome."

This condition is similar to, but different from, a rare disorder called auto-brewery syndrome (ABS), also referred to as gut fermentation syndrome. ABS happens when some microbes in the gut ferment carbohydrates into alcohol, leading to people with the condition becoming intoxicated without consuming alcohol. In the case of the Pennsylvania woman, however, her condition was confined to her bladder, so the alcohol did not reach her bloodstream. She therefore never seemed drunk, although her urine was ethanol-positive.

To be sure about their suspicion, scientists performed an experiment. The researchers took a fresh urine specimen from the patient and incubated it at a temperature of the human body (98.6°F or 37°C). Ethanol in the sample zoomed within no time. The sample did not yield any alcohol, however, if it were incubated below normal temperature (39°F or 4°C) or after the addition of a chemical for stopping fermentation. This test conclusively established that the yeast in her bladder was the cause of the alcohol production.

Additional lab tests determined the offender—Candida glabrata, a yeast that is normally present in the human microbiome. Candida glabrata is closely related to brewer's yeast, which is employed in alcoholic fermentation. Under conditions of excess sugar, as in the case of the woman with uncontrolled diabetes, Candida glabrata metabolized the glucose in her bladder to ethanol.

Due to these observations, the woman was finally reevaluated for liver transplant, a move that could turn around her condition and save her life. Her case highlights the need to cast aside standard assumptions of diagnosis and to explore infrequent metabolic phenomena.

Although sporadic reports of such cases have appeared, they were usually considered postmortem changes or laboratory artifacts due to the improper storage of urine samples. This case presents tangible evidence that bladder fermentation is possible in living patients and serves to increase awareness among medical professionals regarding distinguishing between true alcohol intake and endogenously produced alcohol.

What Is Auto-Brewery Syndrome?

Auto-brewery syndrome, or gut fermentation syndrome, is a rare condition where carbohydrates ferment to alcohol within the gastrointestinal tract. Patients can present with signs of intoxication, such as dizziness, slurred speech, and coordination impairment, without alcohol consumption. This results from an imbalance in gut microbiota, typically yeasts such as Candida.

The syndrome is well-documented in medical literature for more than 50 years, yet it remains significantly underdiagnosed. A study published in 2021 estimated that fewer than 100 cases had been reported globally. Experts, however, estimate that numerous other people might be suffering from the condition unknowingly, as the symptoms might be confused with alcohol intake, metabolic conditions, or psychiatric issues. In severe instances, people with ABS have been charged with DUI, even though they consumed no alcohol.

How Is Urinary Auto-Brewery Syndrome Different From Typical Auto-Brewery Syndrome?

Urinary auto-brewery syndrome (bladder fermentation syndrome) and conventional auto-brewery syndrome (gut fermentation syndrome) are similar but differ significantly.

In urinary auto-brewery syndrome, alcohol is synthesized in the bladder because of microbial fermentation of sugar. It may also happen in an open sample of urine outside the refrigerator. But as the alcohol is contained within the bladder and does not get into the bloodstream, individuals who have it do not have symptoms of being intoxicated.

In contrast, classical auto-brewery syndrome happens within the gastrointestinal tract, where fermentative microbes metabolize carbohydrates into alcohol. This alcohol is absorbed into the bloodstream, resulting in a positive plasma ethanol reading and creating symptoms of intoxication similar to that following alcohol intake.