Now a joint publication of the FJMC and MRJ

 Issue #36 -  November 9, 2016

We would like to thank our sponsor RCA, Retirement Corporation of America. They have graciously been our primary sponsor for the last 2 years.

HEALTH TIP

These two articles mark the first example of a new strategy for the Health WealthRetirement newsletter.  This health article was created for FJMC by healthprofessionals Dr. Seth Cohen, Dr. Steven Mandel and Elisabeth Mandel. 

Erectile Dysfunction and You

Erectile Dysfunction can wreak havoc on relationships, often leading to extramarital affairs. Couples often avoid talking about sexual challenges, opting for avoidance over intimacy. They do not have the language for discussing their concerns in an environment that feels emotionally safe. Erectile dysfunction causes a great deal of anticipatory anxiety in both partners, and problems arise over time when one partner wants to keep trying while the other chooses to avoid trying for fear of experiencing shame or rejection. Inevitably, this dissonance creates resentment in the relationship, deteriorates intimacy and increases the likelihood of infidelity. Erectile dysfunction tends to psych men out, hindering their willingness to explore alternative ways of pleasing their partners. In turn, sexually frustrated partners will globalize their experience and start to devalue the relationship, as they believe that their partners do not care about their needs. Couples therapy provides a safe forum for expressing unmet needs in order to build emotional safety, thereby using erectile dysfunction as an opportunity for greater connection.

Elisabeth Mandel is a New York Licensed Marriage and Family Therapist.  She maintains a private practice in Midtown Manhattan where she treats individuals, couples and families

Male Sexual Dysfunction 

An estimated 20-30 million American men are affected with ED of varying degrees of severity. Erectile dysfunction has traditionally been seen as an age-dependent problem.  However, approximately 2% of men are affected at 40 years of age and this may be a gross underestimation secondary to reporting bias. One reason for the rise in ED is the rapidly growing prevalence of diabetes mellitus (DM), which is a major risk factor for ED.  ED, however, is not an inevitable result of aging; rather, as a man matures it is likely that he will experience a neurovascular insult, trauma and/or scarring resulting in ED.

Erectile dysfunction may signal serious underlying and potential life-threatening diseases, such as diabetes, hypertension, cardiovascular disease, peripheral vascular disease, and other neurologic and endocrine disorders treatment.  Erectile dysfunction is often secondary to an anatomical/physiological defect that creates an arterial inflow deficiency, venous incompetence or a combination of the two. 

It is imperative to first attain the etiology(cause) of the ED and second to discern severity. Penile duplex ultrasound (US) provides reliable and detailed information on penile hemodynamics and vascular anatomy and is recommended as a first-line test to evaluate penile arterial and veno-occlusive (narrowed veins) function.

Among the many stated treatments on the market today, phosphodiesterase type 5 inhibitors (PDE5-I), remain the most widely used oral agents and have great success rates, mainly due to their ease of administration and proven efficacy. PDE5-I, including sildenafil (Viagra), tadalafil (Cialis), vardenafil and avanafil have become first-line drug therapies for the treatment of ED.  The side effects for most men are minimal though these drugs should be taken under the supervision of a physician.

In cases where the above oral agents are not adequate or otherwise not appropriate, the specialists tool box includes intra-cavernosal injection utilizing a small, typically 31-gauge needle, to inject vasoactive agents into the side of the penis to achieve an erection often times harder than can be achieved with oral PDE5i’s alone.

When oral and injectable solutions have been exhausted or the patient is unable to tolerate them, a penile implant is a permanent surgical solution. The ideal prosthesis would provide its recipient with a penis that resembles as closely as possible both normal penile flaccidity and tumescence.  Only a three-piece inflatable device can approach this ideal. Three-piece prostheses have paired corporeal cylinders, a scrotal pump, and an abdominal fluid reservoir.

Lastly, fatigue, loss of libido and erectile dysfunction are commonly reported, but non-specific symptoms of low testosterone. Testosterone is necessary for normal libido, ejaculation, and spontaneous erections. There is a threshold testosterone value with individual variation, below which sexual function is impaired. Low testosterone may become apparent at different ages within an individual. Before supplementing with testosterone, it is imperative to discuss the risks and benefits with your medical health professional.

Ideally, discussions regarding the treatment of ED should include the partner; however, this is not always possible especially in a man who may not have a life partner at the time of presentation. The most important take away point from this quick overview is that there is always a solution to ED and it is most often through an oral medication prescribed by his primary care physician.  The best chance for a man suffering from ED refractory to oral medication is to see a urologist or better yet a sexual medicine expert to discuss the diagnostic studies and treatments available to him.

Seth D Cohen MD MPH NYU School of Medicine Assistant Professor of Urology Division of Sexual Medicine, website: www.sethdcohenmd.com

Dr. Steven Mandel is a neurologist in New York, New York and is affiliated with Lenox Hill Hospital in New York City.  

WEALTH TIP

Peter Lynch said, "Invest at least as much time and effort in choosing a new stock as you would in choosing a new refrigerator." 

The One Thing I Want in an Investment

Dr. Elfrig from Retirement Millionaire describes that perfect investment.  He suggests that World Dominating Dividend Growers (WDDG’s) fit that criteria.

What you want is a chart that looks like this.

This is a chart of cash that stockholders received over this period investing in these kinds of stocks.

We should realize that no stock price or investment goes straight up over a period of years.  What you can count on is that high quality, solid companies that have rising dividends over a long period of time will increase value every year.  There will be some ups and downs but ultimately you will increase your value each year.  Yields on these kinds of stocks are usually 2.5-4.5 %.  They frequently have price appreciation as well.  If you are always collecting dividends and these companies are always increasing their dividends then it virtually becomes a win-win investment over a period of years.

Companies like Coke, Microsoft, Intel, Johnson and Johnson, McDonalds, and many others fit this scenario.

Example- Lets say you bought 100 shares of Microsoft at 50 dollars. That is 5,000 dollars.  Since 2003 Microsoft has raised its dividends on average of 19%.  Let’s assume though a 10 % dividend growth and a 5 % share growth over a 20 year period. In fact Microsoft has done much better then that.  As shown in the table below, your 5,000 dollar investment would be worth over 35,000 dollars.

If this is done in your retirement plan you will also grow these companies tax free.  At times, like in 2008, you will have to ride the market and value down but ultimately this is a good situation because you will be collecting dividends at a lower price. This means with dividend reinvesting you will increase your value more rapidly.  A rising dividend is one of the strongest ways to build wealth in finance.  It has been wonderful investing in these kinds of companies and just sitting back and watching them grow.

I am not making any specific recommendations.  These are companies that fit the criteria for building wealth with a large degree of safety over a long period of time. 

Here's to our Health Wealth and Retirement:

We hope you have enjoyed this wealth tip. It is very valuable and several newsletters, including RetirementMillionaire, use this as one of their tools to building wealth.

Email sent at approximately 11:30 am, Thursday November 9, 2016
 

LEGAL DISCLAIMER: This work is based on current events, interviews, corporate press releases, and what we've learned from several mentioned health and wealth newsletters. It is also based on some personal experiences. It may contain errors and you shouldn't make any investment decision based solely on what you read here. It's your money and your responsibility. FJMC is not making specific recomendations of stocks or bonds just possible ideas that might be considered for research and investing purposes. This information is being provided for informational purposes only.

FJMC - Federation of Jewish Men's Clubs - Involving Jewish Men in Jewish Life.  The FJMC involves Jewish Men in Jewish Life through Leadership   Innovation   Community