Weird Medicine: The Podcast - 348 - Nocturnal Penile Tumescence

Episode Date: February 13, 2019

Do we have "wood" all night long? Dr Steve explains! Also, recurrent rashes, nicotine and erectile function, increasing "ropes," and more! Call in your questions for the sommelier to 347 766 4323 for a future show! PLEASE VISIT: stuff.doctorsteve.com simplyherbals.net noom.doctorsteve.com Learn more about your ad choices. Visit podcastchoices.com/adchoices

Did you hear about the cassidia on Tinder? He's hot, spicy, and super cheesy. You're listening to Weird Medicine with Dr. Steve on the Riotcast Network, Riotcast.com. My esophagus. I've got subolivodes dripping from my nose. I've got the leprosy of the heartbell, exacerbating my incredible woes. I want to take my brain out, and plastic with the wave, an ultrasonic, ecographic and a pulsating shave. I want a magic pill. All my ailments, the health equivalent of citizen cane.

And if I don't get it now in the tablet, I think I'm doomed, then I'll have to go insane. I want a requiem for my disease. So I'm Beijing, Dr. Steve. It's weird medicine, the first and still only uncensored medical show in the history of broadcast radio, now a podcast. I'm Dr. Steve, and this is a show for people who would never listen to a medical show on the radio or the internet. If you have a question, you're embarrassed to take to your regular medical provider if you can't find an answer anywhere else. Give us a call at 347-76-4-3-23. That's 347 Poo-Head. You're listening to us live

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Take everything you hear with the grain of salt Don't act on anything you hear on the show Without talking it over with your doctor, nurse, practitioner, physician, assistant, pharmacist, chiropractor, acupuncturist, yoga master, physical therapist, clinical laboratory scientist or whatever. All right, very good.

Hey, so we have some new equipment in here and I'm still working out the bugs. So forgive the levels. I will get it. It's just, there's a lot of moving parts in just getting the game right on every channel. You know, the last mixer I had for two years, I fiddled with it for six months

before I got it the way I liked it. So I apologize if there's a, if I'm blowing, your ears out at times and too soft at other times. But let me know. If it's too egregious, I'll sit down one day and just work it all out in one day. But it's kind of as a work in progress. Thank you for your forbearance. Don't forget, speaking of forbearance, thank you to the people who have signed up for premium.com, who used to have a premium subscription and then I canceled them all by accident. Well, it wasn't really by accident. It was my intention, but it was stupid.

And I, you know, at the time was thinking of just canning the whole thing. And I was going through kind of a dark period. And so I called our hosting place and said, just cancel the premium. I don't want to take anyone's money anymore for this bullshit. And then I changed my mind. I woke up and I'm better. So, and thank you all for the support. Go to premium.

dot dr steve.com that's premium dot dr steve.com for a buck 99 a month you can get all the archives and all the premium content such as it is uh and um also if you use the offer code fluid when you sign up you'll get a huge discount just for the pain in the ass i put you through so i appreciate that check that out also i am uh my bMI my body mass index which i i don't put a whole lot of stock in But it is used in medicine all the time, and it's used by insurance companies to determine whether you're obese or not, is normal for the first time in my adult life. And I attribute that to Noom, N-O-O-M. You've seen the ads for it. And it's an app, and they're not a sponsor, okay? But I am a firm believer that this is a worthy application for your smartphone.

if you want to lose weight. So instead of being a diet, it is a psychological tool. It helps you change your relationship with food. That's the best way I can tell you. And it actually, you know, some of the psychology is applicable to other things in your life as well. So I think it's helping me on a couple of things like that. I tend to pop off at the mouth and then wish I hadn't said something, which is great when you've got a radio show, not so great in real life. and I always say, you know, if I would just think of the second, just don't say the first thing, say the second thing that comes to my mind.

And it's always better. So, you know, it's helping me with that even. You know, it's great. It's 10 bucks a month less than Weight Watchers. And you can do the first two weeks free. So if you want to check it out, go to Noom. dot dr steve.com it's n-o-o-o-m dot dr steve.com and uh yeah that's my you know referral link so if you use it i get a little something i don't know with some gift card or something but you

get to get 20% off plus a two-week free trial and uh you get a counselor you get a group you get a group counselor you you know it interfaces with your fitbit sort of that part could be better but You know, there are things that it'll interface with. And I have found it to be a great program. I'm going to stick with it. I'm down, like I said, for the first time in my life, or in my adult life, I'm below 25 on my BMI, and I'm planning on going for another 15 to 20 pounds. And it's, it's been very easy and enjoyable.

So, all right, check that out. Don't forget Dr. Scott's website at simplyerbils.net. If you need some earbuds, go to tweakeda audio.com. Best customer service on anywhere that I've ever seen and use offer code fluid and you get 33% off your order, which is insane. I can't believe they're still doing this after all these years. You can buy three of the same thing and only pay for two of them. And if you're going to do any shopping at all online, go to stuff. Dottersteve.com.

You can click straight through there and go. to Amazon or you can scroll down and find a bunch of different products that we've talked about on the show, including the Saline Navage, which is one of my favorite things. Oh, and the womanizer. That's at the very bottom, NSFW. And it is an adult toy that was, we were turned on to by a person on Twitter called Dr. Perkins. And it is quite amazing. So we have had an opportunity to try it out. Check it out at stuff. Dot, Dr. Steeb.com, even if you just want to

gawk at it. It's pretty interesting. All right. Don't forget the Brandon Strong campaign for bone marrow donation. Join.bethamatch.org slash Brandon Strong, all one word. Go there. If you're 18 to 44, you don't have to pay a fee

to donate. And you don't even have to donate. They just take some saliva and see if you're 18 to 44, you don't have to donate. If you're a match for people, then they will call you if you are, and then you donate some bone marrow. Sometimes you can do it just with a blood draw. So join.bethamatch.org slash Brandon Strong.

And I'll try to remember to put this in the description for this week's podcast. Okay. We were supposed to have our Somelier episode this week. And one of my partners at work came down with influenza. and our Somelier is coming from a place called Primlin, which is the number five resort in the whole United States and number one in the southeast, you can check them out at primland.com.

Tell them Dr. Steve sent you. But they, because I was so closely associated with this employee, I didn't want to be the typhoid Mary of influenza at Primland, and give Master Sommelier Carl influenza to take back to everybody. So we're postpone that for two weeks. But what this does is it gives you an opportunity to call 347-766-4323. That's 347-76-6-4-3-23, and it should be on the pad data. And ask him a question.

Call in and ask a question regarding wine, wine in health, whining being a drunk, whatever you want to call in about. I would like to have at least five to ten excellent questions from our listeners. And if there's a couple of Ramon questions in there as well, it's totally fine. If that's funny, I'll play it. If it's not, I'll probably still play it and just shit on you. Because I need questions. Anyway, so do that.

347-766-4-3-23. Call-in your wine questions for Carl the Somelier from Primland, and he's also the general manager in food and wine and everything. I mean, he's everything up there, but extremely knowledgeable on the subject. And we'll talk about the health impacts of drinking, but particularly any health benefits that may be associated with drinking as well. and there are some so all right uh very good uh please do that all right um let's get into some uh medical news there was um okay that one way we've got a question about well let's let's take the question and um oh well i didn't download the question okay well somebody called in and said um they read something about gum disease causing Alzheimer's now this is an association It's not a direct cause, but it is kind of interesting. This is from health.com, and it's the article states, you know, brush floss, see your dentist regularly.

Why? To save yourself from painful cavities, from eating candies, fresh little candies, and keep your smile looking bright, but also to stay cognitively sharp. Okay, they're making a claim. I don't know that we can make that claim, but you know how medical journalism is. It likes to make broad statements that may or may not be supported by the literature. But this new study published in science advances details new discoveries in dementia research, namely a type of bacteria called porphyrimonus gingivalas, which is associated with parodontitis, meaning inflammation of the gums,

and the tissues around the teeth has been found in the brains of patients with Alzheimer's disease. Now, I'm very suspicious of any claim that bacteria were found in the brains of these patients. So we're going to go look at the article here in a second. I saved this for you. I just wanted to show you how we kind of work through these things when we see them in the news. Parodontitis is an advanced form of gum disease or an infection of the tissues. that support the teeth. And the, uh, the research was, uh, oh, conducted by, oh, a corporation,

core, korexime, a privately held clinical stage pharmaceutical company, which says the discovery is a step toward a drug that can effectively block the pathogen. So first off, uh, they have a vested interest doesn't mean the research is bad, okay? There's lots of industry funded research. but what we will want to see if you're making an extraordinary claim you need extraordinary evidence and what needs to happen is this claim needs to be independently verified and this research whatever it is and we'll get to it needs to be reproduced now for years I remember there was a couple of there are a couple of researchers that said

they thought bacteria called helicobacteria. I don't even know if it had a name then, but they thought bacteria might be associated with causing ulcers in the human stomach. And the gastroenterologist just guffod. They thought that was hilarious that anybody could think that a bacterium could be associated with this. So they did a couple of studies, and then they were verified that showed that the bases of ulcers in some people have this helicobacter pylorii or pylori bacteria and when you treat that they get better so now this is common

practice as a matter of fact it's standard of care if you do an endoscopy on somebody to test them for helicobacter so that's how much the research informs our standard of care and what's great about medicine is when we figure out something new we don't just stick with the same old bullshit, we'll change our ways and start treating based on the new research. Another example of that is when I was in training in the 80s, it was malpractice to have someone who had congestive heart failure on beta blockers, which made sense beta blocker decreases the contractility of the heart. And one of the problems with congestive heart failure, is that they lack contractility of the heart. So people would come into the emergency room

and frank congestive heart failure and they'd be on a beta blocker and sometimes those doctors would get fussed at for keeping them on that. Well, now it's malpractice not to have them on it because it turns out that outcomes are better when you have people on beta blockers. So it's counterintuitive and a lot of medicine is

and that's why we have to do research and not just make assumptions and think things are true. and then base our treatments on those things. So anyway, so this is very interesting. If this turns out to be true, this could be a very important research. Of course, this company has developed an investigational drug called C.O. 388, and they've said the preclinical trials have shown that this is brain protective

and reduces the P. Gingervalis bacteria. and what they postulate is that the pea gingervelis bacteria creates or helps to create or maybe co-promotes or maybe produces itself amyloid beta and inflammation in the brain, which is not good. And when you make amyloid beta proteins, you get these neurofibrillary tangles, which are pathologic entities that you can see on Microsoft. evaluation of someone with Alzheimer's in their brain tissue, and they're considered at least, at the very least, a marker for Alzheimer's disease, if not the eventual cause.

Now, this isn't the first study to make the connection between gum disease and dementia. Chronic inflammation from periodontal disease has been thought to encourage the development of Alzheimer's dementia since 2017. That was from a review in Frontiers in Aging Neuroscience. And, you know, the fact that they've got this drug that targets this process is exciting, but it also points out something very simple that you can do at home. Brush your teeth and floss. And if you've got teenagers, particularly, you know, they're horrible at this.

A lot of them are. You've got to get their gross detector turned up. you know, I have this finely tuned gross detector, meaning that if I touch something and I don't wash my hands afterward because I'm in health care, I've got to do it. So my brain is constantly sending this signal. Your hands are dirty. Your hands are dirty until I clean them. Not to the extent where I have OCD, but I am relatively compulsive about hand washing in the workplace, which is what you want from your health care provider. you know and i'll have these little old ladies say well ho your hands are so cold well cold hands warm heart well no it's not that it's the alcohol that they make us jell in and gel out it um as it um you know steals heat from your hands and makes them cold but anyway um so but you got to turn up your kids gross detector so that they'll wash their hands before they eat and they

won't stick their finger in their nose and then stick it in their mouth and that they will brush their teeth and these little flossing sticks if you don't like flossing these flossing sticks are great you can buy a bag of them of you know a hundred of them for five bucks at any pharmacy and they've they look like um i don't know what do they look like kind of like a bow like a little tiny weirdly shaped bow like you would bow a violin with and um And, you know, the floss is between the two prongs, and you can just stick that in your mouth and floss. And make sure that you're going to the dentist every six months. I know it sounds crazy.

A lot of you haven't been to the dentist two in three years. You need to go and just get a regular appointment. You know, dental care now, as far as just getting teeth cleaning and is relatively inexpensive. And you can get dental cards to go and do. it. And if you're not going to do it every six months, at least do it once a year. Very important. And, you know, look, we talk a lot about prevention on this show. If you don't want to have erectile dysfunction and cancer or heart disease and stroke, don't smoke. I can't ever scare anybody into not smoking because of cancer and heart disease, but I can get men on erectile dysfunction almost every time. We've got a question later on that's going to address this regarding tobacco. and erectile dysfunction. But, you know, half of adults over 30 in the United States have chronic periodontitis, according to the American Dental Association.

And, you know, it matters. This matters. Inflammation in the head matters. There are, you know, chronic infections in the head and neck, sinus infections, herpes infections chronic infections of the gums can cause infections of the veins in the brain and cause blood clots, all kinds of stuff.

So cut the shit, get your teeth taken care of. Now let's look at this original study. Let me see if I can find the original study. Okay, here we go. Porphyrimonous, gingivalis, in Alzheimer's disease brains, evidence for disease causation and treatment with small molecule inhibitors.

Okay. So this was written by Stephen Domini and et al and a bunch of my countrymen, it looks like. I see a bunch of check-looking names on here. Okay, so I'm just going to read the abstract, assuming that the abstract reflects what's in the article. It's not always true, but, you know, for a radio show, we don't have time to go through the whole article.

It says porphyrimonus ginger valis, the keystone pathogen and chronic parodontitis, meaning that that's the number one bacteria that you find when you culture people's gums that are chronically infected was identified in the brain of Alzheimer's disease patients. Okay, so I want to know how they did this and how many, you know, is it a hundred percent? association, or is it 30%, which would make a difference? You know, if you only see it in 30% of Alzheimer's disease patients, but there's still Alzheimer's disease patients, either you're missing it or it's not always there. So it could be some, and if it's not always there, then this drug you would assume would not help everyone. Toxic proteases from the bacterium, these are enzymes called, you know,

ginger pains, ginger, I don't know what in the hell that is, were also identified in the brain of Alzheimer's patients, and the levels correlated with pathology. So, oral pea-gingevalis infection and mice resulted in brain colonization and increased production of these beta amyloids. And further, they were neurotoxic in vivo and in vitro, meaning in the test tube and in the mice exerting detrimental effects. So to block this neurotoxicity, we designed and synthesized a small molecule inhibitor targeting these proteins, and it reduced the bacterial load of these brain infections. That's pretty interesting.

Now, let me see here if, we can figure out how they found this in people's brains. And I can't quickly get to that, so that's interesting. But we're going to look into this further, and I'll get you some information on that. You know, they do brain biopsies on dead people who had a diagnosis of dementia. So the other thing you've got to do is you've got to get a bunch of normal brains

and test those. Is this stuff there? Is it in the same concentration? Or is there a correlation between increased load of this P. Gingervalis and the severity of the Alzheimer's disease? Do the normal brains not have it at all? Or are there some people who are normal patients who also have this? So these are all things we've got to determine before we can say, yes, this causes this. Right now it seems to be an association, and it's very interesting.

but we don't have a cure for Alzheimer's yet. All right. Condom-free birth control shot for men. This was been in the news. Maybe more effective than other methods. Well, what other methods? There are no decent other methods. So that's the problem.

This is from Medical Daily. It says, you know, when it comes to birth control, women have more options than ever. Female contraceptives like the pill, intrauterine devices, and hormonal implants. plants, been widely used among women to prevent pregnancy. Meanwhile, male contraceptives had basically remained at a standstill, leaving men with two viable options, vasectomy or condoms.

And so, now, this is journalism, says a recent study finds birth control shots may soon be on the horizon in preventing unintended pregnancies. So what they found was they, and we'll go to the study in a minute, because the journalism and the studies are two different things, found it possible to have hormonal contraceptive for men that reduces the risk of unplanned pregnancies and the partners of men who use it. So, you know, there have been a lot of attempts at developing contraceptive for men. They've tried several methods, including the male oral contraceptive. And what these do is they'll block the effects of testosterone, so the testicles stop producing healthy sperm cells.

It's been a difficult feat since you constantly produce sperm. You're pumping out 1,500 sperm a second. 1,500 a second. Think about that. That's a lot of dang sperm. And you have to do 1,500 a second because every time you splooge, it's millions of sperm are released. Let's see if Alexa knows the answer to that.

Alexa, how many sperm in the air? average ejaculation. Sorry, I don't know that. Okay. Of course. We'll find it. So in this study, they tested the safety and effectiveness of injectable contraceptives and 320 healthy men.

And first, they tested them to make sure they had a healthy sperm count at the beginning, which makes sense. You don't want people who are shooting blanks in your dumb study because it'll skew the results. then they gave them Norrith let me see Norrithstrone ananthate Norrithysteroon

norathisturone ananthate and a long-acting androgen called testosterone undecinoate. Now that's just a long acting testosterone. Now when testosterone supplement someone it's going to stop their testicles from producing sperm.

It just shuts them down. And they gave these shots every eight weeks and they provided semen samples after eight and 12 weeks in the suppression phase and then every two weeks until they met criteria for the next phase. Now, then they were asked to solely rely on injections for birth control once the men's sperm count was lowered to less than one million per ML. So your average splooge is what, 2.5 ml, so, you know, half a teaspoon. So, you know, these people still had 2.5 million sperm going around at maximum of that. Some of them probably had much less, but that was maximum of that.

And they continued to receive injections every eight weeks for 56 weeks. And the finding revealed that the hormones were effective in reducing the sperm count to 1 million per ML. So that's like 1,200th of normal. But still, you only need one. and the method was effective in 96% of continuing users. Only four pregnancies occurred among the men's partners during the efficacy phase of the study. Well, I'm sure for those four, they were still pretty pissed if they joined this study to not get pregnant. The rate of adverse effects, specifically depression and mood disorders, they stopped enrolling new participants because of this.

and of the 1491 reported adverse events in what how many did we have in this 300 people 350 people and they had 1400 adverse events 40% were found to be unrelated oh to the contraceptive injections so that means that 60% were so what's 60% of 1491 Alexa what's 60% of 1491 60% of 1,491 is 894.6. Okay, so 895 adverse events in 350 people. That's about two to three adverse events per person were related to it. So, oh, and then these included one death by suicide, which was assessed not to be related to the use of the drug. Okay.

drug-related side effects included injection, sight pain, muscle pain, increased libido, and acne, of course, the acne from the testosterone. 20 men dropped out of the study due to side effects. There aren't really side effects, they're adverse effects. And despite the adverse effects, more than 75% of participants reported being willing to use this method of contraception at the end of the trial. So they're saying, so could this be better than the male pill, probably, but that's not on the market. That's really not your question. Is this safe and effective for use in men so that women could come off their birth control? Because it is really, there's this disparity. Women do seem to carry the burden of birth control. And plus, you know, if you're out

there in the single scene, you're relying on other people. If you're a dude saying that they're on birth control, most of the time they're truthful. But, you know, you don't have any control over that. So, you know, it would be nice to have some control and to participate in birth control out there in the scene. Now, this does nothing to prevent disease. So if you're single and you don't know your partners, you still got to use condoms. So this is really for people in monogamous relationships where they know their partner. They're not worried about disease. They want a ride bareback, but the dude wants to contribute to the birth control, not leave it all on the woman.

Now, there's a new drug on the horizon. Researchers at Wolverhampton University have found a new compound that is able to deactivate the protein enabling sperm to swim. This is interesting. If they can't swim, the egg can't be fertilized, and it only lasts a few days. So that makes the men temporarily infertile. So if you're going, you know, on a singles cruise, you can, you know, take this medication and not worry about getting a call nine months later from three or four people. And unlike the female pill, which takes a week to take effect, it may only take hours or minutes to activate.

they're going to be doing live animal tests within the next two to three years if it proves to be successful it'll be on the market as a pill or even a nasal spray by 2021 so that'll be just in time for my kids to have this because they better not be having

intercourse before 2021 anyway all right very good well let's take some questions uh-oh don't take advice from some asshole on the radio wait what number one thing don't take advice from some asshole on the radio

no wiser words have ever been said thank you Ronnie B well okay helps a few and I haven't really gotten good advice from my doctor I am on Adderall and it can't

I might want to need to start this one over Sorry. And it's, hey, I know that you just got off the air, and I haven't really gotten good advice from my doctor. I am on Adderall, and it tends to make me want to drink more alcohol to help me go to bed. And it's screwing my body up. I'm in my early 20s, and I know it's not a good way to do it. The only other option that I've seen is using, you know, smoking marijuana. you know, to help kind of, like, soothe me down or whatever.

I was just wondering if there's anything that you would recommend other than, like, melatonin because that hasn't been that useful for me. And every other ADHD medication I've used hasn't really helped me focus. I've just been drowsy throughout the day, even with coffee and things like that. I just don't feel alert. But, yeah, I mean, smoking marijuana isn't going to help me if, you know, if there's a drug test or something like that at work. Alcohol, you know, is not good in general.

But if there's anything you would recommend, just please let me know. My email is 2.8.1. Okay. Hey, all right. So he has adult ADD. And the medication he's taking is Adderall. And the thing about Adderall is that it is a stimulant. You know, it's a psychomimetic amine.

So he's having trouble sleeping at night because he's on speed, basically. So a couple of things. One is you could talk to the provider, make sure that they're aware of this, that you can't sleep on this medication. You could take it earlier in the day. You know, if you're getting up and taking your shower and doing, you know, all your ablutions to use a word my grandmother would have used. you may be able to take it right when you wake up. Or you could even wake up and take it and if you can go back to sleep. And then so that it's wearing out quicker.

There are other versions of Adderall. There's one called Vivance that is cleaved differently in the body as it's metabolized. And that may wear out a little bit quicker or earlier for you. You don't want it to wear out quickly because it. and you crash. But talk to them about it. There are other stimulant ADD medications that might work better for you. It may be that you're a slow metabolizer of that stuff,

and so you're just still speeding along. Yes, I would not add an illicit substance because your Adderall provider may drug test you at some point. A lot of them are doing this now because Adderall is a Schedule 2 drug. And if they find THC in your system, they may just stop writing the Adderall altogether. now there are other medications for adult attention deficit disorder and not all of them are stimulants I think probably the ones that you had that made you sleeper sleepy were the

antidepressants there are lots of different antidepressants that can be used for this and the but there's but there are other things there's cognition in enhancing medications like stratera or atomoxetine. There's one called Guanfacine, which we used to use as a blood pressure medication. And these things can help as well. So these are things that just talk to your provider. There are a lot more options. Rather than taking a medication having to take something else to counteract it,

you may consider trying something else and seeing if it will, work as monotherapy. In other words, just one drug. The issue, of course, is you'll have to come off the stimulant and then get on this thing, so it'll be a several-week trial, but it may be worth it because you really need to be able to sleep. The other thing is, if you haven't tried the melatonin gummies, which we've talked about, you know, people who listen to the show know I hate marketing. The way that they market gummies to adults just makes me physically ill. But gummies have an advantage in that they completely dissolve. So if you have a drug that may be bound to the binder in a pill and isn't released,

and so it's not what we call bioavailable, then taking it in a gummy form may help because there's, you know, the gummy is just, you know, what, starch and glucose. I don't even know what they make gummies out of. let me see how let me see gummy bear recipe gummy bear recipe because I think it's

corn starch and glucose oh no well I'm an idiot okay it's gelatin of course it is I'm a fool it's gelatin what am I thinking of a corn starch there's something that you make with cornstarch

and gelatin and I don't remember what it is maybe it's marshmallows I don't know so yeah it's gelatin and a little bit of sugar so there's nothing there to not for the drug to bind to irreversibly so when the gummy bear dissolves it'll completely dissolve and then the drug is just left behind to be absorbed so you could try that but just talk to your provider and there are lots other options out there other than just the antidepressants which probably were the things that made you sleepy, and the Adderall, which just jazes you up.

And hopefully you can get on that and not take. And please don't, if marijuana is illegal in your state, or if your company has a policy against it and you're at risk for being drug tested, or if the doctor is drug testing, don't use that to sleep, that's not going to help. It's just going to either get you fired from their practice or fired from your job.

Okay. So I'm a 50-year-old male. Okay. I've had, for the last few years, a bunch of years ago I had a desperate bypassed. I lost 214 pounds. Excellent. But in the last two years, every night is full erections that don't go away until I get up and walk around. It's not really sexual.

It's just, I don't know if it's the way I'm sleeping or what, but I have no other issues. I managed to keep 200 pounds off of that weight, so I'm, right at 575, 580 pounds, and I just have these, and they're all night long erections. Yeah, they're not. That's the thing. They're when you're aware of them. So nocturnal penile tumessence is what he's talking about. I love that word, two messence, so does little Jimmy Norton.

It was one of the favorite words I talked to him during an appearance on ONA once. These are spontaneous erections, and they occur during sleep, and you can measure them. We actually have a nocturnal penile-to-mescence monitor. It's a little velcro strap that you wrap around your penis, and it has stretch receptors in it, and you can determine we'll do this for people who have erectile dysfunction. And if they are having nocturnal penile to mesence, but they're having erectile dysfunction when they're having sex with their spouse,

then we know that it's psychological and not physiological or not physiologic. So we generally determine that penile tumessence is a sign of a healthy penis. So he's actually doing very well in this regard. And they most often occur, I believe, during REM sleep. And during REM sleep, what comes after that is light sleep, and he's waking up right after his REM sleep with this raging hard on.

And he feels like it's happening all night long. If it were happening all night long, he would have horrendous penile pain in the morning because an erection that lasts more than four hours is called Priapism, and those are those those those erections are extremely painful so if he's sleeping six to eight hours it's really not possible that it could be happening all night long now but he could find out by getting a nocturnal penile tumessence monitor from a urologist and just see if it goes up and down through the night i'm not aware that you can buy one of those online but you could

look and see and there may be one that you know you can connect to your smart phone through an app of some sort. Let me see. Yeah, anyway. They don't know what the cause of this is. There was a hypothesis that there are these neurons from this one part of the brain called the locus serulius, and that those actually inhibit penile erection, and then during REM sleep, those those nerve fibers are turned off so that there's no inhibition of penile erection,

which tells me that without that part of the brain, our normal state would be to just have a raging erection all the time, which makes sense because we're dudes. Anyway, all right. So that's that. Sign of a healthy penis, my brother. If you actually get one that won't go down, you need to go to the emergency room and get it checked. Hi, Dr. Steve, 64-year-old retired truck driver.

In problems where you've got like stuff breaking out occasionally, like one on the stomach, someone said, hey, that might be a deer tick. Better go get it checked out. So you check into an urgent care and then you get a, they don't find anything. It's just a cyst. We'll give you the battery of antibiotics and give you some penicillin prescription and then send you a bill for $4,000. $4,000 from an urgent care. So now whenever there's some kind of skin eruption, whether it be on your butt or tummy or behind your knee on your arm, I get these all over, especially in the buttocks, which is too embarrassing to want to go to your doctor. I got a new primary care physician where I've moved here when I retired in Florida, but I should.

Other than getting more sun, there's some vitamins you get from the sun. You can't really sun your butt in your backyard unless you've got privacy, but I wanted to get your take on this. Yeah, if you have recurrent skin lesions, if you don't want to show your butt to your primary care, I get that. I mean, eventually they're going to have to do a prostate exam on you. So you'll be showing them more than that, and they'll be feeling more than that. But if you're uncomfortable doing that, go to a dermatologist. Let them see this. This could be a lot of different things.

And you didn't describe the lesion. So, you know, if they're flat and reddish and scaly or discolored, it could be a fungal infection, including tinnia versicolor, which causes kind of a patchy, discolored. rash on the skin. You know, if it's blisters and it's recurrent in the same place every time, which is really not what he said, it sounded like it was showing up on different places, but blisters that show up the same place every time

that are painful or itchy can be a sign of herpes. But you really need to see someone and they need to put eyeballs on it. I've found that diagnosing rashes by cell phone pictures is almost impossible for me anyway and certainly from someone's description unless it's a classic description it's nearly impossible so all right see a dermatologist that's a johnny fair play said hey your whole show is somebody tells you something you tell them to go see their doctor and guess that's true i try to give a little bit of information in the meantime all right I am a 45-year-old healthy adult male, fairly fit, very active, and I've got a question about sexual health.

Sorry, I think I cut out there. Anyways, just skip to the question. My question is, is it possible for a male in his mid-40s to increase the amount of volume in his ejaculation. In other words, I've noticed that it feels way better when there's more volume. Yes, it absolutely does feel better. It's interesting.

And I've had people who have retrograde ejaculation, which is seen in certain medications and people with advanced diabetes where they actually ejaculate into their bladder because fluid will follow the path of least resistance. and they lose the tone in the valve coming out from the bladder that's supposed to keep urine in and semen going out. And so they end up ejaculating backwards. And they still get the feeling of an orgasm and ejaculation.

But the feeling of that vast emptying that you kind of get, women, it's very difficult for us to explain this. But they don't get that. so there's something missing. So, yes, the increased amount of ropes or the volume vejculate does seem to increase pleasure slightly. So we've done a lot of research on that in this show. The only thing I found in the medical literature was people who took sylidinifil, which is the active ingredient in Biagra. On a chronic basis, had a 25% increase in volume of ejaculate.

Having said that, you know, sildenophil is a powerful medication. We'll use it every day, three times a day, in people that have pulmonary hypertension, because it's a great drug for decreasing the blood pressure from the heart going into the lungs in people that have this pulmonary hypertension. But there are adverse effects from, taking that much of it and significant adverse effects. So, and most of them potential, including changes in vision and, you know, low blood pressure and stuff like that.

So I don't recommend that method for increasing your ropes. I've talked to some adult film, male adult film stars, and they recommend things like arginine as a supplement, haven't seen any data on that. Arginine is a precursor of nitric oxide, and it's a substrate for some of the some of the enzymes that make nitric oxide. Nitric oxide is what sylentephyl targets as well to increase those levels, increases blood flow to the penis, decreases venous outflow from the penis. And when you get a bigger, meteor erection, that seems to enhance that whole process as well.

I'm not 100% sure why. Abstinence, so not beating off as often. And if you really want to have that feeling of the great emptying with your partner, don't masturbate within a few days of having intercourse with them. Also, staying well hydrated makes a big difference. Drinking lots of fluid will make more fluid available to the tissues that are generating semen, which are the prostate and the seminal vesicles. The testicles themselves only contribute about 2% to fluid, so that's really not going to make any difference.

Okay? so try those things and remember a lot of the stuff that you see in adult films are special effects and that's confirmed by several adult film stars who have been on this show so if you see these people ejaculating gallons of semen don't think you're somehow deficient because you just don't have the the pump and the tubing and the setafil to simulate a giant ejaculatory volume Okay. All right. Hey, there's Dr. Steve.

You had a caller, Colin. He was talking about, he was a fat fuck. He had something wrong with his feet. Socks take him off. Anyways, you're talking about how he had erectile dysfunction, and he said that the number one cause for reversible erectile dysfunction is tobacco. Now, if I remember correctly, what's causing

ED is a vasoconstriction. Give yourself a bill. What causes the vaso constriction is technically the nicotine in the tobacco. Give yourself a bill? Would it technically be the nicotine that is caused in the ED? So while I...

Give yourself a bill. Big, very, very big vape is with the nicotine in that, That's just as likely to be giving me EDIA as any other feller. Give yourself a bell. Yes, okay, okay. So he got four, give yourself a belles on that.

Everything he said was correct. So I've always, look, where I got, I'm old, okay? And old habits die hard. So when I talk about erectile dysfunction, the tobacco abuse, of course, there's no real tobacco use, is there, it's all abuse. But a taco tobacco abuse is the number one cause of reversible erectile dysfunction. Well, this is 2019, and a lot of people have their vape pins that they're tooting off of, these big giant tanks and these giant clouds of God knows what.

And but with many of them having nicotine in them, yes. So it is the abuse. I need to change my verbiage. The abuse of nicotine is the number one cause of erectile dysfunction, reversible erectile dysfunction in men over 40. So I could never, I have dissected cadavers that had so much atherosclerotic plaque in them, so much calcium in the aorta that it was crunchy. You could dissect it.

You could feel the scalpel crunching as it cuts through the tissue of the aorta and you open it up and it's white in there and it's white and crunchy. I've seen that caused by smoking and genetics, of course, and high cholesterol. I have seen dissected lungs of smokers where a normal dissected lung has kind of got bluish areas and pink and it's nice and pink on the inside when you cut open. It looks like a beautiful sort of spongy thing. And I've seen tobacco smokers' lungs and they're black. They are, it looks like you've squirted a squid ink into these lungs or dyed, throw them in a washing machine with black dye. It's unbelievable how disgusting and how are they not diseased. You look at that and you understand why.

Google that. Google smokers. Let me try it. Smokers lung, do a goomer, Google image. Yes, oh, there's some good ones. Okay, just smokers' lungs. And Google image that. You can see a smoker's lung next to a normal lung.

And it's quite impressive. I would wonder, I've been off tobacco for 20 years now, and I wonder if my lungs still are stained from the tobacco or if they've come back and looking reasonably healthy. That would be interesting. You know, I'm going to have tissue bank James when I die just to make him uncomfortable. I'm going to donate my body to his service and just to make him uncomfortable so he'll have to see my flaccid dead penis and those kinds of things where I'm just laid out on. his on his um on the beer b i er why he's probably drinking beer at the same time while he's cutting cutting me open and taking my parts out but um i i want him to look in there and then maybe

report back to the weird medicine public yes his lungs were back to normal or no they were still looked horrendous anyway goodness great oh this is just horrible i cannot believe that i ever did this what a fool and i was a doctor and smoking and i i knew better but it's a hell of an addiction nicotine a hell of a drug uh because it's so available you can just go anywhere and buy it used to at least of the pharmacies although they still sell homeopathic malarkey they at least don't sell things that are actively trying to kill you aka tobacco anyway So I'm going to see inside some vapors' lungs after somebody's been vaping for long enough. We need, you know, in about 10 years, we'll have enough people who are vaping die that we can get some information on what that stuff's doing to their lungs.

All right. We have some good questions for the sommelier. For the next time, I want you all to call in 347-7664323, and do, give us some wine questions. If you want to throw a Ramon question in there as well, I'm totally fine with that. We don't hear enough of Ramon on this channel anymore. But I would like some serious questions, and not in the vein of serious questions only, although those are fine, too. I'll pick and choose and cherry pick the ones that I want to use, but I do, I think it'll be a great show. don't forget to go to the Brandon Strong campaign for bone marrow donation.

Join.bethamatch.org slash Brandon Strong. If you're 18 to 44 years of age, you can donate a saliva sample. And if you're a match for someone, you can save someone's life down the road through bone marrow transplantation. If you're older than 44, you can pay 100 bucks and still do it. So that is an awesome, awesome thing that you can do if you just want to do. feel good about yourself today. We can't forget Rob Sprantz, Bob Kelly, Greg Hughes,

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whose early support of this show has never gone unappreciated. Listen to our Sirius XM show on the Faction Talk channel, Sirius XM Channel 103s, Saturdays at 8 p.m. Eastern, Sundays at 5 p.m. Eastern on demand and other times at Jim McClure's pleasure. Many thanks to our listeners whose voicemails and topic ideas make this job very easy. Go to our website at Dr. Steve.com for schedules and podcasts and other crap. Until next time, check your stupid nuts for lumps, quit smoking, get off your asses and get some exercise. We'll see you in one week for the next edition of Weird Medicine.

Thank you.