Special guest blog by Prof. Prokar Dasgupta of MV.Health
As people live longer, healthier lives, the conversation about healthy aging is expanding — but sexual and pelvic health remain largely overlooked. Conditions such as erectile dysfunction, menopause-related changes and pelvic pain can have a significant impact on quality of life, relationships and well-being, yet they are often treated as inevitable parts of getting older rather than health concerns that can be addressed. In this guest post, Prof. Prokar Dasgupta, Chief Medical Officer at MV.Health — an AgeTech Collaborative startup participant — uses more than three decades of medical experience to explore why intimate health belongs in the healthy-aging conversation, how evidence-based innovation is changing the possibilities for care and why more of that care may ultimately belong in the home.
In more than three decades as a urologist, I have learned that the most important question in the exam room is usually the last one. A patient comes in about a prostate result or a bladder concern, we finish the appointment, and then, hand already on the door, they pause. “Doctor, one more thing.”
What follows, more often than not, is a question about intimacy: about erections, about pain, about a marriage that has gone quiet. It is asked in a half-whisper, with an apology attached, as though it were somehow improper to want a full life after 60.
It is not improper. It is human. And it is time the aging-innovation community treated it that way.
A Career Spent Making Treatment Gentler
The great British pioneer of minimally invasive surgery, John Wickham, believed that the less trauma we inflict in treating a patient, the better they recover, in body and in spirit. My generation took that principle and ran with it: from open surgery to keyhole, and from keyhole to the operating robot. In 2009 I became the inaugural professor of robotic surgery at King’s College London. With Prof. Clare Fowler, I had earlier helped develop an outpatient injection technique that spared patients with severe overactive bladder from major surgery.
Every step of that journey pointed the same way: gentler, more dignified, closer to the patient’s own life.
Followed to its logical end, that road leads somewhere many of my colleagues did not expect — to therapy that is not invasive at all. Evidence-based treatment a patient can use in their own home. And it leads to the field where gentleness and dignity matter most of all, and where serious innovation has been slowest to arrive: sexual and pelvic health.
The Numbers Are There. The Conversation Isn’t.
The need is anything but marginal. More than 112 million Americans are aged 50 or older, and the conditions that my field treats — erectile dysfunction, overactive bladder, urinary tract infections, prostate disease — are everyday realities among them. Millions of women are navigating menopause and the intimate-health changes that come with it. There is scarcely an older household untouched by a condition almost no one will name at the dinner table.
The silence weighs heaviest on older women, who face a double taboo of age and of gender. Menopause has finally begun to receive the attention it deserves, but the conversation still tends to stop at hot flashes, well short of the pelvic and sexual health changes that most affect daily life and relationships. Those, too, are treatable, and they, too, belong in this conversation.
Yet walk the floor of most aging-technology conferences and you will find excellent sessions on falls, hearing, cognition, mobility and loneliness, and almost nothing on sexual and pelvic health.
The gap is not a gap in need. It is a gap in permission.
Intimate Health Is Health
Sexual function is not a luxury bolted onto the “real” business of medicine. It is tightly linked to quality of life, relationship satisfaction and mental well-being at every age, and the connections run deeper than most people realize.
Erectile difficulties, for example, can be an early signal of cardiovascular disease, sometimes appearing years before other symptoms. That makes them a reason to see a clinician, not a source of shame. For women, the genitourinary changes of menopause are common, distressing and highly treatable, yet they remain among the least-discussed topics in primary care.
When we wave these things away as “just aging,” we do not merely diminish quality of life. We miss medicine.
The Evidence Has Quietly Arrived
I published my first study of vibration-based therapy for neurogenic bladders in 1997, at a time when the subject was guaranteed to raise eyebrows. Nearly 30 years later, the evidence base has matured beyond recognition. At MV.Health, my colleagues and I have supported more than 20 clinical studies, published in peer-reviewed journals like Journal of Sexual Medicine and Journal of Psychosexual Health, showing that non-invasive, drug-free approaches such as focused mechanical vibration can deliver clinically meaningful results, including improvements of roughly 80% in erectile function in psychogenic erectile dysfunction over eight weeks; a five-fold improvement in pain scores in genito-pelvic pain over twelve weeks; and measurable support for recovery after prostate surgery. What was once dismissed as fringe has become publishable, reproducible science.
I also spent eight years as editor-in-chief of the BJUI, and I have rejected enough weak manuscripts to hold my own field to a high standard. The point is not that everything on the market works. Most of it has never been tested at all, and the category is flooded with unregulated wellness gadgets making claims no journal would print.
The point is that rigor is possible, it exists, and older adults are entitled to demand it: regulated medical devices, published evidence, transparent claims and a clinician somewhere in the loop. We would accept nothing less for hearing aids or cardiac monitors. Intimate health deserves the same bar.
Care Is Moving Home, and Intimate Health Can Move with It
AARP research has long shown that three in four adults over 50 want to remain in their own homes as they age, and healthcare is steadily following them there. For most specialties, home-based care is a matter of convenience and cost. For intimate health, it is something more: The home is often the clinically better setting. Privacy, dignity, one’s own pace, a partner’s involvement — these are not amenities in this field; they are conditions for success.
The pathways now exist to do this properly. Clinician-prescribed, at-home therapeutic devices, supported by remote follow-up — including the remote therapeutic monitoring frameworks now recognized in the United States — keep the clinician engaged in the outcome while sparing the patient a waiting-room encounter they may have spent years avoiding. For this field, that combination is a genuine game-changer.
Wickham dreamed of surgery so gentle that patients could go home the same day. The next dream, surely, is care that never requires them to leave home at all.
What the AgeTech Ecosystem Can Do
For the innovators, investors and care providers reading this, I would offer five practical suggestions.
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Name it. Include sexual and pelvic health explicitly in healthy-aging frameworks, alongside mobility, cognition and hearing. What is unnamed remains unfunded.
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Design for older bodies. AARP research finds that nearly six in ten adults over 50 say technology still isn’t designed with their age or needs in mind. In a category where embarrassment already gives people every excuse to give up, friction is fatal; dexterity, vision and simplicity matter doubly here.
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Hold the evidence bar. Investors and partners should ask the same questions of this category they would ask of any medical technology: Where is the peer-reviewed data? What is the regulatory status? Do the claims match the studies?
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Equip the front line. Primary-care physicians, physical therapists, senior-living teams and telehealth providers all encounter these conditions; few have referral pathways or even comfortable language for them. Education here is high-leverage.
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Normalize the conversation. Every time a trusted institution treats sexual health as ordinary health — such as in a blog like this one, a community program or a survey — that patient’s whisper at the exam-room door gets a little louder and comes a little earlier.
Aging Well Includes Intimacy
My patients are not asking for miracles. Mostly they are asking for permission to raise the subject, to be taken seriously, to be offered something better than a shrug or an untested gadget. A lifetime of making treatment gentler has taught me that dignity is not a soft outcome; it is the outcome.
So let me leave you with the question I would ask of every organization in this community: When your member, patient or customer finally works up the courage to ask about intimate health, where will you send them?
I look forward to the day that question is answered everywhere, and the one in my exam room is no longer asked with a hand on the door, but at the start of the visit, in an ordinary voice. In this field, as in all the others we have transformed together, the sky is the limit.
About Professor Prokar Dasgupta
Prof. Prokar Dasgupta OBE, is the Professor of Urology and Robotic Surgery at The London Clinic and Chief Medical Officer of MV.Health, an AgeTech Collaborative™ portfolio company that develops clinically validated therapeutic devices for sexual and pelvic health. A pioneer of robotic urological surgery and an editor-in-chief of the BJUI for eight years, Prof. Dasgupta was previously Chair of Surgery at King’s College London.
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