#260 ‒ Men’s Sexual Health: why it matters, what can go wrong, and how to fix it | Mohit Khera, M.D., M.B.A., M.P.H. | The Peter Attia Drive - Private Subscriber Feed (🔓 for Vijay Khakhria)

In this episode of The Drive, Peter Attia interviews Dr. Mohit Khera, a urologist and expert in male sexual health, to discuss various aspects of male sexual dysfunction and hormonal health. The conversation begins with an overview of erectile dysfunction (ED), including its prevalence, diagnosis, and connection to cardiovascular disease, before transitioning to treatments like drugs, shockwave therapy, and lifestyle changes. They explore Peyronie's disease, penile fractures, and enlargement treatments, followed by discussions on premature ejaculation, anorgasmia, and the roles of testosterone, DHT, and estrogen. The conversation covers testosterone replacement therapy, measurement methods, and its implications for prostate cancer, concluding with concerns about DHT, finasteride, and post-finasteride syndrome.

Outlines

Part 1: Introduction to ED

Part 2: Peyronie's and ED Treatments

Part 3: Premature Ejaculation and Anorgasmia

Part 4: Testosterone and TRT

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#260 ‒ Men’s Sexual Health: why it matters, what can go wrong, and how to fix it | Mohit Khera, M.D., M.B.A., M.P.H.

The Peter Attia Drive - Private Subscriber Feed (🔓 for Vijay Khakhria)

Part 1: Introduction to ED

Introduction to Male Sexual Health with Dr. Mohit Khera

Prevalence and Initial Assessment of Erectile Dysfunction

Psychogenic ED, Treatment Options, and the Discovery of Viagra

Pathophysiology of Venous Leak and the Benefits of Daily Cialis

Cost of Cialis, Refractory Period, and the Link Between ED and Cardiovascular Disease

Endothelial Dysfunction, Lifestyle Modifications, and Peyronie's Disease

Part 2: Peyronie's and ED Treatments

Peyronie's Disease: Active vs. Quiescent Phases, Trauma, and Traction Devices

Stretching Devices, ED Diagnostics, and Penile Prosthesis

Penile Prosthesis Surgery, Priapism, and Trazodone

Treatment of Priapism, Shockwave Therapy, and Stem Cells

Stem Cells, PRP, and Summary of ED Treatment

Part 3: Premature Ejaculation and Anorgasmia

Premature Ejaculation: Diagnosis and Treatment

Anorgasmia, Ejaculatory Latency, and the Importance of Estrogen

Part 4: Testosterone and TRT

SHBG, Free Testosterone, and Symptomatic Assessment

Testosterone Replacement Options: Clomiphene, HCG, and More

Injectable Testosterone, Zyosted, and Oral Testosterone

Injectable vs. Other TRT Methods, and Erythrocytosis

Testosterone, DHT, and the Prostate

5-Alpha Reductase Inhibitors and Post-Finasteride Syndrome

Testosterone and Prostate Cancer: Challenging the Paradigm

Treatment After Prostate Cancer, Testosterone and Breast Cancer, and Finding a Specialist

#260 ‒ Men’s Sexual Health: why it matters, what can go wrong, and how to fix it | Mohit Khera, M.D., M.B.A., M.P.H.

The Peter Attia Drive - Private Subscriber Feed (🔓 for Vijay Khakhria)

Part 1: Introduction to ED

00:10Introduction to Male Sexual Health with Dr. Mohit Khera

Introduction to Male Sexual Health with Dr. Mohit Khera

07:08Prevalence and Initial Assessment of Erectile Dysfunction

Prevalence and Initial Assessment of Erectile Dysfunction

12:14Psychogenic ED, Treatment Options, and the Discovery of Viagra

Psychogenic ED, Treatment Options, and the Discovery of Viagra

19:20Pathophysiology of Venous Leak and the Benefits of Daily Cialis

Pathophysiology of Venous Leak and the Benefits of Daily Cialis

26:30Cost of Cialis, Refractory Period, and the Link Between ED and Cardiovascular Disease

Cost of Cialis, Refractory Period, and the Link Between ED and Cardiovascular Disease

32:39Endothelial Dysfunction, Lifestyle Modifications, and Peyronie's Disease

Endothelial Dysfunction, Lifestyle Modifications, and Peyronie's Disease

Part 2: Peyronie's and ED Treatments

38:10Peyronie's Disease: Active vs. Quiescent Phases, Trauma, and Traction Devices

Peyronie's Disease: Active vs. Quiescent Phases, Trauma, and Traction Devices

45:01Stretching Devices, ED Diagnostics, and Penile Prosthesis

Stretching Devices, ED Diagnostics, and Penile Prosthesis

52:31Penile Prosthesis Surgery, Priapism, and Trazodone

Penile Prosthesis Surgery, Priapism, and Trazodone

59:30Treatment of Priapism, Shockwave Therapy, and Stem Cells

Treatment of Priapism, Shockwave Therapy, and Stem Cells

1:07:09Stem Cells, PRP, and Summary of ED Treatment

Stem Cells, PRP, and Summary of ED Treatment

Part 3: Premature Ejaculation and Anorgasmia

1:14:10Premature Ejaculation: Diagnosis and Treatment

Premature Ejaculation: Diagnosis and Treatment

1:21:20Anorgasmia, Ejaculatory Latency, and the Importance of Estrogen

Anorgasmia, Ejaculatory Latency, and the Importance of Estrogen

Part 4: Testosterone and TRT

1:28:33SHBG, Free Testosterone, and Symptomatic Assessment

SHBG, Free Testosterone, and Symptomatic Assessment

1:37:54Testosterone Replacement Options: Clomiphene, HCG, and More

Testosterone Replacement Options: Clomiphene, HCG, and More

1:45:21Injectable Testosterone, Zyosted, and Oral Testosterone

Injectable Testosterone, Zyosted, and Oral Testosterone

1:52:25Injectable vs. Other TRT Methods, and Erythrocytosis

Injectable vs. Other TRT Methods, and Erythrocytosis

2:00:04Testosterone, DHT, and the Prostate

Testosterone, DHT, and the Prostate

2:07:315-Alpha Reductase Inhibitors and Post-Finasteride Syndrome

5-Alpha Reductase Inhibitors and Post-Finasteride Syndrome

2:15:13Testosterone and Prostate Cancer: Challenging the Paradigm

Testosterone and Prostate Cancer: Challenging the Paradigm

2:23:04Treatment After Prostate Cancer, Testosterone and Breast Cancer, and Finding a Specialist

Treatment After Prostate Cancer, Testosterone and Breast Cancer, and Finding a Specialist