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Full episode and show notes: https://bit.ly/3Pu6LL0 Become a member for exclusive content: https://peterattiamd.com/subscribe/ Peter's email newsletter: https://peterattiamd.com/newsletter/ 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, 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 - About: The Peter Attia Drive is a deep-dive podcast focusing on maximizing longevity, and all that goes into that from physical to cognitive to emotional health. With over 60 million episodes downloaded, it features topics including exercise, nutritional biochemistry, cardiovascular disease, Alzheimer’s disease, cancer, mental health & more. Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of lengthening their lifespan and simultaneously improving their healthspan. Learn more: https://peterattiamd.com Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Podcasts: http://bit.ly/TheDriveGoogle Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor-patient relationship is formed. The use of this information and the materials linked to this podcast is at the user's own risk. The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have, and they should seek the assistance of their healthcare professionals for any such conditions. I take conflicts of interest very seriously. For all of my disclosures and the companies I invest in or advise, please visit my website where I keep an up-to-date and active list of such companies. For a full list of our registered and unregistered trademarks, trade names, and service marks, please review our Terms of Use: https://peterattiamd.com/terms-of-use/

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