Huberman Lab Podcast with Dr. Michael Eisenberg: Male Sexual Health and Fertility

Host: Andrew Huberman

• Professor of Neurobiology and Opthalmology at Stanford School of Medicine

Guest: Dr. Michael Eisenberg

• Medical Doctor Specializing in Urology
• Expert in Male Sexual Function and Fertility
• Published over 300 Peer-Reviewed Articles
• World-Renowned in Male Sexual Health

Key Topics Discussed

Erectile Dysfunction (ED)

• Causes:
  • Predominantly vascular or neural issues
  • Small percentage due to hormone dysfunction
• Treatments:
  • Oral medications like Viagra and Cialis
  • Urethral suppositories
  • Penile injections
  • Penile implants (non-inflatable and inflatable types)
• Myths: Vast majority of ED not linked to low testosterone.

Prostate Health

• Functions: Produces proteins/enzymes for sperm health
• Common Issues:
  • Enlargement causes urinary symptoms
  • Treatments include lifestyle changes and medications like Tadalfil

Fertility and Sperm Count

• Components of Sperm Quality:
  • Volume, concentration, motility, morphology, DNA fragmentation
• Global Trends:
  • Controversial reports of declining sperm quality
  • Factors include obesity, chemical exposure, and geographic variations
• Hormones:
  • Testosterone levels are declining over time
  • Obesity affects testosterone conversion to estrogen
  • Importance of both testosterone and estrogen signaling

Penis Length Trends

• Findings:
  • Penis lengths increasing over the last 30 years
  • Possible reasons: earlier puberty, androgenic exposures
• Measurement Methods: Stretch measurement and erect penis measurement

Impact of Lifestyle

• Good Practices:
  • Exercise, adequate sleep, moderate alcohol, no smoking
  • Avoid prolonged heat exposure (saunas, hot tubs)
  • Keep a healthy weight
• Smoking and Alcohol: Harmful to sperm quality
• Vaping and Drugs: Limited but concerning data

Testosterone Therapy

• Uses and Risks:
  • Often misused by younger men
  • Can reduce sperm production significantly
  • Requires careful medical supervision
• Alternatives:
  • HCG to maintain sperm production
  • Clomiphene to stimulate the body’s own production

Other Health Issues

• Cycling: Prolonged saddle pressure can harm sexual function
• Urinary Tract Infections (UTI): Rare in men, typically signals an underlying issue
• Sleep: Important for maintaining sperm quality and hormone levels
• Pelvic Floor Health: Important, especially post-surgery
• Testicular Health: Regular checks recommended for lumps, changes

Male Aging and Offspring Health

• Older Fathers: Higher risk for offspring’s health issues (e.g., autism, genetic mutations)
• Recommendations: Consider sperm banking at a younger age if planning to have children later
• Testicular Exams: Men should be aware, despite changing guidelines on self-examination

Psychological Health

• Impact of Sexual Health on Mental Health: Strong interrelation
• Treating Sexual Dysfunction: Often includes counseling and addressing psychogenic components

Important Takeaways

• Health is Holistic: Vascular, hormonal, and lifestyle factors all interplay
• Regular Medical Check-Ups: Essential for early identification and intervention for issues
• Awareness and Education: Key to proactive and preventative health practices