Unlocking Men's Health: Erectile Dysfunction, Lifestyle Changes & Cutting-Edge Treatments with Dr. Jeff Loh-Doyle | Anew Ep. 52

Welcome to ANEW Body Insight Podcast, where we dive deep into the intersection of psychology, nutrition, and fitness to help you achieve optimal health. Hosted by Dr. Supatra Tovar, a clinical psychologist, registered dietitian, fitness expert, and best-selling author of Deprogram Diet Culture, we bring you expert insights from leading professionals in the field of health and wellness.

In this episode, board-certified urologist Dr. Jeff Loh-Doyle unpacks ED misconceptions, psychological factors, and advanced treatments. A common but taboo issue, ED affects millions beyond just aging.

Dr. Loh-Doyle shares evidence-based solutions for ED, including:

• How lifestyle changes such as diet, exercise, and weight management can naturally improve erectile function
• The impact of testosterone, cardiovascular health, and psychological stress on sexual performance
• The best diets for improving erections, including the Mediterranean diet
• Common myths about ED medications and whether online prescriptions from services like Hims and Roman are safe
• The rise of online pharmacies prescribing testosterone therapy and its potential side effects
• Emerging treatments like shockwave therapy, stem cell injections, and penile implants
• The role of relationship dynamics, stress, and mental health in sexual performance
• How young men are misusing ED drugs for performance enhancement and the long-term effects

If you or someone you love is struggling with erectile dysfunction, this episode is a must-listen. Discover how simple lifestyle changes, medical advancements, and expert guidance can restore confidence, intimacy, and overall well-being.

For more information about Dr Jeff Loh here are his social media link: https://keck.usc.edu/faculty-search/jeffrey-loh-doyle/,  https://www.keckmedicine.org/provider/jeffrey-loh-doyle/,  https://www.rrh.org/find-a-provider/jeffrey-c-loh-doyle-md/,  https://profiles.sc-ctsi.org/jeffrey.loh-doyle,  https://x.com/drlohdoyle,  https://www.linkedin.com/in/jeffrey-loh-doyle-94b023114. 

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Thank you for joining us on this journey to wellness. Remember, the insights and advice shared on the ANEW Body Insight Podcast are for educational and informational purposes only and do not constitute medical advice. Always consult with a healthcare professional before making any changes to your health routine. To learn more about the podcast and stay updated on new episodes, visit ANEW Body Insight Podcast at anew-insight.com. To watch this episode on YouTube, visit @my.anew.insight. Follow us on social media at @my.anew.insight on Facebook, Instagram, TikTok, and Threads for more updates and insights. Thank you for tuning in! Stay connected with us for more empowering stories and expert guidance. Until next time, stay well and keep evolving with ANEW Body Insight!

Transcript

00:00:01:17 - 00:00:04:13
Welcome
to the ANEW Body Insight podcast,


00:00:04:22 - 00:00:08:00
empowering and inspiring your journey to optimal health.


00:00:08:14 - 00:00:11:20
Hosted by Dr. Supatra Tovar, clinical psychologist,


00:00:11:20 - 00:00:16:14
registered dietitian, fitness expert, and author of Deprogram Diet Culture:


00:00:16:21 - 00:00:20:18
Rethink Your Relationship with Food, Heal Your Mind, and Live a Diet-Free


00:00:20:18 - 00:00:25:10
Life, and Chantal Donnelly, physical therapist and author of Settled:


00:00:25:19 - 00:00:28:17
How to Find Calm in a Stress Inducing World.


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Here at City Club Los Angeles, we follow our guests journey to optimal


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health, providing you with the keys to unlock your own wellness path.


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Tune in and evolve with us.


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Welcome back to the ANEW Body Insight podcast. 


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We are back for the second half
of our interview with board


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certified urologist Jeff, Doctor
Jeff Loh-Doyle.


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Doctor Jeff gave us some invaluable
insight into the misconceptions,


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psychological factors,
and some of the treatment options


00:00:59:01 - 00:01:03:08
for erectile dysfunction
and we cannot wait to learn more.


00:01:03:12 - 00:01:05:21
Welcome back, Doctor Jeff. Thank you.


00:01:05:21 - 00:01:06:23
I could talk about this for hours.


00:01:06:23 - 00:01:09:15
Yes, me too. It's so exciting.


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So we have talked
about psychological factors.


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We have talked
about some of the treatments.


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We have talked
about some of the contributors to ED.


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What about lifestyle?


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How important is lifestyle
in the management


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and the treatment of ED?


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So there's no mystery behind this.


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If you have a patient
that doesn't work out,


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doesn't eat correctly and is overweight.


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So each of those issues
can impact erectile function.


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So I'll tell someone I can give you
all the medication in the world.


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But if you don't change those things
that no matter what


00:01:44:03 - 00:01:46:01
that erection will continue to decline.


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And these medications
are just Band-Aids to the problem.


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So there's also an opportunity
to reverse some of this.


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And so if you look at the data,
if you look at each of those things


00:01:57:04 - 00:02:01:15
we talked about weight
loss, exercise and a better diet.


00:02:02:07 - 00:02:06:19
Each individually can improve erectile
function parameters after six months. Yes.


00:02:06:19 - 00:02:11:03
So if you combine all three
obviously they’ll work together. Yes.


00:02:11:03 - 00:02:15:09
And so I always recommend
patients to just eat less, work out more


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and to lose weight.


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I mean obviously within reason.


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But overall
the American diet is to eat too much.


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Oh absolutely. So eat less.


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And eat healthier.


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I think it's really important.


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Obviously sleep matters too.


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But, I will tell a patient,


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They say, doc, what can I do?


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Five days of exercise.


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Moderate cardiovascular exercise.


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And I guarantee you after 3 or 4 months


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you're erectin will be better.


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And also your testosterone
will be better too.


00:02:48:02 - 00:02:51:11
So we know that just exercising
and building


00:02:51:11 - 00:02:55:04
muscle mass will improve your own
inate testosterone production.


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And testosterone in itself is as a separate talk.


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Completely.


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But we know that testosterone
also can contribute to better erections


00:03:04:15 - 00:03:05:14
or poorer erections.


00:03:06:10 - 00:03:09:20
And so we want to do everything
that your body can do to improve


00:03:09:20 - 00:03:11:00
erectile function.


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And it's that simple. Workout, eat less.


00:03:15:03 - 00:03:18:20
Yes. And lose some weight. If you’re able to.


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Well I'm also a dietitian


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and so I'm very interested in this aspect.


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We always kind of hear
this broad, you know, eat less, move more.


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But I think it's really important
to really hone in on


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what are you actually eating less of?


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What are your suggestions
as far as the type of diet? For example,


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would you see better, erections with,


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someone who maybe follows
more of a vegetarian lifestyle?


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Maybe has a little bit
less saturated fat in the diet?


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Or is it the opposite?


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Are you seeing any kind of correlations
with the type of diet in particular?


00:04:01:14 - 00:04:03:19
Mediterranean diets have better erections.


00:04:04:07 - 00:04:06:15
And so less red meat,


00:04:06:15 - 00:04:09:15
more fish, more olive oil
more leafy greens.


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But but also allows you to indulge
a little bit and that's okay.


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And so there's nothing wrong
with enjoying what you want to have.


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I'm not telling people to deprive
themselves of what you want to have.


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You want to have your Double-Double?


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Enjoy that Double-Double.


00:04:22:13 - 00:04:26:23
But if the balance that out with
you know maybe having some more more leafy greens.


00:04:27:03 - 00:04:27:14
Yeah.


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You know
I need to give credit to my wife.


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She's a big proponent on celery juice.


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So she has celery juice every day.


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And I have celery juice every day.


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And I have an apple every day
for breakfast.


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And it has really powerful
antioxidant cleansing properties.


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And I think that overall it just creates
a really good mindset for health.


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And then you know I think that you know


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minimizing the red meat not eliminating
it is important.


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But also if you have other issues too,
I mean if you're a smoker you got to


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quit smoking.


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These are obvious things.


00:05:01:00 - 00:05:03:00
That I get are not easy.


00:05:03:00 - 00:05:04:23
But these are things
that you can eliminate.


00:05:04:23 - 00:05:07:22
And what's very funny
is that all of the patients saying


00:05:07:22 - 00:05:11:11
you know doc, I've never been motivated
to lose weight or exercise.


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I was like, well do you value
your erection?


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That can be very motivating.


00:05:16:16 - 00:05:17:14
If you value your erection,


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you got to do these things. Yes.


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You know, you can kiss your erection
goodbye I guarantee you that. Yes.


00:05:22:19 - 00:05:26:17
And so maybe, you know their wife's
been motivating him to work out.


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They won’t listen.


00:05:27:21 - 00:05:29:07
So the one thing that can get that


00:05:29:07 - 00:05:31:17
motivate is like,
well you want to save your erection?


00:05:31:17 - 00:05:33:11
Here’s what you have got to do. Right.


00:05:33:11 - 00:05:37:07
Well I think we're kind of in
a, you know, sort of a bro culture as well


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when it comes to protein consumption,
especially, animal protein consumption.


00:05:42:21 - 00:05:46:20
And there's been a lot of studies
to show that, that may contribute,


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having a great proportion of your diet
being animal protein.


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And I think in this country,
you go to any restaurant


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and half of your plate
is going to be animal protein.


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Do you think that that's
a direct contributor to the difficulties?


00:06:03:23 - 00:06:08:13
Obviously it you know, saturated fat, 
contributes to heart disease


00:06:08:13 - 00:06:13:11
it even contributes to diabetes, other age
related diseases and cancers.


00:06:13:11 - 00:06:13:22
Yep.


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So it has to be related, correct?


00:06:16:05 - 00:06:16:11
Yeah.


00:06:16:11 - 00:06:19:04
I mean, I think that it's really
what type of protein too.


00:06:20:03 - 00:06:22:22
You know there's
this you know there diets out there


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that really say oh if you just
maximize protein you're good.


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But it also doesn't take into account
that some of these proteins


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are rich in sodium
and saturated fats as well.


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So I think it's just all about you know
there's a lot of gimmicks out there.


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And I think that there's really what I try


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and portrayed in my clinic
is that I'm not gimmicky.


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I mean this is just there's
a, there's really it takes discipline.


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It takes effort and and it takes
not just diet, it takes


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also just being active and healthy.


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And you know I get it.


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There's also a genetic disposition
for some folks.


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I mean sometimes there are some folks
that just, you know,


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they do everything they can.
They just can't do it.


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But I think that overall
I think if someone is having


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a lot of red meat, 5 or 6 meals a week,
you know, that's, that's that adds up at some point.


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Because we know that


00:07:14:03 - 00:07:17:14
having an erection that's very much
dependent on cardiovascular health.


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And you know no one would argue


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that eating more red meat is good
for your cardiovascular health. Yes.


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I mean that's definitely not
that's definitely counterintuitive. Yes.


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But I think it's really not even just red
meat.


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It's the saturated fat itself.


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And you're getting that with pork


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and getting that with chicken
and especially with chicken.


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They're injecting it
with so much sodium too.


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I'm really big proponent of getting,
you know, organic meat.


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Whatever possible from a farmers market. Absolutely.


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And, you know, sometimes that's not


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you know,
there is a cost associated with that.


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But there's actually now ways


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of getting organic meats online,
not necessarily in a grocery store


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that makes it very cost effective too.


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Yeah, absolutely.


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And I think if we look at the blue zones,
you can see too that their diets are


00:08:03:13 - 00:08:08:19
primarily plant based and have, you know,
smaller amounts of saturated fat.


00:08:08:19 - 00:08:13:11
And these
these guys are living too well over 100. No smoking and excercising.


00:08:13:12 - 00:08:15:17
Like in Loma Linda and the Redlands. Yes


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I know Loma Linda's like kind of this
you know


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unique little pocket in the United States. Inland Empire.


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Yeah. Exactly.


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But they're one of the healthiest
you know.


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And they're mostly vegetarian and vegan,
which I think is really interesting.


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Now, you said exercise.


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What are your suggestions for exercise?


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Because we hear a lot of different things.
You should do


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steady state cardio.
No, no, no, that's not good.


00:08:42:08 - 00:08:43:21
You got to do strength training.


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What do you think is the best for men's
erectile health?


00:08:48:12 - 00:08:50:07
So I think all of it.


00:08:50:07 - 00:08:53:17
I think that cardiovascular exercise
though some moderate levels


00:08:53:17 - 00:08:55:13
are really getting your heart rate up.


00:08:55:13 - 00:08:58:06
I think that's critical
for having better erections.


00:08:58:06 - 00:09:00:08
You can't just focus in on strength.


00:09:00:08 - 00:09:02:06
That’s not really going to help your erections.


00:09:02:06 - 00:09:06:13
But I also think that building up muscle
mass is also important for testosterone.


00:09:06:13 - 00:09:10:09
So I think that if someone's able
to integrate all of it and blend it.


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I think that's a good option. Yeah.


00:09:13:04 - 00:09:16:03
What about like going back to gym
bro culture.


00:09:16:09 - 00:09:17:02
What about people


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who take a lot of supplements
or who may, you know, even take steroids?


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How does that affect?


00:09:23:04 - 00:09:25:08
Oh yeah. We you know, unfortunately.


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So I personally don't treat low
testosterone in my clinic but I used to.


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And a lot of what we saw was
that patients would come in


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saying I need testosterone.


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And you
look at them they don't need testosterone.


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They've got plenty of it.


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But now there's now been online pharmacies


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that have made testosterone therapy
a lot more easier to access.


00:09:48:03 - 00:09:52:21
And so it's very much about identifying
for the patients that truly needed it.


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And maybe some of the patients


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that are just maybe microdosing it or boosting
their own testosterone production.


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Because that absolutely


00:09:59:09 - 00:10:03:18
may have some downstream consequences
for their fertility and other issues.


00:10:04:22 - 00:10:08:11
You know,
so yes, it's all about looking big.


00:10:08:19 - 00:10:11:19
But sometimes you're looking big


00:10:12:07 - 00:10:15:09
externally at the expense
of maybe looking smaller down below.


00:10:15:09 - 00:10:17:10
And that's something
that you don't necessarily want.


00:10:17:10 - 00:10:21:22
So if they're taking testosterone
that could lead to ED?


00:10:21:22 - 00:10:25:03
Well, their erections or I mean their,
the testicles are definitely shrinking.


00:10:25:13 - 00:10:26:16
Whoa. Right.


00:10:26:16 - 00:10:30:18
So, I wouldn't say that that testosterone


00:10:30:23 - 00:10:34:12
supplementation
will impact their erections, but,


00:10:35:03 - 00:10:38:07
I think that it has downstream
cardiovascular


00:10:38:07 - 00:10:41:00
side effects that have to be factored in.


00:10:41:00 - 00:10:42:17
It’s not what's happening
to the erection now,


00:10:42:17 - 00:10:45:17
but what's happening to their erection
maybe five or ten years later.


00:10:45:17 - 00:10:47:11
Don’t know. Interesting.


00:10:47:11 - 00:10:48:14
And steroids,


00:10:49:16 - 00:10:51:23
that definitely contributes to ED?


00:10:51:23 - 00:10:55:20
No, it's definitely more related
to what happens to their fertility


00:10:56:04 - 00:10:59:04
and also just the overall impact
on their overall health.


00:11:00:01 - 00:11:01:18
And what, and what would that be?


00:11:01:18 - 00:11:04:09
So will definitely affect their fertility.


00:11:04:09 - 00:11:10:02
So if you take someone that is taking
testosterone, you suppress your own body's


00:11:10:02 - 00:11:13:04
ability to make testosterone
but also sperm production.


00:11:13:17 - 00:11:16:12
So it's governed
by the same pituitary axis.


00:11:17:16 - 00:11:21:06
Also you can have anabolic steroids
that can also impact


00:11:21:06 - 00:11:24:06
just overall health
including your cardiovascular health.


00:11:24:17 - 00:11:27:11
And it can lead to atherosclerosis
and other issues too.


00:11:27:11 - 00:11:27:20
Yeah.


00:11:27:20 - 00:11:31:12
That's why you're hearing about
you know the biggest gym bro's


00:11:31:12 - 00:11:35:06
having some like heart attacks
and dying at a young age.


00:11:35:08 - 00:11:40:14
I mean I just think that there's you know,
I mean, for ever people have found


00:11:40:14 - 00:11:45:19
ways of just, you know, doing things
to really not help their bodies.


00:11:45:22 - 00:11:46:10
Right.


00:11:46:10 - 00:11:51:17
But it's our job to kind of educate them,
that you can make your own choices.


00:11:51:17 - 00:11:53:18
But there may be some consequences
for what you do.


00:11:53:18 - 00:11:56:02
Absolutely. Well, let's shift it.


00:11:56:02 - 00:11:57:14
Let's talk about couples.


00:11:57:14 - 00:11:57:22
Yeah.


00:11:57:22 - 00:12:01:03
Let's talk about the communication
needed between couples,


00:12:01:15 - 00:12:04:12
especially if they are experiencing.


00:12:04:12 - 00:12:08:06
If the male male is partner
is experiencing ED.


00:12:08:06 - 00:12:11:21
What do you suggest for couples
to increase their communication?


00:12:12:01 - 00:12:15:01
So we always encourage couples


00:12:15:08 - 00:12:17:23
to at least come in if they can.


00:12:17:23 - 00:12:22:07
So what's more, often
the cases that the male will come in


00:12:22:22 - 00:12:26:05
and they won't tell their partner
about what's happening or,


00:12:27:01 - 00:12:30:01
they're just too ashamed to really
talk about it, but it actually took them


00:12:30:01 - 00:12:31:17
a while to even see us.


00:12:31:17 - 00:12:35:01
So we first congratulate them on coming in
to see us because that's a big step.


00:12:35:14 - 00:12:41:00
And then we talk about you know this is
not just about, you know a physical issue.


00:12:41:00 - 00:12:43:10
It's also involves
an emotional connection.


00:12:43:10 - 00:12:48:12
And so the best success are
the folks that come in that have a partner


00:12:48:12 - 00:12:51:12
that says, you know I'm willing to work
with you, I'm willing to,


00:12:51:13 - 00:12:54:08
you know, to kind of go with you
and not shame them.


00:12:54:08 - 00:12:54:19
Yeah.


00:12:54:19 - 00:12:57:00
Because we definitely have
some patients out there.


00:12:57:00 - 00:13:00:18
And it's just really, you know, it's
so unfortunate when they come and say,


00:13:00:18 - 00:13:03:18
you know, my wife is going to divorce me
because I can't just pleasure her.


00:13:03:18 - 00:13:04:23
Yeah. That's crazy.


00:13:04:23 - 00:13:08:10
I mean, that's really wild where,
you know, having pleasure.


00:13:09:02 - 00:13:11:04
You don't need to have penetration
for pleasure.


00:13:11:04 - 00:13:13:20
I mean, you know,
there's other ways of kind of doing this.


00:13:13:20 - 00:13:16:11
So it's very much awareness


00:13:16:11 - 00:13:20:04
from a couple standpoint to say,
look it's not just about getting it in.


00:13:20:04 - 00:13:22:09
I mean, you can figure this out. Yeah.


00:13:22:09 - 00:13:25:08
And so there's sometimes a lot of marriage
counseling that we have to do as well.


00:13:26:22 - 00:13:28:18
But if you have


00:13:28:18 - 00:13:32:14
the partner involved
and they're bought in


00:13:32:14 - 00:13:36:17
just helping their husband
or their boyfriend or whatever.


00:13:36:17 - 00:13:38:01
I think that's really helpful.


00:13:38:01 - 00:13:39:15
Yeah. Absolutely is.


00:13:39:15 - 00:13:43:06
But I think that a lot of, you know,
if they're partners,


00:13:43:19 - 00:13:47:11
they internalize it
as it being something wrong with them.


00:13:47:11 - 00:13:50:06
Or maybe they're not attractive anymore.


00:13:50:06 - 00:13:51:19
What do you suggest?


00:13:51:19 - 00:13:54:02
In that case,
I know you're treating the man,


00:13:54:02 - 00:13:56:02
but you're also treating the couple.


00:13:56:02 - 00:13:59:01
How do you encourage the other partner


00:13:59:10 - 00:14:02:01
to not necessarily take it personally?


00:14:02:01 - 00:14:03:08
Well, it's all about counseling.


00:14:03:08 - 00:14:06:08
I mean, we have to provide reassurance
that you know,


00:14:06:12 - 00:14:08:07
we have to review their medical history.


00:14:08:07 - 00:14:12:01
Maybe they have their prostate taken out
or they've had bad diabetes.


00:14:12:15 - 00:14:15:06
You know, it's not how they look.


00:14:15:06 - 00:14:17:02
It's not how sexy they are.


00:14:17:02 - 00:14:18:16
It's just a physiological issue.


00:14:18:16 - 00:14:20:10
It's no fault of their own.


00:14:20:10 - 00:14:22:23
It's just overall health.


00:14:22:23 - 00:14:26:20
And but there are some patients that are
maybe younger and you can provide data.


00:14:26:20 - 00:14:30:06
So you can give data to the patient
that they can give back to their partner.


00:14:30:08 - 00:14:34:12
And that can simply just be with a
penile ultrasound.


00:14:34:12 - 00:14:37:03
And that can just show physiologically
what's happening


00:14:37:03 - 00:14:38:19
with the arteries and veins. Yeah.


00:14:38:19 - 00:14:41:14
And they can just say
look you know I'm excited.


00:14:42:05 - 00:14:44:16
I really think that you're, I'm
sexually stimulated by you.


00:14:44:16 - 00:14:47:06
But I just can't do it
I mean it just my body won't let me.


00:14:47:06 - 00:14:52:02
And so once you kind of tell patients
and their partners and you educate them.


00:14:52:02 - 00:14:54:17
But I think that really helps
break down that barrier.


00:14:54:17 - 00:14:55:03
To say, all right,


00:14:55:03 - 00:14:55:22
Well what can we do?


00:14:55:22 - 00:14:57:01
How can we work through this?


00:14:57:01 - 00:14:59:07
Yes. And I see couples too


00:14:59:07 - 00:15:01:00
that experience this.


00:15:01:00 - 00:15:05:10
And I think what I tend to see
on the psychological end,


00:15:05:18 - 00:15:08:11
if there is that contributing factor,


00:15:08:11 - 00:15:11:23
not to say that the partner's doing
anything wrong or anything like that,


00:15:12:05 - 00:15:15:20
but oftentimes if there's stress
and strain in the relationship,


00:15:16:03 - 00:15:19:05
very poor communication skills,


00:15:19:05 - 00:15:22:05
a lot of,
you know, kind of volatile fighting


00:15:22:08 - 00:15:26:14
that can also lead to,
you know, difficulties in the bedroom.


00:15:26:14 - 00:15:28:10
And so I always encourage


00:15:28:18 - 00:15:31:23
all, all couples to go and seek


00:15:31:23 - 00:15:35:17
some psychological help as well,
especially if they're also doing,


00:15:36:02 - 00:15:39:14
you know, some medical treatments
because you can never,


00:15:39:20 - 00:15:44:03
you know, do harm if you're trying
to improve your communication.


00:15:44:04 - 00:15:44:08
Yeah.


00:15:44:08 - 00:15:46:01
I mean, if you're not communicating,
sometimes


00:15:46:01 - 00:15:48:04
we as urologists have to do a timeout.


00:15:48:04 - 00:15:49:13
We're not good about this.


00:15:49:13 - 00:15:52:10
We've had a couple
that's bickering in the clinic room.


00:15:52:10 - 00:15:55:10
And it's like, all right,
I'm going to back out of this room slowly.


00:15:55:13 - 00:15:56:18
You can send them to me.


00:15:56:18 - 00:15:58:00
Exactly (laughing)


00:15:58:00 - 00:15:58:23
I’m like, okay.


00:15:58:23 - 00:16:00:06
Lets, I think we need to take a break.


00:16:00:06 - 00:16:02:08
Yeah. And we need to talk about things.


00:16:02:08 - 00:16:04:12
But I'm not the best person
to talk about this.


00:16:04:12 - 00:16:06:17
But we have to identify those issues.


00:16:06:17 - 00:16:09:20
I say all right,
well I can do all these things,


00:16:09:20 - 00:16:11:17
but if you two aren’t getting along,


00:16:12:18 - 00:16:14:11
you know there's nothing that's
going to make this work.


00:16:14:11 - 00:16:15:20
Exactly. It’s not your erection


00:16:15:20 - 00:16:16:16
that's a problem.


00:16:16:16 - 00:16:17:08
Yeah.


00:16:17:08 - 00:16:20:00
There's other issues that are going on.


00:16:20:00 - 00:16:22:08
You know
if you guys really despised each other


00:16:22:08 - 00:16:24:19
how are you going
to get an erection? Exactly.


00:16:24:19 - 00:16:26:12
So working on their communication


00:16:26:12 - 00:16:29:12
together with a therapist
I think is super important.


00:16:29:20 - 00:16:32:06
Along with seeking
some medical treatments.


00:16:32:06 - 00:16:35:00
And speaking of which,
what are the advancements?


00:16:35:00 - 00:16:38:14
There's all sorts of new
and exciting treatments out there.


00:16:38:14 - 00:16:40:12
You've talked about the penile pump.


00:16:40:12 - 00:16:41:13
Is that what you call it?


00:16:41:13 - 00:16:42:11
Yeah, the penile implant, yeah.


00:16:42:11 - 00:16:43:16
Penile implant. What else?


00:16:44:10 - 00:16:47:01
There's cool things happening
in the penile implant space.


00:16:48:03 - 00:16:52:19
But also you know that's a quote unquote
very, would say extreme.


00:16:52:19 - 00:16:56:06
But that's for the patient
where nothing really is really working.


00:16:56:13 - 00:16:58:18
It's very rare when someone says I want a penile implant,


00:16:58:18 - 00:17:02:14
but they haven’t tried oral medications
or they haven't tried gels.


00:17:02:14 - 00:17:04:23
So oral medications, we all know them.


00:17:04:23 - 00:17:07:12
You know the little blue pills
they've been around.


00:17:07:12 - 00:17:08:12
They still work really well.


00:17:08:12 - 00:17:11:12
That is absolutely our first line therapy.


00:17:11:12 - 00:17:16:17
And for me at least, it's always worth
trying someone out on those medications.


00:17:17:20 - 00:17:20:08
And what do they do
exactly for people who don't know?


00:17:20:08 - 00:17:21:06
Just improves blood supply.


00:17:21:06 - 00:17:24:16
So, what it does is that it
relaxes the plumbing in the penis


00:17:24:16 - 00:17:28:05
to allow more blood to flow into the penis
a little bit more efficiently.


00:17:29:17 - 00:17:30:21
And just think about your erection


00:17:30:21 - 00:17:33:06
like being a really simple
but sophisticated bathtub.


00:17:33:06 - 00:17:35:09
And you need to have enough blood
flowing in.


00:17:35:09 - 00:17:38:08
But you need to have that stopper
that keeps the blood in place.


00:17:38:13 - 00:17:40:06
If you have a problem with the inflow,


00:17:40:06 - 00:17:42:12
or a leak in the outflow. That’s when you


00:17:42:12 - 00:17:46:07
start getting physiological or vascular
erectile dysfunction.


00:17:47:02 - 00:17:50:18
So what the medication does that
it just improves the inflow.


00:17:51:21 - 00:17:53:22
And so that's something that can be taken


00:17:53:22 - 00:17:56:22
either daily or it can be taken as needed.


00:17:56:23 - 00:17:57:22
There's no right or wrong answer.


00:17:57:22 - 00:18:01:00
That's where we talk about
you know, what are your lifestyle goals?


00:18:01:00 - 00:18:02:16
You know do you date frequently?


00:18:02:16 - 00:18:03:18
Do you have a set time?


00:18:03:18 - 00:18:07:03
Do you have a Friday night
that you always plan on having sex?


00:18:07:03 - 00:18:09:22
And you can kind of time
those things accordingly.


00:18:09:22 - 00:18:12:21
But, you also have to counsel patients
how to take it best.


00:18:12:21 - 00:18:13:06
Okay.


00:18:14:15 - 00:18:17:15
Beyond pills there's also gels.


00:18:17:16 - 00:18:19:05
There's topical gels.


00:18:19:05 - 00:18:22:18
There's actually now a medication
that just got approved


00:18:22:23 - 00:18:25:23
in the US that was available in Europe.


00:18:26:10 - 00:18:28:05
That's a topical as well.


00:18:28:05 - 00:18:28:16
Okay.


00:18:28:16 - 00:18:31:02
So that’s something for patients to keep an eye out as well.


00:18:31:02 - 00:18:33:16
And what do they do.
And so you put it on the penis.


00:18:33:16 - 00:18:36:21
And then theoretically
it allows an erection to happen.


00:18:37:03 - 00:18:38:16
How with. Yeah.


00:18:38:16 - 00:18:41:15
Just improved blood supply. Interesting.


00:18:41:15 - 00:18:43:09
And so that's on the horizon.


00:18:43:09 - 00:18:45:19
And then there's also injectable therapy.


00:18:45:19 - 00:18:48:14
So injection
therapy has actually been around


00:18:48:14 - 00:18:50:18
for a long time
even before oral medications.


00:18:50:18 - 00:18:54:01
So you actually inject your penis
with a very very small needle.


00:18:55:03 - 00:18:56:16
Just before you want to have sex.


00:18:56:16 - 00:19:00:03
And then it goes directly to the target
the penis.


00:19:00:03 - 00:19:02:04
And it makes the blood vessels relax.


00:19:02:04 - 00:19:04:11
More blood to flow in. And it works.


00:19:04:11 - 00:19:09:05
So it really works well in certain
patients where pills just don't work.


00:19:09:05 - 00:19:12:09
And patients who aren't afraid
of needles on their penises.


00:19:12:09 - 00:19:13:07
That’s the biggest thing.


00:19:13:07 - 00:19:16:01
It comes to us to, to decide, you know,
is this person.


00:19:16:01 - 00:19:17:04
So we teach them first.


00:19:17:04 - 00:19:19:02
And we do a diagnostic injection.


00:19:19:02 - 00:19:20:14
If they're needle phobic,
it's not going to


00:19:20:14 - 00:19:22:10
we're not going to be friends, we just can’t do it.


00:19:22:10 - 00:19:25:10
And that's someone that we maybe have to
talk about doing a penile implant on.


00:19:25:16 - 00:19:26:07
Okay.


00:19:26:07 - 00:19:29:05
And lastly
there is new things like stem cells.


00:19:29:05 - 00:19:31:07
And there's also shockwave therapy.


00:19:31:07 - 00:19:34:20
So shockwave
therapy is now gaining some traction.


00:19:34:20 - 00:19:37:18
There are some clinics out there
that are doing this


00:19:37:18 - 00:19:39:12
not necessarily run by urologists.


00:19:39:12 - 00:19:42:12
So you have to, you know, for any patients
that are listening,


00:19:42:20 - 00:19:46:14
you have to really make sure
where you're going


00:19:46:14 - 00:19:49:14
and what their training is
and what type of machine they have,


00:19:49:16 - 00:19:51:23
because there are some people
that would just sell you the world,


00:19:51:23 - 00:19:54:23
and then it's really expensive
and it's just not going to be effective.


00:19:55:02 - 00:19:57:13
There's a few machines out there
that may be effective.


00:19:57:13 - 00:19:58:12
What is this supposed to do?


00:19:58:12 - 00:20:01:12
So what it does is that it's
my it's just shockwaves are meant


00:20:01:12 - 00:20:04:12
to actually stimulate
new blood vessels to grow.


00:20:04:20 - 00:20:06:17
So by actually stimulating new blood


00:20:06:17 - 00:20:08:22
vessels to grow,
you can make the penis healthier.


00:20:08:22 - 00:20:12:20
So you know that's also something
there still trials out there


00:20:12:20 - 00:20:16:15
investigating the durability
of these treatments.


00:20:16:23 - 00:20:18:15
But there are some promising results.


00:20:18:15 - 00:20:20:20
Right. In certain patient populations. Okay.


00:20:20:20 - 00:20:24:09
So you know there's exciting things
happening in the regenerative space


00:20:24:09 - 00:20:27:01
including shockwave therapy
where you know,


00:20:27:01 - 00:20:30:06
can we do something beyond Band-Aids
like pills?


00:20:30:06 - 00:20:34:03
I mean, can
we actually allow tissue to be healthier?


00:20:35:05 - 00:20:37:05
Well tell me a little bit more about stem cells.


00:20:37:05 - 00:20:39:03
How is that used?


00:20:39:03 - 00:20:42:03
So stem
cells have been studied for decades.


00:20:42:15 - 00:20:46:10
What's really interesting is that
there really hasn't been a lot of traction


00:20:46:10 - 00:20:49:10
in the erectile dysfunction space
in a meaningful way.


00:20:49:16 - 00:20:52:18
They're going to have some clinics
that will inject stem cells


00:20:52:18 - 00:20:55:08
and they'll promise oh this is going
to make your erection great.


00:20:55:08 - 00:20:58:06
So $5,000 later what's going to happen?


00:20:58:06 - 00:20:59:00
Nothing.


00:20:59:08 - 00:21:02:11
Or, there are some patients
that have an anecdotal success.


00:21:02:22 - 00:21:06:22
But, there have been
no trials to show in a meaningful way


00:21:07:08 - 00:21:11:11
that it's better than the placebo
or durable beyond X number of months.


00:21:12:02 - 00:21:15:02
Do you think there will be a time?


00:21:15:04 - 00:21:18:22
There may be a time
where they just find a way to keep


00:21:18:22 - 00:21:23:17
the stem cells in place,
to actually sustain the the target organ.


00:21:23:19 - 00:21:27:17
But right now, we're still having some
issues with the durability of stem cells.


00:21:28:00 - 00:21:30:06
Interesting.


00:21:30:06 - 00:21:32:23
So what are your suggestions


00:21:32:23 - 00:21:37:12
for men in overcoming the stigma of ED?


00:21:37:12 - 00:21:41:21
We talked a little bit about that before,
but what are your main takeaway points


00:21:41:21 - 00:21:45:19
to anyone out there
who might be suffering from this?


00:21:45:19 - 00:21:48:20
Suffering in silence
because they're ashamed?


00:21:49:07 - 00:21:53:13
So, suffering in silence is a really, really great term
because men suffer in silence


00:21:53:13 - 00:21:55:02
from a lot of things. Yes.


00:21:55:02 - 00:21:56:06
Erectile dysfunction.


00:21:56:06 - 00:21:59:00
Urinary issues, urinary leakage.


00:21:59:00 - 00:21:59:18
You know, you're you're


00:21:59:18 - 00:22:03:05
just kind of being a man to persevere
through this and just deal with it.


00:22:03:16 - 00:22:06:16
I think that, the first step for any male patient


00:22:07:00 - 00:22:09:15
that is experiencing
just something that just doesn't feel


00:22:09:15 - 00:22:11:09
right is they should seek out
medical care.


00:22:11:09 - 00:22:11:21
Yeah.


00:22:11:21 - 00:22:15:06
Because that could be an indicator
that there's something amiss.


00:22:15:09 - 00:22:19:08
And then it's our job
as medical professionals to discern.


00:22:19:08 - 00:22:19:21
All right.


00:22:19:21 - 00:22:22:10
Well what's going on?
What's that underlying issue?


00:22:22:10 - 00:22:24:05
How can we solve this for you?


00:22:24:05 - 00:22:26:02
Because there's great
treatment options out there


00:22:26:02 - 00:22:28:12
I mean there's
a really really good treatment options.


00:22:28:12 - 00:22:31:22
And now the good thing
about kind of the internet is that


00:22:31:23 - 00:22:35:07
that there's now
more direct to patient access just online.


00:22:35:08 - 00:22:37:23
I mean you don't necessarily
have to go to a doctor's office.


00:22:37:23 - 00:22:42:05
I mean you can just go see us via telemedicine
and we can talk about these issues.


00:22:42:05 - 00:22:44:21
I mean, I don't
necessarily need to do a physical exam


00:22:44:21 - 00:22:47:08
to understand the problem
and to try something.


00:22:47:08 - 00:22:49:12
Yeah. You may need that eventually. Yeah.


00:22:49:12 - 00:22:52:08
But as a first encounter,
we can just talk about things. Yeah.


00:22:52:08 - 00:22:56:09
I feel like, you know, you'd be better
served seeing you than we can do that.


00:22:56:09 - 00:22:57:23
So we can kind of quarterback things.


00:22:57:23 - 00:23:01:03
But we really want to let patients


00:23:01:03 - 00:23:04:05
know that they should not feel afraid
to seek out care.


00:23:04:05 - 00:23:05:14
I mean that's number one.


00:23:05:14 - 00:23:09:02
Because there's absolutely
you know there's great treatment options


00:23:09:02 - 00:23:10:09
that are now inexpensive.


00:23:10:09 - 00:23:11:12
I mean that's the other thing too


00:23:11:12 - 00:23:14:13
is that while these medications
have become generic and it's just now


00:23:14:13 - 00:23:17:13
very inexpensive
to try these medications out.


00:23:17:20 - 00:23:21:08
Even for people without insurance,
I know there's so many people out there


00:23:21:08 - 00:23:23:08
who don't have medical insurance. Absolutely.


00:23:23:08 - 00:23:26:08
And we you know, I take care of patients
rich and poor.


00:23:26:08 - 00:23:28:02
And I always tell patients


00:23:28:02 - 00:23:31:18
I don't care how rich you are, but I don't
want you paying X for these medications.


00:23:31:18 - 00:23:32:18
I can give you a coupon.


00:23:32:18 - 00:23:35:06
I'll make it Y so much cheaper.


00:23:35:06 - 00:23:38:22
And if you really feel compelled
to pay that out of pocket,


00:23:39:10 - 00:23:41:04
just give me the difference
and I'll give you that.


00:23:41:04 - 00:23:42:22
So I really don't want people


00:23:42:22 - 00:23:45:09
spending a lot of money on this,
because you don't have to anymore.


00:23:45:09 - 00:23:48:09
You can get to this at any pharmacy
for a reasonable cost.


00:23:48:09 - 00:23:50:20
And then there's online pharmacies
that are very reputable,


00:23:50:20 - 00:23:53:05
and you can get those as well. Okay.


00:23:53:05 - 00:23:56:21
So there is you know, 
there are a lot of options for people,


00:23:57:04 - 00:23:59:10
especially if they were to come to you
personally.


00:23:59:10 - 00:24:00:13
It sounds like you.


00:24:00:13 - 00:24:01:11
Cost should not be a barrier.


00:24:01:11 - 00:24:04:04
I mean, that's number one.
Cost should not be a barrier.


00:24:04:04 - 00:24:07:20
I think that that's a reassuring thing
for a lot of people to hear,


00:24:08:03 - 00:24:12:22
because access to health care,
I think is a big problem for many people.


00:24:13:06 - 00:24:17:04
What we need is more folks like you that are willing
to talk about this because, yes,


00:24:17:10 - 00:24:20:18
you know, there's enough urologists,
but there's not enough mental health


00:24:20:18 - 00:24:24:19
professionals that are really trained
to talk about sexual dysfunction.


00:24:25:03 - 00:24:28:20
I mean they’re really, really important in someone's care.


00:24:28:20 - 00:24:30:07
Absolutely.


00:24:30:07 - 00:24:33:05
So, let's talk about,


00:24:33:05 - 00:24:36:09
how people can get in touch with you.


00:24:36:09 - 00:24:38:11
How how can they work with you?


00:24:38:11 - 00:24:41:23
So they can just access, access me via
the USC website.


00:24:41:23 - 00:24:45:15
So there's a great portal online where
you can schedule appointments online.


00:24:46:04 - 00:24:50:03
And then there's also just 1-800-USC-CARE.


00:24:50:06 - 00:24:56:02
Our our urology office
which is (323) 865-3700.


00:24:56:14 - 00:24:58:22
Just ask to speak to my scheduler
who's Rene.


00:24:58:22 - 00:25:01:02
And they can facilitate an appointment.


00:25:01:02 - 00:25:04:02
Now say for the people
who are not in California,


00:25:04:09 - 00:25:09:11
is there like a national center
that they can go to for more information?


00:25:09:22 - 00:25:12:07
And for ways to find help?


00:25:12:07 - 00:25:14:22
So there's a great website
that's called ED Cure.


00:25:15:09 - 00:25:16:03
ED Cure.


00:25:16:03 - 00:25:20:15
And that has a really great list
of urologists that are specifically


00:25:20:15 - 00:25:25:07
trained to offer the gamut in erectile
dysfunction treatments, including surgery.


00:25:25:12 - 00:25:26:20
And that'll be a great perk.


00:25:26:20 - 00:25:28:16
That's a great place to start.


00:25:28:16 - 00:25:31:16
Wow. Okay. Lots of options for you guys.


00:25:31:16 - 00:25:34:09
We have some time right now to open up,


00:25:34:09 - 00:25:37:17
to our audience
for some questions for Doctor Jeff.


00:25:38:01 - 00:25:39:22
Does anyone have any?


00:25:39:22 - 00:25:41:06
Yes. Come on.


00:25:41:06 - 00:25:43:22
Whoever the mic is, right there.


00:25:46:18 - 00:25:49:06
Hi. Thank you for the great talk, doctor Loh-Doyle,


00:25:49:06 - 00:25:51:16
I have a few questions
regarding the penile implant.


00:25:51:16 - 00:25:52:04
Sure.


00:25:52:04 - 00:25:55:21
It seems like it's very effective
and a great solution.


00:25:55:21 - 00:25:58:18
Are there any patients
that cannot receive this implant?


00:25:58:18 - 00:26:01:05
And is there any age, restriction?


00:26:01:05 - 00:26:04:22
Can, someone that's 30 receive
the same implant that someone that 70?


00:26:05:18 - 00:26:06:22
Great questions. Yeah.


00:26:06:22 - 00:26:09:20
So what are the countra
indications to a penile implant?


00:26:09:20 - 00:26:12:17
So anyone that has an active skin
infection


00:26:12:17 - 00:26:14:16
should not receive a penile implant.


00:26:14:16 - 00:26:16:00
But for the most part,


00:26:16:00 - 00:26:20:02
a penile implant can be placed in anyone
that has erectile dysfunction.


00:26:20:04 - 00:26:20:18
It's number one.


00:26:20:18 - 00:26:23:17
So that you have to make sure
that they have erectile dysfunction.


00:26:24:04 - 00:26:26:23
And you bring up a quick question
about the younger patient.


00:26:26:23 - 00:26:28:14
So we have some patients.


00:26:28:14 - 00:26:31:22
If they have strictly psychogenic
psychological ED


00:26:32:05 - 00:26:33:23
you want to be absolutely sure


00:26:33:23 - 00:26:38:19
that they also have a vascular issue
as well because a penile implant is great.


00:26:39:08 - 00:26:42:05
But if you're young
these are mechanical devices.


00:26:42:05 - 00:26:46:07
What happens to every mechanical device
with time? It can have a failure rate.


00:26:46:07 - 00:26:49:07
So if you’re young we’re now almost guaranteeing


00:26:49:07 - 00:26:52:17
someone that they may require
numerous operations in their lifetime.


00:26:52:22 - 00:26:57:01
So you want to be absolutely sure
that they also have a vascular component about it.


00:26:57:01 - 00:26:58:17
So that it's where we almost


00:26:58:17 - 00:27:02:16
we try these younger patients
on every single type of treatment option.


00:27:02:16 - 00:27:03:05
We'll do a


00:27:03:05 - 00:27:07:07
penile ultrasound just to confirm
that there is an actual vascular issue.


00:27:07:07 - 00:27:09:23
And then we'll decide
okay after appropriate counseling.


00:27:09:23 - 00:27:10:06
All right.


00:27:10:06 - 00:27:12:07
This is your best option.


00:27:12:07 - 00:27:14:21
Conversely is there an age limit?


00:27:14:21 - 00:27:18:08
I mean, the oldest person I've done
a penile implant on is 90.


00:27:18:21 - 00:27:21:12
Woah. Very healthy 90.


00:27:21:12 - 00:27:24:15
So it's very much dependent
on the health of the patient and the what


00:27:24:15 - 00:27:26:10
their body is able to tolerate.


00:27:26:10 - 00:27:29:14
Obviously, the older patients have to go
through appropriate anesthesia clearance


00:27:29:14 - 00:27:31:18
before we do
any sort of outpatient surgeries.


00:27:33:03 - 00:27:35:00
Oh 90.


00:27:35:00 - 00:27:36:08
Perfect.


00:27:36:08 - 00:27:40:13
With the penile implant, can it increase
the size of the penis as well? Or?


00:27:40:17 - 00:27:42:08
So that's the million dollar question.


00:27:42:08 - 00:27:44:23
If I could increase someone's penile size.


00:27:44:23 - 00:27:47:00
You'd be a very rich man.


00:27:47:00 - 00:27:48:14
I'd be very wealthy.


00:27:48:14 - 00:27:51:18
So that is probably the second
most common question I get.


00:27:51:18 - 00:27:54:17
Is that's, okay, that’s cool and all,
but can you make my penis bigger?


00:27:54:17 - 00:27:57:12
so I can’t make it bigger than what
God gave you, all right.


00:27:57:12 - 00:27:58:18
There are things


00:27:58:18 - 00:28:01:18
and there are surgeons out there
that can maybe make girth better.


00:28:01:22 - 00:28:02:15
There's actually now


00:28:02:15 - 00:28:05:15
fillers that have become available
that are quite good and safe.


00:28:05:21 - 00:28:09:20
There's also another implant
that also has had some success.


00:28:11:03 - 00:28:13:08
But the implant itself
that we're talking about,


00:28:13:08 - 00:28:16:20
the inflatable implant, is strictly
to give you an erection.


00:28:17:15 - 00:28:20:15
It's meant to inflate, deflate,
to give you a functional erection.


00:28:21:02 - 00:28:25:03
So when I counsel a patient,
as I can't guarantee any size outcomes


00:28:25:03 - 00:28:26:18
except for that, I'm
going to do my absolute


00:28:26:18 - 00:28:30:03
best to give you the largest implant
that your penis can fit.


00:28:30:16 - 00:28:32:15
If you're a size 12 shoe


00:28:32:15 - 00:28:35:15
and you want a size 14 shoe,
you're not going be able to run on that.


00:28:35:20 - 00:28:38:23
So I always tell someone,
we have to give you what fits properly,


00:28:39:04 - 00:28:40:04
what your anatomy allows.


00:28:41:17 - 00:28:43:11
Yea, and one last question,


00:28:43:11 - 00:28:45:12
Regarding prostate cancer treatment.


00:28:45:12 - 00:28:47:18
I know it's very common for people
to experience,


00:28:47:18 - 00:28:49:21
erectile dysfunction
after prostate cancer surgery.


00:28:49:21 - 00:28:53:22
Is there an appropriate time
for men to seek help?


00:28:53:22 - 00:28:56:11
Should he wait one year after surgery?


00:28:56:11 - 00:29:00:07
Or, is there any signs
that were taken to a urologist beforehand?


00:29:00:13 - 00:29:03:13
My suggestion for anyone
is that they should see


00:29:03:13 - 00:29:06:18
a urologist
that specializes in erectile dysfunction.


00:29:06:18 - 00:29:11:04
Even before the prostate gets taken out,
to discuss rehabilitation strategies.


00:29:11:11 - 00:29:14:00
So there are strategies available
for patients


00:29:14:00 - 00:29:17:16
after the prostate
is taken out to make the penis healthier.


00:29:17:16 - 00:29:20:22
Now, it can take anywhere
between six months to two years


00:29:20:22 - 00:29:22:07
for erections to come back.


00:29:22:07 - 00:29:24:09
And there's no guarantee in some patients.


00:29:24:09 - 00:29:29:07
So what can you do to maximize the success
or likelihood of recovery?


00:29:29:07 - 00:29:30:23
Well, there are some medications you can take.


00:29:30:23 - 00:29:32:16
There's exercises you can do.


00:29:32:16 - 00:29:34:04
There's supplements that you can take.


00:29:34:04 - 00:29:36:10
You can use vacuum erection devices.


00:29:36:10 - 00:29:41:08
So if you have in your practice
the ability to, to see someone


00:29:41:08 - 00:29:46:00
besides the prostatectomy, besides that
oncologist who also just specializes


00:29:46:00 - 00:29:49:17
in what we do, I think it's very helpful
because you can also involve the partner.


00:29:49:17 - 00:29:54:06
I mean, it's very much gets them involved,
but also sets realistic expectations,


00:29:54:06 - 00:29:55:01
which I think is critical.


00:29:56:02 - 00:29:57:08
Wow. Okay.


00:29:57:08 - 00:30:00:08
I think we have time
for one more question.


00:30:01:18 - 00:30:03:00
Hi. In keeping with,


00:30:03:00 - 00:30:06:00
the penile implant,
you mentioned, you've done


00:30:06:03 - 00:30:09:00
implanted them on someone
up to 90 years old.


00:30:09:00 - 00:30:11:21
But what is this shelf
life of a penile implant?


00:30:11:21 - 00:30:15:19
So 10 to 15 years
is what I quote patients.


00:30:15:19 - 00:30:17:10
But that's with normal use.


00:30:17:10 - 00:30:21:01
Now, that's very much dependent
on what normal use is.


00:30:21:13 - 00:30:25:01
We have some folks that are using it daily
and they're using it.


00:30:25:08 - 00:30:26:13
Congratulations to them.


00:30:26:13 - 00:30:29:13
If you're using that you may break it
sooner. (laughter)


00:30:29:13 - 00:30:31:13
If it breaks? Then you fix it.


00:30:31:13 - 00:30:33:18
So it's really your penis won't fall off.


00:30:33:18 - 00:30:35:13
It just won't stop,


00:30:35:13 - 00:30:36:10
the penile implant stops working.


00:30:36:10 - 00:30:38:06
You just replace the parts.


00:30:38:06 - 00:30:41:06
The penile implant
hasn't really changed much in


00:30:42:01 - 00:30:45:04
that I'm aware of in the past
40 or 50 years that it's been around.


00:30:45:05 - 00:30:47:05
Yeah.
What is the future of the penile implant?


00:30:47:05 - 00:30:50:05
Are we ever going to have a remote control
penile implant?


00:30:50:05 - 00:30:53:01
App powered? Pumping it up the old fashioned way? 


00:30:53:01 - 00:30:55:04
So that's going to be happening
sooner than you think.


00:30:55:04 - 00:30:59:08
So there's absolutely things
heading in the right direction


00:30:59:08 - 00:31:01:05
to make it as you would envision.


00:31:01:05 - 00:31:03:11
Wouldn't it be cool if you could have


00:31:03:11 - 00:31:06:21
something that's controlled with an app
that is on demand?


00:31:06:21 - 00:31:09:13
That will just be a little bit
more spontaneous.


00:31:10:04 - 00:31:14:03
So keep your eyes out because it's
definitely, definitely happening.


00:31:14:12 - 00:31:15:17
Might be good for the couples


00:31:15:17 - 00:31:18:17
because they're on the Apple
phone and say, hey, yeah, let's go.


00:31:18:19 - 00:31:20:01
Yeah, yeah.


00:31:20:01 - 00:31:22:13
Or female controlled. Exactly.


00:31:22:13 - 00:31:23:05
It's time. 


00:31:23:05 - 00:31:24:20
And in my final question,


00:31:24:20 - 00:31:25:15
you mentioned a lot of


00:31:25:15 - 00:31:28:15
younger men with erectile dysfunction.


00:31:29:09 - 00:31:33:03
Do you see a lot of patients
that are experimenting with ED drugs,


00:31:33:03 - 00:31:36:03
and that's also contributing
to their erectile dysfunction?


00:31:36:04 - 00:31:37:05
That's a really good question.


00:31:37:05 - 00:31:40:07
So are people just taking it for sport
rather than necessity?


00:31:40:17 - 00:31:41:11
Absolutely.


00:31:41:11 - 00:31:45:15
I can think about three or four of my friends that do that, so, (laughter)


00:31:45:15 - 00:31:49:14
you know, and that's where it comes
out of the dating culture now. Yes.


00:31:49:15 - 00:31:53:10
You know, there are options
where you can meet lots of people quickly.


00:31:53:22 - 00:31:57:02
But if you want to be like the guy
every single time,


00:31:57:12 - 00:31:59:12
you know, there is some pressure


00:31:59:12 - 00:32:02:18
where you actually feel like
I got to perform every single time.


00:32:02:18 - 00:32:06:15
New partners, new experiences, and
you want to leave that lasting impression.


00:32:07:00 - 00:32:11:01
So absolutely, I think that
because medications are easier to access


00:32:11:01 - 00:32:14:10
and they're cheaper now, you know,
you definitely people taking for sport.


00:32:14:19 - 00:32:17:13
But at some point
does that create a dependency


00:32:17:13 - 00:32:19:17
whether it's either physiologic or mental.


00:32:19:17 - 00:32:23:13
So we do have the sometimes uncoach


00:32:23:13 - 00:32:28:14
that we have to get people out of those
dependent those dependencies. Yes.


00:32:28:18 - 00:32:30:06
You're probably seeing that as well.


00:32:30:06 - 00:32:31:13
Oh yeah. Absolutely.


00:32:31:13 - 00:32:32:17
Yeah. Yeah.


00:32:32:17 - 00:32:35:04
My question is, along similar lines.


00:32:35:04 - 00:32:36:14
Great talk, by the way.


00:32:36:14 - 00:32:39:00
What what do you notice when


00:32:39:00 - 00:32:43:02
people, that are younger,
they go on websites such as Him’s


00:32:43:10 - 00:32:47:08
to get a prescription
for Cialis or, Viagra?


00:32:47:08 - 00:32:50:23
And how do you think that has impacted
the overall culture


00:32:50:23 - 00:32:53:22
behind ED and seeking a urologist?


00:32:54:00 - 00:32:57:23
I would say that it's really made access
to care easier.


00:32:58:03 - 00:32:58:18
Yeah.


00:32:58:18 - 00:33:01:21
And it's this destigmatize
these medications for good and bad.


00:33:01:21 - 00:33:02:13
Yeah.


00:33:02:13 - 00:33:05:13
Because it has made things
more accessible.


00:33:05:22 - 00:33:08:01
I'm not going to go into costs.
People should just do their own due


00:33:08:01 - 00:33:11:00
diligence when it comes to these medications.


00:33:11:00 - 00:33:13:17
But what I would say is, is that


00:33:13:17 - 00:33:16:07
medications are very easy to access now.


00:33:16:07 - 00:33:16:19
Yeah.


00:33:16:19 - 00:33:19:19
At a very reasonable rate
from pharmacies here.


00:33:20:20 - 00:33:24:22
But I would congratulate those websites
for at least raising awareness.


00:33:25:03 - 00:33:29:03
And kind of making us even busier
because.


00:33:29:07 - 00:33:31:20
Yeah. You know there are some patients
for medications don’t work.


00:33:31:20 - 00:33:35:14
And so if things don't work
then they have to come to us


00:33:35:14 - 00:33:37:07
for a little bit
more of a different option.


00:33:37:07 - 00:33:39:19
Yeah I actually think
it's a really good thing.


00:33:39:19 - 00:33:41:23
I think it helped to reduce the stigma.


00:33:41:23 - 00:33:44:23
I think people feel more comfortable
oftentimes


00:33:45:04 - 00:33:48:17
seeking that out at home first
and then trying that out.


00:33:48:17 - 00:33:52:12
And if it doesn't work, then
I think that it they're they're fueled


00:33:53:00 - 00:33:54:19
then to go further.


00:33:54:19 - 00:33:56:23
So I think it's a really good thing.


00:33:56:23 - 00:33:59:07
And I think what you're doing
is a really, really good thing.


00:33:59:07 - 00:33:59:17
Thank you.


00:33:59:17 - 00:34:02:21
You as. Well. And,
we are out of time now.


00:34:02:21 - 00:34:06:11
And this was a really fascinating episode
for me.


00:34:06:11 - 00:34:09:15
And I think hopefully
people got a lot out of this.


00:34:09:22 - 00:34:12:01
And we can reduce that stigma.


00:34:12:01 - 00:34:14:14
We can get people in, we can get help


00:34:14:14 - 00:34:18:14
because there's plenty out there
and a lot more on the horizon.


00:34:19:00 - 00:34:23:08
So thank you so much, Doctor Jeff,
for coming and speaking with us today.


00:34:23:11 - 00:34:25:13
Thank you very much. Absolutely.


00:34:25:13 - 00:34:27:01
And thank you all for joining me.


00:34:27:01 - 00:34:30:06
ANEW Body Insight podcast
here at City Club Los Angeles.


00:34:30:11 - 00:34:31:10
We are looking forward


00:34:31:10 - 00:34:34:15
to our next exciting interview
and we really hope you join us.


00:34:34:23 - 00:34:36:13
Thank you everyone for being here.


00:34:36:13 - 00:34:38:22
(clapping)


00:34:41:05 - 00:34:45:04
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00:34:45:04 - 00:34:48:15
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00:34:48:15 - 00:34:51:16
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