Help Me Interview Urologist Dr Michael Rotman About Prostate Issues

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Has the Dr. had any experience with supplements to manage DHT? Has he seen clinical results (i.e. improved BPH, less hair loss)? Has he seen serum DHT improve with any supplements?
 
Defy Medical TRT clinic doctor
Please talk about the role of Estradiol in BPH and prostate cancer.

Standard of care seems to be witholding TRT for prostate cancer patients. Do you think this is supported by current evidence?
 
Your opinion on estrogen effects on prostate growth and do you think managing estrogen levels can be preventative to certain prostate problems.
 
I am about to do another interview with Dr Rotman. Any other questions regarding TRT, prostate and other men's health issues? Thanks
 
I still have this same question--curious what doctors other than mine are seeing and thinking?

"What is current thinking for resuming TRT after treatment of prostate cancer with brachytherapy (seeds implant)? Data seems to be scarce and mostly addresses radical prostatectomy (complete removal), which may not necessarily translate to brachytherapy or IMRT (external radiation). I have seen anywhere from 1 year, to 2 years, to 5 years, to "never". Is there any developing consensus?"
 
1. How do you approach or modify treatment with a patient who has been on a TRT program for a couple of months but is still experiencing a significant amount of fatigue?

2. What's your preferred method for treating a new patient with high estrogen levels or one who is currently on a TRT program and is experiencing the sides of high estrogen levels?

3. Getting a patient “dialed in” if you will who's suffering from low T seems to be fairly complex and appears to involve a lot of protocol adjustment and trial/error based on the patient's labs and feel. What is your basic approach for treating a new patient as it relates to having initial labs drawn and then creating a protocol?

4. As in life, there are certainly risks with everything we do and HRT is no different. How do you personally address the risks/rewards of TRT with a new patient?

5. For a new patient or current patient who is experiencing ED issues to some degree, what are your approaches to treatment?

6. It would appear that with most patients there is a sweet spot somewhere between 800ng/DL total T and upwards of 1300 ng/DL.
Is there a certain level at which you believe total T becomes too high where the risks become ever increasing and the side effects too difficult to manage?
 
Research has shown that TRT can, and does, improve LUTS. I his own experience, is this something many men see? Some men? What other factors can impact improvement in this area?
 
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Defy Medical TRT clinic

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