madman
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This is gold!
Mohit Khera is a urologist with expertise in sexual medicine. In this episode, he provides an overview of male sexual health. He first goes in-depth on erectile dysfunction, shedding light on its prevalence across different age groups, diagnostic methods, and its intriguing connection to cardiovascular disease. He then ventures into Peyronie's disease, penile fractures, penile enlargement treatments, prolonged erections, premature ejaculation, and anorgasmia. Mohit then delves into the intricate workings of testosterone, DHT, and estrogen, emphasizing their physiological significance and interplay. He explains blood tests for diagnosing low T, the correlation between symptoms and blood levels in cases of low T, and the various methods for increasing testosterone. He concludes with a conversation about the role of testosterone in patients with prostate cancer and addresses concerns surrounding DHT, finasteride, and post-finasteride syndrome.
We discuss:
0:00:00 - Intro
0:01:18 - Mohit’s career path and interest in sexual medicine
0:03:25 - The anatomy of the male genitalia
0:05:06 - The prevalence of sexual dysfunction & impact on quality of life
0:08:58 - Erectile dysfunction (ED): definition, diagnosis, pathophysiology
0:13:41 - The history of medications to treat ED and the mechanisms of how they work
0:18:21 - Relationship between aging & erectile dysfunction and Mohit's approach to treating patients
0:29:14 - The impact of lifestyle on sexual health & the association between ED and cardiovascular disease
0:37:52 - Causes and treatments for Peyronie’s Disease & penile fracture
0:48:32 - The value of ultrasound for ED diagnosis and management strategies
0:51:55 - Various treatment options for ED: injections, penile prosthesis
0:59:38 - Priapism (prolonged erection)
1:05:40 - Shockwave therapy as a treatment for ED
1:11:46 - Stem cell therapy for ED
1:15:48 - Platelet-rich plasma (PRP) injections as a treatment for ED
1:18:36 - Premature ejaculation (PE): prevalence, pathophysiology, and treatment
1:26:34 - Anorgasmia: causes and treatment
1:31:52 - Sex hormones, the impact of aging, symptoms of low T, & considerations for testosterone replacement therapy (TRT)
1:44:49 - Methods for increasing endogenous testosterone
2:00:03 - Testosterone replacement therapy: various forms of exogenous testosterone & weighing risk vs. reward
2:11:03 - The physiology and purpose of testosterone and DHT, why some men feel fine even with “low” testosterone, personalized approaches to treating low T
2:18:25 - Post-finasteride syndrome
2:26:42 - The role of testosterone in prostate cancer and addressing the notion that TRT could increase risk
2:38:29 - The effects of testosterone as an adjunct to therapy for estrogen-sensitive breast cancer in women
2:40:08 - Resources for those looking for healthcare providers
Mohit Khera is a urologist with expertise in sexual medicine. In this episode, he provides an overview of male sexual health. He first goes in-depth on erectile dysfunction, shedding light on its prevalence across different age groups, diagnostic methods, and its intriguing connection to cardiovascular disease. He then ventures into Peyronie's disease, penile fractures, penile enlargement treatments, prolonged erections, premature ejaculation, and anorgasmia. Mohit then delves into the intricate workings of testosterone, DHT, and estrogen, emphasizing their physiological significance and interplay. He explains blood tests for diagnosing low T, the correlation between symptoms and blood levels in cases of low T, and the various methods for increasing testosterone. He concludes with a conversation about the role of testosterone in patients with prostate cancer and addresses concerns surrounding DHT, finasteride, and post-finasteride syndrome.
We discuss:
0:00:00 - Intro
0:01:18 - Mohit’s career path and interest in sexual medicine
0:03:25 - The anatomy of the male genitalia
0:05:06 - The prevalence of sexual dysfunction & impact on quality of life
0:08:58 - Erectile dysfunction (ED): definition, diagnosis, pathophysiology
0:13:41 - The history of medications to treat ED and the mechanisms of how they work
0:18:21 - Relationship between aging & erectile dysfunction and Mohit's approach to treating patients
0:29:14 - The impact of lifestyle on sexual health & the association between ED and cardiovascular disease
0:37:52 - Causes and treatments for Peyronie’s Disease & penile fracture
0:48:32 - The value of ultrasound for ED diagnosis and management strategies
0:51:55 - Various treatment options for ED: injections, penile prosthesis
0:59:38 - Priapism (prolonged erection)
1:05:40 - Shockwave therapy as a treatment for ED
1:11:46 - Stem cell therapy for ED
1:15:48 - Platelet-rich plasma (PRP) injections as a treatment for ED
1:18:36 - Premature ejaculation (PE): prevalence, pathophysiology, and treatment
1:26:34 - Anorgasmia: causes and treatment
1:31:52 - Sex hormones, the impact of aging, symptoms of low T, & considerations for testosterone replacement therapy (TRT)
1:44:49 - Methods for increasing endogenous testosterone
2:00:03 - Testosterone replacement therapy: various forms of exogenous testosterone & weighing risk vs. reward
2:11:03 - The physiology and purpose of testosterone and DHT, why some men feel fine even with “low” testosterone, personalized approaches to treating low T
2:18:25 - Post-finasteride syndrome
2:26:42 - The role of testosterone in prostate cancer and addressing the notion that TRT could increase risk
2:38:29 - The effects of testosterone as an adjunct to therapy for estrogen-sensitive breast cancer in women
2:40:08 - Resources for those looking for healthcare providers
Summary
This podcast episode discusses men's sexual health, including the prevalence of sexual dysfunction and the barriers to seeking treatment. It highlights the importance of addressing sexual health issues and the impact they can have on overall well-being and relationships.Highlights
- 40% of men in a survey reported some degree of sexual dysfunction, with 50% of them expressing a desire for treatment but not knowing where to go.
- Only 51% of men with sexual dysfunction informed their doctors, and even fewer (44%) shared it with their partners, leading to suffering in silence.
- Embarrassment and the lack of inquiry from clinicians contribute to the silence surrounding men's sexual health.
- Erectile dysfunction (ED) affects 52% of men over the age of 40, with prevalence increasing with age.
- Other sexual health issues include premature ejaculation, Peyronie's disease, and ejaculatory dysfunction.
- Sexual dysfunction can lead to depression, anxiety, impaired quality of life, and strained relationships.
- Psychogenic ED, typically found in younger patients, is treated differently from organic ED and may involve sex therapy and medication such as daily Cialis.
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