What if everything you've been told about aging and sexual health is scientifically incorrect?

Today's guest has discovered breakthrough approaches that are helping men in their sixties reclaim the sexual vitality of their thirties without the blue pill.

We are here today with just Dr.

Judson Brandeis, award-winning urologist and sexual medicine pioneer, and we are thrilled.

I'm Dr.

Willow Brown.

I'm here with my amazing co-host.

To Leah Piper, and we are so grateful for all your wonderful likes, shares, and subscribes.

Okay, friends, you know what to do.

The time has come.

Let's tune in.

Let's turn on and let's fall in love with Dr.

Brandeis.

Welcome to the Sex Reimagined Podcast, where sex is shame-free and pleasure forward.

Let's get into the show.

Welcome to the show.

We're

Oh, thank you for having me here.

This is such an honor to be here.

Yeah.

Yeah.

So you've been in the world of sexual medicine and helping men with their virility for quite a long time now, and have studied extensively.

You've written a book, you've got a podcast coming out.

So many good things to share with us.

Why don't we start with, um, where this all began for you?

What kind of got you on this sort of track with medicine?

Yeah, the world of sexual medicine.

Yeah.

So as a urologist, I've been a urologist for 25 years.

Uh, sexual medicine was always sort of part of what we did, but I started out, uh, first interested in kidney transplantation and then, uh, became really interested in prostate cancer.

Was a pioneer in surgical robotics for prostate cancer.

And then I built a kidney stone center, and then MRI guided it prostate biopsies.

But about six or seven years ago, I became really interested in the use of regenerative medicine to help men who no longer were able to get adequate erections for intercourse to get them back on track.

So using low intensity shockwave therapy or PRP or even stem cells and supplements to help men turn the clock back 5, 10, 15, 20 years.

Wow.

To, to turn the clock by two decades.

That is very significant.

I just imagine that you've got patients just filling up your calendar.

Um, so many men that I see, uh, noticing that they can get hard, but they're having a hard time staying hard as they get into their fifties and sixties.

And we've just been, um, we've had a couple guests on talking about stem cell therapy, which was new to me.

Um, what can you say about stem cells?

Yeah, so stem cells, it is kind of a generic category for.

Uh, a type of treatment that utilizes either a growth factor or the actual cells.

But, uh, a lot of people think when they think stem cells, okay, they're gonna inject these cells and these cells are gonna start growing in my body.

But as it turns out, most of the data points to the fact that stem cells contain, um, what are called growth factors.

So, um, chemical messages that cells send.

To other cells to make those cells grow.

So.

Within our own body, we we're loaded with stem cells.

That's how our hair grows.

That's why our intestines grow.

That's how the cells inside our mouth grow.

Really anything in your body has stem cells and so it's more of a function of stimulating the stem cells that are, um.

That are our own stems.

Endos, I'm, I was going to use the word endogenous, but I didn't know if anyone knew what that meant, but obviously Yeah, there you go.

The stem cells that are already inside your body, uh, to, to grow into the tissues that they're supposed to be, whether it's blood vessels or, or connective tissue.

You know, I can't remember if it was, um, Dr.

Elliot, Justin or Dr.

Gittens, who we've had on the show, who described the process as, it's like the stem cells are, are the chicken and the chicken soup, but it's not like it's the chicken that is going to.

Um, make the stem cells work.

The stem cells are really about the broth, and so it's, it's like the broth is coming into your tissue and it's working with your own stem cells.

Is that an adequate explanation?

If I was going to give you a metaphor,

Yeah, I mean, I think that's a pretty good explanation.

It's, it's, uh, they've, um, radio labeled, um, stem cells that they put into animals.

To see how long they stick around and they stick around anywhere from one to four regenerations, and then those cells are gone.

And so it's really the growth factors that the stem cells are releasing that are causing the growth of the native tissue.

And so when you say growing the native tissue, how is that helping with erectile dysfunction?

What is the actual function of this, uh, intervention?

And can you explain that to me?

Yeah, well, the erectile function really is physiologically, it's, it's a function of circulation, right?

So we all know, and you guys know better than I, that there's a whole psychological aspect to it.

Um, but I'm, I'm speaking purely physiologically.

It's the ability to pump blood into the penis and expand what we call the corporate caber, Noosa, or the erectile body, to the point where it.

Occludes, the veins that empty out the corporate caber Noosa.

So there's an artery called the deep cerno artery that pumps blood through the middle of the erectile body, and then the blood drains on the periphery, and as the pressure increases, it blocks.

The venous return back to the body and traps the blood in the penis.

And that's how you get a penis that's rigid enough for, uh, penetration.

And so it's, it's all about raising the blood pressure in the penis.

And so you can do that by boosting the signal.

And so there's a molecule called cyclic GMP, which starts a cascade of events that leads to.

Blood vessels opening, and so you can use nitric oxide or your body uses nitric oxide to increase the amount of CGMP.

And so I have a supplement called Affirm, which is a nitric oxide booster.

And last year at the Sexual Medicine Society meeting, I presented data that affirm alone taken before you go to bed using Elliot Justin's firm tech ring showed that you can increase erectile function 33% at night

Wow.

by taking.

Wait.

Okay.

So what's in Affirm?

Affirm.

So there's two ways you can boost nitric oxide.

One is the citruline arginine pathway, and so Affirm has a lot of citruline in it.

And then the other is the nitrate nitrate nitric oxide pathway.

And beats have a lot of nitrate in them, so there's beats, ginseng and miama.

So you wanna be activating both the Citraline arginine pathway and the nitrate nitrate nitric oxide

So is it working on, um, like proteins amino acid?

Is that, is that

No, it's, it's, it's creating nitric oxide.

And nitric oxide is the second messenger that nerves release onto blood vessels to cause blood vessels to dilate, to open up.

And that's true, that's true all throughout the body.

What?

The Affirm is your own formulation.

is my own formulation.

And I was actually at UCLA when, um, when Lou Iro won the Nobel Prize for discovering nitric oxide as the second messenger.

And then he and one of my professors, Jake Rafer, actually wrote the, the paper in the New England Journal of Medicine describing the mechanism of action of Viagra.

Now.

Now my understanding of nitric oxide is that it also brings a flush to the body,

Well, it's a,

people get a pretty intense flush?

well it's a vasodilator, so it opens up blood vessels so it improves people's blood pressure.

So, you know, I'm constantly getting men off their blood pressure medication.

'cause for the most part, blood pressure medications are bad for erectile function.

So if I can get them on a natural blood pressure medication, like a nitric oxide booster, like a firm, then it helps improve circulation in the penis and it reduces their blood pressure.

Is that what you're using then to get them off of blood pressure medication is the Affirm

I am, and you know, it's, it's, it's really ama.

I had a patient the other day his, he had elevated blood pressure and he was seeing a cardiologist at Stanford and I said, do me a favor before the cardiologist put you on a blood pressure medication, I want you to take two Affirm pills twice a day and monitor your blood pressure.

And his blood pressure went down to 1 20 80

That's amazing.

Yeah.

And the, the Stanford cardiologist was flabbergasted.

Like he had never, he had never heard of this.

And you know, the reason no one's ever heard of it is'cause you really can't patent it.

So there's no real reason for drug companies to sink a hundred million dollars into a study.

If they're not gonna make any money off the, the, you know, and there are a lot of supplements out there that are kind of useless, but, uh, nitric oxide is not one of them.

It's very, very, very well researched and very well established.

Uh, and it's, it's been shown in athletes to improve athletic performance three to 5%.

It's been shown to improve, uh, cognition.

It's been shown to improve blood pressure and also, of course, it's improves erectile function.

You know, I remember my husband used to take it before workouts.

Um, I don't know if he still takes it, but I've got a couple questions.

One, how does someone order Affirm?

Uh, if you go to www.AffirmScience.com, A-F-F-I-R-M science.com, it's super easy to to order.

We'll have that in the show notes.

And then what about women taking this product?

I mean, we've got a lot of erectile tissue we wanna get fluffed up and turned-on.

Any mammal?

Yeah.

you know, I mean, um, vaginal and clitoral blood supply is really important, you know, for lubrication, for sensation.

Um.

For sort of clinical clitoral, um, erectile tissue.

Uh, so it's, it's critically important in women and not just for sexual function, but also for physical fun, physical function, for blood pressure, cognitive function.

What.

can women take affirm?

Yeah.

Yeah, absolutely.

No.

I had a friend give me ni um, nitric oxide.

Is that what it is?

And I got so hot, I got so flushed.

My skin felt like it was on fire.

I actually really hated it.

Um, I'm just assuming she gave me too much.

either.

Either too much or, um, you can do that, arginine will do that.

Yeah.

L- arginine.

Yeah, I think that's

so a better thing to take is citraline, and then citruline is better absorbed by the intestines, and then it's converted into arginine in the kidneys, and then it's recycled back to, there's a citraline arginine cycle.

Okay, so Citraline.

Now your supplement can women take that too, or is it really designed for men?

No, no, both.

Both.

Okay.

I'm so excited.

yeah.

There's actually a, a, a pink labeled, uh, affirm, but you know,

What, what would you say about, um, what about the peptide, PT 1 41 for sexual function and health?

Yeah, that, you know, that's a great, uh, peptide.

I have a lot of my patients on that.

Um, it, it gives people spontaneous erections.

So, and the other thing is it's a little bit less predictable than say, Viagra or Cialis.

So Viagra and Cialis, you take it and you can pretty much set you're, you're watched by it, you know, 30 to 45 minutes later, uh, it kicks in.

Whereas the PT 1 41, there's two ways you can take it either as a, a nasal or, uh, an subcutaneous injection.

The nasal has fewer of the side effects, which are mostly like nausea or, or kind of upset stomach.

But it's a little bit less effective.

And then the injectable, it's a little bit more effective, but it does give a, about a third of folks, um, pretty bad nausea.

I had a patient, uh, the couple took it and, uh, it wasn't New Year's, and she was saying that like she was basically out throwing up for the New Year's.

Yeah,

yeah,

tried it

It very dose specific like you

it, it is dose specific.

And you know, the thing is, it's FDA approved for women.

It's called vii.

Uh, and so it's a very, very safe drug.

You know, it's got FDA approval.

It isn't f FDA approved in men, but it, that's just because it's hard to compete against$1 Viagra,

Now is this the peptide that also increases melatonin in one's skin?

So a lot of people's skin color changing.

Yeah, so it was being developed in Australia as a sunless tanning agent, um, because so many people there get skin cancer.

And so they were giving people, uh, this peptide every day.

Uh, and so they were starting to get darker skin, but they were also like horny as hell.

And so, you know, cornier than the average Australian anyway.

I love this idea of everyone just getting hornier.

I am very, um, sex positive in that direction.

Let's get

Yeah, but it's, it's a little unpredictable in terms of when it works.

So if you take it at like noon, you, it may start working at one o'clock, it may start working at four o'clock.

And so it's, it's more of like a, like a weekend away kind of drug

But it isn't it also like an ongoing treatment, like where you would do it kind of like once a week for several weeks?

um,

it was as needed, though.

You

yeah, it's, it's more kind of as needed.

As needed.

Okay?

Like you know you're gonna be on a hot

it every week, then you take it every week.

Yeah.

Right, right.

How long does it last in the system?

Yeah, it, that's also pretty variable.

I've had patients tell me, you know, two, three hours, I've had patients tell me, you know, 12 hours, I've had a couple patients who were kind of younger and healthier, tell me that they had an erection that lasted almost like six hours.

Wow.

Yeah, my, um, my former, um, business partner who is 75, has been taking it on a pretty regular basis, and he's like, I'm getting spontaneous erections while I'm driving my car.

It's amazing.

He is like, I feel like I'm 30 years old again.

He goes, it's awesome.

Yeah, I mean, you certainly like don't necessarily have a lot of control.

I mean, you could be watching like a Margaret Thatcher documentary and all of a sudden get an erection.

Yeah, so you know, I'm sure that there's a lot of guys who are actually missing those volunteer erections and are missing the, the hardness of their erections.

I.

is that gonna work?

Well also for people who've had proses um, or prostate

Yeah, good question.

Yeah, so if you've had prostate cancer and you had a non nerve sparing prostate cancer surgery, then it's, it's not gonna work because it, it relies on nerves to send a signal to the penis.

And so in those patients, you really have to do something like, uh, injection therapy or a penile implant.

Um.

Um, okay.

I really want to get into your work with expanding girth and length, um, for men who are insecure or subconscious or just long for having a bigger cock.

You know, and it's really interesting.

It's really interesting because when we did the P long study, I was kind of expecting all the participants to be sort of below average length for, for men.

In the United States, the average length of the erect penis is 5.1 inches, so I figured everyone would be below 5.1 inches, but it wasn't, you know, we had about a third of the pa, the study participants were below that.

About a third were around that and about a third were, were larger than that.

So

How many participants in the

we had a 30 participants.

Oh, okay.

Yeah, I.

Wow.

Yeah, that's interesting.

That's actually not surprising.

Um, people who I've been working with for years, men and, and I would say a lot of them.

Uh, this might surprise women, or maybe not, but a lot of men, a high percentage of the men who come through my office have insecurities about their cock size.

And I've seen a lot of penises folks, and I'm proud to say that I've had the privilege of that.

And I'm looking at some of these, we call them Lingham and Tantra, um, and going, you are perfectly beautiful.

You have a lovely size.

Yeah.

You're not giant, but you're not teeny.

Like, it kind of boggles my mind at how much men are insecure about their size.

I, I don't, women don't think about it nearly as often as men do.

And do you think that that's just a result of porn, this

Yeah.

I, I, I think that you're right.

I think men care more about penile size than women do.

Uh, and yeah, it's, it may be secondary to porn.

It may be just like, uh, one more thing that guys use to compare with each other.

Yeah.

And to be honest, like I don't really care how big guy's penises are.

That's not my thing.

But, uh, what I do care is that men don't do stupid things to hurt themselves in the, in the pursuit of enlarged penis.

And so as a urologist, a surgeon and a sexual medicine expert, I would see men come to my office who've had surgeries, who've had fillers, who've had fat transfers, who've had ligament ligations, uh, with really disastrous consequences, like guys who with like a, like you said, a perfectly normal functional penis.

The function of the penis is to procreate and to urinate, and so if you can urinate and procreate, your penis is fine.

Uh, but that's not what society tells us.

And so guys do things and spend lots of money, uh, on making their penis bigger.

And so I wanted, what I wanted to do was to create something, a study that would figure out a way to increase the length and the girth of the penis in a way that was totally 1%, 100% healthy.

And so I put together a study, I've done research at, at Harvard.

I've done research at UCLA.

I've done research at American Red Cross, so I know how to do research studies.

Um, we got institutional review board approval.

We had it listed by the NIHI presented the data at the International Society of Sexual Medicine and the Sexual Medicine Society of North America.

It's written up in andrology, uh, which is a reviewed journal.

And what we found was that in the 30 men in the study, we increased the length of the penis, about eight tenths of an inch, and increased the girth of the penis about a half an inch over a period of six months.

Uh, and the most important thing is there wasn't anyone that had any negative side effects, and everyone in the study had felt like they had better erectile function.

Really.

Did they feel like they had more sensation as well?

You know, subjectively, yes.

Um, but we don't really have anything that we can measure sensation with.

And so, you know, it's, it's purely a subjective thing.

Also, you know, the, the improvement in erectile function was also purely subjective because these are by definition men that have normal erectile function.

So we don't have a survey instrument to measure.

Um.

An improvement over what's already normal, other than, you know, guys know when things work better.

Yeah, I'd be curious to know if, if there was a group of men who, um, was frustrated with, with, I mean, their ability to get hard was fine, but their frustration of being able to stay hard was challenging, and if that helped them stay hard to the point of being able to finish, I.

So, you know, PRP and Shockwave therapy will help men do that.

But in this study we weeded out anyone that wasn't, uh, didn't have

Having normal

good erectile function.

'cause the thing is, you know, men get 30 to 60 minutes of erections every night.

That's, you know, that's one of the things that I, I discovered.

In, in a real way.

When we did the, the, um, confirm study, which is the use of Affirm, um, to improve nighttime erections and to the really, really, really, really exciting study is the confirm two study, which I just like literally got data on, uh, yesterday for my statistician, which combines Viagra, a small dose of Viagra, 40 milligrams with Affirm.

And, uh, I can't spill all the beans, but, um, but the, the data is really exciting.

And the great thing is a lot of men will have side effects from taking a dose of Viagra.

Cialis, that's too high.

They'll get facial flushing, they'll get headaches, they'll get reflux, they'll get stuffy nose, they'll get muscle aches.

And so if you can use a nitric oxide booster like a firm.

To augment the effectiveness of Viagra, then you can take a a dose that's effective, but it won't give you that level of side effect.

Oh, that's cool.

That's a good combo.

I like that.

Yeah.

What's the, what is P long?

Like what?

What are men actually doing to increase the length in the girth?

Yeah, so there's a, a stretching device called the Restore X Device that was developed by a friend of mine at the Mayo Clinic, and that's, that's used mostly, it was developed for Peyronie's disease, which is a curvature of the penis, but it, it stretches and improves length.

Um, and then a penis pump by the Dr.

Joel Kaplan people, which will improve girth and then the Affirm nitric oxide booster to improve erectile function and especially nighttime erections.

And then the secret sauce is a PRP injection.

So platelet rich plasma injection.

So what we do is we draw blood, we spin the blood down, the red blood cells go to the bottom.

The plasma goes to the top.

We take those off, and in the middle there's a layer of platelets, and those platelets are resuspended in plasma and injected into the penis.

Okay.

And platelets have two functions.

One function of platelets are to cause a clot, but the other function of platelets is to regenerate tissue, to cause tissue to regrow.

And so PRP is used in hair growth.

It's used in, uh, didn't work for me, but, but it's used in, in hair growth.

It's used in orthopedics, it's used in dental surgery, uh, and it's used in penises.

As the p shot and, uh, and, and vaginas as the, or clitoris as the OShot.

Okay.

Okay.

That's good to know.

I didn't know that.

Um, what's the treatment like if someone really wants to do this?

Are they using the pump and the um, thing that stretches the penis?

Are they doing

know, I wanted it, I wanted the study to be doable, the protocol to be doable by men.

So there was a study out like 20 years ago on a stretching device that you had to wear like nine hours a day for six to nine months, and that got you about an inch in length.

But most people don't have jobs where they can wear a penile extender for

Yeah, like what does it look like?

What does it feel like?

And so, and so the, uh, the penile protocol is the using the Restore X device, 20 minutes in the morning, 20 minutes in the evening, and using the pumping diet device, 12 minutes in the morning, 12 minutes in the evening.

Okay.

So it's about 30 minutes in the morning, 30 minutes in the evening.

Okay.

Plus the, how often are the PPRP

Yeah.

PRP is once a month for six months,

Once a month.

And then how long does this extra girth and link last?

uh, as long as you're getting adequate erections, uh, it should last forever.

Really?

Okay.

So it, it has

30 person study, you had these guys doing this 30 minute protocol in the morning, 30 minutes in the evening, and getting PRP injection once a month.

And how many months in total were

six months.

Six months for the study.

Okay.

you know, we, we ended the study at six months because we were able to achieve a high level of statistical significance.

Yeah.

But I mean, we, I, we have plenty of guys that, that have aspirations to be bigger and so they continue to, to go and they continue to

do the protocol.

Although I had a patient the other, uh, a couple months ago and he's like, doc, you know, this is gonna be my last visit here.

And I'm like, you know, how come you know, like, you're, you're, you're doing so great.

And he is like, well, I was talking with my wife and now I'm too big for oral and I'm too big for anal, and I, I need to leave at least one orifice open.

Oh my God.

That's amazing.

I, I am very sympathetic to her plight.

I'm not one of these women who really loves giant penises.

I find them to be painful.

Um, so yes.

Interesting.

You had to press pause on the protocol.

Um, now do people have to come to the Bay Area?

I know that your, um, office is in San Ramon, or are there clinics across the

Yeah.

No, we have, we have a network of about 50 or 60 offices around the country that offer P Long, that are

So you're training other practitioners in this

Yeah.

Yeah.

And, and what kind of, um, who's, who can get certified to do this treatment?

Uh, you know, physicians that are, um, that have a capability of, of injecting penises, which,

Okay.

uh,

You have to be a medical doctor or a nurse practitioner.

Could a nurse practitioner do

yeah, we have nurse practitioners that do it.

Cool.

Awesome.

Yeah, I mean, technically it's not, it's not prostate cancer surgery, so.

Right.

But it is something that really, that really shakes the confidence of so many men out there.

And I think people don't know about this.

Um, I think the other alternatives seem really invasive, and so that scares a lot of people and

Yeah, I mean the, the alternatives are really lousy.

A lot of people do what's called a ligament ligation, uh, and so the penis hangs lower.

Mm.

but when you get an erection, it points down towards your toes and it doesn't actually increase the length of the penis.

What, uh, if you, if you look at a penis anatomically about half the penis is on the inside and half the penis is on the outside.

Uh, and so when you cut the ligament, it just hangs lower, but it's actually not bigger.

So like if you're with a guy and the guy's like, well, I have a six inch penis, and then you're in bed with him, and you're like, no, you only have six inches.

He'll say, well, no, I have six on the inside and six on the outside.

Mm-hmm.

Which is why women are such terrible judges of distance.

Um.

so I have a question for you.

Do, do you get any intel or do you talk to your patients about, um, like how this changes other sectors of their life, like their confidence at work?

Like when they're, when they've got more confidence in their cock, how is it changing other areas of their life, their

Yeah, I mean, we don't, we didn't really,

I don't talk about that much.

put questionnaires out there.

There are some actually validated sort of quality of life.

And, and confidence type questionnaires that we could have used.

Um, but I think in general, uh, I notice that that men are sort of happier and more confident when things are working much better down there.

So I knew about like the li the ligament, um, the cutting of the ligament.

Yeah.

And I knew about fat injections.

Can you say more about the filler, what your

Yeah.

So.

Um, there's collagen, there's hyaluronic acid, there's uh, PMMA.

So, um, a lot of those are, um, just bulking agents that, like people get put in their lips or get people get put in their face.

The thing is that they have to be suspended in fluid in order to be viscous enough to be injected through a small needle.

And so basically if you're 50%, um, suspended in water.

Then within a couple of months, you're gonna lose 50% of the bulking almost immediately as that water gets reabsorbed.

And typically the fillers last maybe a year or two.

And then you end up with this kind of dry, lumpy, bumpy penis, almost feels like sand under the, the skin of the penis.

And then you have to go back and get more fillers placed.

Um, and they're not cheap.

You know, it's usually 10,000 bucks for the initial injections and then, uh, two,$3,000 every couple of years for additional injections.

And so it's expensive, it's temporary.

That's a good

and the other thing is it gives you girth.

It doesn't give you length and it doesn't do anything to the head of the penis, right?

So now if

Mm

big girth and a little, uh, head of the penis, uh, what I call that, you know, scientifically we call that a pig in a blanket, penis.

scientifically.

And so, yeah, I mean, pig in a blanket is great at a cocktail party, but it's not not great in a bedroom.

Wow,

you know, and the other thing is, I mean, and you guys tell me, but I don't think women are looking in particular for the size of the penis.

It's more like the confidence of the man who owns the penis.

And so if you're in bed with a guy and you're like, you know, why does your penis look like a pig in a blanket?

Or, you know, why is, why can I feel this, uh, you know, silicone implant under the skin of your penis?

I think they'll, that will reflect more poorly on the guy than actually having a, a penis that's on the smaller side.

Well, yeah.

What we try to do sort of energetically, emotionally and psychologically for men is to help them connect too.

It's not how big you are that makes you a great lover.

It's how much love and consciousness and power you can put out that penis, and so it's much more a mind body connection to go.

How big do you wanna be?

And using the power of your mind to, you know, bring that forward.

And, and that leads to a lot of success in terms of how magnetic and attractive and potent that man feels when inside of you.

Um, but you know, again, one has to use very specifically the power of their mind to be able to own that.

And sometimes people can't dig that deep to be able to feel their versatility.

In that way.

Okay.

Yeah.

Yeah, I, I totally agree with you and, you know, you said mind body connection.

It just made me think of something totally off the subject.

But, um, my, my book the 21st Century Man, it's the, it's the most comprehensive medic men's health book.

Ever written.

And, uh, so I, I started a podcast using artificial intelligence to create podcast episodes, and I thought it would just like, basically take the, the chapter, synthesize it and kick out a summary.

But the really, really spooky thing is it read the whole book.

Then the podcast, I was listening to the podcast to make sure it was okay.

Because you have to, like, we spent a lot of time working on the prompts to figure out how to get it just right and AI was like, this is the first men's health book to emphasize not just men's physical and sexual health, but also the mind body connection.

Mm-hmm.

So like AI has like insight.

was crazy.

I'm listening to this,

The MINDBODY connection in your book.

not like using those words, like there's a whole section on relationships.

There's a whole section on mental health.

There's a whole section on lifestyle.

There's a whole section on aesthetics.

Um, and so there are, there are large parts of the book that relate to that, but I never had anyone kind of synthesize the book to me and say, wow, you know, this is really an amazing book.

Emphasizing not just like physical health, but also sexual health, the mind body connection.

So it's really like

Pretty professional

out there is, is it's crazy.

It,

is doing.

we're going in this world pretty wild.

Well, who knows what the penis is gonna experience?

yeah, exactly.

So, yeah,

Well, you know, they're, they're, they're trying to achieve artificial general intelligence, but maybe they'll also achieve artificial penile intelligence, right?

Because everyone says the penis is the second brain,

Yeah.

I don't think the IQ that they'd have to hit would be quite as high as for the, uh.

Probably not.

It's more simplifi simplified.

Thank you.

Yeah.

You know, I don't know if you would have an answer to this question, but I've heard, um, that as men age, their oxytocin levels go up.

Um, where women, as they go into menopause, their oxytocin levels go down.

And there's one theory that it's, it's why there's a lot of men, older men and younger women who tend to be attracted to each other because their oxytocin levels are starting to match up.

It's one theory.

And um, and so intimacy, like feeling really connected.

To a person, as men are older, like that connection becomes more valuable.

It's more important than maybe some of that more exciting or shallower, um, sex where they're just going from one partner to another partner, where connection isn't as vital.

It's really like the desire and the friction.

That's the big turn on.

And as men age, that need for connection is greater.

And um, and emotionally there's a connection between that and their penis responding.

Have you heard of anything like that?

Do you know if that's true?

know, I.

I would think of it more as like their testosterone levels and then the, you know, their testosterone levels coming down and then the estrogen levels.

Also in women coming down and that sort of connecting

The interplay.

being why?

I, what, what both of you're saying makes, makes a lot of sense to me.

Um, I, I think that, you know, from my own sort of patience perspective, you know, as you hit your sixties and seventies and eighties.

Um, your erectile function, erectile stiffness isn't what it used to be.

And so you have to become more creative in terms of, um, the way that you pleasure a woman.

And so, you know, connecting with them physically in a non penile penetrative way, um, becomes more important and oxytocin may help with that.

Is that true?

Do you know?

Does do oxytocin levels, um, rise as men age and

That, that I don't know.

as women age?

Um, I, I wanna segue to the prostate and ask you about prostate massage as an intervention to help with prostates that it get swollen.

To help milk the prostate for just greater health.

Of course there's a lot of sexual benefit for men who get turned on by prostate massage.

There's a hypogastric nerve, um, and that part of the body that can carry orgasmic energy up to the brain.

Is there anything you can share or enlighten us when it comes to that, either as a preventative medicine process for keeping the prostate young or just from a pleasure standpoint?

Yeah, well, I mean, clearly the best thing you can do for the prostate is to ejaculate.

Okay.

Um, so the prostate, the only function of the prostate is to make semen.

And so you have seminal vesicle that makes semen in the prostate that makes prostate secretions and, and semen.

And so it's a gland.

Just think of like the salivary gland makes saliva, the prostate gland makes semen.

And so, and the semen obviously is like a very thick, viscous, um, fluid.

And so if it sits around for a long period of time, then the, the channels that it, it comes out through will get clogged.

And so we see this when we do prostate surgery like a turp, where you're scraping away prostate tissue, and a lot of men will have a lot of prostate calcifications.

So that's where those ducts or channels get blocked.

The, the semen just sits around and eventually it gets calcified.

And so definitely, um, cleaning out the tubes is important.

I

Does that cause if it's calcified, is that then painful when they ejaculate?

No.

'cause it just, it's just blocking.

Well, I don't know.

That's a good question.

I don't think anyone's ever studied that.

Um, because it would be, be a challenging study to do.

I, I would imagine that would cause some discomfort if the, the glands were contracting and, and, and being blocked.

And certain, certainly that can lead to enlarged prostate.

That also can lead to a prostate that gets infected.

And so before some of the stronger antibiotics that we have, that was the treatment for chronic prostate titis or prostate infection was was prostate massage, basically pushing out the infected prostate secretions.

Mm-hmm.

And

So.

that's like milking the prostate basically.

So, so, so ca could milking the prostate, could be and feel different for a man than a normal ejaculatory orgasm.

Yeah.

Well, you know when, when you're milking the prostate in a pleasureful way.

It's a lot different than coming to a urologist like me who's got big fingers and 12 patients in the waiting room, and I'm just trying to get you better and get the prostate secretions out.

So

Right.

Very different

it's a, it's a relatively uncomfortable experience.

There's no soft music.

There's

there's, yeah.

I don't send flowers the next day.

woman half dressed.

Yeah.

No.

You get an old, bald, pissed off urologist.

Yeah.

I actually have a, a young client right now who's, who's having issues with that.

So it really can happen at any age.

This, uh, sort of pooling of semen or calcification could take place if it pulls for too long.

is it semen or is it prostate fluid?

I thought the semen was held in the balls and the prostate fluid was in the prostate.

And in order to release semen, the prosthetic fluid has to go into, uh, the testicles and it does its chemical reaction.

And then you have an Ejaculation.

Do I have that wrong?

it's a close.

Close.

So the testicle makes sperm.

The sperm swim through the epididymus.

And the epididymus is where the sperm actually matures.

So from the day you make a sperm in the testicle, it takes about 75 days for it to mature and to be released.

And so the sperm swim up through the, the epididymus and then into the VAs deference.

And then the VAs deference joins the prostate and seminal vesicle in what's called the prostatic urethra.

So the part of the urethral tube, um, that's at the prostate level.

And so during Ejaculation you get contraction of the semial vesicle, contraction of the prostate, and that pushes the fluid, which is really high in fructose, fructose type of sugar, uh, that the sperm kind of need that sugar to because, you know, they're, they're whipping that tail around.

They're swimming a long, long distance.

You know, they're swimming basically across the English channel to get to the to the egg.

And so that's the purpose of semen.

Uh, and the sperm really only make up about one or 2% of the total Ejaculation.

Oh, that's a lot less than I thought.

Hmm, interesting.

So like when you, when we do vasectomies, um,

it's prostate fluid.

yeah.

So when I do vasectomies, uh, you know, prostate.

Ejaculation, you know, or Ejaculation looks and feels the same because the semen, the sperm are only, you know, one or 2% of the

Wow, that's interesting.

Now, how often should a man be ejaculating in order to maintain prostate health and avoid this

Yeah.

You know, I, there again, I, I don't think anyone's ever done a, a, a real study on that, but you know, at least twice a week maybe.

Well, would you say it's different for different ages of men or maybe different sort of biological, physical, like if they're really healthy and they're in their sixties versus, you know, not healthy in their twenties.

Uh, I mean, I think in general to keep the, the fluid flowing at least twice a week is probably healthy.

Okay.

I know there was an Oh, oh, well we're, oh, I had something.

No, no, no, no, no.

We talked about the prostate.

There was another

chat GPT of urology.

I put my arms out here and it's like me giving wonderful prompts to the universe.

Unfortunately, this doesn't always work.

Well, I wanna hear about, um, maybe some success stories.

Like, you know, like a guy comes in and he is just all down and out, really not having a good time with his penis

Yeah.

So you know what, what I do, um, I just, for me, the penis is a way to see a man's sort of general overall health.

There's like a, for me, there's like this Maslow's pyramid of, of health for men over the age of 50.

So for men, you know, in their twenties, erectile function's easy.

Um, but for men over 50 to have a, a fulfilling sex life, you know, at the very bottom at the foundation, you need to have good physical health.

Then you have to have good mental health and you have to have good emotional health and financial health.

And then at the top is really sexual health.

Mm-hmm.

and so men, men come into my office, you know, for me to treat their erectile function, but I also treat their physical function.

I also treat their mental health.

I also, you know, refer them to therapists for relationship issues and those kind of things.

And so what's really gratifying to me is I see a man who comes in six and then, you know, I talk to them about their physical health and I get them on, uh, eating better.

I get them to stop drinking.

I get them to stop smoking.

I get them to lose 20 or 30 pounds.

Um, I get them into an exercise routine.

I get them on good supplements.

Um.

Then I get them, uh, on testosterone replacement, and then I'll get them on Affirm.

I'll get them on some daily tadalafil.

We'll do shockwave therapy.

We'll get them with a penis pump.

We'll do PRP and six months later they look like a million bucks.

They're, you know.

Everything in their life is better and they're having be the best sex that they've ever had in their life.

And that, you know,

Oh, I love

and yeah.

And that, you know, that's really, really gratifying to me, and that that happens fairly frequently in my office.

And, you know, the, the sad thing is, um, the way that our medical se system is these days, you just don't, as a physician, you don't have enough time to spend with patients.

Mm-hmm.

So, I mean, I had a patient who came in to see me for a circumcision, but he was 80 pounds overweight and drinking eight beers a day.

And I looked at him, I said, dude, you know, I'll do your circumcision.

That's fine.

But you know, if you don't stop doing what you're going to, you're doing, you're gonna fucking die in five years.

He looked at me and he started crying,

Oh

I'm like, yeah.

And I was like, you know, what's going on, dude?

He's like, you know, I've been going to doctors for 25 years, and no one's ever said that to me in a way that, that it just landed for me.

wow.

And I saw him back, you know, two, three months after a circumcision.

He had stopped drinking eight beers a day.

He had already lost like 20, 25 pounds.

And you know.

His, his whole life was turned around and, and so sometimes it doesn't take someone with like extraordinary knowledge.

Sometimes it just takes someone

up.

to who's a professional,

Yeah.

that that cares enough to just pause and, and tell someone what they see.

Yeah.

To like compassionately tell the truth in a, in a way that a like for this person lands.

I mean, I'm sure like people in this guy's life, were telling him, dude, you gotta stop drinking.

You gotta lose weight.

Uh, and it, it, it didn't really land.

So some, sometimes, you know, that's the privilege of wearing, uh, a white coat

Mm-hmm.

and having fancy diplomas up on your wall is that sometimes people will listen to you in a way that they don't listen to other people in their life.

And so, to me, you know, I, I consider it really a, a, a honor and a privilege.

And I, I try to use that sort of pedestal to get people to see things that they don't wanna see.

Yeah.

Wow.

That's a lot of responsibility too.

and to look more closely at their lifestyle.

Do, do you treat people with, um, who come?

Do people come in.

Wanting help with, uh, ejaculatory control or delayed Ejaculation where they're just having a hard time getting over that climax hill.

You know, so I treat people with premature Ejaculation.

They tend to be younger patients, and I treat patients with delayed Ejaculation, tend to be older.

So for guys with premature Ejaculation, you know, the, the delay sprays like PROEs, uh, are really useful.

Um, I also have a supplement called Pre Prolong

what's PROEs?

PROEs.

It's like basically a topical numbing cream.

Mm.

You know, they're wipes, there's creams, there's sprays.

I find that pubescent sticks to the penis a little bit better,

Over the counter or

over the counter.

Yeah.

then I have a supplement called Pre Prolong, which is an extract of St.

John's Wort.

St.

John's Word is a natural selective serotonin reuptake inhibitor.

Mm-hmm.

Uh, and so what we found is that the antidepressant medications in the class of selective serotonin reuptake inhibitors, SSRIs, delay Ejaculation.

Um, but you don't, some people don't wanna be on an antidepressant.

Um.

Yeah.

But

a lot of stigmas and side effects of those.

So pre prolong, which you can also pick www.affirmscience.com, uh, works really well.

Or you can go on on antidepressant or there's, um, there's one called Priligy, which unfortunately is not available in the United States, but it's a short acting one to three hour, uh, window.

And so, uh, I have patients who get it from India, they get it from England.

you can take that one to three hours before, and that will delay Ejaculation.

Now on the, on the flip side, you have guys that, uh, take a long time to ejaculate.

Uh, and so sometimes testosterone is good for that.

Uh, if you have low testosterone levels, boosting testosterone will boost libido, which then will, um, increase excitation and guys will be able to ejaculate.

Um, there's a medication called Cabergoline, um, which works on the dopamine, uh, supplies in the brain.

Uh, and then there's a device called the Emsella chair.

Uh, and so I actually did the original research, which showed that it improves ejaculatory function, 10 treatments.

So the Emsella was actually developed for women for treating stress incontinence.

And then, uh, Kim Evans, a friend of mine, did research on women that showed that it improved sexual function by improving the, the strength of the, uh, the vaginal tissue.

Did you say Emsella chair?

Is it a chair that you sit in?

Yeah, it's a chair that you sit on, uh, but it's basically you're sitting on a giant magnet

Okay.

and when you run electricity through a coil, it creates a magnetic field and that magnetic field contracts the pelvic floor.

Kinda like you're doing a Kegel exercise,

it's for you, it's

but it's, yeah, but it's, it's 20 fold stronger than you could ever do on your own.

Oh, does it hurt?

that sounds interesting.

It feels actually.

Yeah, I was gonna say, that might feel nice.

No, it feels, feels good.

Yeah.

Um, you know, when I have paperwork on the weekend, I come in, I sit on that chair, I, I get a pelvic floor workout, and I get my paperwork done.

Nice.

I'm in efficiency.

I, I have four kids, three companies, two houses, and one wife.

So I have to be super efficient with my time.

Yeah, evidently.

Wow.

Well, this has been so fascinating.

Um, Dr.

Willow, do you have any final questions?

I don't Thank you so much for coming on the show, Dr.

Brandeis.

It was such a pleasure to just pick your brain for an hour and learn about all this amazing stuff.

And the 21st century, man, it is all in the book, soon to be coming out in podcast form.

No, we're already out.

If you go to, yeah, if you go to, it's the 21st century, man, so if you go to Spotify

okay.

and just put in the 21st Century man, or we're

We don't have to read.

We can just listen to the podcast now.

Yeah.

Well, you know, like, do both.

It's, I don't know.

I'm old fashioned.

I like to have a, like a book, like yeah, a book

I actually like to read a book and listen to the book at the same time.

If I

Ooh, that's good.

yeah.

Yeah, well, we'll have all those links in the show notes, friends, uh, remember to please stay tuned because up next you've got me and Dr.

Willow dishing it up and we look forward to that.

And, um, have a beautiful day.

Thanks so much for joining us.

Oh, thanks for having me.

I

Mm-hmm.

it.

Now our favorite part, the dish.

Well, well, well, you know, we've had so many great, interesting sexual health doctors recently.

We have.

It's been fun.

I love it.

'cause we get such a good education.

I mean, that was fast.

I didn't realize that only one to 2% of an Ejaculation is semen.

How?

How did I not know that?

I know that's fascinating.

I had no idea either.

I thought there would be a much bigger volume.

It's mostly prostate fluid.

So, and this is something that I've actually been wanting to talk to you about privately, but since we're here privately talking, um,

Yeah.

uh, with, with milking the prostate, what is coming out is primarily prostate fluid.

My understanding was that it was prosthetic fluid.

Yeah.

'cause I was totally not confi.

I was a little.

But it sounds like that it's also semen.

One to 2%

And what I thought of as semen, I was equating with sperm.

But it sounds like there are actually three different things.

You have sperm, semen and prosthetic fluid.

And the prostate is what creates the semen and the prosthetic fluid.

Okay.

And we're gonna have to listen to that little portion again.

'cause that was really good education.

Yeah.

So, Dr.

Brandeis, what a, what an amazing urologist to know about y'all.

What an incredible guy like gay for the penis man.

It's like making everyone have better relationship with their cock.

I love it.

And for those of you who are in California or near the Bay Area, um, he would be in your backyard.

Uh, but it sounds like he's got other clinicians that he's trained who can also, um, help with some of the things that he's created.

Really great, that there's a more natural way to have permanent

yes.

Extra girth, extra length.

I mean,

Yeah, exactly.

you know, I can just see how many men would invest in that if they had the chance to just up their confidence by another inch.

Well.

I can't tell you how many people I know would say yes.

mean, I know exactly, but I, I imagine too, if we're increasing length and we're increasing growth, we've gotta be increasing sensitivity as well because there's just, there's that much more cellular tissue for blood to be flowing through.

So that's gonna be increasing sensitivity.

So.

Oh, I never thought of it that way.

Gonna be feeling better too.

Not only are you gonna have more confidence in the way that it looks, but also in the way that it feels and probably in your control as well.

I mean, I, I do, I do know that Leah and I are, are experts in teaching control, but, um, you know, I think if you, yeah, the confidence is a huge part of, of being able to be in choice.

I like the word choice a little bit better than control.

Yeah.

You know, if I do go down and.

Get on that magnet chair he was talking about.

I, I wanna, I wanna talk to him if I could have a few more minutes of his time and explain the interventions that we have so much success with when it comes to teaching men ejaculatory choice by working with muscular contractions, pressure points, and breath control because again, it's a non-invasive way of actually getting some really great results.

I would much rather teach somebody that than give'em a spray.

God knows what that spray tastes like.

Just so y'all know, if you don't know, Leah is not into yucky tasting medicine.

I don't like yucky, tastes

like the taste of.

nothing bitter, especially.

Well, yeah, I actually wanted to ask him that and I just didn't, but, um, you know, do you ever refer to Dakini, do you ever refer to, to Tantikas who, who teach men like hands-on how to, um, how to use their own, their own systems?

Sound, breath.

You know, body control, running energy through your meridians.

I mean, it would be interesting, I think I did ask one of our doctors at one point that we had on the show, that question, and they were like, huh, never thought of it before.

Yeah, right.

I think that was Dr.

Gittens and um.

Yeah.

You know, I, I've, and I got the vibe from him too.

This is not something he

I, yeah, that's.

typically refer.

It's like I think some of those physicians are like, you know, I don't wanna sound judgy, but there is a certain academic thing that they feel like that's the only thing that has credibility because they know they've been through so many years at a university and they've have.

You know, clinical measurements and things.

So there, there's a status izing when it comes to, um, the type of education that you've had,

Yeah, definitely some of them, some of them can.

Although I will say for Dr.

Brandeis, he was, he was very receptive and very open and pretty, pretty playful I thought.

And like when, when he

And so was Dr.

Gettin's, honestly, he

afraid to admit it, you

Mm-hmm.

Yeah, and I think, um, I think we asked the same question to Dr.

Elliot Justin, who I was thrilled that he mentioned because he loves, um, Dr.

Uh, Justin's cocking that we were so impressed

it's an amazing fucking ing.

Yeah, I really, if you haven't listened to either of those episodes, go back.

I'll put the links in the show notes because it would be really interesting to get some feedback from you, um, listeners about what landed with you, because each one of these doctors touches on many of the same themes.

For instance, Dr.

Gittens is really all about the, um the, uh, injections for increased girth, the filler injections, and has had great success in his office.

So it's really interesting, um, uh, what Brandeis had to say, uh, and his alternative that he's getting a lot of success with.

So, and then not to mention Dr.

Anne

Yeah.

Yeah.

Who spoke a in depth about the

can get a whole education on prostate and penile health by those three episodes alone.

Yes.

And you know, I think one of the things that might if be a turnoff, if I was considering, um, the p long treatment that he has is just, although he did say it's just a half hour in the morning and a half hour in the evening, but it does feel like a lot of steps.

But then again, it's permanent.

Yeah.

So maybe, you know, it's six months and you get a permanent result and it, it takes an hour a day of an investment and you gotta go into the office to get those injections.

I don't know how important is it to you?

Yeah.

Well this was fun.

Okay.

Love, love, love.

Thanks for tuning in.

This episode was hosted by Tantric Sex Master Coach and positive psychology facilitator, Leah Piper, as well as by Chinese and Functional Medicine doctor and Taoist Taxology teacher, Dr.

Willow Brown.

Don't forget your comments, like subscribes and suggestions matter.

Let's realize this new world together.