27.11.2025

Men's intimate health: interview with Professor Allaire

Professor Allaire, vascular and endovascular surgeon at the Clinique de Genolier, shares his expertise on male intimate health, the causes of erectile dysfunction and the personalised solutions he offers.

Professor Allaire, could you introduce yourself and tell us about your career path?

I am a vascular and endovascular surgeon. I joined the Clinique de Genolier, where I now devote myself entirely to men's intimate and vascular health.

My career as a university surgeon has combined innovation, when I was director of a CNRS unit, and teaching, as director of the Master's programme in surgical research in France. I have done extensive work on the treatment of venous leakage, a common and little-known cause of erectile dysfunction, which until now was considered incurable.

My goal is to offer every man personalised and scientifically validated care for his intimate vascular health.

At what point should erectile dysfunction prompt a man to seek medical advice?

A man should definitely seek medical advice if his erectile difficulties persist for more than three months, and if they occur in the morning upon waking or when he is alone. In these situations, performance anxiety is not the cause, and it is therefore most likely a problem with what I call «the erection-making machine».

It is also necessary to seek medical advice when there is suffering, either individually or within the couple.

What are the possible underlying causes of erectile dysfunction?

You are right to mention «the causes»: there is not «the» erectile dysfunction, but «erectile dysfunctions»:

Vascular conditions, such as arteries blocked by smoking or diabetes, venous leakage, a condition in which blood enters the penis but leaves too soon – erections are soft and/or unstable.
Then there are neurological disorders, such as diabetic neuropathy, compression from a herniated disc, or even rare diagnoses of multiple sclerosis.
There are also hormonal disorders, which play a complex role, often leading to a decrease in desire, for example due to a lack of testosterone.
Finally, psychological factors can contribute to erectile dysfunction: relationship issues, emotions, stress, variations in desire, etc.

This means that an organic cause must be ruled out before concluding that erectile dysfunction is psychological in nature.

Does that mean a diagnosis is necessary?

Absolutely. It's time to view erectile dysfunction as a symptom, just like fever or pain. Consulting a doctor about erectile dysfunction can also lead to the discovery of diabetes, a neurological disease, high blood pressure or even serious heart disease!

Before Viagra came along in 1998, we looked for the causes of erectile dysfunction. Then we said, «The little blue pill will solve the problem.» However, these drugs remain ineffective in 30 to 40% of potential users, and in half of these cases, this is due to venous leakage!

As always in medicine, the diagnostic process is the basis for treatment. It begins with a detailed analysis of erections with the patient, who «describes» what is happening, guided by the doctor. It continues with blood tests and often a Doppler ultrasound of the penis with stimulation by a drug according to very specific rules. I would like to thank Dr. Raffaele Muto, a neurologist at Genolier, for agreeing to develop the practice of penile electromyograms when I arrived.

At the end of this investigation, we are able to determine the causes of each patient's erection problem. We can then discuss solutions. There are several, and there is one for every man. This is the profound meaning of the personalised medical approach we have implemented at Genolier.

What are the different treatment options?

I usually tell every patient at the end of the first consultation that there is always a solution. It all depends on the goal you set for yourself. The choice depends on the patient's priorities, but also, of course, on the causes identified by the assessment.

The first line of treatment is medication in tablet form that promotes erection. Prescription of this medication must be very carefully supervised, as there are contraindications that must be strictly observed. Its effectiveness rate is 60 to 70%, so not 100%.

In the case of venous leakage, treatment – and this is a breakthrough – mainly involves microsurgery and vascular techniques (embolisation) to enable the penis to retain blood again.

Psychotherapeutic and/or sexological approaches can also be of great benefit to the patient.

In your experience, why are men so reluctant to talk about their erectile difficulties, even to their doctor?

The reason often given is modesty and taboo. There is a lot of traffic on websites about this subject. There is no taboo on the internet, because users remain relatively anonymous. But it must be acknowledged that the information is often outdated or incorrect.

I believe that one important reason for men's reluctance is the lack of training for doctors in the management of erectile dysfunction. Patients are disappointed. They say so. The average time between the onset of erectile dysfunction and my surgery is 11 years! Patients are generally told more than five times that their problem «is in their head», when in fact it is in the veins of their penis.

How can we break this taboo and encourage more men to seek help?

By listening to them!

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