238. Testosterone - An Education

You Are Not Broken

Kelly Casperson, MD

Medicine, Health & Fitness

5 • 743 Ratings

🗓️ 19 November 2023

⏱️ 57 minutes

🔗️ Recording | iTunes | RSS

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Summary

238. Testosterone: An Education Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken Go to Addyi.com and use code NOTBROKEN for a $10 telemedicine appointment. Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN uberlube.com Dr. Khera lives in Houston, TX practices at Baylor and has dedicated his clinical and research efforts to three main areas: Men’s Health, sexual medicine, and hormone replacement therapy. His basic science and clinic experiences have allowed him to thus far give over 250 lectures at scientific meetings throughout the world, publish over 120 articles in peer-reviewed journals, complete 15 book chapters, and edit and write two books, all in the field of sexual medicine and Men’s Health. Why is testosterone so interesting to Dr. Khera? Testosterone and prostate cancer – what do we know. Is a lowering Testosterone in men "natural"? and if it isn’t, what causes low testosterone in men? What do the new weight loss drugs do to testosterone levels and male fertility? We discuss the different ways you can give testosterone to women: topical, pellets and compounded injectable doses of testosterone for women: 50mg/ml and start at 0.1 mg injected a week. The benefits of testosterone for women besides low libido. The role of chronic pain and testosterone and pain meds. The mechanism of how your testosterone goes up when you lose body fat. The four pillars of health for natural testosterone production – diet, exercise, sleep, stress reduction Erectile dysfunction is a harbinger for heart attack and heart disease. “There is not a better barometer of a man’s overall health than his sexual health” – Dr. Khera The role of DHEA (a mild androgen made in the adrenals) in men and women. The link with Peyronies disease and Testosterone. And we discuss penile stretching devices. We discuss a 2013 Finkelstein article – they gave men testosterone and blocked its conversion to estrogen. So are we undertreating men by not addressing their estrogen? Dr. Khera was part of the NEJM study that came out this summer looking at T in men with low T and high risk CV risk. The Traverse trial. Conclusions: In men with hypogonadism and preexisting or a high risk of cardiovascular disease, testosterone-replacement therapy was non-inferior to placebo with respect to the incidence of major adverse cardiac events. Barriers to a testosterone prescription include that it is a regulated medication, a physician needs a DEA license to prescribe it – similar to a narcotic. Dr. Khera lends his opinion to safe prescribing of testosterone but thinks the DEA regulation is here to stay. He clarifies the number of men who suffer from hypogonadism and the number of men who are undergoing treatment for this condition? Testosterone levels are dropping because men are getting less healthy. Dr. Khera talks about measuring a baseline testosterone level in men as a marker of overall health and focus on lifestyle changes to naturally get this normal. 50% of men don’t talk to their doctor about their erectile dysfunction, and 44% of those men don’t talk to their partner about it. www.instagram.com/drmohitkhera Dr. Mohit and Dr. Morgentaler’s testosterone course ⁠NEJM article discussed: Gonadal Steroids and Body Composition, Strength, and Sexual Function⁠ ⁠Traverse Trial https://drmohitkhera.com/ Did you get my “You Are Not Broken” Book Yet? https://amzn.to/3p18DfK Listen to my Tedx Talk: Why we need adult sex ed Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit megaphone.fm/adchoices

Transcript

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0:00.0	You are listening to You Are Not Broken, the only podcast that combines science, medicine, and psychology to re-educate your brain and help you live your best love life. And I'm your host, board-certified female urologist, Dr. Kelly Casperson.
0:16.2	Hey friends, I am super excited today to have on Dr. Kara, who is another urologist, and I love having
0:21.7	the urologist on the podcast. He lives in Houston, Texas, practices at Baylor, and is dedicated
0:26.5	his clinical and research efforts to treat three main areas, men's health, sexual medicine,
0:31.2	and hormone replacement therapy. So he's a shoe-in-natural for this podcast. His basic science
0:36.8	research, he's so well published, his 15 book
0:39.4	chapters, recently on the Peter Attia podcast, which now you have to put on your bio. And welcome to
0:45.5	the podcast. Thank you so much for having me on. Absolutely. So why is, we're going to jump in and start
0:50.8	talking about testosterone. Why is testosterone so interesting to you? It's been very interesting. You know, I think it's all started back in 2007 when I finished my
0:58.3	fellowship, and we were taught that testosterone is dangerous for prostate cancer. It's like putting fuel
1:03.7	on the fire. And I remember that. And I said to my mentor, I said, where's the article that
1:08.9	shows that it's dangerous? And what we found
1:11.9	was that there was no article. In fact, it started in 1941 by Huggins and Hodges and was based
1:17.3	on one patient that was a myth that said testosterone and causes prostate cancer. And so there was a lot
1:23.2	of unknowns with testosterone. There's a lot of fears, unnecessary fears. And more importantly, there's a lot of
1:30.4	people who benefit from testosterone. It has a profound impact on a patient's quality of life. So
1:35.4	it's always intrigued me. Yeah. I mean, I was taught the same thing in urology. Like,
1:40.1	the only Nobel Prize won by a urologist was the showing low T fuel to the fire of prostate cancer.
1:46.0	It was always that Nobel Prize that I think kept everybody from actually questioning that.
1:50.5	Kelly, based on one patient, by the way, 1941, one patient.
1:53.6	But, you know, I will say this, and this is important.
1:56.1	So many years we're taught that it's dangerous and then we started realizing maybe it's safe for prostate cancer
	...

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