The Jordan Harbinger Show - 1254: Justin Houman | Wiggling Out of the Male Fertility Crisis

Episode Date: December 9, 2025

Your fertility might be the canary in your body's coal mine. Urologist Dr. Justin Houman explains why this matters way beyond making babies.Full show notes and resources can be found here: jordanharbinger.com/1254What We Discuss with Dr. Justin Houman:Male fertility is a diagnostic window into overall health. Low sperm counts correlate with cardiovascular disease, metabolic dysfunction, hormonal imbalances, and even earlier mortality. Your reproductive system is essentially sending you a biological memo about the state of your entire body.Varicoceles (varicose veins of the testicles) are one of the most underdiagnosed yet treatable causes of male infertility, low testosterone, and testicular pain. They cause blood to pool and overheat the testicles, and most men never know they have them because general practitioners rarely check for them during routine physicals.TRT (testosterone replacement therapy) shuts down natural testosterone and sperm production — and once you start, you essentially can't stop. Before jumping on the TRT train, explore alternatives like addressing vitamin deficiencies, improving sleep, and using medications that stimulate natural production instead.Erectile dysfunction isn't just a bedroom problem — it's often the first warning sign of cardiovascular disease. The same arterial issues that cause heart attacks show up in penile blood flow first, making your erection quality a surprisingly accurate early warning system for your heart health.The foundations of long-term hormonal and sexual health are remarkably simple: consistent strength training, quality sleep, stress management, and whole foods. Starting in your twenties and thirties, these habits build the infrastructure that keeps your systems running smoothly for decades to come.And much more...And if you're still game to support us, please leave a review here — even one sentence helps! Sign up for Six-Minute Networking — our free networking and relationship development mini course — at jordanharbinger.com/course!Subscribe to our once-a-week Wee Bit Wiser newsletter today and start filling your Wednesdays with wisdom!Do you even Reddit, bro? Join us at r/JordanHarbinger!This Episode Is Brought To You By Our Fine Sponsors:Northwest Registered Agent: Get more at northwestregisteredagent.com/paidjordanBetterHelp: 10% off first month: betterhelp.com/jordanArticle: Visit article.com/jordan for $50 off your first purchase of $100 or moreAirbnb: Turn your house into a host: airbnb.com/hostHomeServe: HomeServe.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Welcome to the show. I'm Jordan Harbinger. On the Jordan Harbinger show, we decode the stories, secrets and skills of the world's most fascinating people and turn their wisdom into practical advice that you can use to impact your own life and those around you. Our mission is to help you become a better informed, more critical thinker through long-form conversations with a variety of amazing folks, from spies to CEOs, athletes, authors, thinkers, performers, even the occasional arms dealer, drug trafficker, former jihadi or four-star general. And if you're new to the show or you want to tell your friends about the show, I suggest our episode starter packs. These are collections of our favorite episodes on topics like persuasion and negotiation,

psychology and geopolitics, disinformation, China, North Korea, crime and cults, and more. That'll help new listeners get a taste of everything we do here on the show. Just visit jordanharbinger.com slash start, or search for us in your Spotify app to get started. Today's episode is about something half the population has, and the other half has to deal with, male fertility. And before you check out, trust me, this is not just a

about whether you can populate a small village. Male fertility is basically a diagnostic report for the rest of your body, your hormones, your cardiovascular health, your metabolic health, even your longevity. Dr. Justin Human is a urologist, surgeon, and men's health specialist at Cedar Sinai, and he's at the forefront of what a lot of experts are calling the male fertility crisis. Global sperm counts have dropped more than 50% in the last 40 years, and most men have absolutely no idea. It's not just a fertility problem.

It is a massive red flag warning sign. Low semen quality is associated. Yeah, I had to get that word out there. Get ready for, there's a lot more where that came from. Low semen quality is associated with diabetes, heart disease, testicular cancer, even earlier death. And yes, we're going to talk causation versus correlation because otherwise this whole episode becomes one giant WebMD panic attack. We'll get into vario cells, one of the most undiagnosed fixable causes of male infertility, the explosion of at-home sperm testing, why AI is suddenly analyzing sperm.

better than actual humans, the bizarre rise in penis size. Yes, really, and you knew that, folks. I couldn't go a whole week without referencing penises on the show. We'll also discuss what every man should be doing in his 20s, 30s, 40s, and whether you should be banking sperm now, like you're prepping for the apocalypse. We'll also, would you have kids during the apocalypse? Probably not, but you get what I'm saying. We'll also hit hormonal decline, testosterone, porn, erections, dopamine, peptides,

PRP, shockwave therapy, Botox for your dick. That's a thing. The future is weird. and how erectile dysfunction is often the first sign of cardiovascular disease. If your heart is struggling, your penis is the canary in the coal mine, a tragic, tiny canary for most of us. This one's loaded, and Dr. Human is one of the best in the game. Let's get into it.

I'm only skeptical of, it's like, it's a fertility crisis. Okay, but maybe because people are having kids at age 40 instead of age 22 like they were in the 60s. Is that part of it or what? Or is there really a actual downfall in fertility across all ages? Yeah, I think it's both. We're doing a lot more semenalases for people, so we're catching more of these abnormal sperm parameters earlier on. So we're getting those poorer results earlier on.

So that's part of the equation. Men definitely in urban areas here in L.A. are getting married at a later age. Sperm counts are declining after your mid-20s. It's depressing. Because mid-20s, you still think, I got a long time to deal with this. That's the problem, though, right?

As a male, your counts are going to, going down. You have to remember each time you ejaculate, there's tens of millions, if not hundreds of millions of sperm, and all you need is one. One. Okay. When you put it like that, yeah. To your point, I do think men are getting married at a later age, therefore they're having kids later, but there's no question about it. We're unhealthier, right? We're less healthy now than we were 20 years ago, 40 years ago, 50 years ago. We're eating more processed foods. We wake up and we're sitting at a desk all day, coming back, watching Netflix all day, and rins and repeat. That's the whole thing. It's unhealthy living, really. It's poor food,

poor exercise, we're consumed by screens, and all of that just ultimately leads so unhealthy life. So I think it's those three things. Okay. But it's global sperm counts. It's not just Americans. Globally, we're all still hooked on screens and stuff, too. There's more commuting. But it seems like some countries would be less affected by the same stuff as we are,

like obesity and all that stuff. America definitely is more obese. But the world as a whole, it's more processed foods. In order to feed the 7 billion people on Earth, we have to mass-produce food. So processed food is lowering our sperm count? For sure. Really? Yeah. What's the mechanism behind that? In simple terms, it's not good for you, right? Processed foods aren't good for you. The more unprocessed natural foods that you have, the better off not just for your reproductive health, your hormonal health, your overall health, your cardiac health health across the board.

You're saying my nanoplastics and my Cheetos is not good for my fertility? It's good for now. It's that dopamine hit, but after that. Yeah, I had kids. I got the whole snip and everything done. I remember one of the doctors. I had a health check recently. I had something on my testicle that was like a vein that he said was not good. And I said, what can happen? He goes, does it hurt? I said, no, he goes, could make you infertile. And you just started cackling because I told him I got it after a vasectomy.

I think it's called a vericoseil. Okay, so we'll talk about that. He was from Taiwan, so he said variocell. And that must have been what he meant. But we'll get back to that. Global sperm counts have dropped over 50% in the last 40 years. But is that a big deal? Because if we only need one and we have eight bazillion sperm in each load, so there's

half a bazillion. If you need one and you got a million in there, it's fine, right? Yeah, it's not as bad. We're producing so many sperm. Is the trend heading in the wrong direction? Yes. Sure sounds like the wrong direction, yeah. Can it plateau and this could be the new norm? Yeah, potentially. But I do think to a certain extent we're making it sound a lot worse than it is to make it sound like human race is going to end. That's good. We need that in the thumbnail for the YouTube version of the show. Otherwise, people with the intention span of a net won't click on this. We need more data. We need good longer data. I think right now we have some data points. We have to capture this longer term to see where this is actually if it's real and where the trend is heading. It sounds though like it's mediumly

a fertility problem, but it's more of a canary in the coal mine of men's overall health because I'm no doctor, but I'm going to guess that healthy people have higher sperm counts generally across the board than somebody who's unhealthy. So if we see low sperm count, it's not just probably that one system in the body that's affected. We're like, looking at, I don't know, cardiovascular health is maybe not as good. Maybe there's something we can't measure, like your immune system or whatever that is, it's just sperm is easier to count because you can put it in a glass and run it through a machine as opposed to, I don't know, the current state of your heart or your immune system or some other

system that's harder to quantify. Does that make sense? Yeah, perfectly said. So yeah, exactly. If you have lower sperm counts, you could say that lower sperm counts can mean that overall you're in poor health. But now we have data, I think it was about a year ago, in Sweden, they published something where they said guys who have lower sperm counts, lower sperm counts, there's a number of things, how they sperm look, how they move. The morphology, how they look. Yeah. Their counts, all these things.

Ultimately, men who have lower sperm counts can have mortality at a younger age. They die younger. Okay. This is the correlation versus causation thing, right? It seems more like people who have a bunch of shit wrong with them and die early also have low sperm counts. So that's what it is. You could say they're unhealthier, right?

Whether it's cardiovascular, diabetes, high blood pressure, metabolic, maybe hormonally, they have low testosterone levels. This can impact them long term. So yeah, it's essentially their overall health. The reproductive health is a snapshot of their overall health. So if you do have low sperm counts, it's kind of a wake-up call. Hey, fix your overall health picture. The thing that's crazy about the sperm count thing is the number of my friends who are healthy, upper middle class or higher have never been schlubby, overweight guys, have never had real serious health problems. This is sneaking up on them, too.

The thing is, they also find out when they're like 40, because they're like, I'm trying to have kids, and it's been really tough. And it's like, well, okay, but I don't get it. I'm a surfer, and I work out three times a week. I eat right, and I'm 150 pounds and 5 foot 10, you know, not overweight. What's the deal? And it's like, they'll go and get a sperm test, and you may have had a low sperm count for the last 20 years, and you just never knew because nobody tests until there's a problem.

Exactly. And there's no symptom. Yeah, you can't look at the result. of anything on your own, so to speak, and go, that doesn't look right. It happens in a laboratory only. These days, you can do an at-home semen test. You can. Oh, yeah.

There's a handful of companies out there. Huh. You can just do it at home. Let's talk about that because I feel like that's a good idea. How does that work? Do you have to freeze it? So these companies, they've created a preservative and they're able to measure the decay.

But ultimately, once you ejacculating a cup at home, you mail it in. Based on the algorithm, they're able to measure what your sperm counts are quite accurately. If any guy, whether he's 22 or 42, you want to have a kid, 52, doesn't even matter. Doing an at-home test, I don't know, it costs $150, 200 bucks. Can you recommend a company or two that's doing this? Yeah, there's one, meetfellow.com. Meatfellow. M-E-E-T.

You never know what the sperm thing. Meetfellow.com is one. I think there's daddy, legacy. Why are they named creepy things? And these companies do crowd preservation as well. Okay, so you can freeze your sperm. Through them. What age should men look at freezing that, you know, women freeze their eggs in their 30s if they're doing the career thing or whatever?

What age should men do this? Is it like you're 25, do it now because it's all downhill from here or what? There's obviously no hard and fast rule on this. I'd say that if you're thinking about doing it, just do it. Ten years ago, it was very expensive. There's only a handful of places in each city, these cryobanks. Now you could do these at home, cost a couple hundred bucks per year. It's not bad.

It's an insurance policy. The same way you insure your car or your home. home, rental insurance, same thing. It's an insurance policy. Buddy of mine recently became a father as well. He had testicular cancer. And I want to say that then he went and froze a bunch of sperm, had that cancer thing taken care of, survived, obviously. And then like 10, 15 years later was, hey, I'm going to need that parachute that I left over there. And it worked. And he had kids. Not everybody has a heads up. Like, hey, you have testicular cancer. Sometimes, I guess you could get injured or something like that and it could be

too late. Luckily you have two testicles. Yeah, I guess it depends on how severe the injury is, but yeah, you're right. So we mentioned that semen quality is essentially a barometer of systematic health. My cardiovascular health was, I don't know, my oral ring was like, you are two years younger than your age. And I was like, that doesn't sound good. My wife was like 14 years younger than her age.

She's Asian, so it's not fair, but whatever. And so I got a trainer and I started working out all the time. And now it says I'm six years younger than my age, still not 14, unlike the wife, but better. So, Oro's your four years younger? Nice. Yeah. Not bad, huh? Yeah, I got to 11.

That's awesome. But you know what, though? The way it tests this, I don't know if you've looked this up, there's something where it puts a sound wave through your system, the wave reflection measures how flexible the arteries are. That's cool. I feel like you can do that with a real machine that's not this big on your finger. If you had something like right here that did it, I would trust that. Or like electrodes all over me.

that seems like it could do that. I'm very skeptical that this can put a sound wave through my whole body and then have it read back in the ring. I just don't buy it. I will say, though, the cool thing about this is I was exercising hardcore

for a good three-month period and I noticed the trend. It got better and better. So it's measuring something, but I'm like, is it really 5.5 or is it like, I don't know. It's too small.

This ring was like, you're not getting deep sleep. You're getting like four minutes of deep sleep per night, really bad. Sleep hygiene wasn't helping nightmas wasn't helping blue blockers, weren't helping that particular thing.

They helped me in all other areas of sleep, so I still use them. So I went and got an at-home test where the sleep lab sends you this like finger device. That said, you have no sleep apnea. I said, I don't believe it. Look at my disturbances in my aura ring. Look at my sleep scores.

Look at all this. So I did the in-lab test, right, where you're hooked up to everything. They're watching you on camera. You're hooked up head to toe, literally with electrodes, a breathing thing, everything. And they were like, you don't have sleep apnea. And I said, how is that possible that this ring says that I do and everything else says that I don't?

And they said, this ring, and this would surprise no one, I guess, but it surprised me. This has to extrapolate a shitload of data off of what it gets from one finger. The motion of your hand, maybe you sleep and you wiggle your finger. It doesn't mean your whole body's moving, but your ring doesn't know that. Maybe your blood pressure is a little bit different because the ring is a little too tight. Okay, your ring doesn't really know that. It just thinks you have high blood pressure, right? So you need a blood pressure cup to tell you what you're.

real blood pressure actually is. So it does a lot of extrapolation and it basically says, oh, this is what we're feeling on this one section of your finger, probably across your whole body, it's like that. And that's just not necessarily the case. It tries to connect dots. Yes. Look, I love the ORA ring. It's amazing. The sponsor the show before, but I've been a customer since Gen 1. It's an incredible device. But it's basically a canary in the coal line. You test something and then you go, I want to dive into this more, not, oh, I'm diagnosing myself with sleep apnea because of what the ring says, it just tells you to get something else tested. That's all it really does.

But that's extremely valuable, especially like you said, for guys that never go to the doctor because, I don't know, reasons. So can you do something like that for your fertility? Like, is there a workout that improves my fertility or is it just diet? No, it's more than diet. So I try to keep it simple. What's good for your heart is good for your testicles. It's good for your sperm.

So lifestyle is one of them within that and talk about diet, exercise, sleep, and stress. Sure, that makes sense. Right. Try to optimize your diet. diet, healthy diet, minimize your processed foods, more unprocessed foods, vegetables, lean proteins. Exercise-wise, combination of cardio, heavy weightlifting, that's good for your hormonal health. We know you need good testosterone levels within the testicle in order to have good sperm

health. Testoster replacement therapy, that shuts down your testosterone. That shuts down your sperm production as well. Oh, yeah, I've heard that. Sure. That's what dudes on steroids. The joke is always like the testicles are a little tiny rocks and don't work. Yeah.

Exactly. So sleep, get seven hours of sleep at night. That's good for hormone health. It's good for your testosterone levels if you're minimizing your stress. The other thing is, like we talked about, the vericoseals, right? Can you optimize your sperm health? Yeah, you have to do a physical exam, see a reproductive urologist. They'll do an exam, make sure everything's okay down there.

If you have, we could correct those. The earlier you correct those, the better off you are. There's genetic aspect to sperm health. There's not much you can do from a genetic standpoint. And then supplements is something a lot of guys talk about. So there's certain supplements within the fertility category that can help. Coenzym Q10. That's a great one.

Oh, really? K-Q-10? I started taking that because I was really low and I did blood work and it was like, this is really low. So I take this, air quotes, good brand of KU10. I had no idea. Okay. That's a good one. Vitamin E is a good one. Oshu-Gana, that's good for your hormonal health as well. That's how you optimize. But at the end of the day, it's not so objective as your cardiovascular health with your aura ring. At end of we've been reproducing for however long as humans. All you really got to do is what's good for your heart health, your overall health is good for your reproductive health. Kind of makes sense, right? I mean, look.

again, I'm no doctor, but from like an evolutionary standpoint or a sexual selection standpoint, the body is going to just do everything better if it's in better shape. If you're able to run a decent mile, you can lift something that's heavy without throwing your back and your knee out or just like ripping your tendons to shreds. You're going to be able to maybe reproduce a little bit better. I mean, I always feel like you level up everything. Like you start lifting weights and your hormones get built up. When your sex drive gets built up because your hormones are built up and then your energy levels are better and then your sleep is better. because your hormones are, but it's all just this sort of self-reinforcing positive cycle.

It's unfortunate because it's America, right? So we're looking for shortcuts. But guys who are like 30, we'll jump into TRT, when now they have to take that for the rest of their life. And they're like, oh, it's fine. My testosterone's optimized. I don't care about the money. But you're not producing your own testosterone. Theoretically, my testicles are producing that every minute of every day.

I don't know how it works, but I assume something. Yeah, steady dose. But if you're injecting it, it's like you get three days and it's off the charts. and then it dips down until it off the charts. So you're on this weird roller coaster. And also, you said that if you're injecting testosterone, it's not helping you produce healthy sperm also, right? Yeah, it kills your testicles ability to produce sperm.

It's also reducing the ability to produce testosterone. Exactly. Basically, shut your testicles down. Jeez. Okay. So yet another reason why people should think twice about TRT. Yeah. If you're trying to have a kid or you're going to have a kid in near future, see somebody who knows what they're talking about before you get started on TRT. Because we have options. We have good options to boost your testosterone, basically tell your testicles to produce more testosterone,

rather than shutting the system down. I did a show about this a few weeks ago because I was like, I'll just do TRT. Everyone's doing it. I might as well. Let me look into it. And my brother-in-law sent me a video, Dr. Mike is Rital. He's like, don't do TRT.

You're going to go bald and your dick's going to stop working. I was like, okay, that's a good point. And then I have a telehealth clinic and the doctor was like, you don't need to do that because once you pop, you can't stop. And he's like, why? I don't, we do blood work. I was deficient in like, KU10, vitamin E, vitamin D, magnesium, like a million things.

So I started taking those and my testosterone went from 250 to 1150. Really? Just from those supplements. Basically, yeah. Also, DHEA. I needed some DHA. That boosted. But it was like magic.

Yeah. And then as I got in better shape, my testosterone leveled off. I had to reduce the dosage of everything because as I got in better shape from having my hormones in order, everything started to be like too high. and then now it's stable at 1150. But it was like magic. You were working out a lot during that time too. A lot, yeah.

Compared to before you weren't. Right. I was basically like a fat 250 testosterone. And then I worked out and I was a strong but still kind of fat 250 testosterone, didn't change my workouts at all and became basically ripped at 1150. Then it went to 1415 and my doctor was like, whoa. That's a thing I wasn't expecting because I guess you respond better to supplements, medication and everything when you're in better shape, which most people don't know. Like your body

being healthy makes even your medication and supplements more effective. The systems are more responsive or something. I do think the workouts that you were doing probably helped you a lot too. That contributed a lot to it. Yeah. We have good data on strength training and what it does to tea levels. Even after a few years of working with a trainer, though, my tea was like 250 to 350. And then once I started supplementing those vitamins, minerals and the DHA, it went from like three 50 to 1600 and then I had to tone it down like I said you felt a difference oh my gosh it was alarming because I was a little bit of a different person in many ways in ways that were not all super comfortable people go oh your sex drives up and you feel like you want to work out harder

I was kind of an animal like I wanted to go to the gym twice a day for 90 minutes each time it's good but then your joints are like bro you're 45 maybe calm down I didn't have rage or anything because I'm not really that guy. But I started to have, I wanted to work on my business all the time aggressively. And it was like, no, maybe just play Legos with your kids, dude, calm down. So I had to take a breath.

And then that's when I got my blood work again and they were like, we need to tone it down. I went rucking like six days a week for people who don't know it's walking with a very heavy pack. And I was doing like 60 pounds. I was like 150 pounds,

putting 60 pounds in my pack, walking like 10 miles. It's too much. At the same time, I was also dieting, right? So I was like getting shredded on a calorie deficit, like a nerdy tech guy special forces training, right? It was ridiculous, though, amount of overload. I told my buddy who was actually in the seals, like what I was

doing, and he's like, your knees are going to fall off if you don't calm down. So I did that. Fun little experiment. It was a fun experiment, but yeah, you can overdo it. And again, I think my original point before I started yammering was you don't need TRT to feel good, bring your testosterone up. In fact, basically it's like a last resort, right? Avoid it at all costs. If you're trying to have kids and you're a young guy, avoid it as much as you can. I would love to drill that into people's heads more because it sounds like, oh, simple, I'll just inject it. But you can't quit doing it and it has all sorts of side effects that you don't get from just making sure your balls work.

Yeah, and unfortunately these days it's so easy to get TRT. People who are prescribing to are telling guys about this. The incentives are wrong for this, right? because if you do a telehealth clinic, the doctor or whoever runs a clinic makes a hell of a lot of money if you're ordering $1,000 worth of testosterone from them every month for the rest of your life.

So they're less likely, theoretically, to tell you that you can do a bunch of other stuff instead to try first that you can stop taking at any time if you decide you don't like it or you don't care about your hormone levels anymore for some reason or something goes wrong. But if somebody sees you as a walking $1,000 recurring payment

for the next 30 years, The incentives are wrong. Complete. That's well said. The incentives in this industry are completely wrong. You mentioned earlier varicocile. What is this again? Because apparently I have one, like I said earlier in the show. Yeah.

So vericose phanes are basically varicosephanes of our legs. Think of a varicosephal as varicvane of the testicles. So it creates basically backflow of blood around the testicle. Testicles need to basically stay within a very narrow temperature range. That's what the scrotum helps with. But anyways, when blood pools around the testicle, it raises the testicular temperature. So it causes a couple of things. It could cause pain.

That's probably the main reason guys come in. It causes infertility. One of the biggest factors of male factor in fertility, it caused hormonal disruption. It could lower your T levels as well. It can shrink the testicles. So this is like when your iPhone is old and starts overheating and runs slower, but it's your test. Yeah, yeah. That's nice.

Jeez. Okay. So I'll have to have this checked out again because the TMI part. So if you got little kids in the car, you're with your grandma. Fast forward a minute. But I had a vasectomy. and it got infected and it was horrible because I had a grapefruit between my legs

thankfully I was on vacation. Much of the lore. It was not good. And after that, the guy, one of the doctors was like, oh, you have a verical seal. But I'm not 100% sure that he was right because I had just gotten over

this completely gnarly infection. Which side was it on? Left. Yeah, usually it's on the left. Really? Why? Just the way it drains back to the body, the way the veins drain back.

But yeah, you probably had one. Yeah, but it can go away, correct? No. No, so it's there forever now? It either stays the same or it gets worse. Oh, good to know. If you've already had a kid, you don't have to stick your pain. Nothing.

No, nothing. He didn't check other than by doing the old grab and whatever. So he can just tell by that. You have to do some breathing, like, you know, breathe hard. Yeah. Yeah, you could feel it then. Huh. Okay.

So why does so many of these things go undiagnosed? Aren't guys getting physicals or is this not something they look for? Guys aren't really regularly tracking in with their doctors until something happens. Not good, guys. Yeah. Come on. And that's a whole different conversation. but men really aren't engaging in the health care system.

And then varicoseal is really, to do that exam, you're only going to do it for those reasons I discussed, like infertility, pain. Even if you're having low tea, no one's going to really check you for varicoseil unless you go to certain doctors. He just said it's really easy to check for. It's a field test.

So it seems like it should just be done every year. But the thing is, it's hard. For example, primary care doctors are the ones who see you for your physicals. It does take someone to know how to really... Got to feel a lot of balls before you. A lot. A lot.

Gotcha. Yeah. You got to know what you're doing. You got to know what you doing. Yeah. You think a GP would get a lot of practice anyway, because they're still doing the hernia test. Yeah, but that one's pretty black and white. You know when someone has a hernia. Because you drop to the floor in a fetal position when you cough and you have a hernia.

But this one, there's varying degrees of it. Like, sometimes you feel something, sometimes you don't. How do you treat that? Surgery only? Very straightforward surgery. Yeah, that's what they said about my vasectomy and look what happened. I don't know. I don't know if I trust that anymore. No, this one is. I just got really lucky that my urologist who did the vasectomy. That guy was like 65. He was like, I've done a thousand of these minimum. And he's like, I've had two infections in my entire career. And you were one of them? Every decade I get what. I guess I'll take off

my calendar. This is what he said. Something like that. It is very rare. Lucky me. But all's well, then ends well, right? I mean, it was kind of a joke, because I said, what could happen? And he said, you could be infertile. And it's just, you're all just love joking about infertility, I guess. So how does the surgery work, though? What do you do to get rid of it? Because the vasectomy, they get in there

and they burn something? I don't know. Yeah, well, they cut the cord. Yeah. They cut the Vaz deference. So this one is we use a microscope, a surgical microscope. We're looking at it like 15 to 20 times magnification. We make a small incision right in that groin area, pull up the cord. We find the veins, tie them off. In simple terms, that's really what we're doing.

We just tie them off and we leave the rest of the structures there in place. Okay, so it's relatively simple, not a big deal. Oh, yeah. We do a couple of these a week. They're very, very common. Local anesthetic only kind of thing? No, you need general. You have to be asleep.

But it's, yeah, it takes about 45 minutes, maybe an hour. Why is it so much more anesthesia than a vasectomy? We're making a larger. I see. The area is a sensitive area. Yes, sir. Yes, it is. I don't think you need to explain that. Yeah, vasectomies are quick. Yeah, that's true. Very quick. It was like 20 minutes. It was like, you are not done.

I can't even believe it took me longer to get parking at Kaiser Permanente than it did for me to get snicked. Come on, Kaiser? Yeah. Nice. Okay. This is something that I've wanted to ask about for a while. I mean, this whole show is about Dicks, but Dick's size is something that men are obsessed with, and I probably should include myself there.

Correct me if I'm wrong. There's been a rise in penis size the last 40 years, average penis size. That's what I read. But how in why? Why would that be true other than endocrine disruptors are making, or dicks bigger? Is that it? So there was like a meta analysis of a study that came out. I think it said we've gone, in the last 80 years, we've gone from like 4.7 to 6 inches, which is a huge difference.

Evolution doesn't take place that fast. Does sexual selection also not? Right. It's not enough generate, but it's going so fast. Like that number doesn't necessarily make sense. I think that's like a 25% increase in 80 years. Imagine what's going to be in 80 years from now. What are you going to be 8 inches?

You better hope women's vaginas are keeping up. Otherwise, we have a big problem. No one really knows the answer to this, but I think endocrine disruptors are one. I think what's happening is the time when people are hitting puberty and what these endocrine disruptors are doing during the time of puberty when penis is growing in length. It could be throwing things off. But I also think some of this is just like a selection bias type thing.

Who we're sampling, what we're looking at, it doesn't necessarily make sense to me in all honesty. Because you said meta analysis, and look, those are valid for all kinds of things. But I'm always a little skeptical because you have to see. see all the studies that were included. And I've noticed, especially with penis size studies, there's huge data sets from other countries. And then when you look at the methodology, it's like, this is self-reported data among dudes in the military in Portugal. And you're like, oh, a bunch of 20-something year old dudes in the army in another country were like, yeah, I have a giant penis. Go figure.

They told the female nurse who was writing down in the spreadsheet that they all had giant dicks. What a surprise. And then you see the measured ones where like a person injects a drug in into the trimix, whatever it's called, into the penis and then uses like a specific bone-pressed measurement. Oh, they match the average everywhere else in the world using that methodology. So I don't know. I'm always a little bit like asterisk whenever I see that penis size is increased. I'm sure it is, but you got to take it with a grain of salt.

That number is massive. It doesn't make sense. Before we talk about why your sperm count is dropping faster than your motivation to go to the gym, here's a quick word from the amazing sponsors that make this show possible. We'll be right back. If you're wondering how I managed to book all these great authors, thinkers, and penis experts every single week, well, it's because of my network, the circle of people I know like and trust. And I'm now teaching you how to build your own network for free over at six minute networking.com.

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You'll be in smart company where you belong. You can find the course again all for free at six minute networking.com. Now, back to Dr. Justin Human. There's pollution all over the place, but some countries certainly have it worse than others. Wouldn't the West have different potentially endocrine disrupting effects than say Asia, South America, Africa? I guess the question is, have we polluted the earth uniform? enough to make that a thing or not? That's the question.

Because sexual selection would have theoretically been similar across populations, probably. Somebody who studies this, it would be very interesting to see. Measurement bias is the go-to when something like this shows up for me. 100%. Tell me more about the puberty hormone exposure stuff. Because I know we have endocrine disruptors, like in our shampoo soap, water supply. What else could cause something like this if it's not just spurious data? Yeah, I mean, the endocrine disruptors, there's tons of these things around us.

Some people are saying now that even like receipts are causing. That's definitely true. Like 80% of receipts have some degree of these endocrine disruptors which throw off our hormones. That said, just for people who are worried, you'd have to touch thousands of receipts in order to have that problem. So if you're a cashier, big time issue, working at a restaurant, big time issue. If you touch a receipt at Chipotle every day, you'd need to like eat the receipts in order to get enough. I think it's BPA or something that's in there. So casual receipt handling, not an issue.

But if you work with receipts, but here's the thing, when do men's penises grow during puberty? Because what kid is touching a shitload of receipts? Yeah, so the adult version of the penis. I see. It's during puberty. Okay. But during that time, I think what's happening is because of these endocrine disruptors, puberty is becoming elongated, right?

This is the theory. It's a longer puberty period. As a result of that, your penis is getting exposed to some of these hormones for a longer period of time. Therefore, you're getting a longer length. You're selling it pretty good. Most guys are like, how many receipts do I have to eat after this podcast? I'm quite skeptical of it, in all honesty. I do think things are growing, but to this extent, there's no way.

It's tough to predict, and I can only imagine the amount of fake crap out there for penis enlargement. Maybe we'll get to that in a bit. There's ads and stuff like that, but I'm going to go ahead and guess that nobody has quite nailed the ability to take a pill that you've ordered from an ad off porn hub to make your penis grow. Get on it, man. And then we'll have the round two on your jet. I wouldn't have to work, if I figured that. Yeah.

Yeah. And your yacht. Yeah. So when we're in our 20s, 30s, 40s, can we go decade by decade and talk about how we might preserve or work on our hormone, sexual function, infertility? Like, is there anything guys should be doing in their 20s other than just not getting fat? Yeah. I mean, your 20s and 30s, you're really laying the groundwork for your 40s, 50s and 60s.

So simple terms, you just get a good exercise routine, mix of cardio as well as heavy strength training a couple times a week as much. as you can. I know we've talked about this, but eating right is quite important. Minimize your stress as much as possible and then sleep. Those are the big things there early on. It's simple stuff. You don't need to supplement. The supplementation and all that stuff, that's the gravy, but you've got to get the mashed potatoes. You've got to do those four things in order to set the ground table for everything else going forward. And that's in 20s, 30s and 40s, I assume. Yeah, 20s, and then once you hit your 40s, this is when we start talking about some other things.

Like, what can guys do at this point to optimize? Our testosterone levels start to decline starting at the age of 30. We say 1 to 2% every year. What can you do at that point? Let's say you're getting poor sleep, you're stressed out. You check your T levels. They're low. Repeat that test in a couple weeks, see what the levels are at. If they are low, then you have to start thinking about other ways in which you could boost your levels. So there's other ways like the supplementation, some of those things that you talked about. We talked about Clomid, which is a medication that could basically tell your testicles to produce more testosterone, this HCG. These are all natural. Well, there's still pharmaceuticals, right? But HCG, I'm familiar with.

Actually, I think, isn't HG and Colomid? Isn't that what steroid guys use after they come off their cycle to restart? Okay, I see. That restarts the natural testosterone production in the body. And then once you get into your 40s, this is one thing I actually recommend. Starting at the age of 40, I tell guys they should start taking Cialis regularly. Okay, talk about this because I take this for gym pumps. It's from my doctor, but he's like, you don't need this, but it's good for the gym.

and it's somehow cardio protective because it dilates my veins. Is that right? We arteries. Artteries. Okay. Yeah. So it's specific for the pelvic area of the penis in terms of dilation. It dilates the arteries of the penis, therefore you get strong erections.

What's the difference between a vein and an artery again? I know I should learn this in seventh grade. Artery takes blood flow to the organ. Yes. And then veins bring blood blood. Okay. Got it. Thank you.

So it dilates these areas. We do have some idea now that it could help even systemically. There's some blood vessel dilation that can even take place in the rest of your body. And that's not bad for me. No, unless you've had a history of heart attacks where you're on medication because your blood pressure has dropped significantly, if you're on nitrhyrites for your heart, basically, those are the patients who are at risk of this. Cialis, like a low dose of Cialis, incredibly rare where it actually drops your blood pressure significantly. It is safe to take. What's a low dose?

Because I know people right now are looking, you can get it online from an air quotes doctor that looks at your email when you submit the form and then mails you like a packet of. of it, people are going to overdo it if we don't tell them what a low dose is. So five milligrams is generally the lowest dose and some people actually take two and a half milligrams. But I'm not saying take it every day, but once or twice a week, starting at the age of 40, especially even if you don't have ED, because we're all going to get ED at some point. But it delays the onset of it. That's the idea. Biochemically, we never develop a tolerance to this. If you start, let's say, 10 years from now is working less and less. It's not because of the medication. It's just progression of disease. We want to call ED a disease. Your erection is just getting worse because of other

things. Honestly, I'm not sure that I can tell the difference because I'll stop taking it if I forget it on a vacation and I honestly don't know the difference. So I take that to be a good thing because that maybe means I don't need it for the activities that happen when you usually take care of. But I don't know. I have heard that it's good for your heart because it lowers your blood pressure, but you're saying that not appreciably so unless it's a higher dose. It's not a blood pressure thing. It basically helps to your arteries to the whole body, which is only good that can only help you. I do notice if I take a 20 minutes before a workout, you get crazy pumps and probably better recovery, which is why they prescribed it in the first place for me.

If you wanted, you could do L-citraline. I take that too. I take both. That's fine. But if people don't want to jump on the Cialis train, doing L-citraline, 3,000 milligrams, three grams daily, that works well too. And that stuff is cheap, man. I think I got a huge bottle of 300 tabs for 40 bucks, 20 bucks.

is also seemingly noticeable. Look, could be placebo, but as a pre-work, yeah. We already talked about banking sperm, but what about testosterone tests? When should guys start testing their testosterone? If you're having symptoms, I wouldn't necessarily jump into testing unless you're really having symptoms, because this is the thing about testosterone. The range is 300 to 1,000, which is pretty unfair for a number of reasons. But one guy, like, for example, for me, when I'm 500, I feel great, right? For somebody else, if they're not at 750, and anything below 7,000. they don't feel very good. So if you go to a doctor, they can be like, you're in the normal

range. I'm not going to really treat you for it. Also, so what? If you're 301, you're okay, but if you're 299, you're low T. That's how health care works though, man. You're a doctor. You know this. Right. Unless you go to somebody who knows what they're talking about, right? But anyways, it comes down to if you're having symptoms, get it checked out. Some guys have all the symptoms. Some guys have one of these symptoms, but it's low energy, not exercising the way you used do. Sexual functions, a big one, whether you have poor erections, your libido, your drive is not there. Even when you go to the gym, you're not exercising the way you used to. Sleep is a big one too. People feel like they're sleeping. They have a lot of sleep disruptions. Even mood,

like anxiety and more so depression than anxiety, but mood's a big one. A buddy of mine who works for this show, actually, Nick Pell, one of the writers for this show, he was depressed. I've known him for a long time. He was depressed. And then he started using testosterone, essentially steroids. He admits this, it's fine. Everyone's like, oh, it's bad for you. And he's like, you know what's bad for me, wanted to kill myself in the morning, literally. And it's hard to argue with that. Yeah. Now, should he have used other alternative methods to try and raise it naturally, whatever

may be possibly debatable? But there's a lot of guys out there. Whenever people tell me I'm having a midlife crisis, I'm depressed, this, that, and the other thing, I always recommend getting their blood work because you might think your entire life is falling apart, but you might also just have some shitty blood work that needs to get handled. Yeah, I can help. I have a psychiatry buddy who screens when a guys are depressed, he'll screen them for low

Good. I feel like that should be step one. Agreed. I know so many guys who say that they're depressed and then the mind is weird. We don't want to go, I'm depressed because of no reason. They go, oh, I'm depressed because my career's not where it was supposed to be and my marriage isn't what it was supposed to be and I'm stressed out about my kids and I'm not sleeping well. Or did your brain look at all those things and decide that's why you were feeling this way because it needs a reason. And this is what happened to a lot of friends of mine and myself as well. When I get sick, I start to go, I'm not happy with this and this and this and this. And then when I'm better, I'm like, was I tripping about it? It's all fine.

And it's because your mind looks for a reason to feel down instead of just going, I have a hormone problem or my blood work. Your mind doesn't know that. Your mind doesn't know that your body's tripping. So if you feel like crap right now and you're struggling to get out of bed, go get blood work done, even if you have to pay for it out of pocket because your doctor is giving you trouble. And if you have low testosterone, or even if your doctor says your tea is normal, but it's under, I don't know. Like low normal, if it's in the low end of the normal range. Get a second opinion because my testosterone was normal, but then when it was fixed, I felt like a totally different person. The closest analogy I have is when I started taking Adderall in college

because I got diagnosed with ADD. Surprise, surprise. And I took Adderall and I was like, wait, is this how normal people feel every day? They can do. just listen to a teacher talk for 45 minutes and they don't look at the sky in the room and count the holes in the ceiling tiles, this is unbelievable. That's what getting my tea fixed felt like. It was like, oh, I want to get up in the morning, and I want to work hard, and I want to work out, and then I want to do all the other things that are intended to having normal testosterone. It was like starting to see in color from black and white. So if you're feeling down or you're feeling a little rough around the edges, go get your blood work done. What about proactive testing

strategies for guys who want to stay ahead. What if you don't have symptoms? Does it make sense to go get a baseline of testosterone when you're 30 just to see, because if you need it again in five years and it's way down or way up, you know, that you can look back in time. Like how to optimize? Well, because when I was 33, I got a CEO health check gifted to me by a show fan. And it was like V-O-2 max, testosterone, all your blood levels. I look back at those documents now and I go, holy crap, I had 39% body fat. My testosterone was 250 when I was 33. I'm 45.

I'm objectively healthier in pretty much every single category. Like my triglycerides are lower. My testosterone's higher. My cholesterol is lower. Everything. Obviously my body fat is not 40%. So I can look at that and I go, I don't have this delusion that I was healthier when I was younger.

I can actually look at the data. And it's been helpful for doctors now because they'll go, oh, you've probably always had this level of testosterone. You don't know that it's the medication. And I go, actually, here's blood work from five years ago, 10 years ago, 15 years ago, all laid out nicely. And they can see the trend instead of just guessing. Is that valuable at all? The trends for sure. Yeah. Definitely. But the first part of your question in terms of what can guys do, younger guys are like, I know I have good healthy testosterone testosterone. I'm trying to optimize, right? I'm trying to take it to the next level. And now we do have some strategies because there's a lot of advancements in the testosterone replacement

therapy world, take them to the next level very safely, pushing the needle a little bit further. And that's a whole different way of treating these guys. These guys in their 40s and 50s, before 60s, 70s, 80s, these guys are usually in testosterone placement therapy. But 40s, 50s, we have different combinations of meds we could give them. What about guys in their 20s and 30s? Is there anything they can do now to, aside from diet and exercise, like we said, to either stay ahead or test for something that might bite them in the ass later?

Yeah. In your 20s and 30s, again, you're on Easy Street, but you don't know that when you're 20 and 30. You have no idea. You know, I'm broadly speaking here. Every part of your body's working well. Eat right, sleep right, exercise, minimize your stress. I can't stress enough. Those four things.

But the exercise early on in your 20s and 30s is massive. Is it healthier to have kids younger? Is there a declining health to my offspring if I have kids in my 40s and 50s as opposed to in my 20s and 30s? You have increased risk. For example, as we age, our sperm become, they have different types of DNA issues. One of them can slightly increase the risk of autism, for example. Oh, really? Oh, they know that now.

It's slightly increases it, slightly increased. But other genetic issues as well, just as similar to the female with her eggs, the older she gets, like increased risk of Down syndrome. My wife had to do extra screening because we had our second kid. She was 35, I want to say. They call that a geriatric pregnancy, which sounds harsh. She did not like hearing that. Let me tell you. Yeah.

increased risk. As we age, there's slightly increased. We say autism is one, but there's other ones that can increase as well, for sure. Do you notice any psychological impacts from male infertility? It's hard to put myself in the shoes of many of my friends who are having trouble, but there's something about it that kind of like reaches into the core of their identity as a man in a way, even if it's a problem on the other side of the wife's physical problem, there's just something about it that I think for a couple is like uniquely difficult and traumatizing, devastating. Yeah. It really gets to the court. Like, if you can't even do this one thing that you're put on this earth to do, I don't know. It screws with you. Have you seen that?

Yeah. I'd say it leads to relationship issues. Yeah. So I think men for the most part, and obviously there's extremes on both ends of this, but men for the most part, once they get the news, it's a punch in the gut, no doubt, especially if it's them. But fertility issues as a whole can lead to a lot of relationship issues because it becomes a finger-pointing thing. It's like, who's at fault? You're smoking a cigarette now. You shouldn't be smoking a cigarette. Why are you in the hot tub? I'm doing all these things to help myself out to increase our chances. You're not doing those things. You're out there drinking, whatever it is. But it can lead to a lot of relationship issues because they're trying to get to that end goal. Not so ironically, but that makes things a lot worse.

Of course, the stress, right? Yeah. So does mental health stress lower testosterone or does lower testosterone cause depression and worse mental health or both? Yeah, it goes both. Okay. Yeah. As you can imagine, if you have a mental health issue with anxiety depression, poor sleep, you're not exercising, you're not eating right, you're not out socializing. It's worsening things for you.

You're not getting the vitamin D from the sun. I actually say they go hand in hand. Mental health and hormonal health really do go hand. If you're out there socializing, getting exercise, seeing the sun, those types of things. It's good for everything. That was another thing I was massively deficient. It was vitamin D. It was like rock bottom terrible.

And then I started supplementing it, ironically, coincidentally, whatever, wanted to go outside all the time. And then my vitamin D was too high because I was outside seven days a week, rucking. So I just cut back on the supplementation. And it's like, it was way over the limit because I was getting it from the sun and from supplementation. How long were you in this period or high tea? Oh, high tea? Probably like four months. Felt great.

Oh, my God. It was like being a superhero, except for the fact of it. it's not good for you. I didn't have any real side effects because I wasn't angry or anything, but the testosterone test only went to, I want to say, 1,500, and it just said greater than 1,500. So it means you could be 2,500, unlikely because I wasn't taking testosterone itself. But I was like, where was this energy in my 20s? Because this would have come in handy, I think, back then. If people hear this, they're like, I want to get on TRT. Yeah, don't take TRT though. I took magnesium, vitamin D, some DHA,

and a couple of other magnesium and stuff for sleep, and my hormones went through the damn roof because I was deficient and I was sleeping like shit. Surprise. And then, of course, I was working out and eating vegetables and chicken instead of freaking processed foods. I was also eating some processed foods,

but not exclusively like I was when I grew up in Michigan. I love Cheetos. Some nice flaming hot. So good. Oh, yeah. Any version of crunchy Cheetos, I will eat it. I don't care. Lime, flaming hot, regular, I'm there.

What is your opinion on, there's these new pills that men can take for birth control. I'm not a doctor, but I always recommend women also avoid hormonal birth control just from what I've read about it. It screws with your whole body.

People think you take a pill it affects one part of you. That's not how anything works medication-wise. Yeah, it's hard for it to be for sure. Like a vasectomy, we've been doing vasectomies for decades. And it's a physical thing. Plumbing is no longer routed

in the same way, the end. Yeah. So it's old school, but it works. And I know there's new technologies they're trying to basically replace the vasectomy. there's different polymers they're trying to inject in there. They inject it in the lumen, right, in that inner part of the Vazdeference. Oh, and then you can dissolve it if you want to reverse it.

Exactly. But that procedure itself is basically half of Vesectomy. In order for them to get access to that inside, they're still opening you up. I see. So it's just as invasive? You know, it's basically half as invasive, if you will. Right now, I don't think we're there for any of these procedures or these medications like the pills.

I think we'll eventually get there. We're just not there yet. Yeah, Vesectomy is still the gold standard. It's great. I tell guys it takes seven or eight minutes. I know you had a bad experience, but you're in, you're out. I looked at the stats before and after, and I was just unlucky. I had a one in 2000 or something chance of getting an infection, and I got lucky there.

And it's like one of those things where you go, oh my gosh, would you have done it? Yes, I did the right thing, even though I had an unlucky role. I still did the right thing. I still got the right result. If I had to have both my testicles removed or something as a result of that infection, then I would probably have gone like, well, shit. that's not what I wanted at all. But since I'm totally fine now, I think it doesn't really matter. But I'm worried about these male contraceptives because I feel like this is one of those things where they go,

hey, there's no side effects. And if you just stop taking it, you'll make sperm again. And then they find out years later that it causes pancreatic tumors or something. Or it stops the production of semen because it stops something else that you need or wants. Exactly. So that's what I'm saying. We're not there you are with these things to shut off sperm production. and then to take a pill, I'm sure you have to time it appropriately. Ultimately, that the mechanical obstruction is stopping the route of sperm, it's the best way of doing it. Yeah. Tell me about porn and sex here, because there's a whole bunch of guys they'll write in or I'll see it online,

and they'll say things like death grip. It's where they like, they masturbate so much that their grip tightens over time to increase stimulation or something because their nerves are desensitized. so then when they have sex with a real woman, it's just too loose, even if it's a normal vagina, which to me is very odd to imagine because I don't know how much masturbating

you have to do to get there, but I can definitely say I've never been close, and I sure has hell tried. What amount do you have to be working on yourself here, cranking it, to get desensitized to real sex? It's both grip and frequency. I mean, years and years, decades of masturbation, but yeah, yeah, it's a real thing.

And guys, as much as premature ejaculations is a very real thing. Delayed ejaculation is a very real thing. There's a friend of a friend, I should say, and he's in the adult entertainment industry. And I was like, wow, you must have crazy stories. And he's like, oh, come out with me and some of the girls. So one of the things the girls told me

was that a lot of male stars, they have to use porn while they are on a porn set in order to finish. And I was like, wait, repeat that. You're filming a sexual scene with three women, but you're on your phone in the corner looking at a video of a guy who's not you having sex or three women so that you can finish. Because this is work.

It's crazy to me. I feel bad for that guy. Like, this man has ruined his penis, essentially. How do you recover from that? A lot of these guys are doing injections, too. They're past the point of Viagra in Seattle. They're doing injections in the penis and order to get erections. Good, God.

And these guys are like in their 20s and 30s, right? Yeah. It's a job. What are they injecting? Asking for a friend. Think of it like liquid Viagro. There's different chemicals, prostate glandins, almost. common one, brings more blood flow to the penis. But a lot of these young porn stars, I mean,

we see them, given where we are, where our office is. Where's your office? Right down the street here. Yeah, here at Beverly Hills. I thought they'd be more in the valley, but, you know, times have changed. They come here, and we see a lot of these patients. And not only are they young guys who are doing the injections, there's even younger guys who are getting the penile implants. Like, guys in their 30s and 40s are getting penile implants. They've exhausted the medications, via Seales. The injections don't work anymore. All they could do now is the penile implants. So is the implant for size or is the implant because they can't get an erection? Purely for function.

Oh my God. Yeah, it's a pump. We literally put a pump in their penis. It's all underneath the skin. How do you pump it up? There's a pump that sits in between the testicles and the scrotum. So you have a third nut. You have a third nut.

That's like a Reebok pump from the 90s. And you have a little reservoir in your belly. Get out of here. So every time you won't have an erection, the fluid from the reservoir goes into the cylinders, gives you a rock art erection. I think Reebok of a car erection. Someone will correct me on this. That's actually incredible technology.

Yeah, it's been around for decades, too. We've been doing this for a long time. I just have to appreciate that there is a third testicle that you pump and then something in your abdomen puts, I guess, a fluid into an implant in your penis and you can get it. That's actually just amazing. And then when you're done, there's a release button. Oh, yeah, I suppose you would want that too. I wouldn't want to have to have that, but it would be nice to not have an erection

in an inopportune time. You're on the airplane, wearing your joggers, hypothetically, folks. And yeah, you're like, crap, where's my... sweater. I got to tie this thing around my waist. It's a good problem now. Yeah, at age 45, again, for those who might have it. It's that daily Cialis, exactly. So what is the cure then? If you've got the porn brain and you can't get an erection, are you screwed now or do you just quit porn and it comes back eventually? Yeah. So look, I see a lot of young guys who have porn-induced ED, right? They're watching too much porn when real life comes about. This is nothing

compared to what I've seen on the screen. This girl doesn't match up, whatever it is. The good thing is, I could tell you, like anecdotally, if a guy stopped for honestly like a couple weeks, you'll start to notice the difference. Obviously, look, you have to make a long-term change. But within a couple weeks, I'd say guys are able to notice it change. I'll have these guys come back four weeks later. Some of them, I'd say most of them. The majority of them, I'm like, look, I'm noticing something. And the longer they do it, the better off they'll be. There's a lot of plasticity here. So the nerves of the penis get more sensitive, the less you death grip it, you're talking about, the less you do it. So no one is screwed with this. You're not screwed.

just change these habits, break these habits, and things will, generally speaking, they'll resolve. We're talking porn, dopamine, and why your brain doesn't know the difference between a real-life partner and a tab you forgot to close. While you go clear your browser history, here's a word from our sponsors. We'll be right back. If you like this episode of the show, I invite you to do what other smart and considerate and likely very fertile listeners do, which is take a moment and support our amazing sponsors,

those who make the show possible. All of the deals discount codes and ways to support the show are searchable and clickable over at Jordan Harbinger.com slash deals. If you can't remember the name of a sponsor or you can't find the code, email me, Jordan at Jordan Harbinger.com. We're happy to surface codes for you. Yes, it's that important

that you support those who support the show. Now for the rest of my conversation with Dr. Justin Human. It's really easy to judge guys who get hooked on porn or watch too much porn, but I don't know. Look, as a guy who grew up in the 80s and 90s,

I have real sympathy for people who grew up with unlimited pornographic shit on the internet. accessible at all time. How do you stay away from it? There's no chance I would have stayed away from it as a teenager. There's no way. It's not, I'm old enough to know you shouldn't do that.

There's no scenario in which I wouldn't have watched porn constantly as a teenager. Zero chance. I just didn't have access to it. If I wanted to download a pornographic image, it would take 20 minutes on dial. Yeah, that's even if, yeah, or 28 or 144, man. And even that was good tech in the early 90s. It goes, John. My mom caught me downloading a porn jiff once.

I remember it was a woman with a life vest on a jet ski, like touching herself. I was like, almost done. And my mom came in and was like, what are you doing? Turn this off. It was all pixelated. Yeah, it was like probably like a tiny, you know, bitmap or whatever. It's just absolute trash. And it's funny.

I remember what that was because it was such an impression on me as a kid. That was all I had access to, man. I didn't have porn hub streaming to my iPad under my blankets at night at age 13 or whatever kids have now. So I have real sympathy for guys that get stuck with this problem because when you're 13, 14, 15, you don't think, gee, if I do this for a decade, I'm going to cause myself a real problem. That's not something that kids think about. At all. Yeah.

I would tell you this, like these young guys who come in, this porn-induced ED, it actually leads to these guys get anxiety as a result of it. Of course. It literally leads to mental health issues. They have anxiety. They have ED, and as a result of it, they get anxiety. And then they come to us. I'm a urologist. And they, I'm thinking about something.

got to go to a therapist, right? This is past the point of what we do. It's really a bad cascade. I agree, man. It's awful. I got an email that was like, I'm afraid to date women. And I was like, they're not so bad. What are you scared of? And he's like, no, it's not I'm even bad with women. If I'm good with women and she wants to have sex with me and I can't get it up because porn-induced ED, I'm 22, she's going to tell her friends. And I'm like, God, you're not wrong. That could happen. And then what? So he's like, I'm just avoiding it. So he doesn't even go on dates. And I'm like, you're actually handicapped. and yourself socially because you have porn-induced erectile dysfunction at age 22. It's really, it's quite tragic.

Porn at that age, Fs you up. Yes, yeah, because your brain's still developing. So guys, stop watching the porn. I know it's fun and entertaining. Minimized it at the very least. Yeah, instead of daily, I don't know, wait until you're about to explode and then take care of it. I don't know.

What's a healthy porn use? I don't even know. So I'll tell you, I had a therapist, a sex therapist who told me this, like, I refer her patients. And she said something good. She was like, for every two times you watch, porn for masturbation one time don't but really just you could masturbate it's fine to masturbate but obviously within a normal amount but do it without porn theater of the mind oh yeah use that creative

mind that's crazy some guys right now are just like how do I do that yeah what's that yeah what's that imagination what's that's like when your phone battery's low and the video won't play yeah it's slow internet guys I did a show recently on insulin men and women for that matter though have insulin issues cortisol issues, thyroid issues seem to be quite common now. Again, I don't know if there's more thyroid issues or if they're just getting caught more because of testing. How do you manage things like that? Or do you not view those as important as, say, testosterone management? We do know that insulin's part of the bigger picture of diabetes and making sure if your blood glucose levels are high. You always want to change your diet, clean that up to minimize that. That's the insulin part.

But thyroid hormone is very closely related to testosterone. So if you have low T, you always want to check your TSA, which is part of the thyroid cascate. T-SH? Yeah, thyroid-stimulating hormone. You want to check that. So that's part of the panel that most doctors will check. Is that what T-3 is? T-3 is one of the thyroid hormones themselves.

But that's part of the comprehensive hormonal panel. Cortisol, people are checking cortisol more and more. And this is the one that, well, you're going to check your cortisol. Your cortisol levels are high. You can probably change your lifestyle. It's more of these things. What are you going to do with this data? Well, you've got to try to minimize your stress levels, which is if anyone knows how to do

that. Yeah, let me know. Exactly. These tests, we're learning more and more about the whole complete picture. I do think some of these tests, you don't necessarily need them as much, but we're slowly getting there. We're getting better tests to fill in the whole comprehensive picture. I know there's C. Alice, for example, but there's also PRP.

Can we talk about PRP, shockwave, Botox? Let's talk about these things. I wonder what's sort of hype and what's proven. Maybe we start with PRP. That sets off alarm bells because PRP is like, oh, put it in your knee, and your knee's better. Put it in your elbow, your elbow's better. People are just injecting this everywhere they can and somehow it fixes everything. That always makes me give some side eye.

Yeah, it's made its weight to the penis now. Of course, yeah. Yeah, so PRP is you spin down the blood. We draw a large amount of blood from you, we spin it down. And then there's a portion of the blood, which is rich in growth factors. And what we do is we inject that into your penis, about 10 cc's of it. Whoa, that's a lot. Yeah, it's a decent amount.

You said it's platelet rich plasma. Is it my plasma? Oh, yeah. Okay, so you take it from my blood. Yeah. Oh, that's cool. The process is you come in, we draw blood, we spin it down for about 30 minutes in order for us to collect that specific platelet rich components. How much blood do you need to get 10 cc's of the platelet rich?

Yeah, we usually take about 60 cc's of blood. Oh, wow. 60 milliliters. So this is like distilling my blood down to one specific part of it. Yeah, it's like petroleum when we're refining petroleum. Same idea. Huh. You're swollen after you get 10 cc's of liquid.

It's a flaccid penis and then you're injecting it. So it could hold it. I try to keep it in there for like an hour and a half, two hours. hours. I tell patients to keep it. We turnicate the penis in order to keep it in place. You wear a tourniquet on your penis for an hour? We wrap it. We do a special wrap on. Oh, because I was like, again, I'm no doctor, but isn't it going to turn blue and fall off? No, no, no. We don't cut it off completely. But it's growth factors in the penis. If you asked me anecdotally a few years ago, guys liked it. Now we have data to support its use. It does help with

erections, definitely in terms of, it helps with basically some of the smooth muscle regeneration within the penis to create more elasticity, so more blood flow comes in for stronger erections. I would say if you're going to do PRP and whatnot, all of these things that we're going to talk about, these are after doing Viagra and Seattle. At least you want to be doing Viagra and Seales while you're doing these things because they only help.

How do you know if you need something beyond Viagra or Seales? Is it because the Seales just stops working and you can't get or keep an erection? Like, what's the red flag that you're looking for? because I have no idea if my erection quality is as good as it was 10 years ago. Like there's no meter I put on there. I haven't hooked it up to any machinery. Yeah, it's like there's no objective number.

So there's two components. So there's two classes, two groups of guys. So one of them is the vagrant sales just aren't working anymore. And they're like, all right, well, I have to try something else. We'll try these things. And sometimes they jump into the injection. Sometimes they jump to the implant. And then there's the other group where they're like, look, I'm young, I'm healthy,

I feel good. I microdose Cialis every once in a while. but I want to optimize my erections. And that's when we talk about PRP. Shockwave is a great one. Tell me about that. Shockwave. Yeah.

Shockwave's fantastic. I'd actually say shock waves probably amongst all these things. Shockwave is probably the best one. The way I came about is as urologists, we treat kidney stones, right? Oh, I never thought about that. I thought you only did erection shit here. No, that's right. You're a real doctor that does other things.

Kidney stones. Anyways, so we treat kidney stones. One of the ways we do it is with high energy sound waves from the outside. You could just break the stone up into pieces? Exactly. No kidding. From the back, right? Okay.

And long story short, one time they looked into the kidney. They're like, wow, this kidney, one of these patients who had numerous shockwave treatments, like, wow, this kidney looks very well vascularized. I wonder what this high-energy sound wave is doing. So we've done a lot of studies on this, and we see now that high-energy sound waves can lead to neovascularization or new blood vessel growth. Why? It's creating microtramas.

Yeah, that's what I was going to say, it's rupturing your tissue, so it regrows. That microtrauma essentially, it doesn't kill it, but a little bit of microtrauma, eventually leads to new blood vessel growth. Wow. It works. So we do it for the erections. There's orthopedic surgeons who do it for tendons. If you're having any type of tendonopathy, it works there as well. There's some cardiac surgeons who are doing it for the heart because it penetrates deep. And it's great. I would say that if you're trying to optimize your sexual health, like your erections, that's the best way of doing it. How many times do you have to get things like PRP or shockwave or is it around and then it's done or is PRP ongoing, a shockwave ongoing? What is it like?

So we know what the induction course is, if you will, the loading those beginning part, but then the maintenance part is the part where we're figuring that part out. Shockwave therapy, it's six treatments over either three or six weeks, and each one takes maybe 15, 20 minutes, and it doesn't really hurt. This little at-home device, which I know is not the same thing as getting it done in a clinic, and I guess I will be, I don't know, shocking my dong with that later on. That's nothing sounds like a jackhammer. I bet, yeah.

The neighbors of the hotel are going to be thrilled. They'll be hearing it. And then PRP is just two treatments. But ultimately, I'd say if these work for you, I have patients who come in quarterly or twice a year just for repeat treatments. Wow, two treatments of PRP and your ED is in some people solved. That's awesome. Not solved.

None of this is solved. Are your erections like a six out of ten? Can we get it to eight, maybe a nine out of ten? Like that kind of movement. It moves the needle in the right direction. That's phenomenal. The shockwave thing is quite interesting. I mean, six treatments over six weeks.

I'm thinking, do you have to do it over that specific period of time? or it can only do it once a month. Is that helpful or not as much? Not as much, the cumulative effect of these treatments. That's the thing that works best. Gotcha. What about Botox? I've actually heard about this, and I did an episode on Piano Enhancement,

and I was like curious about this. So I went to a doctor and asked about it, and he offered to give it to me. And he put that in, it was like, I'll do this. It's like minimally invasive, right? It's a tiny little, I think, insulin like needle or something. And I will say, I don't have EDs, so I can't say that it helped or anything. I probably wouldn't do it again because. I'm not a big fan of injecting things into myself

for no good reason. I did it for the show, but tell me how this works, supposedly. Did you notice anything? I actually noticed that it maybe did the opposite. And I can't tell, again, because it's like placebo, nocebo kind of stuff, but I'm like, huh, I can't tell if it made things better or if it, like, actually relaxed too much and now it's not as good. Because I noticed that it wore off and I feel like it's better now. So I'm on the fence.

Like maybe I took too much or if you don't need it, it does bad things. And if you do need it, it does good things. I really don't know. Or maybe he gave you too little. Too little, I see. Maybe. Huh, okay. Too small of a dose.

But anyways, what does Botox do? It relaxes muscles. So the idea here was it relaxes the smooth muscles. So his arteries dilates them. So more blood flow comes in. It's like Cialis. What Cialis does, though. Exactly.

Same idea. But this is like a stronger dose. Botox is very concentrated, right, right in the penis. We've done penalitis. ultrasounds on patients before and after Botox. And objectively, like the pulse wave, the amount of blood flow, the velocity in which blood is coming into the penis is definitely higher after Botox. So the objective data supports it, but clinically is it making an impact.

I have some patients who love it. They come in every three months for it. Some guys love this thing. And other guys, no response. Interesting. That's why I wouldn't put it at the top of that list. Okay. But what do you think is at the top?

Shockwave, you said? Yeah, shockwave and BRP for sure. What about exosomes? Do you use those? Those are like always hit the news cycle. It's like micro RNA type proteins that can only help with the idea. I know people are using it for pain throughout their body. People are injecting it in the veins to see goes anywhere in the body and people love it.

We've done it for the penis. We do it with PRP. So to what extent is it the exosomes is the PRP? TBD on that one. PRP looks like it hurts. I looked up a video of this happening. And I'm like, that's a big needle going into your penis. No, do you small needles for that.

Oh, really? Oh, yeah. Okay. You could use a small nail for it. Not an insulin needle, but a small one. Okay. Yeah. It just, there's something viscerally unappealing about a needle going into your penis.

I try to numb guys up for that. I bet. Yeah. Do my favor. I'll visit if I ever feel the need to get the PRP. I always want to try this stuff, but I'm also like, I have this, maybe it's a cognitive bias where I'm like, okay, if it ain't broke, don't fix it. And whenever it comes to medicine, you don't just get the one thing that you want. There's always something else that maybe happens if we don't necessarily fully understand.

Oh, yeah. Everything's a trade-off. Yeah. So it's like, I don't know how much I need X, Y, Z. So even with the C-Alas thing, I'm like, I always am looking at, is there new research that says that this maybe isn't so good for you? Is there anything I need to avoid as a result of this? I'm always sort of a little bit risk-averse maybe when it comes to medication.

What do you make of the whole, like, penis pump, penis extension device thing? Some of it maybe works. If you stretch tissue for two hours a day for a year, is that going to make it longer? I don't know. Yeah, it's the vacuum erection device. Or just the ones that clamp onto the glands, the head, and they literally pull. Restorix. Yes, I researched that for an episode.

They can only help. To what extent are you going to get maybe a centimeter, maybe two centimeters? Yeah. Not even a full inch, basically, half inch. Yeah, it's hard to get that. I would tell you this. If you're putting the penis on stretch for long periods of time throughout the course of months, yeah, you could get better length on that.

The Restorex is one of those things that's, you can't be functional. You can't move around your daily life. life with that thing on. No, I saw one, because again, I researched it for our skeptical Sunday on penis enhancement. And it's, it also helps get rid of curves if you curve left right up down. But it's strapped in between your legs. It's this big piece of plastic and then it's got like metal rods. So you're not going to the grocery store with this thing on. You probably can't even walk with the thing on. It's like a scaffolding. Yes, it's a scaffolding around your penis. But continuous weight or stretch can, like any other part of our body, it'll add length to it,

small amounts, like you're not going from four to eight inches. But, but, you're, But yeah, you could get a few centimeters. Okay. But man, what a commitment to get not even an inch of length. Although, I guess if you're below average, we have, what is it, a micropenus, like, you take whatever you can get. Yeah. There's surgeries now that offer girth and length. What kind of surgeries are those?

You look into Pernuma. What is that? They call it the hymn plant now. Oh, yes. I've heard of that. It's like they put a silicone sheath underneath the skin but outside the erectile bodies of the penis. and that adds girth. But what we're seeing is over time

because it's continuously stretching, it adds length as well. I see. Yeah, so that's the continuous stretch I talk about. The problem I've seen with that online is that when I research this, since it's a silicone sheaf, your body responds by basically building a wall around it.

A capsule. Yes. And that capsule can become rigid and scar-ish, and it can actually shrink. So it pulls inwards. The other problem, I think, was that having rubber or silicone inside your penis can rub against the skin. If that happens a lot, it can just rub through the outside of the skin. Yeah.

And then if you ever rode in that area, you got to take it out. It's an infection. It's a big mess. I don't know how you take something like that out without also destroying other tissue around it. It just makes me clam up thinking of that. It comes with risk. No question about it. That's scary.

What about the pumps and things like that? I've seen those. They seemed a little bit harmless at first, but I've also seen, unfortunately, I've seen many photos of guys who claim that they've used it for years. And I'm always like, what is wrong with your penis? Like discolored, weird looking. Yeah, because I guess what it does is it causes the blood vessels to burst if you overdo it. You overdo it. And then if you do that for long enough, you end up with, forget what these are called, but basically like discolored rough skin.

Like little hematomas? Is that what it is? It's essentially like bruises that. that don't go away. Is that what a hematoma has? Scars, basically. Yeah, like the skin is just discolored and brown. I talked with another doctor who does hyaluronic acid fillers, and I was like, oh, what about the pumps?

And he's like, you can tell, he does a lot of the adult stars, too. You can tell when these guys come in because their dick looks like it's just been abused from the pump. There is some role for the pumps, though. I will say, like, for example, like with this penile implant idea that I talked about, sometimes you have to take it out due to infection. Anyways, when they scar down as a result of it. So the pump itself really could restore some of that length.

It gives them that elasticity. They're doing this for a couple months before we go back in there. But if you're overdoing the pump, it could cause damage for sure. Yeah. It just seems like a tough thing to not overdo. If you're trying to make your penis bigger, you're going to overdo it. That's kind of the idea, right? Yeah.

So we've optimized, like, sexual function, like ED. We've figured out ways of optimizing that hormonal health. But when it comes to optimizing length, we don't have it. Everything comes with risk. So you've got to be careful. What do you think of the other? enhancement procedures that are out there on the market. There's hyaluronic acid fillers, which I just mentioned.

Tell me what you think about that. That seems to be like maybe the only safe-ish thing. Because there's PMMA, which is like a plastic, but you get granulomas over years, which are essentially, what are those again? Those granulomas just come about because either the way they've injected is not uniform or your body is absorbing certain parts of that injectable material, but not other parts of it. So it becomes like your body's a bit.

absorbing some of it. What's left is this weird, bumpy, uneven. It really doesn't look good. Imagine trying to take out a little silicone bead, but there's a thousand of them, right? Or 100,000. That surgery is messy. And the thing is the nerves for the penis for sensation are right there. So that surgery gets very messy. Yeah. So hyaluronic acid, what appealed about that when I looked at the safety profile was that it just goes away over time. And also, you can dissolve it using enzyme. So like anything where there's an undo switch that takes hours to a day, that seems way safer than injecting silicone or putting an implant in there. Yeah. You just want to go to somebody with anything, whether you're doing any type of surgery. You want to go to someone who knows what they're doing with the filler.

And you want to just have them guide you through the process, but someone who knows what they're doing who does this regularly. One of my friends who was also a source on this show is Dr. Joel Pash. I don't know if you know him, but he owns upsized clinics. They have 24, 25 clinics. They only do the high-eller. Acid Filler. And I asked why because, man, you could make so much money doing all this and he basically told me all the downsides of how unsafe some of the other things are. The horror stories are really horrible. They're bad, man. I know the ones that you've probably

heard too. And I don't want to get sued so I won't mention specific companies. But some of the stuff that we've talked about has complications where they say their complication rate is like 1%. But if I look at pending lawsuits on LexisNexis, there's a lot of them. Allegations are pretty severe. And the injuries that are caused are not worth it at all. Yeah. Like permanent scarring and disfigurement of your penis or having to take out necrotic tissue, parts of your penis tissue is dead. It's just not something you want to research before lunch. And these guys are young guys. These guys who are getting the surgery are young guys. So be careful. The obsession with size is something that I think a lot of guys probably should try to work on and get over. But I'm down.

for maximizing the health of the erection, especially because it seems like from this conversation maximizing the erection health is maximizing your health in general. Yeah. There's very few times where I think to go to that extent for length and for girth and whatnot, it's a big leap. To your point, focus on your erectile function and your sexual health. Those things are more important. Get there. Thank you very much, man. Super interesting conversation. I know a lot of the women are like either tuned out or have learned a lot about dicks. But I think for guys, I know I needed to hear this stuff probably several years ago. I think it'll maybe some people who don't really care because they're married. Maybe if they find out that they're letting their dick stop working slowly by

eating those Cheetos, this will be the motivation they need to clean it up. So thank you very much. My pleasure. Thank you very much. Really great conversation with Dr. Human. And if there's one takeaway here, it's that male fertility isn't just about making babies. It's a long-term health signal. Seamen quality reflects cardiovascular function, metabolic health, hormone balance, even cancer risk. The earlier you pay attention, the better your chances of preserving fertility, sexual function, and overall longevity. We'll link Dr. Humann's practice and resources in the show notes at Jordan Harbinger.com. If you haven't had a basic workup, testosterone, sperm analysis, vascular health,

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Something that will affect your decisions, psychology, and or your relationships. If you haven't signed up yet, I invite you to come check it out. It is a great companion to the show. Jordan Harbinger.com slash news is where you can find it. Don't forget about six-minute networking as well over at six-minute networking. I'm at Jordan Harbinger on Twitter and Instagram. You can also connect it to me on LinkedIn. In this show, it's created an association with podcast one. My team is Jen Harbinger, Jace, Sanderson, Robert Fogart, Tadasidlowskis, Ian Baird, and Gabriel Mizrahi. Remember, we rise by lifting others. That sounds weird in an episode about erectile dysfunction, but I'm going to leave that right there. Anyway, the fee for the show is you share it with friends when you find something useful or interesting. In fact, the greatest compliment you can give us is to share the show with those you care about. So if you know somebody, I don't, how do you delicately share, just share this show with guys. How's that?

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