Dr. Irwin Goldstein didn't set out to become a pioneer of sexual medicine. He was a biomedical engineer turned urology resident who, as he tells it, asked one stupid question during a 1976 surgery: "Could you explain the physiology of erection to me?" The surgeon shrugged. Irwin spent the next decade figuring it out. Along the way, he co-discovered that nitric oxide, the elephant of our air, is what makes erections possible. He published the first paper on it in 1991. Seven years later, he became the first author on the New England Journal of Medicine paper that introduced Viagra to the world. But that's only half the story. The other half is Sue Goldstein, Irwin's college sweetheart turned partner in life, parenting, and eventually the practice itself. Sue spent decades raising their family while quietly absorbing the science her husband brought home. She is now an AASECT-certified educator, a published researcher, and one of the most outspoken patient advocates in the field. Together, they run San Diego Sexual Medicine, a clinic where every patient gets a three-hour visit, full education, and an entire team practicing what they call true bio-psycho social care. In this first half of our two-part conversation, Dr. Jenni Skyler and Daniel Lebowitz sit with the Goldsteins and explore how a field gets built, and how it still leaves so many patients behind. They cover prostate cancer and the silent erectile crisis that follows it. The buccal grafting innovation that's helping women with severe vestibular pain finally get answers. Why women, on average, see ten or twelve doctors before they get a real diagnosis. And Sue's pet peeve, medical gaslighting and what to do when a doctor says "there's nothing that can be done." This is a conversation for anyone who has ever felt unheard by a clinician, dismissed by their own body, or convinced they were the problem. The Goldsteins want you to know — you're not. You just haven't been to the right office yet.

Irwin Goldstein, MD, IF (he/him/his)
Director, San Diego Sexual Medicine
5555 Reservoir Drive, Suite 300, San Diego, CA 92120
Director, Sexual Medicine, UC San Diego Health East Campus, San Diego, CA
Clinical Professor of Urology, University of California at San Diego
Voluntary Clinical Professor of Obstetrics, Gynecology and Reproductive Services
Past President, International Society for the Study of Women’s Sexual Health
Past President, Sexual Medicine Society of North America
Editor Emeritus, Sexual Medicine Reviews, The Journal of Sexual Medicine,  International Journal of Impotence Research
phone: 619 265-8865
fax: 619 265-7696
mobile: 619 987-7432
dr.irwingoldstein@gmail.com
http://www.sandiegosexualmedicine.com
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