Moore Style - Removing The Stigma of Erectile Dysfunction with Dr. Judson Brandeis

Episode Date: August 21, 2023

One of the top urologists and leaders in his field, Dr. Judson Brandeis, speaks to me this week about all things health and erectile dysfunction. I couldn’t believe the plethora of knowledge that Dr. Brandeis offered us and any man of any age could benefit from this episode. Stronger erections and hormonal health starts in your 20s and 30s but is maintained and supported later in life and there is so much men can do to support their overall health now. Like Dr. Brandeis said, if you have a stick and two balls this episode is for you!  In this week’s episode, we discuss: [1:15] About Dr. Judson Brandeis [3:50] What inspired Dr. Brandeis to focus primarily on men’s sexual health [6:44] The main reason why men don’t go to the doctor as often as women  [10:10] Why men are embarrassed to talk about erectile dysfunction  [12:56] What it means to take care of yourself in your early years and what that looks like  [26:48] Does cutting out alcohol and sugar lead to longer, harder erections?  [29:00] As men age does their testosterone lower naturally?  [30:21] Are men usually coming to you when they are at a severe point in their life?  [31:55] More explanation on ED  [39:06] Is a man’s obsession with a larger penis primarily impacted by locker room judgment?  [39:47] About the P Long Protocol  [42:02] Supplements Dr. Brandeis offers [48:54] Once you start testosterone, are you on it for life?  [51:42] What are other ways you help men with ED, other than the PRP protocol?  [55:57] Dr. Brandeis’s favorite date   Connect with Dr. Brandeis:  Website   Book  LinkedIn

Hi, everyone. I'm your host, Celeste Moore, and you are listening to the Down and Dirty podcast, aka the Double D's of dating. This is a podcast for navigating the ins and outs of modern midlife dating. Here, we will discuss the challenges that men and women face in today's dating world. Like many industries, this one is forever changing, and I believe this platform will help those who need or want it. Today, it is the best time to take control of your desired outcome, whether it is a marriage, significant other, life partner, or just to gain the confidence in dating once again. Every other week, we will dive in and talk about different viewpoints that seem to be challenges in today's dating arena. So let's get into today's episode.

Welcome everyone to another episode of the Down and Dirty podcast. As always, I am your host, Celeste Moore. But before we dive into today's episode, I would love to introduce my expert guest today is his name to me is Dr. Judson Brandeis. So Dr. Judson Brandeis is honored to have been voted the top urologist in the San Francisco Bay Area by San Francisco Magazine from 2014 to 2020. In February 2019, he opened his comfortable office in San Ramon, where he focuses his practice entirely on men's sexual health and rejuvenation. Dr. Brandeis, MD, is a national leader in technology and innovations in sexual medicine. Dr. Brandeis is the national director of clinical excellence for Gaines Wave and created and runs

the SWEET study, the largest study of shockwave therapy for ED ever performed. Dr. Brandeis created and directed five IRB approved clinical research protocols in sexual medicine, two of which are still active. So these include the SWEET study, the largest study of shockwave therapy treating erectile dysfunction. Dr. Brandeis is a national sexual medicine educator who has run weekend educational seminars all around the country and has created a male sexual medicine curriculum on teachable.com. He is the director of sexual medicine for the aesthetic show annual meeting in Las Vegas, as well as the author of advances in sexual medicine chapter for large Urology Group Practice Association textbook. As a native New Yorker, he left the Empire State to

attend Brown University to study history before attending Vanderbilt for medical school. He spent a year at Harvard Medical School doing research sponsored by the Howard Hughes Medical Institute. Finally, he has finished his formal medical training with two years of general surgery and four years of urology training at the world-famous UCLA Department of Urology. I, I really wanted to put out there where, where you've been, where you're coming from your plethora of knowledge so that everybody here can kind of understand a little bit more about you, but thank you again for jumping on the episode of me today. I feel very, yeah.

Thanks for having me. I appreciate it. Yes. Mainly my audience is men over 40, but I definitely have women who listen to this as well. So I feel that we really should be educated, you know, men and women currently about what's going on with men's health and their sexual health. So I know you studied and became a urologist and that's what you did. You focused for many years on and practice.

What I would really love to know is what kind of turned you in the direction of focusing mostly on men's sexual health, so on and so forth. Yeah. So I always like to be on the forefront of technology. So 2002, I helped pioneer surgical robotics routine. I helped pioneer MRI guided prostate biopsies. I built kidney stone centers. I was chief of urology at my hospital. And about four or five years ago, I learned about low intensity shockwave therapy for erectile dysfunction. So the ability to help men who can't get erections anymore, all of a sudden be able to get erections again, naturally. And so that was really kind of fired me up to be on the forefront of regenerative urology.

So helping men using low-intensity shockwave therapy, using platelet-rich plasma, using stem cells, all the new technologies to help men regain sexual function. Then as part of that, I became really interested in hormonal rejuvenation, physical rejuvenation, weight loss and all the things that kind of go towards helping men live healthier, better, happier lives. Yeah, that's amazing. I don't feel that there's enough focus on the man over 40. I feel that, you know, there's a ton of research that's done for, you know, female hormones and talking, you know, we're really open about what could we do to improve our, you know, length lifespan? What can we do to be healthy? What can we do to be beautiful? So it's like,

this is such a, I love that you are taking this initiative to educate men. Oh yeah. Men need help. Yeah. Like, and, and they need, they need help getting help. Right. I mean, you got to push men into the doctor's office, but the fact of the matter is a hundred years ago, women lived one year longer than men did. Now women live five years longer than men. Wow. Right. So what happened in the last hundred years? And even before COVID, the longevity of middle-aged men in the United States was actually declining. And it was declining because of what we call diseases of despair because of alcohol, because of opioids and because of suicide. Right. I mean, that's really horrible. That's what's going on with men's health. And if you

look at who goes to the doctor, women are twice as likely to go to their primary care physicians as men. Right. So, I mean, there are some really catastrophic developments in men's health. And if we don't take, you know, control of the information and provide that really good information to men and inspire men to live better, healthier lives, things are just going to get worse and worse. And that's sort of my mission is to help men live better, happier, healthier lives. Yeah, I love that. I really, really do. Why would you say in your experience, you talk about men, it's such a difficult, you know, like task to get to the doctor to do their checkups? I mean, why do you think that is? Yeah. So, you know, it's interesting. It's a great question you ask. So first of all, women are kind of more dialed in to doctors, right? Because a lot of women have babies, right? So they have, by the nature of delivering a baby, they have an obstetrician gynecologist. So they have a doctor that they know that if they have a urinary tract infection or

they have some issue, they have a touch point in the healthcare system. In addition, women are much more likely to take the kids to the pediatrician than their husbands are, right? So they actually know where the health insurance card is. Maybe they even know a little bit about health insurance. Whereas I had a patient the other day who is a nuclear physicist at Lawrence Livermore labs because the lab isn't too far from my office. And this guy had no idea whether he had an HMO or a PPO. Oh my gosh. Right. So he's like splitting atoms for a living, but he doesn't know the

difference between an HMO and a PPO in terms of health insurance. And so that's the, that's the situation that men find themselves in. And the thing is like, for the most part, men don't need that much up until age 40 in terms of, of you know, care from a doctor, you know, there's, You go to a checkup when you're 30, 35 years old, what's your doctor's going to do? He's going to tell you you're pretty healthy. Yeah, that makes a good point. And they wouldn't unless they were sick

or, you know, some other issue that would come along the way, but not as far as regular healthcare maintenance. Yeah, I mean, it's, you know, at that point, it's really all about knowledge and preventative healthcare, right? Because the things that you do in your 20s and 30s and 40s, really blossom in your 50s and 60s and 70s. So if you're taking

good care of yourself in your 20s and 30s and 40s, you're going to have a great 50s and a great 60s and a great 70s. And if you're not taking good care of yourself in your 20s and 30s and 40s, you're going to have a rough 50s and 60s and 70s. You're going to be overweight. You're going to be sedentary. You're going to have erectile dysfunction. You're going to have all these bad things happen to you. And so that's, that's sort of part of my mission is to help educate people. And I even wrote a book, this 21st century man is the most comprehensive and medically accurate men's health book ever written. It's over 900 pages, 101 chapters on every aspect of men's health for preventing any of the major problems that men have in their fifties and

60s and 70s okay you all heard that right the 21st century man 21st century man the 21st century man go buy that it's a bible it is randy hetrick the the guy that invented trx calls it the dude bible the dude bible i love it it's perfect yes there needs to be more like that's perfect let's pick it up any question you have you know if you don't want to actually go into the doctor but you should read the dude Bible. I love it. Well, I, I think that, you know, I guess you kind of answered one of my questions, but I'm still going to kind of preface it in a different way. I, in your expertise, why do you feel that men are embarrassed talking about ED, let alone, would they even know what the symptoms were as they get older to, to basically come see

you, a urologist to say, well, doc, what's going on? Yeah. I mean, you know, men's virility is, is a central part of who they are. And so a lot of guys will be in denial that, and then, you know, the thing is sometimes things work well, and sometimes things don't work so well. And a lot of guys don't quite understand why that is. But for example, if you were playing in the club tennis championships, right? Would you play that tennis match at 11 o'clock after a big meal and a half a bottle of wine? No, of course not. But when do, when do a lot of guys, you know, have physical intimacy? Well, they'd have it at that time. So, you know, if things aren't working at 11 o'clock at night after a big meal and a half a bottle of wine, but then, you know, two days later,

intimate with your partner at eight o'clock in the morning and things work great. And then you're like, well, then I don't have a problem because things work just fine at that point. But this is a really essential part of understanding erectile dysfunction and what it really means. And this is the reason I don't like all these online pill dispensing companies, because erectile dysfunction is a critical sign that your circulatory system isn't working as well as it should. So, for example, in your 20s and 30s, you're getting great morning erections, but sometime in your late 30s or your early 40s, you wake up and your morning friend isn't there, right? So you're not getting morning erections. That means that your circulatory system isn't functioning as well as it did when

you were younger. Okay. 10 years after that, you're going to be intimate with someone and your penis isn't going to work as well as it should. Now that's a really big warning sign that your circulatory system isn't working as well as it should. And 10 years after that, you may have a heart attack or you may have a stroke or you may need a heart stents. And the timing of that is pretty consistent. And so if you don't realize that there are some lifestyle changes that you need to make because you have erectile dysfunction, you're missing an opportunity to help prevent your first heart attack. So I know you said, yeah, that's huge because it's like you said in your twenties and thirties, you really need to take care of yourself. What does

that mean? I mean, what does that look like? Yeah. I mean, the thing is like, you don't have to take care of yourself for your twenties and thirties, right? Cause you're pretty much bomb proof in your twenties and thirties. You can do anything you want. You can be out all night partying next day, wake up on three hours of sleep, go to work function, you know, then go play basketball and then go party all night again. Right. That's the way we're built, but your 50 or 60 year old self is going to be pissed off at you. Right. 20, 30 years later, you're going to be like, what the hell did you do to me? You know, I'm fat out of shape and I can't get it up. But if your 20- or 30-year-old self is exercising, eating right, getting enough sleep, has really healthy habits, then your 60-year-old self is going to be trim, in shape, and having good sex still.

And your 60-year-old self is going to be like, dude, my 30-year-old self really hooked it up for me. Right. Yeah. And that's, that's sort of the way that you need to think about things is that the decisions that you make now are going to have implications 20, 30 years down the line. And it, it's still the same person. yeah yeah so what if you know you were just like this crazy party frat boy and you know 30s even you were like started to date all these girls and you just thought the way of the world was you know drinking and not sleeping much now you're 40 and is some of the damage that was done irreversible yeah absolutely okay you know the thing is you build up cholesterol and calcified plaque in your arteries and you know it's not like the stuff that you build up under your kitchen sink you know if your kitchen sink gets clogged you call the plumber the plumber opens up the pipe cleans it

out changes the pipe and you're good as new that's not the way it happens in in the human body right and if if you need to change out the blood vessels someone's going to crack your chest wide open and put vascular grafts in there or shoot some stents up into you so it's you know the process of cleaning out the pipes in humans is a lot different than you know cleaning out your kitchen sink pipes oh yeah you're better off keeping them clean and there's all sorts of of stuff that you can do you know from just eating better exercising better don't smoke don't drink you know try to avoid stress getting good sleep to medications like crustor or you know other statin drugs i mean there's a ton of stuff out there for for people that are interested in

in keeping and maintaining their health yeah well you make a good point because you can reverse some of that but from what i hear and i think this is something you've said that there's also there's this damage that happens, kind of what happens to heart when we have heart disease. Can you talk a little bit about that? Yeah. I mean, to a large extent, it's fairly irreversible. I mean, our body develops what we call collateral circulation. So if there's a blockage, you develop blood vessels around that main blockage. And so you can develop enough collateral circulation that you can function. But my patients want to function at a high level. My patients want to be optimized. my patients want to have good physical intimacy into their 60s 70s even 80s and that's what i

really focus on in my office is helping my patients live healthier better lives and it's really it's never too late to start but the earlier you can do that and the earlier you can be informed educated and motivated because the thing is like it's really simple to improve your health. I mean, if you don't drink alcohol, don't smoke cigarettes, don't do drugs, exercise every day, don't eat too much, stretch every day, meditate a little bit every day, get a good night of sleep and be nice to other people, you'll be healthier than about 95% of people. That's crazy. I mean, you really will. I mean, those things are, they're easier said than done. Right. But I mean, you can control what you put

in your mouth. You have some control of your time. And so with willpower, most of those things are within our grasp. Yes. Yes. I think it's really creating a healthy, overall healthy lifestyle. Cause you know, it's, I, I don't like when I'm, I'm really like, you know, do this diet, do that diet. I mean, I great. If you really need to lose 20 pounds relatively soon. Okay. But I don't think it's healthy, nor do I think it's like the best thing, but you know, I'm

not a doctor, but I think it's the overall lifestyle of wanting to have a better, healthy life. So implementing those, all of those things that you said sound so easy, they really can be yeah i mean weight loss is easy it really is yeah don't eat right that's what i tell my patients but you know with my patients it's about losing fat and building muscle yes right as men age that's what that's critical is burn fat build muscle now the mathematics of weight loss is pretty simple, right? I mean, there are people that have metabolic issues that make it more complicated, but for the most of us, you have to figure out how many calories are going into your

body, right? And there are a ton of apps out there that will help you track calories. Most of my patients like MyFitnessPal. I think it's a free app and it helps you track calories. If you want to save money, you have to know how much money you're making and how much money you're spending, right you don't know how much money you're making how are you ever going to save money if you don't know how many calories you're taking in how are you ever going to figure out how to lose weight and you don't have to track calories every single day right because that that's a hassle but i tell my patients just choose a couple of typical days and get an idea of how many calories you're taking in right and then i have a body composition scale in my office and i get what's called a basal

metabolic rate, right? And that's the number of calories that you burn at rest. Okay. So now you have calories in minus calories out. There are two other things that you need to know. One is when you exercise and you sweat and you get your heart rate up to your heart rate, about three quarters of your heart rate max. And the way to figure that out is you take 220, subtract your age and then multiply it times 0.75. Right. So I'm, I'm 55, but for the purposes of easy math, say I'm 60, 60 minus two 20 is 160 times 0.75 is 120. Right. So when I'm exercising and going after it, if my heart rate is 120, I'm putting in a good effort and I'm sweating. Then I burn about 500 calories an hour, give or take, right? And then the last critical piece of information

is one pound of human fat is 3,500 calories. So if you eat 3,500 calories above and beyond your basal metabolic rate, and you're not exercising, you're going to put on one pound of fat. Wow. Okay. So if you take 3,500 and divide it by seven days a week, it's 500. So if you drop 500 calories a day, you'll lose one pound of fat per week. Okay. That's if you ask any nutritionist dietician around the world, they'll tell you the way to lose weight in a healthy way is one pound of fat per week okay that should be your goal so if you're going to lose 20 pounds it's going to take you six months right don't think you're going to go on some crash diet you know because you have a wedding in in in a month and you're going to lose 20 pounds of fat that just doesn't happen

you'll lose fluid you know you can dehydrate yourself to lose that amount of but in order to lose fat it's going to take you a half a year yeah and you just have to set those expectations for your weight loss, and then you won't get discouraged. You know, weigh yourself once a week. That's it. You don't want to follow those, you know, ups and downs and you have to be disciplined. And the other thing about losing fat is that it's hard for your body to turn protein into fat, right? Protein's got nitrogen in it and fat doesn't have nitrogen. So it's a, it's a difficult trick for your body to take protein and turn into fat so you know if you're you know average size guy you should be hitting about 100 grams of protein a day yeah and that will help you

reduce the carbs right because carbs are basically complex sugars and carbs can't make muscle right you don't make muscle out of sugar you make muscle out of protein okay so those are you know basically the simple diet tips that I give my patients that, you know, any licensed nutritionist dietitian will accept as, as truth. You know, I don't get into the weeds of like, eat this, don't eat that. That's, that's, that's up to someone else. As long as you're doing the basics, then you're going to be great. You know, you can do keto, intermittent fasting, Mediterranean, Miami. I I don't care what you do. As long as you follow the principles that I just laid out, you'll lose fat. Yeah. And at the same time, you won't sacrifice muscle.

Right. Well, it's amazing too, on just keeping that type of, you know, eating habit and losing weight. I know that getting rid of sugar, alcohol, which is just empty calories, right? I mean, that just is. Yeah. Well, it's not just empty calories. It's really important that people understand that it is empty calories and what empty calories means is calories or energy with no nutritional value right so you're just basically burning fuel for the sake of fuel but the interesting thing is i'll sit with my patients and you know they'll be 25 pounds overweight and i'm like well do you want to use do you want to lose 25 pounds and they're like well, yeah, that'd be great. I said, well, you know, how much do you drink? Well, you know,

I have like two glasses of wine a night. Like, okay, take out your phone, put it on the calculator. And then I go to my computer and said, how many calories in a glass of wine? 125 calories in a glass of red wine. Multiply that times two, multiply that times 365, and then divide it by 3,500, which is the number of calories per pound of fat, right? What do you get? 26. What does 26 mean? 26 pounds of fat that you're putting on every year based on drinking two glasses of wine at night. So if you want to lose 25 pounds, stop drinking two glasses of wine at night. Don't replace it with anything maybe water and there you go next year you'll be 25 pounds lighter plus you'll probably save you know five thousand dollars worth of wine right i mean wine's not

not not cheap not cheap i mean especially like where i am up near napa you know people are dropping a couple hundred bucks on a bottle of wine but like easy with impunity so more money less fat yeah hey i'll take it i mean everybody wins exactly i had a guy the other day this guy he manages a big club and we figured out he takes 140 shots of alcohol a week oh my god he's a big guy like big muscular guy and we figured out that was 200 pounds of fat per year in alcohol. Isn't that crazy? That's insane. That's a lot of alcohol. That is a lot of alcohol and a lot of fat. Oh yeah. Just completely taking that out is going to eliminate so many health issues. Okay. So it's empty calories, but also alcohol is a

depressant, right? That's the class of drug that it's in. And the other thing is it disinhibits you. Right. So most of the stupid things that most of us have done in our lives are done under the influence of alcohol. So fat, stupid, and sad. That's what it is. I mean, who wants to be fat, stupid, and sad? Oh man. Okay. It's like, uh, yeah. No, you ever see the movie animal house of course when they get called in front of the dean oh man and uh and yeah and dean wormer says fat stupid and drunk is no way to go through life son right fat stupid and sad pretty much uh yeah wow so on that note with with obviously when men lose fat right and they cut out alcohol and they're cutting out say sugar they're drinking more water they're working out more isn't that

the perfect recipe for longer harder erections more erections yeah of course and it's also the perfect recipe for boosting testosterone naturally oh right so yeah how does that work yeah i mean so think about it this way your body is really smart your body only makes what you need right so if you were a hunter back in the caveman days and you were taking down wild buffalo out on the plains you needed a lot of testosterone because wild buffalo don't like being killed right if if you're a farmer you didn't need as much testosterone as the wild buffalo hunters but you needed a fair amount because those farmers are working hard all the time yeah right but if you sit in front of a computer all day you know making trades or calling people or whatever your

body's like well i don't need to make that much testosterone right and so if you look as a society our testosterone levels are 30 percent lower than our grandfathers right and so what does that mean it means you have less energy less libido less muscle more fat and fat converts testosterone into estrogen, right? So you have, you get man boobs, you get, you know, more sort of emotional outbursts, emotional qualities, you know, all those kinds of things. So it's this, it's this bad cycle. So if you get into the gym and start pumping iron again and eat a better diet and cut the alcohol and all those things, not only are your circulation to your penis going to be better, but your testosterone is going to be naturally better. So, you know, these things are just going

to permeate your entire being in terms of improving your overall outlook, your overall physical fitness, your sexual function, everything's going to get better. Yeah. So is it true as, as men age, they lose testosterone just naturally forget about, yeah, that's significant 30% that are their grandfathers, but, or forefathers. Yeah. I mean, there's something called the ADAM or androgen decline of the aging male, right? So when you're, when you're 12, your testosterone is 200, when you're 18, your testosterone is a thousand. And when you're 80, your testosterone goes back down to 200. And there's a relatively linear line from that, you know, a thousand down to 200. Women are different, right? So women hit menopause and

then their ovaries basically stop making hormones and their levels plummet, right? Guys, it's kind of a slower process. And so a lot of guys don't really realize it. Women realize it because all of a sudden things change and their tissues dry up and they get hot flashes and all those things. And so there's, you know, big blaring signs, you know, we're hitting menopause now, but for men, it's, it's kind of that, what do they call that frog in the boiling water, you know, the changes are so incremental, that you don't really realize it until, you know, you're there, you're that grumpy old guy that you used to make fun of. Yeah, because it's so gradual. Are men coming to you when they're just like at a severe point in their life, and they need help? You know, sadly, that's when a lot of people show up or, you know, I have a lot of public safety officers, SWAT team guys, police, fire. So a lot of guys who rely on physical fitness in order to do their jobs.

Yes. And so, you know, those guys will come to see me too, because they can't perform as well in their jobs as they used to. In fact, I had a patient the other day, he's a San Francisco SWAT guy, and I put him on testosterone. His testosterone was super low. He was having trouble keeping up and I put him on testosterone and he told me the other day he came in, he's like, yeah, my partner and I, we were chasing down these two criminals.

One went one way, one went the other. My partner was chasing this one guy, he lost him, but I chased down this other guy and I, I tagged him, knocked him down, you know, arrested him. And this guy looked up at me and he goes, damn, you run fast for an old dude. That's awesome. Yeah. Yeah. My patient was totally pumped. And, you know, like he, I guarantee you, he couldn't have done that if I had, didn't have him on testosterone because testosterone builds muscle. You know, it's the most important growth factor for men.

And if you're low on testosterone, your physical performance suffers. There's no question. No one will dispute that fact. Okay. So ED is a combination of the two of unhealthy diet and low testosterone or one or the other? Yeah. I mean, so erectile dysfunction, you know, the pressure of blood flowing into the penis doesn't really have anything to do with testosterone. Okay. Right. So testosterone is responsible for libido, right? And libido can be an impetus for increasing blood flow into the penis, but it doesn't, it doesn't open and close blood vessels, right? So testosterone will build muscle. It'll get rid of fat. It'll increase libido, increase energy, motivation, drive. It helps prevent heart disease, helps prevent diabetes.

I mean, testosterone is like the miracle drug for men. It's not a drug, it's a hormone, right? And, you know, patients ask me, well, is it going to work for me? And I tell them anyone with a bat and two balls, it works for, right? You know, the reason you have a bat and two balls and a mustache and you're losing your hair is because of testosterone and testosterone derivatives, right? So you are testosterone sensitive. Okay. But erections are different.

Erections are a function of blood flow, right? So your heart pumps and the two last places they get blood flow are your toes and the penis, right? But you don't get toe erections, right? At least most of us don't, right? When the blood flow declines to your toes, you get cold feet, right? So when you get cold feet, you put socks on, no problem. Your feet don't stop working, but the penis is different, right?

The penis, if you don't get enough blood flow to the penis, it will stop working. It's like a big on off switch. Okay. And so you have to get a threshold amount of blood pressure into the penis in order to block the backflow of blood out of the penis. So as the blood is flowing through the middle of the penis, it's expanding. And when it's expanding, it blocks the backflow of blood. So it locks blood into the penis in order to get a rigid erection that rises up off the floor. Okay. And so you have to hit a certain amount of blood pressure. So for example, like say you're on the top of a burning building, right? And there's another building that's six feet away. If you jump six feet, it's a great day. If you jump five and a

half feet, it's a really, really bad day, right? So the penis is the same way. If you hit 101 millimeters of mercury of blood pressure in the penis it's a great night and if you hit 95 you have a full penis but you don't have a rigid erection and it's a lousy night yeah right so i'm focused on working with my patients on figuring out how to increase blood pressure in the penis that's awesome thank you for educating me and hopefully you know other people that maybe are scared to go to the doctor. Yeah. Don't be scared. I know. And if you're scared, read my book, the 21st century man, like everything is in there or go to my website, which is Brandeis MD or go to my YouTube. I just counted it up. I have like 140 videos on sexual medicine, hormonal medicine.

I just launched what's called the P long protocol, which is the first scientifically proven way to increase the length, girth, and function of a guy's penis. Ooh, I know they want to hear about that a little bit. Yeah. And there's a disclaimer, a double disclaimer. Okay. First of all, I don't care how long guys' penises are, right? That's not important to me, but if it's important to you, go to p-long.com and learn how you can improve the size and function of your penis. The other thing is i will never tell a man that their penis is too small right that's a as long as you can urinate and you can you know use it for sexual function you're fine yeah right and but you know 300 000 women a year in the united states get breast implants and not all of them had breast

cancer right so people make decisions about the way that they look and that's entirely up to them I don't judge people. My goal is to provide an alternative to some of the really lousy ways that people try to increase the size of their penis, either with fillers, which don't stick around and are expensive. And you end up with a lumpy, bumpy penis or with fat transfers, you know, which you get, I call it a pig in a blanket penis, right? You get a fat shaft and a small head, kind of like when you go to a cocktail party and eat pig in a blankets or guys i don't want to eat those no i'm sorry i ruined i ruined picking up blankets for you forever oh man yes or the guys use traction therapy so that you get a really long thin

penis i call that a pencil penis and you know when they ask women what they prefer most women prefer girth over length and so you know a pencil penis may may work well in the locker room, but it doesn't really work in the vagina. And so, you know, the issue is how can we increase the length and girth and function of the penis? And so because I saw a lot of guys coming in dissatisfied with the other technologies out there, I created the P-LONG study. We got institutional review board approval. You know, I've done research at American Red Cross. I've done research at Harvard. I've done research at UCLA. So I have a lot of research background and I got it listed at clinicaltrials.gov, which is the NIH website. And we tested 32 patients,

32 men who finished my six month protocol. And on average, we got almost an inch in length, a half an inch in girth and improved function over that six months. And it was a symmetrical growth of the penis it wasn't um it wasn't a pig in a blanket penis and it wasn't a pencil penis wow that's amazing and no side effects whatsoever no negative effects and you know i did all the the injections of prp and i you know i took care of all the patients in the study myself and you know all the patients were happy wow i would never do anything if i thought patients weren't going to be happy. And I would never promote this nationally because my reputation as a doctor is at stake with really anything that I do. And if I didn't think patients were going to be happy

with this, I'd never would have, I never would have rolled it out. No, I completely understand most of my family's in medicine. So I understand you work really hard for your name and your, you know, to put some, your name on something is huge. Yeah, exactly. At the end of the day, that's all you got. Yes. Yes. So do you think that, like you said, you use a great example with women getting breast implants, you know, they're not happy with their breasts, but do you find that men it's mostly like, Oh, like you said, it's a locker room thing where a guy's like, yo, his penis is so small or it's like this. Yeah. You know, guys are, are secretly checking each other out. Yeah, they are. It's like an alpha status kind of thing. And then even,

you know like i had a guy yesterday who came in for a p long protocol consultation and he was like 35 years old married you know decent job you know he just wanted a bigger penis i mean yeah that's you know i said great you know like i can help you out yeah we can you know we can it takes a little bit of time you know you need to do some stretching and some pumping in the morning and some stretching and pumping in the evening. But, you know, most of the old protocols were eight to 10 hours a day. And, you know, most people with normal jobs don't have that kind of time. But, you know, for me, for my patients, it's, you know, it's 35 minutes in the morning, 35 minutes in the evening, come in once a month for, for a P-shot, take my Affirm nitric oxide

boosting supplement, which improves circulation. And, you know, you can expect on average about an inch in length a half an inch in girth and better function and if that's important for you great you know there's a way to do it now that you don't have to pay a lot of money to get filler squirted into your penis or you know have to have a surgery that's probably not going to work for you anyway yeah well that's great it's huge revolution then that's yeah it's really i'm actually really excited about it so it's a it's been a fun project very cool well i hope all those men out there that are happy with this you know uh well he's your doctor for this so yeah well i mean no actually i have a network of physicians throughout the united states so we have i think 50

or 60 p long providers now certified p long providers and then we have one in new zealand we have three in canada we have one in bahrain one in korea so we're you know they're this as this concept as we, and we've only, it's only been three, four months. That's not surprising. So as we, as people learn about this, we're actually going to be in Maxim magazine later this week. Yeah. So I think as this, as people learn more about it, it's going to take off. And I'm really happy because the existing technologies for penile enhancement and augmentation really do guys a disservice and are ridiculously expensive and don't work. And P-Long is not that expensive. It's natural. There's no synthetic fillers or implants. And yeah, so that's been

really cool. That's great. I'm excited for you. So good stuff. You said you just provide some of your patients with a supplement for that? What type of supplements do you, have you created or provide for your patients? Yeah. So, you know, when I was at UCLA, one of my professors, Lou Ignaro, won the Nobel prize for discovering nitric oxide as a second messenger. And then he and another one of my professors wrote the paper on how Viagra works, right? And it all works through nitric oxide and as we get older the amount of nitric oxide that we make decreases and what that does is it means our circulation declines just like testosterone declines nitric oxide declines and and we think oh we're just getting older but getting older means that

certain physiologic processes wind down and one of them is testosterone another is human growth hormone. Another one is IGF-1, but another one in a really, really, really important one is nitric oxide. Right. And the other nice thing is it's relatively simple to replace, right? So there's two pathways that you get nitric oxide from. One is the citrulline arginine pathway, and the other is the nitrate nitrite nitric oxide pathway. So citrulline and arginine come from things like watermelon and nitrate nitrite nitric oxide comes from things like green leafy vegetables and beets right and so i have a supplement called affirm available at affirmscience.com and it's a combination of citrulline beet extract ginseng and murapuama which is potency potency wood

from Brazil. And really what that does is it non-specifically increases circulation. So guys in their 60s and 70s will notice an increase in cognition, better short-term memory. A lot of elite endurance athletes will take nitric oxide boosters to improve their performance. It works amazingly well as a blood pressure medication. I had a patient the other day, he was a CEO of a tech company in Silicon Valley. I'm not too far from Silicon Valley. And his blood pressure was running like 140 something over 90, right? And his Stanford cardiologist wanted to put him on a blood pressure medication. And he was like, you know, I'm a natural guy. I don't want to be on blood pressure medications, but I'm always stressed and this and that. And I put him on

two tablets of Affirm in the morning, two tablets of Affirm in the evening. And then we talked about some lifestyle changes and eating better and exercising and his blood pressure you know he had this blood pressure tracking app was 118 over 78 and his stanford his stanford cardiology professor was like couldn't believe his the change in blood pressure just from a nitric oxide booster but the thing is it's nitric oxide was the molecule of a year in 1998 it's the basis of how Viagra works. And, you know, it's central to our physiology, but the thing is drug companies can't make money on it. So they don't promote it. You know, you don't see nitric oxide booster commercials on TV, like you see Ozempic commercials. So, so messed up. I know. So,

yeah, so that, so that's a firm, you know, the other, the other supplement that, that I have is called support, right? So a lot of patients have borderline low testosterone, but they don't want to replace testosterone for a number of reasons. And if you're really interested in testosterone, either buy my book, or I have a free ebook on my website, BrandSMD. If you go to BrandSMD.com and go to media and drop down, I wrote three ebooks on testosterone. One is just a general all about testosterone. One is on testosterone levels. So the levels of all the different ways to get testosterone. And the other is on performance enhancing drugs. So I get a lot of patients in my practice that are bodybuilders and ex pro athletes, and they really mess themselves

up because very few people actually understand performance enhancing drugs. And so I went through the trouble of demystifying performance enhancing drugs. And it's like a free ebook, right? I don't charge you a penny for it, but I, it's part of like, I want to educate people because I had these guys coming in who had infertility because of stuff that they took when they were younger, or they have to be on testosterone for the rest of their lives because of stuff that they took when they were younger, or they messed up their liver because of that. And so, you know, if you're on testosterone or any of these performance enhancing drugs,

DECA, TREN, Winstroll, any of that stuff, please, please, please just read my book, understand what you're putting in your body. because there are long-term implications of this stuff yeah anyway I got off topic you asked me a totally different question and I'm so sorry because I can ramble and go on and talk about all sorts of stuff and you have to keep you have to keep me in my swim well I know everybody's learning so much here so you going off topic is still educating everyone here so I think it's amazing. I did want to say too, that I think it's phenomenal what you're doing as well, because all of the information from these, you know, bodybuilders and athletes, and they're just

randomly doing stuff to their body. And then they're educating people because they have a, you know, they have a licensed train, you know, and they think it's crazy because there's so much misinformation yeah you know what my epiphany moment was what's that big mic right i had a police officer right these guys should know better but most of the the the gym you know the bro science uh you know that stuff all comes out of mexico right even the police officers they get their stuff from mexico wow and i asked my my my patient i'm like so how do you know how to use this stuff and he's like oh there's this guy at the gym big mike he's like big mike knows everything big mike tells everyone what to do i'm like well what

medical school did big mike go to it's like no he didn't go to medical school right so you know and the thing is i'm not saying i know everything about everything but i know where to look for it and i know how to synthesize information and i'm the one that's going to take care of the problem if big Mike is wrong. So they might as well get their information from me because I have access and understanding to all that, that, that the best science and the best information. Yeah. I don't think any guys want their, you know, liver messed up or never get an erection or is once you go on testosterone, is that, is that it? Are you, are you on it for life? Yeah. I mean, see, that's the thing that's, that's what people think. And if you don't do it

properly that's the case like i had a patient he was a all pro for the raiders for 15 years just gigantic guy right and 350 pounds like one of the biggest guys i've seen and i examined him and his testicles were the size of raisins oh shoot yeah because he was on like super high doses of testosterone for a long period of time right because i mean that's the difference between flipping burgers and making five or $10 million a year, you know, tackling people. Right. And so I'm not going to blame him for wanting to do that. But at the same time, there are things that you can do because there's a negative feedback loop. When you take testosterone shuts down your brain chemicals that tell your testicles to make testosterone. Oh, okay. Right.

So if you're taking testosterone from the outside, your brain's like, well, we don't make testosterone anymore. We're getting it already. So that's why the testicle shrinks. And when the testicle shrinks, you stop making testosterone and you stop making sperm. So you get infertility and you lose your ability to make testosterone. Now you can take medication like clomiphene or beta HCG that will maintain your ability to make testosterone. And so, you know, I put all my patients on those medications, but I don't know that big Mike knows that. I don't think, you know, or, you know, there's testosterone and estrogen, right? Women are from Venus and men are from Mars, but the, the difference in chemical structure between

testosterone and estrogen is only different by a single hydrogen atom. So the smallest unit of matter is the difference between men and women. And so your body can easily flip testosterone into estrogen. So you get these bodybuilders that are using a lot of testosterone and all of a sudden they get, you know, man boobs. It's because your body is turning testosterone into estrogen at higher levels. And if you don't take a medication to block that conversion, then, you know, you get man boobs, you start going to Barbra Streisand concerts. I mean, you do all these things that are very uncharacteristic of manly mass yes yes well yeah that's good to know too as well so taking these things properly is so important and and that's why i'm like thank god someone's out

here like advocating for proper men's health yeah just read my free ebooks yes do it so i guess do you do you offer other treatments for ed then or i have i have options a through z i thought so and i just wanted if you could talk about a few or yeah i mean i put i put all my patients on a firm everyone needs nitric oxide everyone over the age of 40 needs nitric oxide supplementation. And there's no side effects, no negative side effects. I did a YouTube video where I took, I think, eight or 10 nitric oxide boosting Affirm tablets. And I woke up with a great erection the next morning, but that was about it. PDE5 inhibitors like Viagra, Cialis. Cialis just published an article like three days ago on Cialis showing that Cialis reduces the

risk of heart attacks, strokes, and other cardiovascular events in patients that take it every day, right? So it's got an indication for BPH, meaning urinating better, you get better erections, and you get a lot less heart disease. I mean, and it's at a low level, it's rare to get side effects. So I mean, here's a medication, we sell it in the office for a dollar a pill that will improve your erections, reduce your risk of heart disease, and help you urinate better. I mean, what could be better than that?

No brainer, right? No brainer for my old guys that don't get nighttime erections. We use vacuum erection pumps or penis pumps. Okay. Right. So you can use that for penis exercise. You know, we do low intensity shockwave therapy. So it's a, it's a medical procedure you can do in the office that improves the vascularity of the penis. We use PRP or platelet rich plasma injections of, of platelets into the penis that will help stimulate the growth of new blood vessels. Nice. And like all these things are all over my YouTube channel, my book, my, my website, you know, so I I'm going through this stuff really, really fast, but I explain it on, on all of my sources of information. You know, I use what's called high FEM, high intensity

focused electromagnetic waves. So this is actually a, one of my research studies that shows that using what's called the Emcella chair from a company called BTL will increase erectile function and ejaculatory function. So, you know, have guys that are in their 60s, 70s that have trouble ejaculating or have really weak ejaculation. And this device can actually help improve the strength of the muscles that cause ejaculation. We use peptides like PT-141, which will help guys get erection or oxytocin or apomorphine recently we started injecting botox into the penis right yeah botox it's fascinating right so a flaccid penis the vascular tone in a flaccid penis is is constricted okay right because when you're not in the mood for for love you don't

want blood in the penis right it's a waste of blood to go into the penis if if you're not using it. And so when you are going to get an erection, your body releases nitric oxide, which causes dilation of blood vessels, which allows blood to flow into the penis more easily. Okay. Right. Well, what does Botox do? Botox relaxes smooth muscle. So if you inject Botox into the erectile body to the penis, it actually relaxes that vascular smooth muscle and gives you better flaccid penile size. So a lot of my gay patients just love the stuff and it makes it easier for blood to flow into the penis to help improve erectile function. Botox does wonders. Yeah. It's like bacon, right? Is there anything that bacon can't do? I love it. Well, I have one.

I mean, if you had bacon, Botox, and Cialis, you'd be set. All right. It's a date. I don't know if you should do everything on that one date, though, guys. Yeah, okay. You got to save something. You got to save something for the second one. I want to ask you one more question because I know we're running out of time here.

But this is something I ask all my guests. And I want to know, what was one of your favorite dates? Oh, gosh. Well, I got engaged to my wife in Santorini. beautiful yeah in a place called ia which is supposed to have the best sunsets in the world so i've been there it's cool yeah so i would say by far and away that was that was my favorite date ever that's amazing thank you for sharing that thank you for all this plethora of knowledge where can and i know you've shout out a few times but where can everybody learn more about you your

YouTube, everything, your Instagram, wherever you post and purchase your books. So my website for my medical practice is BrandeisMD, B-R-A-N-D-E-I-S-M-D.com. And then I have a YouTube channel, which is BrandeisMD. I have an Instagram. I don't really know how to use Instagram, but like I give my people content and they put it up for me. So I think if you have, if you look up Brandeis MD, you could probably find my Instagram somewhere. Okay. And, and then my book is called the 21st century man. So if you go to the 21st century man.com, but just write it out all in letters. Okay. You'll get to the book. And then my supplement, we have a supplement, a nitric oxide boosting supplement for circulation. We have the testosterone boosting supplement called

support. We have a supplement for premature ejaculation, which is something that about a quarter of guys suffer from and then we also have a prostate health supplement called spunk and so these names yeah i'd like they all come from this like demented mind of mine yeah but i like uh like i like double entendres right so spunk like there's spunky like because the thing is right there's prostate is kind of a hard word to you know there's no synonyms for prostate you go to like the thesaurus and you look up prostate, like there's only one word prostate, right? So like, and all the good prostate names are taken up like super beta prostate and prostate, whatever. And then, you know, prostate, the only thing prostate does is it makes semen. Yeah. Right.

And it makes urologists rich, but I mean, it just basically makes semen. Right. And so like semen is not a great word to vibe on, but in England, they call semen spunk. And then in australia if you're sexy they call you spunky and then in the united states if you're spunky you're like energetic so anyway that's where i came i love it yeah so if you go to affirm science.com a-f-f-i-r-m science.com okay you can pick up some of our supplements wonderful well thank you so much for coming on today's show and educating and bringing the all of these topics to my spunkiness you. Thanks for bringing your spunkiness. I love it. Well, again, you guys go buy his book, go look up his website and buy his nice, a firm spunky vitamins for that. Awesome. But most

important, take care of yourself. Yes. Take care of yourself. You know, no one else is going to take care of you. You have to learn how to take care of yourself. Yes. I love that. Thank you so much for having me on. Have a wonderful day. Thank you. All right. Thanks for tuning in to today's episode. Come and hang out with me on Instagram at Celeste Moore image. Let me know your thoughts on today's episode because I always love hearing from you all. You can find all the links and resources in the show notes of the episode on my website, celestmore.com. Okay, that's all for now. I'll see you in the next episode. See you next time, friends.