1 00:00:04,240 --> 00:00:12,119 Speaker 1: It's that time. Time, time, Luck and Load. The Michael 2 00:00:12,200 --> 00:00:27,680 Speaker 1: Varie Show is on the air today. Joe is sponsored 3 00:00:27,680 --> 00:00:29,800 Speaker 1: by Peanut Butter. 4 00:00:31,120 --> 00:00:36,479 Speaker 2: For pure versatility of application, ability to make anything it 5 00:00:36,680 --> 00:00:42,800 Speaker 2: touches better, and shelf life. I don't know that there's 6 00:00:42,840 --> 00:00:45,280 Speaker 2: anything better that comes in a bottle. I really don't. 7 00:00:45,960 --> 00:00:49,239 Speaker 2: I really don't. Let's just take a moment and think 8 00:00:49,240 --> 00:00:50,760 Speaker 2: about your best peanut butter moment. 9 00:00:54,320 --> 00:00:54,720 Speaker 1: Ramon. 10 00:00:55,160 --> 00:00:59,520 Speaker 2: Your peanut butter moment should not involve sex. But my urologist, 11 00:00:59,560 --> 00:01:03,320 Speaker 2: doctor with Kara is our guest. Welcome to the program. 12 00:01:03,360 --> 00:01:08,600 Speaker 2: Good sir, Thank you Michael. Everyone has a lifespan, Ramon. 13 00:01:08,640 --> 00:01:10,720 Speaker 2: You know that you have a lifespan. We talk about 14 00:01:10,760 --> 00:01:14,480 Speaker 2: our life span, doctor Mohicz. Kara is writing a book 15 00:01:14,720 --> 00:01:19,640 Speaker 2: called Or about the sex span. How long can a 16 00:01:19,720 --> 00:01:26,080 Speaker 2: human being have a functional, fulfilling sex life, Doctor Kara? 17 00:01:26,120 --> 00:01:26,959 Speaker 1: Why does that matter? 18 00:01:28,600 --> 00:01:30,039 Speaker 3: Well, Michael, the first, thank you for having me on 19 00:01:30,040 --> 00:01:32,440 Speaker 3: the show. You know, everyone where you go, every where, 20 00:01:32,440 --> 00:01:36,440 Speaker 3: talks about lifespan and health span. That's the big buzzwords 21 00:01:36,480 --> 00:01:39,959 Speaker 3: in the community. And I'll give you an example. Everybody wants, 22 00:01:40,040 --> 00:01:43,280 Speaker 3: I assume their health span to last as long as 23 00:01:43,319 --> 00:01:46,560 Speaker 3: their lifespan but in the United States, the average health 24 00:01:46,600 --> 00:01:50,080 Speaker 3: lifespan is seventy seven years old. Women live typically seventy 25 00:01:50,120 --> 00:01:52,800 Speaker 3: nine years old, men live typically seventy five years old. 26 00:01:53,200 --> 00:01:56,040 Speaker 3: But the health span in the United States is roughly 27 00:01:56,240 --> 00:01:59,160 Speaker 3: sixty seven years old, which means most of us for 28 00:01:59,200 --> 00:02:01,480 Speaker 3: the last ten years of our life are not going 29 00:02:01,520 --> 00:02:04,440 Speaker 3: to be living in a healthy condition, which is very unfortunate. 30 00:02:04,840 --> 00:02:05,440 Speaker 4: And all these. 31 00:02:05,280 --> 00:02:07,960 Speaker 3: Countries talk about how they're expanding their lifespan and getting 32 00:02:07,960 --> 00:02:10,400 Speaker 3: people to live longer. In my mind, that is not 33 00:02:10,560 --> 00:02:15,200 Speaker 3: what I want do, not expand my lifespan without expanding. 34 00:02:14,720 --> 00:02:15,560 Speaker 4: My health span. 35 00:02:16,520 --> 00:02:19,440 Speaker 3: But this concept of sex span is also important because 36 00:02:19,880 --> 00:02:21,600 Speaker 3: many men would say, look, I said, if you're going 37 00:02:21,639 --> 00:02:25,160 Speaker 3: to live till eighty, but you only have sex till fifty, 38 00:02:25,760 --> 00:02:28,080 Speaker 3: that's a problem for many men. And so what we 39 00:02:28,200 --> 00:02:31,320 Speaker 3: want to do is try to expand our sex span 40 00:02:31,840 --> 00:02:34,959 Speaker 3: and our health span as long as our lifespan. I 41 00:02:34,960 --> 00:02:36,840 Speaker 3: think that's a really important point. 42 00:02:38,560 --> 00:02:39,120 Speaker 1: I know. 43 00:02:39,160 --> 00:02:41,640 Speaker 2: One of the things I like about you is that 44 00:02:41,680 --> 00:02:44,600 Speaker 2: you don't just rely on what you learned in medical 45 00:02:44,639 --> 00:02:47,080 Speaker 2: school and then mail it in every day. You're constantly 46 00:02:47,120 --> 00:02:52,200 Speaker 2: reading studies, you're constantly performing research and publishing and speaking 47 00:02:52,240 --> 00:02:54,520 Speaker 2: literally around the world, because you're always somewhere else when 48 00:02:54,560 --> 00:02:56,400 Speaker 2: I call you just to see what you're up to 49 00:02:56,720 --> 00:02:59,880 Speaker 2: giving a speech on this or that. How important is 50 00:03:00,160 --> 00:03:04,600 Speaker 2: sex to the human body in terms of purely physically. 51 00:03:05,560 --> 00:03:08,639 Speaker 3: Yeah, it's extremely important. So I want to just clarify 52 00:03:08,720 --> 00:03:12,839 Speaker 3: one thing. A rectile dysfunction is not a disease. It's 53 00:03:12,880 --> 00:03:17,679 Speaker 3: a symptom of other underlying diseases. Right, So ED does 54 00:03:17,720 --> 00:03:20,000 Speaker 3: not happen in healthy men as they get older. If 55 00:03:20,000 --> 00:03:22,679 Speaker 3: a man gets a rectile dysfunction, it is a symptom 56 00:03:22,960 --> 00:03:26,200 Speaker 3: of his diabetes, it's a symptom of his Cardiovasker disease, 57 00:03:26,400 --> 00:03:29,440 Speaker 3: it's a symptom of his radical procestecto your surgery, or 58 00:03:29,440 --> 00:03:33,320 Speaker 3: it's a symptom of depression or anxiety. So when someone 59 00:03:33,360 --> 00:03:36,000 Speaker 3: develops a rectile dysfunction, the second question you should be 60 00:03:36,000 --> 00:03:40,480 Speaker 3: asking is what else is going on that's causing this condition? 61 00:03:40,560 --> 00:03:44,160 Speaker 3: Because if he was perfectly healthy, that would not happen, right, 62 00:03:44,200 --> 00:03:46,640 Speaker 3: And so the best example I can give you is 63 00:03:46,680 --> 00:03:49,160 Speaker 3: this is that did you know that if a man 64 00:03:49,240 --> 00:03:52,520 Speaker 3: walks in today and has a rectile dysfunction, fifteen percent 65 00:03:52,560 --> 00:03:54,600 Speaker 3: of them will have a heart attenic orth stroke within 66 00:03:54,640 --> 00:03:59,400 Speaker 3: seven years fifteen percent. It's an underlying marker of cardiovask disease. 67 00:03:59,800 --> 00:04:02,800 Speaker 3: If a man walks in with ED today, thirty percent 68 00:04:02,880 --> 00:04:06,120 Speaker 3: of them have a cult diabetes thirty percent, which is 69 00:04:06,160 --> 00:04:09,520 Speaker 3: a lot. And if a man walks in today, thirty 70 00:04:09,520 --> 00:04:12,840 Speaker 3: percent of them will have depression or anxiety. So the 71 00:04:12,880 --> 00:04:16,360 Speaker 3: biggest mistake I can do is give this man viagra 72 00:04:16,440 --> 00:04:18,800 Speaker 3: and send him on his way, because maybe he has 73 00:04:18,800 --> 00:04:22,120 Speaker 3: that occult cardiovask disease, maybe he has diabetes, maybe he's 74 00:04:22,160 --> 00:04:26,479 Speaker 3: suffering from depression or anxiety. So it's really important to 75 00:04:26,480 --> 00:04:29,919 Speaker 3: figure out what is causing that ED. And what's so 76 00:04:30,080 --> 00:04:32,839 Speaker 3: nice about this is that there's a bi directional relationship. 77 00:04:33,120 --> 00:04:35,719 Speaker 3: So if I treat a man's ED, that actually improves 78 00:04:35,760 --> 00:04:38,239 Speaker 3: his depression. If I improve a man's depression, it actually 79 00:04:38,279 --> 00:04:41,359 Speaker 3: improves his ED. So I think the paradigm is shifting. 80 00:04:41,440 --> 00:04:43,560 Speaker 3: No longer do I want to just hand the man 81 00:04:43,640 --> 00:04:47,000 Speaker 3: the pill. You've got to figure out what's going on underneath, 82 00:04:47,320 --> 00:04:49,000 Speaker 3: because this is what I call the canary and the 83 00:04:49,000 --> 00:04:51,680 Speaker 3: coal mine, and you can actually save someone's life. I mean, 84 00:04:51,839 --> 00:04:55,839 Speaker 3: imagine if I catch someone's cardiovasker disease today or diabetes 85 00:04:55,839 --> 00:04:59,120 Speaker 3: today or I catch it ten years from now. It's 86 00:04:59,160 --> 00:05:02,600 Speaker 3: a total trajectory in terms of their house span and 87 00:05:02,680 --> 00:05:03,320 Speaker 3: their life. 88 00:05:03,839 --> 00:05:07,200 Speaker 2: Well, it goes back to viagra originally being a cardiovascular 89 00:05:07,240 --> 00:05:10,680 Speaker 2: disease in an off label benefit being. 90 00:05:12,240 --> 00:05:13,400 Speaker 1: The ability to get erection. 91 00:05:14,800 --> 00:05:17,719 Speaker 3: Yeah, Michael, that's a funny story because remember this one. 92 00:05:17,760 --> 00:05:19,599 Speaker 3: But they were trying to make a blood pressure medication 93 00:05:19,839 --> 00:05:24,320 Speaker 3: and accidentally everyone in this study was getting erections, and 94 00:05:24,360 --> 00:05:30,200 Speaker 3: they figured it out because people were not returning the pills. 95 00:05:31,839 --> 00:05:34,880 Speaker 2: I had a friend, I was a baby lawyer at 96 00:05:34,880 --> 00:05:36,960 Speaker 2: the time at a firm called Jakins and Gilchrist and 97 00:05:37,080 --> 00:05:38,720 Speaker 2: I worked with a guy named Darren Alt who was 98 00:05:38,760 --> 00:05:41,159 Speaker 2: my best friend there. And his wife, Tracy, was the 99 00:05:41,160 --> 00:05:43,480 Speaker 2: head of viagra in Houston, which was the top market 100 00:05:43,520 --> 00:05:46,000 Speaker 2: for viagra in the country, and they were taking a 101 00:05:46,040 --> 00:05:48,520 Speaker 2: trip every other week with their sales reps, and they 102 00:05:48,520 --> 00:05:51,440 Speaker 2: had all sorts of stories of people and at that 103 00:05:51,480 --> 00:05:54,479 Speaker 2: point it was still you'd go to your cardiologist to 104 00:05:54,520 --> 00:05:57,520 Speaker 2: get viagra, So everybody was faking a heart problem to 105 00:05:57,560 --> 00:06:01,000 Speaker 2: go in and get this medication. And the story goes 106 00:06:01,360 --> 00:06:04,560 Speaker 2: that the doctors were getting calls from the wives going, hey, 107 00:06:04,680 --> 00:06:06,039 Speaker 2: knock it off, take him off. 108 00:06:06,040 --> 00:06:10,640 Speaker 3: Of that, right, right, right right, yeah, absolutely, And so 109 00:06:10,760 --> 00:06:14,040 Speaker 3: you know what the issue is is that ED back 110 00:06:14,080 --> 00:06:16,200 Speaker 3: then was not considered a very serious condition. 111 00:06:16,240 --> 00:06:18,159 Speaker 4: People used to make fun of it, and oh he 112 00:06:18,200 --> 00:06:18,640 Speaker 4: has ED. 113 00:06:19,400 --> 00:06:22,880 Speaker 3: ED is a very serious condition. Someone gets erected on dysfunction. 114 00:06:23,360 --> 00:06:25,760 Speaker 3: Take it seriously. Something else is going on. 115 00:06:26,279 --> 00:06:31,479 Speaker 2: Well, and to oversimplify this, that is because it means 116 00:06:31,520 --> 00:06:34,239 Speaker 2: you're not getting proper blood flow or you're not pumping 117 00:06:34,279 --> 00:06:37,280 Speaker 2: your blood properly. And that's I guess as good a 118 00:06:37,279 --> 00:06:39,599 Speaker 2: way as any for us to check, maybe the easiest way. 119 00:06:40,920 --> 00:06:43,000 Speaker 3: Yeah, And so think about this. I teach their medical 120 00:06:43,040 --> 00:06:46,240 Speaker 3: students this new monic called event vascular, meaning there's not 121 00:06:46,400 --> 00:06:49,039 Speaker 3: enough blood flow coming in or there's too much blood 122 00:06:49,040 --> 00:06:51,480 Speaker 3: flow coming out. And too much blood flow coming out 123 00:06:51,560 --> 00:06:53,600 Speaker 3: is the most common cause of ED. So the guy 124 00:06:53,640 --> 00:06:55,359 Speaker 3: will tell you I can get the direction, but I 125 00:06:55,480 --> 00:06:58,159 Speaker 3: just can't maintain it. He's telling you the blood flow's 126 00:06:58,200 --> 00:06:59,800 Speaker 3: coming out too quickly. The number one cause of e 127 00:06:59,839 --> 00:07:02,560 Speaker 3: D in the world. But the event stands for vasco 128 00:07:02,760 --> 00:07:05,920 Speaker 3: e means androcrine. It's a testosterone. The testosterone goes low, 129 00:07:06,400 --> 00:07:10,480 Speaker 3: ED goes up neurologic meaning nerve injury. And then trauma, 130 00:07:10,840 --> 00:07:15,360 Speaker 3: and don't forget medications. Medications are notorious, for example, beta blockers. 131 00:07:15,560 --> 00:07:18,400 Speaker 3: How many people are on Beta blockers shuts down the erections. 132 00:07:18,640 --> 00:07:21,920 Speaker 3: Antidepressants shuts down the directions. So you've got to look 133 00:07:21,960 --> 00:07:25,240 Speaker 3: at all the different causes for ED. And I just 134 00:07:25,240 --> 00:07:28,800 Speaker 3: want to stress one other thing. Sexual dysfunction is a 135 00:07:28,840 --> 00:07:31,800 Speaker 3: couple's disease. You know, we're so fixed on these silos. 136 00:07:31,800 --> 00:07:33,120 Speaker 3: I got to take care of the woman, I got 137 00:07:33,160 --> 00:07:34,680 Speaker 3: to take care of the man. You got to look 138 00:07:34,720 --> 00:07:36,600 Speaker 3: at both of them. I'll give you an example. Back 139 00:07:36,600 --> 00:07:39,160 Speaker 3: in two thousand and seven, I finished my fellowship and 140 00:07:39,240 --> 00:07:39,960 Speaker 3: I was so. 141 00:07:39,840 --> 00:07:40,560 Speaker 4: Proud of myself. 142 00:07:40,600 --> 00:07:43,000 Speaker 3: I was able to get these men, these amazing erections, 143 00:07:43,440 --> 00:07:46,520 Speaker 3: amazing libido. And one day a woman called me and 144 00:07:46,560 --> 00:07:50,080 Speaker 3: said to me, she said, everything was great with our 145 00:07:50,120 --> 00:07:51,760 Speaker 3: relationship until he met you. 146 00:07:52,120 --> 00:07:52,840 Speaker 4: We never fought. 147 00:07:52,880 --> 00:07:55,040 Speaker 3: We fight all the time because every day he wants 148 00:07:55,080 --> 00:07:56,720 Speaker 3: to have sex with me and I don't want to 149 00:07:56,720 --> 00:07:59,400 Speaker 3: have sex with him. And you've ruined our relationship. And 150 00:07:59,440 --> 00:08:02,280 Speaker 3: I thought to myself, she's right. What is the point 151 00:08:02,440 --> 00:08:05,640 Speaker 3: of raising one libido without raising the other. Either leave 152 00:08:05,800 --> 00:08:09,040 Speaker 3: both libidos low, it's fine, leave them both low, or 153 00:08:09,160 --> 00:08:11,280 Speaker 3: raise both, but you don't raise one without the other. 154 00:08:11,720 --> 00:08:14,720 Speaker 2: Doctor Mohit Kara at the Baylor College of Medicine and 155 00:08:14,840 --> 00:08:18,320 Speaker 2: my urologist and friend coming up. The book will be 156 00:08:18,760 --> 00:08:20,200 Speaker 2: I've got to get the name of it. It's about 157 00:08:20,240 --> 00:08:21,680 Speaker 2: the sex ban maybe called or sex. 158 00:08:21,560 --> 00:08:27,720 Speaker 1: Bennerments A hard problem to librarian. Everyone listens to Michael 159 00:08:27,880 --> 00:08:28,400 Speaker 1: Very Show. 160 00:08:29,600 --> 00:08:32,319 Speaker 2: The only downside to having doctor Mohiit Kara on the 161 00:08:32,360 --> 00:08:36,720 Speaker 2: air as our guest is then people ask me how 162 00:08:36,800 --> 00:08:38,720 Speaker 2: to get in to see him because it takes so 163 00:08:38,800 --> 00:08:43,720 Speaker 2: long to see him because he is so insanely popular. 164 00:08:44,320 --> 00:08:45,360 Speaker 1: Everybody I know. 165 00:08:46,800 --> 00:08:54,000 Speaker 2: Is now his patient after hearing my experience with him. 166 00:08:54,040 --> 00:08:56,079 Speaker 1: He's just fantastic. I think the world of him. 167 00:08:56,559 --> 00:08:59,720 Speaker 2: Doctor Mohit Kara is at Baylor College of Medicine where 168 00:08:59,720 --> 00:09:04,600 Speaker 2: he is urologists. He has a forthcoming book. Is the 169 00:09:04,640 --> 00:09:07,120 Speaker 2: book called the Sex Span Moment or what is the 170 00:09:07,120 --> 00:09:07,720 Speaker 2: book called? 171 00:09:08,559 --> 00:09:13,440 Speaker 3: It is called sex Span and a Proactive Approach, A 172 00:09:13,520 --> 00:09:15,480 Speaker 3: proactive approach to prolonging your sexpan. 173 00:09:16,200 --> 00:09:18,679 Speaker 2: So, as we were going into the break, you made 174 00:09:18,720 --> 00:09:22,760 Speaker 2: a statement about if you help a man build his 175 00:09:22,840 --> 00:09:27,360 Speaker 2: libido and his sexual function, but you do not concurrently 176 00:09:27,400 --> 00:09:30,000 Speaker 2: do that for the woman you end up causing problems 177 00:09:30,360 --> 00:09:33,800 Speaker 2: for them. Let's take the physical out for a moment. 178 00:09:34,120 --> 00:09:39,240 Speaker 2: In your opinion, how important is sexual relations to a 179 00:09:39,360 --> 00:09:43,280 Speaker 2: couple and to an individual emotionally? You tied it to 180 00:09:43,600 --> 00:09:46,880 Speaker 2: the antithesis of depression, but talk about that if you would. 181 00:09:47,800 --> 00:09:51,040 Speaker 3: It's extremely important. If you look at couples that engage 182 00:09:51,080 --> 00:09:55,040 Speaker 3: in regular sexual activity, they tend to be happier overall, 183 00:09:55,040 --> 00:09:57,720 Speaker 3: satisfied with their quality of life. They usually tend to 184 00:09:57,720 --> 00:10:00,280 Speaker 3: be healthier and easily tend to live longer. So there 185 00:10:00,280 --> 00:10:02,640 Speaker 3: are numerous aspects. So there's one study that I saw 186 00:10:03,040 --> 00:10:06,000 Speaker 3: that talked about couples that engage in who do not 187 00:10:06,120 --> 00:10:12,360 Speaker 3: engage in sexual activity typically can have a twofold traction 188 00:10:12,440 --> 00:10:15,320 Speaker 3: from their relationship. But if they do engage sexual activity, 189 00:10:15,559 --> 00:10:17,679 Speaker 3: it actually can add four x to the quality of 190 00:10:17,679 --> 00:10:18,359 Speaker 3: the relationship. 191 00:10:18,480 --> 00:10:19,720 Speaker 4: So I mean, let's be honest. 192 00:10:19,720 --> 00:10:22,800 Speaker 3: I mean it does bring intimacy and closeness to the relationship. 193 00:10:22,840 --> 00:10:25,440 Speaker 3: It does strengthen the quality of the relationship, and in 194 00:10:25,480 --> 00:10:29,079 Speaker 3: many cases people find this extremely important. So I do 195 00:10:29,120 --> 00:10:33,600 Speaker 3: think that there is a medical benefits psychological benefit in 196 00:10:33,720 --> 00:10:36,760 Speaker 3: patients engaging in sexual activity. 197 00:10:38,160 --> 00:10:40,240 Speaker 2: I have had friends over the years who when they 198 00:10:40,240 --> 00:10:42,280 Speaker 2: put their parents in old folks homes. 199 00:10:42,800 --> 00:10:44,200 Speaker 1: They talk about how. 200 00:10:45,840 --> 00:10:48,240 Speaker 2: It is surprising how much activity there is in the 201 00:10:48,280 --> 00:10:50,000 Speaker 2: old folks home. And when I did that for my 202 00:10:50,120 --> 00:10:52,480 Speaker 2: dad earlier this year, that was one of the things 203 00:10:52,480 --> 00:10:57,560 Speaker 2: that everybody consistently across the board talked about. I don't 204 00:10:57,559 --> 00:10:59,800 Speaker 2: know if there's any if there's anything to that, but 205 00:11:00,000 --> 00:11:01,920 Speaker 2: we're talking about people in their eighties and nineties, and 206 00:11:01,960 --> 00:11:04,160 Speaker 2: I have heard this story consistently. 207 00:11:06,160 --> 00:11:08,439 Speaker 3: You're actually right, so one of the highest levels of 208 00:11:08,520 --> 00:11:11,200 Speaker 3: STDs do occur in nursing homes. So you do know 209 00:11:11,240 --> 00:11:15,760 Speaker 3: that there's increased sexual activity that does occur in those 210 00:11:15,880 --> 00:11:19,319 Speaker 3: in those nursing homes, and so, but part of it 211 00:11:19,360 --> 00:11:22,520 Speaker 3: is because there's at some point, there's an inflection point. 212 00:11:22,840 --> 00:11:25,839 Speaker 3: As you live longer and longer, those patients that are 213 00:11:25,880 --> 00:11:29,440 Speaker 3: the healthiest tend to live the longest, and those patients 214 00:11:29,440 --> 00:11:31,160 Speaker 3: who are tend to be healthier tend to be more 215 00:11:31,920 --> 00:11:33,640 Speaker 3: the ability to engage in sexual activity. 216 00:11:35,000 --> 00:11:37,600 Speaker 2: When you and I talked about the book the first time, 217 00:11:38,080 --> 00:11:40,600 Speaker 2: you said that one of the things that the book 218 00:11:40,720 --> 00:11:43,080 Speaker 2: is going to cover is the importance of screening for 219 00:11:43,240 --> 00:11:46,360 Speaker 2: testosterone and how erect all dysfunction is a marker of 220 00:11:46,400 --> 00:11:49,640 Speaker 2: other underlying major medical conditions, such as a heart attack. 221 00:11:50,280 --> 00:11:53,520 Speaker 2: The screening for testosterone, why is that important? 222 00:11:54,679 --> 00:11:57,280 Speaker 3: So, Michael, I am very passionate about this topic because 223 00:11:57,800 --> 00:12:01,679 Speaker 3: you know, everyone thinks about testosterone as energy and sex 224 00:12:01,840 --> 00:12:05,400 Speaker 3: drive and erections. And yes, it's true if you have 225 00:12:05,520 --> 00:12:09,479 Speaker 3: low energy, low libido, rectal dysfunction, giving a man testosterone 226 00:12:09,520 --> 00:12:11,960 Speaker 3: can improve these symptoms. But now we're in an era 227 00:12:12,080 --> 00:12:14,920 Speaker 3: where it goes way beyond that. So did you know 228 00:12:15,160 --> 00:12:17,640 Speaker 3: that a man who has low testosterone is much more 229 00:12:17,720 --> 00:12:20,679 Speaker 3: likely to have a heart attack, non negotiable, much more likely. 230 00:12:20,800 --> 00:12:22,760 Speaker 3: A man who's low test awso is much more likely 231 00:12:22,800 --> 00:12:24,920 Speaker 3: to break a bone. A man who's low test austin 232 00:12:25,040 --> 00:12:28,120 Speaker 3: is more likely to have diabetes obesity metabol syndrome. A 233 00:12:28,160 --> 00:12:30,280 Speaker 3: diet man who's low test awsome is much more likely 234 00:12:30,320 --> 00:12:33,920 Speaker 3: to suffer from depression. And giving a man back his 235 00:12:34,040 --> 00:12:39,480 Speaker 3: testosterone can help mitigate improve these conditions. So it's not 236 00:12:39,559 --> 00:12:42,680 Speaker 3: just about sex, it's about your overall health. The problem 237 00:12:42,760 --> 00:12:45,160 Speaker 3: I have is that when I walk into my primary 238 00:12:45,240 --> 00:12:48,160 Speaker 3: care doctor's office every year and he checks my blood, 239 00:12:48,559 --> 00:12:52,199 Speaker 3: he does not check an annual testosterone. He'll check a thyroid, 240 00:12:52,280 --> 00:12:54,040 Speaker 3: He'll check a TSH. I say, why are you checking 241 00:12:54,080 --> 00:12:55,679 Speaker 3: a TSH? He said, well, we do that every year 242 00:12:55,720 --> 00:12:58,360 Speaker 3: to make sure you're not hypothyroid. There is not a 243 00:12:58,440 --> 00:13:02,800 Speaker 3: better marker of a man's overall health than a testisteral level. 244 00:13:03,040 --> 00:13:05,560 Speaker 3: It gives you a marker level what his health is today, 245 00:13:06,040 --> 00:13:07,680 Speaker 3: and it gives you a marker of what his health 246 00:13:07,720 --> 00:13:10,800 Speaker 3: will be in the future. And so every man over 247 00:13:10,840 --> 00:13:13,200 Speaker 3: the age of forty, every single man, should be getting 248 00:13:13,200 --> 00:13:16,439 Speaker 3: a testisteral level every single year after the age of forty, 249 00:13:16,440 --> 00:13:19,240 Speaker 3: because I do think it's the best predictor of his 250 00:13:19,360 --> 00:13:22,600 Speaker 3: overall health currently and in the future. And it's modifiable 251 00:13:22,720 --> 00:13:26,000 Speaker 3: because there's things I can do to improve his testosterone. 252 00:13:25,280 --> 00:13:25,920 Speaker 4: If he's low. 253 00:13:26,920 --> 00:13:30,480 Speaker 1: You suggested testosterone for me ten years ago. 254 00:13:30,559 --> 00:13:31,880 Speaker 2: I know you weren't going to talk about it because 255 00:13:31,880 --> 00:13:35,679 Speaker 2: you're the doctor, but I can, and obviously it changed 256 00:13:35,679 --> 00:13:38,520 Speaker 2: my life. It made a huge difference for me. But 257 00:13:38,760 --> 00:13:42,440 Speaker 2: when you do that for folks, what kind of differences 258 00:13:42,480 --> 00:13:44,920 Speaker 2: do you typically see? 259 00:13:45,360 --> 00:13:47,120 Speaker 3: Well, the first thing I have to ask yourself is 260 00:13:47,200 --> 00:13:49,240 Speaker 3: are they young and do they want to have children? 261 00:13:49,360 --> 00:13:53,840 Speaker 3: Because most people don't realize that giving testosterone actually shuts 262 00:13:53,880 --> 00:13:56,600 Speaker 3: down your fertility. So I can't tell you how many 263 00:13:56,600 --> 00:13:58,880 Speaker 3: patients I see in my practice every week that said, look, 264 00:13:58,920 --> 00:14:01,320 Speaker 3: I was started on testoso or no one told me 265 00:14:01,320 --> 00:14:03,760 Speaker 3: that the test as can make me infertile. Now we 266 00:14:03,800 --> 00:14:06,280 Speaker 3: want to have kids, what do I do? So there's 267 00:14:06,320 --> 00:14:08,960 Speaker 3: the ways I can reverse it. So the reality is, 268 00:14:09,000 --> 00:14:11,160 Speaker 3: if you're in the reproductive years, if you're planning on 269 00:14:11,600 --> 00:14:15,559 Speaker 3: having children and your tea is low, don't take test austone. 270 00:14:15,600 --> 00:14:18,400 Speaker 3: But let me give you medications that make you make. 271 00:14:18,280 --> 00:14:19,840 Speaker 4: Testosterone that's safe. 272 00:14:20,000 --> 00:14:22,200 Speaker 3: So I can give you medications to make you make 273 00:14:22,240 --> 00:14:26,040 Speaker 3: test alstone and that will enhance your fertility. But if 274 00:14:26,080 --> 00:14:28,360 Speaker 3: you're older and you're not trying to have children, then 275 00:14:28,400 --> 00:14:30,600 Speaker 3: there are many ways to give a man testosterone. We 276 00:14:30,640 --> 00:14:33,640 Speaker 3: now have oral testosterone, which is fantastic world. Test Austional 277 00:14:33,760 --> 00:14:35,280 Speaker 3: is very new in the United States. It's only been 278 00:14:35,280 --> 00:14:37,400 Speaker 3: out for five years. And now we have a pill, 279 00:14:37,480 --> 00:14:38,440 Speaker 3: we have injections, we. 280 00:14:38,400 --> 00:14:40,600 Speaker 4: Have pallets, we have patches. But I will tell you 281 00:14:40,640 --> 00:14:41,160 Speaker 4: that I. 282 00:14:41,160 --> 00:14:43,920 Speaker 3: Do think that this medication can have a profound effect 283 00:14:44,160 --> 00:14:46,480 Speaker 3: on the quality of life. And many patients, I mean 284 00:14:46,480 --> 00:14:49,000 Speaker 3: many patients come in they're thanking you, they're telling you 285 00:14:49,040 --> 00:14:50,920 Speaker 3: that they have a significant improvement in the directions their 286 00:14:50,960 --> 00:14:52,520 Speaker 3: libido muscle mass. 287 00:14:52,680 --> 00:14:53,360 Speaker 4: Not everybody. 288 00:14:53,400 --> 00:14:55,640 Speaker 3: I mean, there are patients that don't respond, but the 289 00:14:55,640 --> 00:14:58,200 Speaker 3: majority of patients who start out low do see a 290 00:14:58,280 --> 00:15:00,840 Speaker 3: significant improvement in their quality of life. 291 00:15:02,440 --> 00:15:06,440 Speaker 2: I was talking with one of our show sponsors, Wayne Wilson, 292 00:15:06,440 --> 00:15:10,760 Speaker 2: who owns Synergenics, and he said, hey, you're urologist. Is 293 00:15:10,800 --> 00:15:14,000 Speaker 2: the one who came when we started, I guess with 294 00:15:14,040 --> 00:15:18,000 Speaker 2: pellets or whatever, and came and talked to them about 295 00:15:18,080 --> 00:15:21,760 Speaker 2: testosterone and obviously that's what they do all day, every day, 296 00:15:22,240 --> 00:15:25,680 Speaker 2: and he went through the various things that you talk about. 297 00:15:25,840 --> 00:15:28,920 Speaker 2: I mean, he took note. He's a physician's assistant by training, 298 00:15:29,440 --> 00:15:31,600 Speaker 2: but it was amazing to me. You were the god 299 00:15:31,640 --> 00:15:35,560 Speaker 2: of testosterone as far as Synergenics is concerned, and I 300 00:15:35,600 --> 00:15:37,840 Speaker 2: didn't know you had an association with them. 301 00:15:38,600 --> 00:15:39,640 Speaker 4: No, I appreciate it. 302 00:15:39,640 --> 00:15:42,600 Speaker 3: I mean, I've been very passionate about this for about 303 00:15:42,600 --> 00:15:44,640 Speaker 3: twenty five years. So all my basic science of work, 304 00:15:44,720 --> 00:15:47,600 Speaker 3: all my lab all my clinical trials are around this topic. 305 00:15:48,000 --> 00:15:50,400 Speaker 3: So when it comes to teaching and education to others 306 00:15:50,440 --> 00:15:54,000 Speaker 3: about testoscerone, I'm all in one moment. 307 00:15:54,200 --> 00:15:57,280 Speaker 2: Doctor Moltera is our guest he's at Baylor College of Medicine, 308 00:15:57,440 --> 00:15:59,920 Speaker 2: and I'm going to start with the question everyone always asked, Well, 309 00:16:00,080 --> 00:16:02,920 Speaker 2: am I more likely to get prostate cancer? Mike, weren't 310 00:16:02,920 --> 00:16:05,200 Speaker 2: you worried about prostate cancer? We'll ask him that coming up. 311 00:16:07,360 --> 00:16:11,840 Speaker 5: With his finger on the pulse, The kingail Ting continues 312 00:16:12,120 --> 00:16:12,960 Speaker 5: on the Michael. 313 00:16:12,720 --> 00:16:18,520 Speaker 2: Berry Show, Baylor College of Medicine, and international renown as 314 00:16:18,600 --> 00:16:28,480 Speaker 2: a speaker on issues of sex urology, testosterone. Forthcoming book 315 00:16:28,640 --> 00:16:32,320 Speaker 2: is called sex Span, which talks about the length of 316 00:16:32,360 --> 00:16:38,040 Speaker 2: time in which a person has a functional sex life 317 00:16:38,840 --> 00:16:43,880 Speaker 2: that will be out relatively soon. Doctor Kara I received 318 00:16:43,880 --> 00:16:48,000 Speaker 2: an email from a fellow named Doug who writes, three 319 00:16:48,120 --> 00:16:52,160 Speaker 2: minutes ago, I figure your interview is pre recorded, but 320 00:16:52,240 --> 00:16:54,360 Speaker 2: if not, I'm curious about bloodcot clots. 321 00:16:54,840 --> 00:16:55,240 Speaker 1: I had a. 322 00:16:55,200 --> 00:16:58,239 Speaker 2: Pulmonary embolism and they told me to stop taking testosterone. 323 00:16:58,240 --> 00:16:59,640 Speaker 2: I used to go to the low Te Center and 324 00:16:59,680 --> 00:17:03,240 Speaker 2: had a great experience experience with the treatment. I miss it. 325 00:17:03,320 --> 00:17:06,000 Speaker 2: I hate that I can't take it anymore. Does doctor 326 00:17:06,080 --> 00:17:07,440 Speaker 2: Kara have a thought about that? 327 00:17:09,520 --> 00:17:10,760 Speaker 4: I do, Michael, so listen. 328 00:17:10,920 --> 00:17:13,320 Speaker 3: There was a concern for that in twenty fifteen, and 329 00:17:13,400 --> 00:17:17,080 Speaker 3: the FDA asked to conduct a large trial. It was 330 00:17:17,119 --> 00:17:19,879 Speaker 3: called the Traverse Trial. I was fortunate enough to be 331 00:17:19,920 --> 00:17:22,800 Speaker 3: involved in that trial with myself and eight other physicians, 332 00:17:23,160 --> 00:17:25,560 Speaker 3: and we designed this trial with several hundreds of millions 333 00:17:25,560 --> 00:17:27,879 Speaker 3: of dollars and the goal was to see if it 334 00:17:27,920 --> 00:17:31,520 Speaker 3: caused increase in cardiovascar events and prostate cancer. What it 335 00:17:31,560 --> 00:17:33,800 Speaker 3: did find was there was no increase in heart attack 336 00:17:34,040 --> 00:17:36,720 Speaker 3: in those men taking test AWSOM versus placebo. We had 337 00:17:36,760 --> 00:17:40,000 Speaker 3: over five thousand patients. We followed them for four years, 338 00:17:40,359 --> 00:17:43,520 Speaker 3: and there was no increased risk in DVT, but there 339 00:17:43,560 --> 00:17:46,960 Speaker 3: was a slight increased risk in pulmonary embolism. And the 340 00:17:47,040 --> 00:17:50,320 Speaker 3: difference was a difference between point five percent and point 341 00:17:50,480 --> 00:17:54,119 Speaker 3: nine percent, So there was a slight signal. And I 342 00:17:54,160 --> 00:17:56,920 Speaker 3: think it's very important to counsel patients when they ask 343 00:17:57,040 --> 00:18:00,440 Speaker 3: about that. So I guess again, you know, I don't 344 00:18:00,440 --> 00:18:04,280 Speaker 3: believe that. I personally don't believe that TESTOSA increases the 345 00:18:04,359 --> 00:18:08,680 Speaker 3: risk of DVT and pulmonary embolism. I think the difference 346 00:18:08,800 --> 00:18:13,080 Speaker 3: was small, but the traversial showed what it showed. Also, 347 00:18:13,119 --> 00:18:15,320 Speaker 3: I just want to mention it showed no increased risk 348 00:18:15,400 --> 00:18:18,800 Speaker 3: in prostate cancer and no increased risk of worsening of 349 00:18:19,000 --> 00:18:21,760 Speaker 3: urinary symptoms. Great study, traverse trial. 350 00:18:22,720 --> 00:18:25,040 Speaker 1: Why do you think this is out there? 351 00:18:25,119 --> 00:18:29,280 Speaker 2: Because I have a friend who started on testosterone, heard 352 00:18:29,280 --> 00:18:32,160 Speaker 2: me talking about it. He starts on it. Three months later, 353 00:18:32,200 --> 00:18:37,080 Speaker 2: he gets prostate cancer. He a text message says, hey, 354 00:18:37,080 --> 00:18:38,800 Speaker 2: I just want you to know I just started on 355 00:18:39,600 --> 00:18:41,760 Speaker 2: testosterone and I got prostate cancer. 356 00:18:41,760 --> 00:18:42,560 Speaker 1: You need to be careful. 357 00:18:42,600 --> 00:18:45,840 Speaker 2: And my immediate response was, you haven't been on testosterone 358 00:18:45,880 --> 00:18:48,879 Speaker 2: long enough. Even if it did cost prostate cancer for 359 00:18:48,960 --> 00:18:51,920 Speaker 2: it to have caused that, if there was no testosterone 360 00:18:51,960 --> 00:18:56,200 Speaker 2: supplement out there, men still got prostate cancer at rapid, 361 00:18:56,720 --> 00:18:59,280 Speaker 2: at large rates. You can't blame every one of them 362 00:18:59,320 --> 00:19:00,000 Speaker 2: on testosterone. 363 00:19:01,480 --> 00:19:03,679 Speaker 3: I absolutely agree with you, and I got to tell 364 00:19:03,680 --> 00:19:05,520 Speaker 3: you where it started from. It started in nineteen forty 365 00:19:05,560 --> 00:19:09,000 Speaker 3: one when Huggins and Hodges published their famous paper I'm 366 00:19:09,040 --> 00:19:11,359 Speaker 3: showing that when you give a man testos increases the 367 00:19:11,480 --> 00:19:13,840 Speaker 3: risk for prostate cancer. If you and I go to 368 00:19:13,840 --> 00:19:16,119 Speaker 3: the library right now and pull that paper, you're going 369 00:19:16,160 --> 00:19:18,960 Speaker 3: to find something very interesting. It was based on one patient, 370 00:19:19,359 --> 00:19:22,960 Speaker 3: one patient, nineteen forty one, and we's instilled fear in 371 00:19:23,080 --> 00:19:25,679 Speaker 3: us for so many years. The good news is in 372 00:19:25,720 --> 00:19:30,960 Speaker 3: twenty eighteen, my society, the American Neurologic Association said testosterone 373 00:19:31,000 --> 00:19:34,760 Speaker 3: does not increase the risk for prostate cancer, strong recommendations, 374 00:19:34,800 --> 00:19:37,640 Speaker 3: So we do not anymore have a concern that testoster 375 00:19:37,960 --> 00:19:40,240 Speaker 3: increases the risk for prostate cancer. I'll tell you a 376 00:19:40,320 --> 00:19:45,040 Speaker 3: very interesting story. If you I had metastatic prostate cancer 377 00:19:45,080 --> 00:19:48,040 Speaker 3: all over our body and we walked into Johns Hopkins 378 00:19:48,160 --> 00:19:51,120 Speaker 3: University today, they would there's a trial where they put 379 00:19:51,200 --> 00:19:55,959 Speaker 3: us on high doses of testosterone to reverse the prostate cancer, 380 00:19:56,000 --> 00:19:59,480 Speaker 3: and it works. It reduces the PSA, reduces the metastactasy. 381 00:20:00,040 --> 00:20:03,120 Speaker 3: We're learning a lot about testosterer and prostate cancer, and 382 00:20:03,160 --> 00:20:06,679 Speaker 3: this concept that testoster increases the risk, I think, to 383 00:20:06,720 --> 00:20:08,679 Speaker 3: me is a myth. Michael, I want to bring up 384 00:20:08,720 --> 00:20:11,440 Speaker 3: one other important thing. You talked about this earlier about testosterone, 385 00:20:11,440 --> 00:20:13,840 Speaker 3: and he said when you give testosterone, does it make 386 00:20:13,880 --> 00:20:17,240 Speaker 3: people feel better? But I tell patients that you've got 387 00:20:17,240 --> 00:20:23,280 Speaker 3: to understand there's something that's just as important. It's lifestyle modification, diet, exercise, 388 00:20:23,640 --> 00:20:26,919 Speaker 3: sleep and stress reduction. I don't have a pill on 389 00:20:26,960 --> 00:20:30,800 Speaker 3: the planet stronger than diet, exercise, sleep and stress reduction. 390 00:20:30,880 --> 00:20:33,200 Speaker 4: And every day when we wake up or when we go. 391 00:20:33,160 --> 00:20:35,320 Speaker 3: To sleep, we should ask ourselves what are we going 392 00:20:35,400 --> 00:20:38,480 Speaker 3: to do on diet, exercise, sleep in stress reduction. I 393 00:20:38,520 --> 00:20:41,560 Speaker 3: call that offense. I four things on offense, and then 394 00:20:41,600 --> 00:20:44,359 Speaker 3: I call it four things on defense. Only four ways 395 00:20:44,400 --> 00:20:45,879 Speaker 3: you and I are going to die. We're going to 396 00:20:45,880 --> 00:20:48,280 Speaker 3: get cancer, we get a heart attack, we're going to 397 00:20:48,280 --> 00:20:51,320 Speaker 3: get metabolic disease, mean diabetes, obesity, or we're going to 398 00:20:51,320 --> 00:20:52,800 Speaker 3: get parking center Alzheimer's. 399 00:20:53,080 --> 00:20:54,399 Speaker 4: So on the defense, every. 400 00:20:54,320 --> 00:20:56,000 Speaker 3: Day we should ask ourselves how are we going to 401 00:20:56,040 --> 00:20:59,040 Speaker 3: keep those four things away? And our offense, how we're 402 00:20:59,080 --> 00:21:01,439 Speaker 3: going to move our health four with those four that 403 00:21:01,680 --> 00:21:03,560 Speaker 3: I think is a really important point I wanted to 404 00:21:03,560 --> 00:21:05,760 Speaker 3: get across. We have a big program on that. I 405 00:21:05,800 --> 00:21:08,320 Speaker 3: mean every time someone comes in, I have a program 406 00:21:08,320 --> 00:21:09,480 Speaker 3: for their offense and defense. 407 00:21:09,760 --> 00:21:10,960 Speaker 4: It's really important. 408 00:21:12,520 --> 00:21:15,440 Speaker 2: The four on offense, which you have preached since today 409 00:21:15,440 --> 00:21:20,880 Speaker 2: I met you, diet, exercise, sleep and stress reduction. 410 00:21:21,200 --> 00:21:22,840 Speaker 1: And do you have four on defense? 411 00:21:24,359 --> 00:21:27,760 Speaker 3: The four on defense are absolutely so it's cancer, which 412 00:21:27,800 --> 00:21:31,240 Speaker 3: means it's a heavy cancer screen. Calling off could be PSA. 413 00:21:31,680 --> 00:21:34,560 Speaker 3: Sometimes we'll do imaging as well. There are new tests 414 00:21:34,600 --> 00:21:36,560 Speaker 3: that come out called gallery. There are others called the 415 00:21:36,560 --> 00:21:39,520 Speaker 3: liquid biopsy test. I mean, there's ways to image and 416 00:21:39,600 --> 00:21:42,639 Speaker 3: to look for patients who may have potential cancer I have. 417 00:21:42,880 --> 00:21:47,359 Speaker 3: Cardiac screening is extremely important. You can sometimes you get 418 00:21:47,520 --> 00:21:50,480 Speaker 3: certain labs like APO B LP, little A. Sometimes we'll 419 00:21:50,480 --> 00:21:52,800 Speaker 3: get a cordery calcium score to look at the heart 420 00:21:52,840 --> 00:21:56,439 Speaker 3: to make sure there's not increase calcium metabolic disease. You 421 00:21:56,480 --> 00:21:58,800 Speaker 3: want to make sure that patients are watching their sugars. 422 00:21:58,840 --> 00:22:01,920 Speaker 3: It's a silent killer. Sometimes we'll put a CGM, which 423 00:22:01,960 --> 00:22:04,600 Speaker 3: is a continuous glucose monitor on them to help them 424 00:22:04,680 --> 00:22:06,800 Speaker 3: look at their sugars to make sure that they get 425 00:22:06,840 --> 00:22:09,320 Speaker 3: the feedback to say these are the foods I should 426 00:22:09,359 --> 00:22:11,679 Speaker 3: stay away from. And then you know, there's not a 427 00:22:11,680 --> 00:22:15,320 Speaker 3: lot you can do with Parkinson's and Alzheimer's. There are 428 00:22:15,320 --> 00:22:17,119 Speaker 3: certain tests that you can look at, some genes you 429 00:22:17,119 --> 00:22:18,640 Speaker 3: can look at to see if you're a higher risk. 430 00:22:19,040 --> 00:22:20,720 Speaker 3: But you know, if you are at a higher risk, 431 00:22:20,960 --> 00:22:23,959 Speaker 3: you can start altering your behavior, exer, you know, and 432 00:22:24,040 --> 00:22:26,840 Speaker 3: doing things. So it's really important to keep the bad 433 00:22:26,920 --> 00:22:30,919 Speaker 3: things away and use the diet, exercise, and sleep and 434 00:22:30,920 --> 00:22:34,520 Speaker 3: stress to move your health forward. In that paradigm, most 435 00:22:34,560 --> 00:22:37,280 Speaker 3: people get the concept of offense and defense four and four, 436 00:22:37,680 --> 00:22:40,040 Speaker 3: and it's really worked well for a lot of my patients. 437 00:22:41,160 --> 00:22:43,040 Speaker 2: I don't know if I've told you this. Doctor Mohitz 438 00:22:43,119 --> 00:22:47,639 Speaker 2: Kara is our guest k E. R At Baylor College 439 00:22:47,640 --> 00:22:50,320 Speaker 2: of Medicine. I don't know if I've told you this, 440 00:22:50,480 --> 00:22:56,680 Speaker 2: but on Christmas Eve, Ramone got a CGM continuous glucose monitor, 441 00:22:57,119 --> 00:23:01,040 Speaker 2: and he started monitoring his blood sugar. And he keeps 442 00:23:01,040 --> 00:23:03,879 Speaker 2: his blood sugar at a very steady between one and 443 00:23:03,920 --> 00:23:06,120 Speaker 2: one thirty, usually about one point fifteen. The first thing 444 00:23:06,160 --> 00:23:08,159 Speaker 2: I do when I walk in the studio every morning 445 00:23:08,600 --> 00:23:10,119 Speaker 2: is he's already here. Is I ask him for the 446 00:23:10,200 --> 00:23:12,359 Speaker 2: number he sees me coming up the stairs, and he 447 00:23:12,400 --> 00:23:13,880 Speaker 2: will write it down and show it on a sheet 448 00:23:13,920 --> 00:23:15,560 Speaker 2: of paper or open the door and tell me. 449 00:23:16,160 --> 00:23:17,040 Speaker 1: And he has. 450 00:23:17,240 --> 00:23:22,800 Speaker 2: It has absolutely changed not only his health but his mood. 451 00:23:23,000 --> 00:23:25,240 Speaker 2: I mean, he is consistent, He can work harder, he 452 00:23:25,280 --> 00:23:29,960 Speaker 2: can work longer by just stabilizing blood sugar, which obviously 453 00:23:30,000 --> 00:23:33,360 Speaker 2: for most people is fluctuating with great volatility. 454 00:23:34,600 --> 00:23:35,480 Speaker 4: I love that story. 455 00:23:35,560 --> 00:23:37,320 Speaker 3: I think that's a see and I see that all 456 00:23:37,359 --> 00:23:39,679 Speaker 3: the time because the reality is there are foods that 457 00:23:39,720 --> 00:23:42,159 Speaker 3: you're eating that you think are healthy and they're not. 458 00:23:42,640 --> 00:23:43,840 Speaker 3: And the foods that you think that are not that 459 00:23:43,920 --> 00:23:46,879 Speaker 3: healthy are you know, and you know, I put a 460 00:23:46,880 --> 00:23:48,600 Speaker 3: CGM on my wife and we went to the same 461 00:23:48,600 --> 00:23:51,080 Speaker 3: restaurant once we ate the exact same thing, and we 462 00:23:51,160 --> 00:23:54,600 Speaker 3: got totally different numbers. Because part of it's also genetics, right, 463 00:23:54,720 --> 00:23:57,200 Speaker 3: so that can play a role in it as well. 464 00:23:57,200 --> 00:24:00,240 Speaker 3: But learning more about what is bad and what to 465 00:24:00,280 --> 00:24:04,199 Speaker 3: stay away from is extremely important because if you give 466 00:24:04,200 --> 00:24:07,320 Speaker 3: yourself feedback, and those who take feedback very seriously, you 467 00:24:07,359 --> 00:24:10,639 Speaker 3: can really alter the quality of your life because that 468 00:24:10,840 --> 00:24:14,760 Speaker 3: sugar is just pounding the blood vessels and just pounding them. 469 00:24:15,680 --> 00:24:18,199 Speaker 2: My dad's a lifelong diabetic. He was nineteen when he 470 00:24:18,240 --> 00:24:20,440 Speaker 2: got diabetes. He's eighty five now. It's amazing. He has 471 00:24:20,480 --> 00:24:22,879 Speaker 2: all ten fingers and toes, but he has monitored he 472 00:24:23,240 --> 00:24:25,240 Speaker 2: I've had doctors tell me your dad knows more about 473 00:24:25,320 --> 00:24:25,879 Speaker 2: diabetes than we. 474 00:24:25,920 --> 00:24:27,800 Speaker 1: Do because he had to treat it before they was instantly. 475 00:24:28,040 --> 00:24:31,159 Speaker 2: But I take Ramon to see him last week, and 476 00:24:31,280 --> 00:24:34,080 Speaker 2: all they talked about was their cgms and their dex 477 00:24:34,119 --> 00:24:36,480 Speaker 2: colm CGM and what the reading was and what this 478 00:24:36,680 --> 00:24:38,600 Speaker 2: was and what that was it was. It was pretty funny. 479 00:24:38,640 --> 00:24:41,439 Speaker 2: To watch home with me for one more segment if 480 00:24:41,480 --> 00:24:43,919 Speaker 2: you can. Doctor Mohit Kara is our guest. Sure, the 481 00:24:43,920 --> 00:24:47,720 Speaker 2: book is The Sex Span, and we will double back 482 00:24:47,760 --> 00:24:49,600 Speaker 2: to that subject. 483 00:24:49,800 --> 00:24:50,400 Speaker 1: Coming up. 484 00:25:01,520 --> 00:25:05,640 Speaker 5: From Portland to Walbany at all great cities in between these. 485 00:25:07,320 --> 00:25:11,840 Speaker 5: The Michael Barry Show is nationwide. 486 00:25:11,840 --> 00:25:14,280 Speaker 1: Doctor Movit Kara is our guest k H. E. 487 00:25:14,480 --> 00:25:14,720 Speaker 5: R A. 488 00:25:15,040 --> 00:25:18,760 Speaker 2: He is my friend and my urologist and an expert 489 00:25:18,880 --> 00:25:23,160 Speaker 2: in matters of sex and testosterone. 490 00:25:23,720 --> 00:25:24,680 Speaker 1: I will read to you. 491 00:25:25,280 --> 00:25:29,320 Speaker 2: Email from one fellow says, well, let me go back 492 00:25:29,320 --> 00:25:34,640 Speaker 2: to that. Another fellow, actually several fellows said, my wife's libido. 493 00:25:34,560 --> 00:25:38,879 Speaker 1: Is way lower than mine. How can he increase a 494 00:25:38,920 --> 00:25:39,840 Speaker 1: woman's libido? 495 00:25:42,200 --> 00:25:44,200 Speaker 3: That's a really important point. So you know I told 496 00:25:44,200 --> 00:25:46,639 Speaker 3: you earlier that couplet. The woman that called me it 497 00:25:46,680 --> 00:25:48,480 Speaker 3: was very upset. So in two thousand and eight I 498 00:25:48,480 --> 00:25:51,760 Speaker 3: actually flew out to California to many fellowship in female 499 00:25:51,800 --> 00:25:54,600 Speaker 3: sexual dysfunction, and I started treating women for the past 500 00:25:54,600 --> 00:25:59,040 Speaker 3: seventeen years because you can't just treat one person without 501 00:25:59,080 --> 00:25:59,800 Speaker 3: treating the other. 502 00:26:00,240 --> 00:26:00,800 Speaker 4: And when you. 503 00:26:00,720 --> 00:26:04,800 Speaker 3: Improve both libidos, you actually it's synergistic. So women, this 504 00:26:05,040 --> 00:26:08,720 Speaker 3: female sexual dysfunction is comprised of four components low libido, 505 00:26:09,200 --> 00:26:13,639 Speaker 3: for arousal meaning poor blood flow to the genitalia, orgasmic dysfunction, 506 00:26:14,200 --> 00:26:14,680 Speaker 3: or pain. 507 00:26:15,280 --> 00:26:15,800 Speaker 4: It was sex. 508 00:26:15,840 --> 00:26:18,199 Speaker 3: If she has any one of those four and is 509 00:26:18,280 --> 00:26:21,919 Speaker 3: bothered by it, she suffers from female sexual dysfunction. And 510 00:26:21,960 --> 00:26:24,840 Speaker 3: there are many treatment options out there. One could be hormonal, 511 00:26:25,000 --> 00:26:28,040 Speaker 3: one could be actually using new Two FDA proved medications 512 00:26:28,040 --> 00:26:30,960 Speaker 3: are out. One's called add ADDYI. It came out in 513 00:26:30,960 --> 00:26:35,120 Speaker 3: twenty fifteen FDA proved strictly to increase a woman's. 514 00:26:34,840 --> 00:26:36,080 Speaker 4: Desire for sex. That's it. 515 00:26:36,280 --> 00:26:39,080 Speaker 3: She takes the pill every day increases her desire for sex. 516 00:26:39,440 --> 00:26:41,840 Speaker 3: By Lisa came out several years later. It's an injection 517 00:26:42,000 --> 00:26:46,120 Speaker 3: EpiPen she injects strictly to increase her desire for sex. Now, 518 00:26:46,440 --> 00:26:49,320 Speaker 3: I just want everyone to be very clear, libido is 519 00:26:49,320 --> 00:26:50,760 Speaker 3: more deeper than that. I mean, there could be a 520 00:26:50,760 --> 00:26:53,480 Speaker 3: lot of other other factors. I mean, it could be 521 00:26:53,480 --> 00:26:57,200 Speaker 3: her stress, it could be her physical condition. It could 522 00:26:57,200 --> 00:26:59,640 Speaker 3: be fatigue, so you can't. It could be the quality 523 00:26:59,680 --> 00:27:01,960 Speaker 3: of relationship. So I mean, if someone has a terrible 524 00:27:02,040 --> 00:27:03,960 Speaker 3: quality and relationship, I can't. I can give them all 525 00:27:03,960 --> 00:27:05,960 Speaker 3: the pill they want. It's not going to help, you know, 526 00:27:06,080 --> 00:27:08,439 Speaker 3: So you just got to look at the whole big picture. 527 00:27:08,720 --> 00:27:09,919 Speaker 4: But I still also. 528 00:27:09,680 --> 00:27:13,600 Speaker 3: Believe when you improve a woman's diet, exercise, sleep, and stress, 529 00:27:13,920 --> 00:27:15,400 Speaker 3: her libido does go up. 530 00:27:16,320 --> 00:27:18,200 Speaker 1: It also helps if you take them to the movies. 531 00:27:20,000 --> 00:27:23,080 Speaker 4: Yeah, that's true. That's true. 532 00:27:23,440 --> 00:27:29,439 Speaker 2: The most these conversations, Alex right, Zar, what if you 533 00:27:29,520 --> 00:27:33,240 Speaker 2: can't always afford the treatment for testosterone? Is there a 534 00:27:33,280 --> 00:27:35,639 Speaker 2: safe supplement I can take that would help? 535 00:27:37,119 --> 00:27:40,119 Speaker 3: So the good news is that you can get testosterone 536 00:27:40,200 --> 00:27:43,040 Speaker 3: even compounded compounding pharmacies. Many of them are called the 537 00:27:43,040 --> 00:27:46,120 Speaker 3: five ZHO three B, which are heavily regulated. They make 538 00:27:46,160 --> 00:27:48,800 Speaker 3: testosterone at a price of about thirty dollars a month 539 00:27:48,960 --> 00:27:52,200 Speaker 3: without insurance. Most people can afford thirty dollars a month 540 00:27:52,240 --> 00:27:55,680 Speaker 3: without insurance. If you look at even medications like Cialis, 541 00:27:55,800 --> 00:27:58,159 Speaker 3: if you use a good RX coupon card or you 542 00:27:58,240 --> 00:28:02,000 Speaker 3: use Mark Cuban's company, you can get ninety days for 543 00:28:02,119 --> 00:28:05,359 Speaker 3: roughly twenty or twenty five dollars ninety days for Siale. 544 00:28:05,480 --> 00:28:09,359 Speaker 3: So these medications are extremely affordable and price should no 545 00:28:09,440 --> 00:28:10,960 Speaker 3: longer be an issue. 546 00:28:11,760 --> 00:28:12,560 Speaker 1: That's interesting. 547 00:28:14,640 --> 00:28:19,800 Speaker 2: Several of the questions relate to hemoglobin, blood thickness, I 548 00:28:19,840 --> 00:28:22,439 Speaker 2: know some people begin giving blood once they get on 549 00:28:22,480 --> 00:28:27,320 Speaker 2: testosterone because they're blood thickens. Your thoughts on that is 550 00:28:27,359 --> 00:28:29,680 Speaker 2: that problematic or is that just a side effect? 551 00:28:30,880 --> 00:28:33,200 Speaker 3: It can be and it all depends on what type 552 00:28:33,200 --> 00:28:36,880 Speaker 3: of formulation you're using. Injectables have the highest rate, injections 553 00:28:36,920 --> 00:28:40,000 Speaker 3: up to sixty six percent. A pellet's about thirty five percent, 554 00:28:40,320 --> 00:28:43,760 Speaker 3: agel's twelve percent risk and appeal is about five percent. 555 00:28:44,120 --> 00:28:47,040 Speaker 3: So if your hermaticrit goes up and the number you 556 00:28:47,080 --> 00:28:49,920 Speaker 3: want to remember is fifty four, if it gets above 557 00:28:50,000 --> 00:28:54,400 Speaker 3: fifty four, there's a slight theoretical increased cardiovascar risk. And 558 00:28:54,440 --> 00:28:56,880 Speaker 3: in my practice, we have these patients start donating blood. 559 00:28:57,000 --> 00:28:59,040 Speaker 3: We don't wait till fifty four. We haven't started donating 560 00:28:59,040 --> 00:29:01,080 Speaker 3: at fifty one, want to wait till fifty four. 561 00:29:01,120 --> 00:29:04,320 Speaker 4: So it is real. And remember that many of. 562 00:29:04,240 --> 00:29:07,240 Speaker 3: These patients have sleep apnea ac cult to sleep apnea, 563 00:29:07,520 --> 00:29:10,520 Speaker 3: and the testostern is unmasking it. So send them for 564 00:29:10,560 --> 00:29:13,200 Speaker 3: a sleep study because you'll find that many of them 565 00:29:13,360 --> 00:29:14,840 Speaker 3: are just suffering from sleep apnea. 566 00:29:16,440 --> 00:29:21,120 Speaker 2: You know, I find a lot of people are suffering 567 00:29:21,240 --> 00:29:24,280 Speaker 2: from some sleep disorder and they've just grown. They don't 568 00:29:24,280 --> 00:29:28,240 Speaker 2: even realize what a contributor to. 569 00:29:28,280 --> 00:29:31,800 Speaker 1: Their overall health or lack of it that sleep is. 570 00:29:32,000 --> 00:29:35,560 Speaker 2: It's almost always accompanied by the person being overweight, or 571 00:29:35,640 --> 00:29:38,200 Speaker 2: maybe the overweight led to the sleep. But that's one 572 00:29:38,240 --> 00:29:40,280 Speaker 2: of those things that I find when I dig into 573 00:29:40,640 --> 00:29:44,680 Speaker 2: people often have bad sleep and they don't think that's 574 00:29:44,760 --> 00:29:46,080 Speaker 2: they don't realize how important that is. 575 00:29:47,440 --> 00:29:49,880 Speaker 3: Michael, You're so right. Listen, when I take care of 576 00:29:49,880 --> 00:29:51,800 Speaker 3: a lot of CEOs, a lot of people, and I 577 00:29:51,840 --> 00:29:54,600 Speaker 3: talk about the four pillars diet, exercise, sleep, and stress. 578 00:29:54,840 --> 00:29:57,360 Speaker 3: They're all pretty good at diet, they're all pretty good 579 00:29:57,360 --> 00:30:01,520 Speaker 3: at exercise. They are lousy at sleep and stress. Right, 580 00:30:01,600 --> 00:30:05,280 Speaker 3: and so, and sleep and stress are so critical, and 581 00:30:05,400 --> 00:30:08,280 Speaker 3: you think about sleep, it is a game changer. Even 582 00:30:08,480 --> 00:30:10,800 Speaker 3: the way you think about sleep. It's not the hours 583 00:30:10,920 --> 00:30:14,640 Speaker 3: you sleep, that's multiplied by how efficient you slept. So 584 00:30:14,680 --> 00:30:16,719 Speaker 3: if you slept eight hours last night, but you were 585 00:30:16,760 --> 00:30:19,280 Speaker 3: twenty percent efficient, and I slept only four hours last 586 00:30:19,360 --> 00:30:21,520 Speaker 3: night but I was eighty percent efficient, I'm going to 587 00:30:21,560 --> 00:30:22,520 Speaker 3: feel a lot better than you. 588 00:30:22,840 --> 00:30:23,040 Speaker 4: Right. 589 00:30:23,080 --> 00:30:25,360 Speaker 3: So, the reality it's not just lying there with your 590 00:30:25,360 --> 00:30:28,560 Speaker 3: eyes closed. You have to get good deep sleep, good 591 00:30:28,600 --> 00:30:32,040 Speaker 3: rem sleep, and even thirty minutes extra of either deep 592 00:30:32,080 --> 00:30:35,200 Speaker 3: sleep or rem sleep. Every night game changer for the 593 00:30:35,240 --> 00:30:38,680 Speaker 3: next day. So I think people need to be very militan. 594 00:30:38,840 --> 00:30:41,160 Speaker 3: Just find a way to make sure that you go 595 00:30:41,200 --> 00:30:44,040 Speaker 3: to sleep on time, wake up on time. And the 596 00:30:44,160 --> 00:30:47,400 Speaker 3: best website I found was the American Sleep Foundation. The 597 00:30:47,440 --> 00:30:50,960 Speaker 3: American Sleep Foundation has twenty tips on their website. They're awesome. 598 00:30:51,440 --> 00:30:53,400 Speaker 3: Follow those tips. That makes a big difference. 599 00:30:55,520 --> 00:30:58,320 Speaker 1: Salt in the diet. So I've been reading a lot 600 00:30:58,360 --> 00:30:59,800 Speaker 1: on salt lately and. 601 00:31:01,400 --> 00:31:03,760 Speaker 2: I have not run this by you yet, so I'm 602 00:31:03,800 --> 00:31:07,640 Speaker 2: curious to see what you think of this. And the 603 00:31:07,640 --> 00:31:10,520 Speaker 2: theory goes that we were told to stay away from salt. 604 00:31:10,560 --> 00:31:14,720 Speaker 2: Salt raises blood pressure, salt causes all these problems, and 605 00:31:15,120 --> 00:31:19,520 Speaker 2: it basically the point of the piece was that we 606 00:31:19,560 --> 00:31:21,880 Speaker 2: are now deprived of salt. And what do you do 607 00:31:22,000 --> 00:31:24,800 Speaker 2: to treat someone for a number of things is you 608 00:31:24,880 --> 00:31:25,840 Speaker 2: give them salt. 609 00:31:25,920 --> 00:31:29,960 Speaker 1: Your thoughts on salt intake, So, I think. 610 00:31:29,760 --> 00:31:32,720 Speaker 3: That I'm still a believer that salt, particularly in patients 611 00:31:32,760 --> 00:31:36,520 Speaker 3: who have hypertension, is a risk factor. And so if 612 00:31:36,520 --> 00:31:40,280 Speaker 3: someone has hypertension, which most many Americans suffer from, that 613 00:31:40,480 --> 00:31:42,960 Speaker 3: is going to be something that's the first thing I'm 614 00:31:42,960 --> 00:31:45,880 Speaker 3: going to ask them to stay away from. As a urologist, 615 00:31:46,160 --> 00:31:48,760 Speaker 3: the other thing we worry about is increased salt intake 616 00:31:49,160 --> 00:31:54,480 Speaker 3: significantly increases the risk for the kidney stones. And so 617 00:31:55,320 --> 00:31:58,720 Speaker 3: I am not a believer yet that we should be 618 00:31:59,120 --> 00:32:02,520 Speaker 3: increasing excuse me, increasing salt unless there's a reason to 619 00:32:02,600 --> 00:32:05,200 Speaker 3: do so. But I'm more concerned about the hypertension and 620 00:32:05,240 --> 00:32:05,880 Speaker 3: the stone risk. 621 00:32:06,080 --> 00:32:07,960 Speaker 1: But on French Fries, it's okay, right. 622 00:32:10,080 --> 00:32:17,240 Speaker 2: Sometimes, doctor Mohi Kara, you are the absolute best. 623 00:32:17,400 --> 00:32:22,320 Speaker 1: The four phases of offense he has outlined or diet. 624 00:32:22,600 --> 00:32:26,600 Speaker 2: Exercise, sleep, and stress reduction all things you can do 625 00:32:26,680 --> 00:32:31,520 Speaker 2: yourself that don't require spending a dollar. Diet, exercise, sleep 626 00:32:31,960 --> 00:32:36,840 Speaker 2: and stress reduction is four pillars of offense and defense. 627 00:32:37,120 --> 00:32:39,400 Speaker 2: I cannot help you get in to see him, so 628 00:32:39,520 --> 00:32:41,560 Speaker 2: don't even try, because I'm want to be overwhelmed again. 629 00:32:42,120 --> 00:32:44,200 Speaker 2: It's Baylor College of Medicine. It does take a while 630 00:32:44,240 --> 00:32:47,800 Speaker 2: to get in to see him, only because he's very popular. 631 00:32:47,880 --> 00:32:50,600 Speaker 2: A lot of people like him. I was my own 632 00:32:50,640 --> 00:32:53,280 Speaker 2: worst enemy in sending too many patients to him at 633 00:32:53,280 --> 00:32:55,960 Speaker 2: the beginning, and he only has so many hours of 634 00:32:56,240 --> 00:32:59,240 Speaker 2: the day. The book is The Sex Span, which is 635 00:32:59,240 --> 00:33:01,600 Speaker 2: not out yet but will be hopefully soon. 636 00:33:01,640 --> 00:33:03,320 Speaker 1: And when you let me know that is the case, 637 00:33:03,720 --> 00:33:06,400 Speaker 1: we will all go and buy it online. 638 00:33:06,800 --> 00:33:08,640 Speaker 4: Will do. Thank you so much, Michael, You're the best. 639 00:33:08,720 --> 00:33:14,520 Speaker 1: My friend, doctor Mohitz A h. E. R A. Baylor 640 00:33:14,640 --> 00:33:17,040 Speaker 1: College of Medicine. Yeah. 641 00:33:17,080 --> 00:33:21,680 Speaker 2: So I'm having dinner at Gringos, the new location at 642 00:33:22,600 --> 00:33:27,000 Speaker 2: ninety nine and two forty nine with Wayne Wilson, who's 643 00:33:27,040 --> 00:33:31,640 Speaker 2: the founder of Centergenics, and he was telling me about 644 00:33:32,920 --> 00:33:37,080 Speaker 2: we were talking about the testosterone replacement, but he was 645 00:33:37,080 --> 00:33:39,560 Speaker 2: talking about this doctor and he said, I think it's 646 00:33:39,640 --> 00:33:43,440 Speaker 2: your doctor. He comes out and trains our people on 647 00:33:44,440 --> 00:33:47,840 Speaker 2: testosterone and the effects and why it's important and all that, 648 00:33:47,880 --> 00:33:49,640 Speaker 2: and it was doctor Kara, and I did not know that. 649 00:33:49,680 --> 00:33:51,880 Speaker 2: I had no idea. Doctor Karen was the first one 650 00:33:51,880 --> 00:33:54,240 Speaker 2: that put me on testosterone. We did the pellets for 651 00:33:54,280 --> 00:33:57,200 Speaker 2: a couple of years, and then low T Center, which 652 00:33:57,240 --> 00:34:00,240 Speaker 2: is also Centergenics, became a show sponsor, so just moved 653 00:34:00,240 --> 00:34:01,920 Speaker 2: over there and started doing the weekly shots. 654 00:34:02,040 --> 00:34:03,880 Speaker 1: I like the shots. I like the shots better than 655 00:34:03,840 --> 00:34:06,160 Speaker 1: the pellets. Some people like the pellets. I gotta take 656 00:34:06,200 --> 00:34:07,000 Speaker 1: my pellet story home.