The Best Sexual Biohacks, Can Vasectomies Decrease Testosterone, Foods & Supplements For Boosting N

You know, folks.

I gotta cut this bad habit of consuming beverages and gum while I am recording things for you.

But did you hear that?

That is. That's my first drink of the day, meaning my first alcoholic drink of the day. My only alcoholic drink of the day. I don't ever get drunk, but I have a drink at the end of each day, I have a drink. I make coffee cocktails that basically bastardize alcohol. Like, I'll take wine and mix it with ice and sparkling water and sea salt. Or I'll take like a Zevia ginger beer and mix that with some gin, which is a really clean burning form of alcohol with some lime and some fresh mint from the garden. But I'll throw like a, like a noon electrolyte tablet in there. Or, you know, I'll put a few squeezes of like a, like a CBD oil in and stir it up. My wife just drinks a glass of wine. I always got to do these crazy things to my booze. Tonight I'm drinking wonderful organic rose from this company called fitvine.

But I have blended that with bottle.

Of this hangover supplement somebody sent me and some sea salt, some ice, and the squeeze of half a lemon.

So there you go.

I wish I could remember the name of this stuff. It's like morning hangover. Hangover Free, I think is the name of it.

Anyways, there's all sorts of hangover.

If you do a Google search for Ben Greenfield hangover pills, you'll find this big article I wrote from Men's Health magazine about all these different ways you could prevent hangovers. But I don't get hangovers. I'll never get drunk. I haven't been drunk in like six years because I just drink one drink a day, rarely have two drinks and never get drunk. I just feel better that way. So that's how I roll. Don't judge. Today's podcast is a good one. This podcast is with this doctor who specializes in male and female sexual performance enhancement. He does some anti aging stuff, some hormone stuff. Interesting.

Dude.

Judson Brandis. Judson Brandes. So this one ought to give you a few cool little things that you can take away for the weekend, especially if you have lover or if you like have bad hormones or kind of like biohacking certain areas of your body. We talk all about that in today's show, which is brought to you. Speaking of biohacking your body, by this company called joovv. I'm standing right by my Joovv right now. The folks at joovv, they're Actually, just up at my house, we were talking all about photobiomodulation, which is this form of therapy. It's also abbreviated PBM that has over 3,000 different clinical studies published on it. For better sexual performance, reduce joint pain, increased muscle recovery, increased skin health, collagen production. You simply flip this light on and you stand in front of it for like 10 minutes. I do it while I'm at work, like working at my office. And yeah, you can like pull your pants down and shine on your nether regions. You can put it on wrinkles, you can put it over like scar tissue. So many benefits of this thing. They've put this particular light through some pretty strict FDA approved, rigorous third party testing and come out with what I consider to be kind of like the Cadillac of photobiomodulation. This thing called a joovv elite, which allows you to put all these lights in different configurations. Like you can make a square that you could stand inside of. You could line a whole wall with the lights. If you own like a clinic or a personal training studio, you can have this as an upgraded function for your clients or for your patients. They have this built in Bluetooth function that yes for you dirty electricity heads out there, you disable. But I mean you can literally pair it with Alexa or Google and you can say like Alexa, I want to Joov for 10 minutes Alexa. Because everybody talks like that when they talk to Alexa. They talk like that. I like to talk like that when I talk to technology. Hey Siri. Anyways, you get a big old cool gift that they're gonna throw in for anybody who orders a joovv.

Very simple.

You go to Joovv.com Ben that's J-O-O VV Ben. Use code Ben at checkout. That's it, that's easy. J-O-O-V-V.com Ben. I meant to say it's that easy, but when I say that's easy, I kind of like the way that sounds. So I'm just going to roll with it. That's easy folks. You know what else is easy? It's easy to eat clean and I have all these superfoods that I love.

Cocoa butter and things that I put.

Into like my homemade avocado organic ice cream that I make at home, White chia seeds, grass fed chick gelatin for my joints and for my gut, organic honey which is just loaded with prebiotics and with immune modulating compounds, almonds, which I love as a source of Mediterranean fats, coconut flakes, cacao Nibs dark chocolate. I decided to take all this stuff and even sea salt, like a special sea salt that's got over 60 different trace minerals in it. And I managed to package all of this up into a bar and it's like crack cocaine. It's rich, chocolatey, coconutty, mind blowing explosions of flavor inside of your mouth. And I spent about two years developing this bar. It's available now for you to order. It's called the Kion Clean Energy Bar. It is mind blowingly amazing. Even my children love it. They ask me for these things. They take them to school, they take them to tennis, they go to jiu jitsu and they have their bars with them. They just love them. No chemical cocktails, no fart in a package type of stuff. It's, it's really good. You go to getkion.com bar grab one or a few boxes, getkeon, get K-I-O-N.com bar. You'll find all the other fun supplements and fancy things that I design over there@getkion.com so enjoy and let's go talk to this doc, shall we?

He's an expert in human performance and nutrition, voted America's top personal trainer and one of the globe's most influential people in health and fitness. His show provides you with everything you need to optimize physical and mental performance. He is Ben Green.

Power.

Speed, mobility, balance, whatever it is for you, that's the natural movement. Get out there. When you look at all the studies done, studies that have shown the greatest efficacy.

All the information you need in one place right here, right now on the Ben Green Screen Fitness podcast.

Hey folks, it's Ben Greenfield. And probably doesn't surprise you that I get a lot of questions on male and female sexual enhancement. Most likely because I made the mistake of being the poster boy for men's health a few months ago about all these crazy biohacks you can do to enhance sexual performance. And frankly, I've gotten so many questions that I decided to get an actual private practice urologist on the call to talk about some of the science and some of the medicine behind not only optimizing male and female sexual function, but also a lot of the procedures that exist out there for everything from vasectomies to things like prostate cancer. That obviously affects sexual performance, but also has a great deal of new research and new science behind it that I want to really get into on today's show. My, my guest is Dr. Judson Brandis and he's from Walnut Creek, California, where I've actually been. You guys have an amazing cryotherapy clinic down there that I visited when I. When was I down there, I was doing that.

The.

The RKC kettlebell certification at a place called Diablo CrossFit. Are you familiar with Diablo CrossFit, Judson?

I am. They have a really good rock wall that I take my kids to.

Yeah, amazing CrossFit. I mean, I'm not much of a CrossFitter, so I would probably wouldn't know, but it seems like a pretty amazing CrossFit facility to me, quite subjectively anyways. Judson has been voted as a top urologist in the San Francisco Bay Area for a few years in a row. Past four years pioneer using technology in urology and an early adopter of robotic surgery and lasers and MRI targeting for prostate canc. He does things like these gainswave treatments for men and the femiwave shockwave thing for women. Which I actually want to ask you about Judson, because I get a lot of questions from girls about how they too can shock their nether regions. And he also even develops special formulas for increasing your availability of nitric oxide. And we'll get into nitric oxide and how you can bump that up as well. And of course, as is the case with many of the guests that I.

Have on, I go for people who.

Are after my own heart. Meaning that Dr. Brandes has not only been involved with pretty extensively triathlon since 1981 when I was born, but he also ran track and cross country for Brown University.

He's a.

He's a fit dude. Even knows how to. How to keep long bike rides from inhibiting your ability to get it up, fellas. So we'll hit on that too. So, Judson, welcome to the show, man.

Oh, thank you. It's an honor to be here.

Yeah, I'm stoked to have you and talk about this stuff and I. You know what? We might as well. I mean, I do want to ask you about your triathlon history and a little bit about specifically endurance athletes and sexual enhancement and testosterone. But before we get into any of that, I'm just going to address the elephant in the room right away, man. This whole femi wave thing for women to enhance sexual performance by blasting their crotch with sound waves. And the reason I'm asking is twofold. A, A bunch of women have been asking me about this since they found out that I go down to. Down to Florida and there's clinics all over the country, including yours, that do this shockwave treatment for men, which I've Done podcasts on before. And if you're listening, just go to BenGreenfieldFitness.com Shockwave and I'll link to my previous podcast on this whole gainswave therapy for men, but there's also this one for women. And of course, we are fine with getting explicit on this show. You can describe in great detail if you need to, Judson.

But what is the deal?

How does this work with women, both physiologically and also logistically?

You know, so the whole key is blood flow for both men and for women. And really for anything in the entire body, the key is blood flow. And so, you know, for gainsway for men and for women, basically what you're doing is using the shockwaves to create inflammation. Inflammation, in this case, tricks the body into creating an inflammatory response. The inflammatory response results in a healing response. As part of that healing response, you increase the amount of what we call vegf, or vascular endothelial growth factor, which is what's responsible in the body for signaling the growth of blood vessels. And when you grow blood vessels, you increase the blood supply. And so for gains weight for men, you increase blood supply to the penis and gains weight for women, you increase blood supply to the clitoris, but also to the labia and the other parts of the vagina.

So you really are causing actual damage, but it's almost like a hormetic style damage that results in this surge of vascular endothelial growth factor.

Well, the beautiful thing is that you don't really create damage. You use shock waves, which are different than sound waves because they have a higher peak and a higher descent. But basically, what you're doing is tricking the body into thinking that there's damage. But instead of having to repair the damage, the body's response, the healing response, can go entirely towards growing new blood vessels and repairing tissue.

So how does that work exactly? How does the body get blasted by the sound waves and not actually experience damage or affectation of the actual tissue itself?

Well, the shockwaves basically perturb the cell membranes. And by perturbing the cell membranes, they trick the cells into thinking that there's actually trauma.

Okay?

And so they release inflammatory cytokines, which are basically microscopic hormones that your body releases, like interferons, tumor necrosis factor, those kind of things that are the signaling mechanisms that your body uses to generate inflammation. And once you get that inflammatory response, think about it. You know, if you have a crush injury of your leg or a cut, those kind of things generate an inflammatory response, which then generates a healing response, which Is what you need to repair an injury. And that healing response is what we're really trying to go for.

Now.

Could you theoretically achieve this? I mean, because I know you guys have these. When I go to the facility, it's like a big box with a wand coming out of it that you. That you basically wave around my testicles and my penis and this entire area for 20 minutes. So I've put numbing cream on first, and then it's just like. Like a.

All around the area.

Could somebody just do that at home with like. This sounds really funny, but people have asked me this before. Like, could you put on earplugs and basically stick your dick between a giant set of speakers, for example?

Yeah. So, you know, that's interesting because I've been asked that question before. But those are sound waves. So sound waves are sinusoidal. These are shockwaves. So shock waves have a high peak and a high descent. So, you know, if that were true, you could use a regular ultrasound, diagnostic ultrasound to do the same thing, but you can't.

Yeah, I guess an ultrasound is kind of similar to. So these waves are different.

These are different than sinusoidal.

Can you describe that again, the difference between the sinusoidal and this form of a sound wave?

Right. So a sinusoidal or a sound wave has kind of a smooth up and a smooth down.

It's kind of a gentle up and down. Whereas a shock wave has a high peak and then a shock wave. Think of like. Well, we use it for lithotripsy for breaking up kidney stones. But the shock waves that we use to break up kidney stones are 100 times stronger than the ones we use to stimulate this inflammation in the penis. But basically, think about a jackhammer. It's the same type of intense up and down that a jackhammer does instead of.

Yeah, it's kind of like a mini jackhammer, actually.

Yeah. Instead of soft music. Soft music, you would use to. To visualize things on the inside of your body. But the jackhammer is what you need to trick the body into creating inflammation. Now, with a jackhammer, you're breaking stuff up with the shockwaves. The shockwaves still go through soft tissue. Now, if the shock waves hit bone, it hurts. Right. So you need someone who's experienced in doing gainswave to do the gainswave, because if they hit the bone, that really hurts or if the shock waves hit the testicle, you know, something that has a lot of nerves that really hurts.

Yeah. Hence the numbing cream. That stuff comes in pretty handy. I Always get a great big old syringe of that handed to me. Then you go in the bathroom and.

You smear it on and you go.

Into thego into a little clinic and you get it done. Now for women though, how exactly does this work for women?

So with women it's the same shockwaves, but you apply it to different areas of the labia and the vagina and the clitoris. And basically it does two things. It increases the blood flow.

Because basically the clitoris is the same as the penis. They're same nerves, they're just packed into a tighter package and they're basically the same blood supply. But then also there's evidence, not really great, double blinded, scientific, controlled studies, but a lot of anecdotal evidence that Gainswave also improves nerves, improves sensitivity. And so women and men after gainswave are more sensitive and they have much better blood supply.

And for women, it's called the femi wave, right? Femi wave, exactly. Okay, got it. So, and by the way, the time we're recording this, my wife and I are going down to do this procedure together. We're gonna be in Florida for a couple of meetings and I'm gonna get the gainswave, she's gonna get the femi wave. And in my experience, and tell me if this is typical, after about four to six hours after the numbing cream wears off, you know, for me personally, I get an erection. Even if I'm not thinking sexual thoughts or I'm in a sexual scenario, I just get an erection almost right away. Like it just, I get that blood flow in it and that continues for about, I would say a month or so. As far as me getting things like nocturnal erections or morning boners or anything like that. Now do women experience something similar?

You know, I think it's important to set expectations. So in my clinic we do this once a week for six weeks.

Really?

Exactly.

Okay.

I thought it was like once every like one to two months, you'd get it done.

You know, at the Gainswave clinic they do it twice a week for three weeks. We do it once a week for six weeks. And the important thing to understand is that after your first or second treatment, especially in younger men, you're going to get a big nitric oxide release. And that's the reason that you're going to get better erectile function early on. After about the second or third week, that's going to go away. And so a lot of patients after the first treatment or two say, wow, that's great, you really fixed it. I'M so excited. And then after the third or fourth week, they're like, things seem to go well and then all of a sudden things weren't going well. But that's normal. It's important when you're undergoing this treatment to understand that it's the fifth week that really begins the good part of the journey because you're growing blood vessels and blood vessels don't grow in the first week or two.

Hmm, interesting.

Yeah. So it's important if you're a patient undergoing either one of these treatments, Gainswave or Femi Wave, to set your expectations appropriately and understand that by the fifth week, that's when things start to improve. And they improve from the fifth week.

Up until about the 12th or 13th week.

Okay. When you're doing this, you're trying to increase vascular endothelial growth factor and nitric oxide. I know you're kind of an expert when it comes to increasing nitric oxide from a nutritional or a supplement standpoint as well. Would there be for the sexual biohackers out there, things that you could consume before or after you do the treatment to either enhance the production of the endothelial growth factor or of nitric oxide or both?

Yeah, absolutely. I know you guys have talked about nitric oxide before on your show, but in 1992, it was the molecule of the year. And I think it's still really underappreciated. As we age, we lose our ability to synthesize endothelial derived nitric oxide. And responsiveness to nitric oxide doesn't change as we age, only the ability to generate it. And so restoring nitric oxide production and supply really is the fountain of youth. I'm 51, and even if I eat really well and exercise, I'm only getting about 80% of nitric oxide. When you're in your 40s, like 37 to 40, you're getting about 90%. So you really have to supplement nitric oxide in a dietary sense in order to get that second messenger that really is critical to increasing blood flow everywhere in the body. And so I developed a supplement called Affirm, which is consistent of L citrulline, red beet extract, Mirapuama and Asian ginseng. And what this does is it boosts from a natural dietary standard the amount of nitric oxide available. And so what we found is that it improved the ability to get an erection earlier with Shockwave therapy with Gainswave. And Gainswave was more effective on a long term basis.

How does that compare to something like Viagra?

Okay, so this is really interesting. I call this actually triple therapy. So what Affirm does, what nitric oxide boosting does, is it increases the amount of nitric oxide available in the synapse. So think of like a salt shaker. As you get older, there's less and less salt in the salt shaker. And the important thing to do is to put more salt or more nitric oxide into the salt shaker so that when the nerve gets stimulated, there's more, more nitric oxide in the synapse. Now, what Viagra and Cialis are, are what we call PDE5 inhibitors. PDE5 is an enzyme that lives in the synapse that scavenges or takes up nitric oxide. And so Viagra, you'll hear about it, called a PDE5 inhibitor. What that does is it blocks PDE5 or phosphodiesterase number five, and it allows the nitric oxide to sit in the synapse for a longer period of time, maximally stimulating the blood vessel. Now, the third part of triple therapy is Gainswave. What Gainswave does is it grows new blood vessels and it removes the micro calcifications from old blood vessels, allowing the increase in circulation.

Wait, so you're using this nitric oxide precursor, then Viagra, then the Gainswave.

The patients that I typically see in my office are patients that have failed Viagra or failed Cialis. So the patients that have mild erectile dysfunction, they go see their primary care physician. The primary care physician puts them on a PDE5 inhibitor, and I never see those patients. So when the PDE5 inhibitors aren't working anymore, I get those patients from the primary care physician. Now, for younger patients who are basically on Viagra and it's working pretty well, then basically all you need is a nitric oxide booster. And I would say you would need a nitric oxide booster in all aspects of your life. Nitric oxide boosters have been shown to reduce blood pressure in a very natural way. They have also shown to reduce coronary artery disease, reduce hypertension, even reduce the risk of Alzheimer's disease. And it's nothing magical about the nitric oxide other than it increases blood flow, and blood flow obviously increases the ability to bring everything into an area to heal, to grow, et cetera, et cetera.

Yeah, and I know, you know, you brought up citrulline, for example, which watermelon is very high in citrulline. A lot of bodybuilders will use watermelon to get, like, a pump before they go out on stage. I used to use Red wine and dark chocolate for a similar kind of vasodilatory effect due to the nitric oxide boosting benefits. There's also this concept, though, that you have nitrates in your mouth that can actually, from what I understand, get converted in the salivary glands along with your oral bacteria in your mouth to allow you to create more nitric oxide. So could you theoretically say that if you, let's say you were like using mouthwash a lot, killing all the bacteria in your mouth, maybe you have poor bacterial profile, you're not using probiotics, et cetera, could that potentially make a nitric oxide supplement less efficacious?

I was actually going to say that it's important to, when you're taking a nitric oxide supplement, make sure that you don't use mouthwash around the time that you take it, because the salivary gland isn't important and saliva is important in the production of and conversion of nitrates to nitric oxide.

Okay, interesting. What about if you were to take probiotics, could that theoretically even increase the availability of nitric oxide levels?

You know, it's a great thought. I honestly, I don't know the answer to that question.

Okay, Yeah, I may want to look at it afterwards to see what kind of research has been done on bacterial status profiles and nitric oxide. That would be interesting to see if you stack those, if that would have an effect. But I do know my friend Joe Mercola was telling me about fermented beets and how when you ferment a beet, from what I understand, it's the actual bacteria that you get when you ferment a beet that are made more bioavailable, the bacteria and the enzymes that result from fermentation. And so if you have a fermented beet source, you might even get better nitric oxide availability. I mean, let's say you were going to do this from a more natural or ancestral standpoint. You could just get beets and put them in a glass mason jar, you know, with whey or salt, and do just like a traditional fermentation. As far as thethe type of beets you use in your supplement, is that, do people do that in the supplement industry? Actually ferment a beet before they turn it into beet powder.

You know, biochemically speaking, that actually probably would work, but I don't know how it would actually taste.

Yeah, I don't know either. I actually haven't done a lot of fermented beets, and this is a conversation I was having with Dr. Mercury just a few days ago. I think he has, I don't know if he has a fermented beet source on his website. He may. Obviously it's not that difficult to make your own fermented beets, but I think it's interesting how many things you can kind of stack together here. But ultimately it sounds like for the person who doesn't have erectile dysfunction, who is just, you know, like a guy like me who just wants to go from good to great, who wants to have longer orgasms or more firm erections, or for a woman who wants more blood flow, for example, the best case scenario would be you could use some type of nitric oxide boosting supplement like the one you described with like citrulline and beet. What was the third component?

Mirapuama, which is a Brazilian root.

Okay.

And also Asian ginseng.

Alright, I won't get into those in just a second. But you could take this and then at the same time do the sexual treatment like the gains wave and you know, again, like I only do it once every one to two months, but it sounds like even a better protocol would be like once a week. And that's going to vastly improve the benefits that you get from it.

Exactly. Well, I mean, the thing is the inflammation kind of builds on itself and the vascular, the concentration of vascular endothelial growth factor and the blood vessels. That's why it's important to do it kind of in a sequential way as opposed to just kind of once in a while. I mean, if you do it once in a while, you might get some of that benefit. But also, you know, I've actually written this up as an abstract that I'm submitting to the Sexual Medicine Society meeting in Miami this year. And we use what's called the SHIM score, which is the Sexual Health Inventory in Men score. And so my shim score bump was about 5 to 6 points. Which basically means that if you're a man, say in your 50s, and you're taking Viagra and the Viagra is working well, I can get you off Viagra if you're taking, you know, if you're in your 60s and Viagra is not working that well anymore, I'm not going to be able to get you off Viagra, but I can get you to the point where the Viagra is actually working really well. And if you're taking a supplement like a firm, a nitric oxide booster, you know, you may actually significantly reduce the amount of Viagra that you need to take. And There's a lot of side effects of those kind of medications, too. A lot of patients complain about facial flushing, about headache, about reflux, those kind of things. And so if you can reduce the amount that you're actually taking.

It may actually become tolerable.

Interesting. Okay, so by the way, you meant you're. You're saying, Are you saying affirm?

Affirm, yeah.

How are you spelling that?

A F, F, I, R, M. And it's available@affirmscience.com.

Oh, just like affirm. All right, Clever name. I see what you did there. Affirm. Hello.

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I can do yoga in it.

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You said there are two other ingredients, ginseng and one other. Tell me about these.

Ginseng. Yeah, ginseng and murapuama. So they're also scientifically studied and potent nitric oxide boosters with also some antioxidant. And red beet extract also is a strong antioxidant and so they have health benefits on top of also being nitric oxide boosters.

Okay, so ginseng. I'm familiar with this other one. I'm not though. Can you say the name of it again?

Mura M U I R a puama P U a M a Where do you get that? It's the root of a Brazilian plant.

Okay. Interesting, huh? As far as, as a lot of these supplements go, have you noted this idea of signature of nature? How a lot of them, like if you look at ginseng root for example, it almost looks a little bit like sperm or a lot of these root based vegetables or this root based thing from Brazil that you're talking about. A lot of times it's like this hard, firm, almost like phallic shaped object. Do you think there's anything to that? This idea that nature gives you clues about what type of things would be beneficial for say, sexual health or for the brain or eggs, for the eyes or anything like that.

From an evolutionary perspective, that makes a lot of sense. You know, if you're a cave person running around and you want something for a certain function, you would certainly grab, you know, that's why people hack horns off rhinoceroses. Not that it necessarily does anything, but.

Yeah, don't put rhino horns in yourin your supplement. That might get you shut down. What kind of things do you personally recommend people either avoid or include in their diet for blood flow? I mean, aside from just popping pills and taking supplements, are there specific foods that you really like to see on a daily basis? Obviously we've talked about something like fermented beets or watermelon. But what would be others that you would especially recommend?

You know, to be honest, I'm not a nutritionist and I'm not an expert in those kind of things. I mean, what we recommend typically is just increasing the amount of water consumption to not even a specific number, but just keeping the urine at a light yellow or kind of hay colored. That's the best way really to figure out exactly what your water consumption is, is what we call the specific gravity of the urine. So we can actually test what that is. But really the color is the easiest way to pick that up. Okay, but in terms of making nutritional recommendations, you're way, way ahead.

Yeah, I can, I can tell you this, the whole the Four Hour Body thing, I love Tim Ferriss. That dude's an amazing forward thinker and immersive journalist, self experimenter. But he had a recommendation, the Four Hour Body to have this huge fatty steak with pine pollen, you know, a few hours prior to a hot date or prior to sex. And in my opinion that's a good way to create a food baby and divert a bunch of blood flow from the crotch to the gut. And there are There are certain things that I actually recommend to my clients that I've recommended on this show before that guys do, you know, before sex or just to increase nitric oxide production in general. Or like a salad that has arugula and then, you know, pumpkin seeds, some extra virgin olive oil for the flavanols and polyphenols and the extra nitric oxide you'd get from that. You know, some, some beets, obviously, you know, like cubed beets or cubed watermelon. And you know, almost like a lighter salad designed to enhance nitric oxide production. You have that with some red wine and some dark chocolate. I mean, that, that's even something that you can use assuming you're okay with the, the fiber content of it, like pre performance. Like, you know, you could use that for a, for a time trial ride on a bike, or to open up the blood vessels prior to doing like, like a sauna detox. Like, there's a, a lot of different ways that you can use a stack of foods like that. But ultimately, in my opinion, I think, you know, on a, on a, for example, on a hot date night with my wife, I actually avoid the huge cuts of meat. Instead go for the, the lighter fare. You know, wild caught fish, salmon, stuff like that. Also very good for, for the omega 3 fatty acids that can help with that as well. But yeah, I'm not a fan of the steak approach, as popular as that is.

I totally agree with you. And I talk to my patients about this all the time. I ask them if you're gonna go out and play a set of competitive tennis with someone, are you gonna do it at midnight after you've had five or six drinks and a big dinner? Of course not. What you're going to do is eat right in the morning, get enough sleep, do some stretching beforehand. But unfortunately, that's a lot of time when people engage in physical intimacy is at the end of the night after a big meal, after a bunch of drinks and so on and so forth. And so the fact that they're not performing the way that they want to perform is related not just to decreased blood flow from atherosclerotic disease and decreased nitric oxide, but also the physical condition that they're in at that point. They're dehydrated, they're tired, and most of their blood flow is being diverted to the GI tract.

Yeah, yeah. It's interesting now in terms of other, either hacks or scientific protocols or medical protocols or anything else that you would do in your clinic to improve Male or female sexual performance. Is Gainswave and Femiwave the only ones, or are there others that you would do as well?

You know, so the data behind Gainswave and Femiwave is really solid, and it's increasing all the time. And in fact, I'm trying to put together a national registry study in the United States so that we can have tens of thousands of patients contributing data to a national registry. Because when you're in private practice, if something works, 70 to 80% of the time, you're going to have 20 or 30 patients knocking on your door telling you how come this didn't work. And so it's really important for us to understand who it works on, but also who it doesn't work on, and then figure out, okay, is this never going to work on those patients? In which case, let's set their expectations that it's not going to work. And let's go to some of the other things that we have, like Trimix injections or a penile implant or vacuum erection device. You know, urologists have all sorts of tricks that we can use to get people back and active sexually.

Vacuum erection device. That's a penis pump, right?

Penis pump, yeah.

There's not an equivalent of that for women, is there?

No.

Okay. So I actually used that. The folks at Gainswave gave me one like a Cadillac of penis pumps, like a digital penis pump to actually use for. I think the Instructions were every 30 days, or, I'm sorry, every day for 30 days following my procedure. And I did that. It was an incredible device. But the funny thing is I got about three days in and decided I wanted to go hands free, meaning that I figured out a way to kind of prop this thing up against my desk just so to where I could still type and have this penis pump doing its thing in the background. I'd leave it on for about 15 minutes or so. It's crazy for guys you've never used this. I mean, you can watch your dick stretch out. It goes, you know, like 12, 15 inches long inside this big tube. And I remember the third time that I was doing this. I was sitting there typing on my computer, and there's kind of like a seal at the bottom, like a gasket at the bottom. And you put some coconut oil or some type of lube on your penis before you put it into this pump. And I heard this sucking sound like a. And my. My left ball got sucked into the pump. The worst feeling on the face of the planet. I look down and my balls, and they're like turning purple and getting, getting pressurized. And so, you know, immediately, of course, I'm trying to rip this thing off my dick and, and rescue my poor little ball from, from getting, you know, I literally thought my ball was going to explode in there. So. So word of warning, if any of you go to Judson Clinic or any of these other clinics to get the Gainsway procedure done and you walk out of there with a digital penis pump, do not try to multitask and go hands free while you use that thing. I do not recommend that. So anyways, though, we digress.

You know, physical intimacy is a really important part of people's lives. And you know, we see all sorts of patients, you know, patients who have prostate cancer that had non nurse bearing prostatectomies or radiation therapy, you know, or testicular cancer, all sorts of things, or trauma. And it's really important and very sort of heartwarming when we can restore erectile function to patients. I had a patient who is 74 years old and he'd been my patient for about 10 or 15 years. I'd seen him for his prostate and he was taking care of his wife who had Alzheimer's for about 10 years. And then finally she passed away. And a couple years later he got a girlfriend and we did gains wave on him and started him on a firm and he came in and he had had physical intimacy with his new girlfriend. And it was the first time that he had had that in 15 years. And it was just, he was so elated and it just made us all feel so good about what we were doing. I mean, it's sad that sometimes people have to resort to penis pumps or penile implants or injection therapy or gainswave, you know, whatever they need to do, but in order to regain that part of their life. It's just. Honestly, it's so rewarding to see patients who come in with that kind of glow that we all get when, when that part of our life is, has come alive for us.

Interesting. Yeah, it's a good point. Vasectomies, though, that's another question I get a lot about. I get asked a lot about. And I haven't had a vasectomy. It's not because I still plan on having more kids. I just. Part of me has a little bit of a reservation about that whole procedure and I think a lot of guys don't understand it. And I'm wondering if you can describe exactly for people who don't want to ask that dumb question how the vasectomy actually works. And then More importantly, does it have an impact on testosterone levels? And I want you to speak to that, because.

I was talking with somebody. I forget where it was, but they suggested that the flow of sperm, I believe it would be through the vas deferens. If it doesn't happen in the presence of vasectomy, that could potentially decrease your testosterone production because that could be a trigger for your Leydig cells in your testes to produce testosterone. And so I figured I'd ask you about it. I realize you do vasectomies, so you. You may have a slightly jaded reply. But ultimately, describe vasectomies in general, how they would work, and then any risk factors associated with them, including testosterone.

Absolutely. So I've done probably about 3000 vasectomies, and having.

That's more of the vasectomies than I've done.

Yeah. And having four kids myself, I have a vasectomy. So obviously I believe in it. So vasectomy is a really fantastic way for men to control the reproductive process. And typically a vasectomy will take about 15 minutes. Most experienced vasectomists use what's called the no scalpel vasectomy, where we just make a tiny little puncture into the skin on either side and pull out the vas. The vas itself looks like a piece of spaghetti. And typically, what I do is I crush the edges on either side, remove a piece of the VAs about a centimeter or two, and then cauterize the edges.

Basically, what that does is when you ejaculate, 99% of the ejaculate comes from the prostate, and the prostate is upstream from the testicle and from the vas. So ejaculation looks and feels the same. You can't tell any difference in ejaculation. Okay. And then in terms of the testicle, 90% of the testicle is built around making sperm. 10% of the testicle is built around making testosterone. Testosterone is delivered to the bloodstream directly. It doesn't go through the vasectomy or the VAS tube. So the only thing that you're doing when you're doing a vasectomy is stopping the flow of sperm. And if a lot of guys think that the sperm is actually the ejaculate, what I tell patients is that you get the whole swimming pool, but no swimmers.

Okay. So there actually isn't a loss of ejaculate. All you're missing out on is the sperm.

Exactly.

Okay. So that kind of shoots that. That shoots that theory down, basically, that the flow of Fluid through the vas deferens would somehow trigger a testosterone release?

No, absolutely not. And, you know, there's a lot of kind of urban legend that it causes prostate cancer and so on and so forth, but when they've done, they did study in New Zealand where they looked at everyone that had a vasectomy and looked at the rates of prostate cancer in those patients, and then looked at the men who hadn't had vasectomy and looked at the rates of prostate cancer, and there was no difference in the rates of prostate cancer. The problem is, you know, when people get cancer, they always want to figure out, like, okay, what's the reason I got cancer?

Right.

So, okay, well, I had a vasectomy, but that must have been it. But men get prostate cancer at a very high rate, whether you had a vasectomy or not. And there's really no difference in the incidence of prostate cancer or really any other.

Disease.

Is a vasectomy reversible?

Technically, it is. So the inner tube of the VAs is maybe a millimeter, maybe smaller. So you need a microsurgical procedure that takes about three or four hours in order to reconnect it. That procedure probably cost you around $20,000. So technically, it is. Once you hit about seven years after a vasectomy, it becomes more difficult to reverse.

Okay, got it. Interesting. All right, so I want to ask you also about this idea of hormone replacement therapy. Do you do much of this at all in your clinic?

I do. I mean, that's. That's part of what we do. It's not extensively what we do.

Okay. For testosterone, particularly, are there things that you would recommend or things that you would combine with even the use of an injectable testosterone or testosterone lotion or cream that would enhance the effects of that? Kind of similar to the use of something like nitric oxide supplements to enhance the effects of. Of a gains wave or a fence.

You know, once you start supplementing with testosterone, you're basically relying on an exogenous or outside source of testosterone to take the place of the testosterone that your body is actually making. So.

It'S kind of either you're taking it or you're not taking it. If you're not taking it, there are some things that you can do.

To boost the testosterone. But if you are taking it, basically what I tell my patients is it's kind of like a space heater versus central heat and air. Like, if you set your central heat and air at 72 degrees, you're going to produce a certain amount of heat Your body has a set point for testosterone that your body will produce testosterone. Now, if you take a space heater and start cranking it up, at a certain point, the central heat and air will kick off. So if you're replacing your testosterone exogenously or from the outside, at some point, your body's testosterone production will stop. And if you do that for long enough, the testicles begin to shrink. I mean, I had a patient who was an ex.

Oakland Raider defensive end. I mean, this guy was massive, 350 pounds. He came in actually for the second, and when I examined him, his testicles were the size of peas. So, I mean, this guy must have been using high doses of steroids for years and years and years. And if you saw him walking down the street, you would definitely walk to the other side. I mean, he was gigantic, but his testicles were minute.

So it's really important to understand that when you start testosterone, that that's basically what you're committing to.

Dr. Well, a lot of guys will come off it, though, and use things like Clomid, for example, is what you'll see. I believe it was Jon Jones that got popped for Clomid use. And a lot of times guys will use that to decrease the effects of coming off of testosterone or stopping it, or even people who are illegally using it because it's banned by their sporting organization. They'll use something like Clomid, for example, from what I understand, which is, ironically enough, also banned. But other things that guys do or that that have been proven to allow you to stop a testosterone replacement, once.

You get on it, right, but then you're simulating a pituitary hormone. You know, once you begin to mess with Mother Nature, you're pretty much committed to doing that. We treat a lot of patients for prostate cancer, and prostate cancer is a testosterone sensitive cancer. And so one of the things we do is we shut down the production of testosterone by blocking the pituitary production of lh. And so what you'll see now, these are older men, 50s, 60s, and above. But once they've been on these medications for three or four years, a lot of times you can go to what's called intermittent therapy, which means you only give them a shot when their testosterone starts going up. And so sometimes the testosterone doesn't start going up for two or three years or longer.

And so basically what you're doing is you shut down the production of testosterone from the testicle. And so if you're on, if you're a young guy and you're on Testosterone replacement for five or six years, you can't automatically assume that it's going to come back.

Yeah, I mean, I hear that over and over again from guys who claim that their decision to use TRT was a huge mistake. Because if your testes are still functioning, basically you're triggering this intense drop in luteinizing hormone that. Yeah, from what I understand, it's incredibly hard to get back. So if you stopped cold turkey, does it ever come back or do you just have a very hard time for several months or. How bad are we talking for guys who are on testosterone?

Yeah, it really varies. It depends on the age, it depends on how long you've been on it, it depends on the levels that you put yourself on. And then it's just genetics. Some people obviously bounce back better than others.

Interesting. How many guys are on testosterone, in your opinion, being a doctor and kind of looking at things from a little bit of an objective standpoint, is it a lot of people who come into your clinic who are using testosterone?

Because I'm a urologist, I tend to get the patients where it's a problem rather than, you know, the patients that are just kind of coming in for regular testosterone replacement. And so, you know, a lot of primary care physicians and endocrinologists have patients on testosterone and if they're not having a problem, I don't see them. So honestly, I don't have a really good read on exactly how many people are on testosterone therapy. But if you're, you know, if you're younger and you're just doing it for.

You can be a better football player or a better weightlifter or, you know, a better cyclist, you know, there are really some very significant long term implications of being on that.

Yeah, especially when there's so much low hanging fruit, from zinc and creatine and mineral supplementation to the use of infrared lights, to, you know, a host of nutrients you can consume, including things like, you know, pumpkin seeds and shellfish. There's, there's even the avoidance, you know, of a cell phone in the pocket or high amounts of dirty electricity or high amounts of stress or low sleep or infrequent sex. Like there's so much low hanging fruit when it comes to things guys don't do and they instead use that quick fix for increasing testosterone. I see this over and over again and it's just, it's flabbergasting when there are so many things that you can do to enhance testosterone naturally.

Yeah, I agree with you entirely. I mean, there are so many great resources on your websites and your blogs that people can tap into to figure out how to do this naturally. And on top of it, it's expensive. I had a patient the other day, a nice guy. I removed his testicle for testicular cancer, and he's been on testosterone replacement. Because of that, he got an abscess of his leg and was hospitalized for five or six days. So it's not, you know, injecting testosterone is not innocuous, and I can't say strong enough that if you're young and you're healthy, there are many, many things that you can do to boost your testosterone and boost your energy without going on testosterone replacement.

Yeah, interesting. So kind of, kind of related to that is this concept of sports, particularly endurance sports. And there is, of course, the use of things like EPO and testosterone and other things to enhance performance in that sport for. For triathlon or for cycling, for example. When it comes to triathlon and cycling, though, I think it's this combination of chronic cardio plus time spent in the saddle that both men and women experience some hormonal issues and sexual issues from that, especially from the pressure in the seat. And both have asked me, both populations have asked me, what do you do about some of the sexual issues that arise from simply being in a place bike saddle for long periods of time?

There's a guy, Irwin Goldstein down at UC San Diego, who's kind of the father of this whole research, and he's a fantastic urologist. He's a great researcher. And he said there are two types of cyclists, those who are impotent and those who will be. Now, I don't necessarily subscribe to this, but there was a big study published by the American Urologic association that compared runners, swimmers, and cyclists and the amount of erectile dysfunction in those different populations. And so it was 1.1% of runners, 2% of swimmers, and 4.2% of cyclists with erectile dysfunction. And it was a big study with thousands and thousands of men. So there's definitely something to.

The link between cycling and erectile dysfunction. And when you look at it, it's really the. The seat, the bike seat. That is really what it comes down to. And, you know, I want to get a little anatomical, if you don't mind. Ishiel. Tuberosity is basically your sit bone, and it evolved into basically the perfect place to bear body weight. You know, the ischio pubic ramus, which is the area that's going to bear weight if you're sitting on a conventional bike seat, is it contains a lot of erectile tissue, nerves, arteries, and the urethra. But the ischial tuberosity has no organs attached to it. No nerves, no arteries. It's just surrounded by fat and muscle to the buttocks. And it's very well vascularized. And it's evolved to allow humans to sit comfortably and safely for hours.

Most bicycle seats are not wide enough to support the ischial tuberosities. And so basically you end up straddling the bike and sitting on the internal part of the genitals. Right. So half the penis is actually inside the body. And so there are two ways you can actually injure things. One way is traumatically, which is pretty obvious. The other thing is kind of a constant compression. And they did studies looking at guys that were leaning on the nose of the bike and 95% of the blood flow was reduced, whereas if they were using a seat with no nose, it was basically 0% of the blood flow.

So these no nose saddles, there's no drop in actual performance or the ability to be able to reduce torque against the, against the cranks.

You know, if you're using toe clips and you're sitting on your sit bones, I don't think there should be. I mean, you know, just from mountain biking for many, many years and doing triathlons and cycling, you know, you basically use the, the nose of the bike to steer. And so for a lot of my patients, I tell them, if you're doing spinning or you're on rollers or on a stationary bike, you better not have a nose on the seat. I mean, that's a situation where you're not steering at all. So you'd be crazy not to take advantage of a wide, well, padded seat with no nose.

Yeah. For me personally, because I experimented with this a lot when I was racing Ironman and I tried a lot of these no nose saddles and I think found that I almost felt like I couldn't get that bike control and power production that I wanted. And there was a brand and they don't sponsor the podcast or anything like that. There's just a brand that I use. It was called ism. Have you seen these ISM saddles where the. There's still kind of a nose, but it's got like, like, well, a hole, like a gap between the two sides of the saddle where the nose sticks out?

Yeah. You got to be careful of those though, because the thing is that that slit down the middle basically allows the urethra to drop down into that hole. But the neurovascular bundle on either side of the penis basically is lateral. So basically those things are directly putting pressure on the area that you don't want it to put pressure on.

What do you use for a bike saddle?

The best seat that I find is there. I don't know what the. I can't remember the name of the brand, but basically the nose drops down and so you sit on the sit bones, and then the nose of the seat drops down. So you still have a little bit of a nose to help you steer and so on and so forth. But most of the sitting is on the sit bones. The other thing is, you know, get out of the saddle fairly frequently. You know, take a rest every once in a while, make sure you're well hydrated. And also, Gainswave is really an ideal treatment for these patients because part of Gainswave, it's not just shocking the penis, but it's shocking the perineum. So what you're doing is you're getting the internal pudendal artery as it comes medial to the issue of tuberosity. So basically you're trying to get as much of that artery as you possibly can to stimulate regrowth and clearing out of blood vessels. So Gainswave actually, in my experience, has worked really, really well on men with cycling related compression injuries.

Interesting. Okay, got it. Yeah. If you find the name of your saddle or if you're at home and you send it to me, I'll be. I'll put a link to it in the show notes because I don't know the one you're talking about with the nose dropping down. But I still have the ism on my triathlon bike upstairs that I admittedly still need to race on. I actually have not done a single triathlon this year, but I swim and I bike and I run quite a bit for cross training. And it's. It's kind of irking me right now that I'm not signed up for a triathlon because, you know, I used to be.

Known for. For racing Ironman triathlons and being a triathlon coach and kind of a crazy triathlon exercise physiologist. And I don't really do much of that at all. So if, if any of you are listening in and you have a triathlon that I should really go do, let me know. I'm looking for the flat and fast stuff now that I've got a little.

Bit of Spartan racing muscle on me.

But ultimately, yeah, I'm a huge fan of triathlon, especially like the sprint and the Olympic distance stuff. That doesn't involve a lot of chronic cardio and doesn't necessarily cause a lot of the same hormonal depletion and over training issues that the longer half ironman and ironman races can, in my opinion. I've seen a lot of people mess themselves up with with that distance. I want to ask you too, Judson, about this concept of stem cells. So I've had my penis injected with stem cells three times and also with PRP and even exosomes. Do you do stem cell injections in your clinic?

You know, I'm just starting to do stem cell injections, and I'm very, very cautious about this. You know, there's a lot of.

Misinformation over information confusion about regenerative medicine. And so if you don't mind, I can kind of sort things out a little bit.

Yeah, absolutely.

So one thing is what's called the P shot or platelet rich plasma. Okay, so what that is is in human blood, you have three different main components. Platelets, white blood cells, and red blood cells. Okay? So what you do is you take about 30cc's of blood and you spin it down. When you spin it down, the red blood cells go to the bottom because they're filled with iron hemoglobin, and you don't need the red blood cells. You take out the red blood cells, then blood floats in basically water called plasma. So you take out the plasma, and in the middle, you end up with platelets and white blood cells. Now, most people think of platelets as just something to stop bleeding, right? But platelets are round. So how can something round stop bleeding and make a clot? Well, what happens is, if you cut yourself, the platelets are drawn to the area where you cut yourself, and then they become activated. When platelets become activated, they put out arms almost like they go from being a round ball to a starfish, and they join with the other platelets and create a web. And then that web catches fibrin and thrombin and all the other clotting factors, and you create this clot. Now, the beautiful thing about the way that the good Lord put us together is he put or she put what we call alpha granules into the platelets. And those alpha granules contain all sorts of amazing growth factors, like platelet derived growth factors, TGF beta, vegf, epidermal growth factor, fibrin, fibronectin, which increases bone formation. And so those growth factors are delivered almost immediately and exactly to where you need the regrowth. And so if you ever wondered why when you cut yourself, you heal so quickly. It's because the platelets are delivering those growth factors. So when you do a P shot, what you're doing is you're drawing the blood out and then you're taking out that concentrated layer of platelets.

And by the way, for people who know you're, you're not drawing the blood out of the penis or the vagina, you're drawing out of like the vein in the arm.

Exactly, exactly. And so.

A PRP is basically four to five times the amount of growth factors and platelets as the regular blood. And when you inject the platelets.

The activation, the growth Factors are delivered. 70% of it is delivered in the first 10 minutes and 100% is delivered in the first hour. And so then basically what you're relying on is that these growth factors will stimulate the growth of blood vessels, epithelial cells, of the spongy tissue of the penis. And obviously it's used in orthopedics and wound healing and those other things. But that's basically what the P shot is. And there's evidence that if you inject it into the penis that it improves erectile function.

I did the gainswave with the P shot and without the P shot, and I definitely, definitely notice it more with the P shot. But I gotta be honest with you, like, nothing seemed to really compare to the actual stem cell injections. Like, those were a night and day difference as far as last, I mean, still lasting in terms of the way that I feel sexually, the length of my orgasm, sexual performance, etc. So, yeah, I'm definitely interested in your take on the stem cells also.

Yeah, so there are three different types of stem cells currently. One is what's called adipose stem cells. So those are stem cells that are harvested from fat. So basically you do kind of a liposuction and then you isolate the stem cells in the adipose. Well, let me back up. So what is a stem cell? Right. A lot of people don't quite understand exactly what a stem cell is and what the stem cells that we're looking for are. So when a sperm meets an egg, it creates one cell. That stem cell is what we call a pluripotential stem cell, meaning it basically becomes everything that you have in your entire body. It becomes your hair, it becomes your teeth, it becomes your kidneys, it becomes your liver, it becomes your toenails. Right. That one stem cell with its DNA basically can become anything. Now, as that single cell begins to replicate, it becomes a morula and a blastula. And all those kind of things you learn in embryology. But then it forms three layers, it forms the ectoderm. So ecto means outside, so it's bones, skin, those kind of things. It forms the endoderm. Endo means inside. Right. So it forms the GI tract and then it forms the mesoderm. Meso means middle blood vessels, heart muscle, those kind of things. And so what we're looking for are what are called mesenchymal stem cells or stem cells that come from the mesoderm. If you're looking for ectoderm or endoderm stem cells, you're looking for the wrong stem cells. You want mesenchymal, which are the ones that grow blood vessels, heart and muscle. In adipose, you can isolate stem cells. And the nice thing about those stem cells is they haven't replicated all that much.

When you take those stem cells out of someone, they're the same age that you are, but they haven't replicated that much. Another thing you can do is aspirate bone marrow. Right? So the bone marrow is producing red cells, it's producing white cells, it's producing platelets. It's a fairly active stem cell population. But when you're looking at those stem cells, those stem cells have already differentiated themselves into stem cells that are building blood vessels. The stem cells in the adipose and the fat are stem cells that have differentiated themselves into building fat and structural tissue. The other thing that you can do are what we call umbilical stem cells. Now, the disadvantage of umbilical stem cells are that they come from someone else.

Yeah, that's what concerns me is you're looking at potentially the.

I guess that even the DNA and nucleus, if I'm not mistaken, from someone else's body going into your body.

Exactly. So. Well, I mean, we get blood transfusions, so I mean, there are, there are. And we do organ transplantation and so on and so forth. So it's not unheard of to do that.

A lot of people on organ transplants, they gotta be onon autoimmune medications or immune suppression medications the rest of their life.

Exactly. So, you know, these. And the women that they get these from, they're tested for all infectious diseases before, during, and after. And a lot of these are in quarantine for a couple weeks to make sure everything's all clean. So basically, you inject these stem cells, which are newborn stem cells, that they get from umbilical cord blood, from the placenta, from Wharton's jelly, from the amniotic fluid. And these are mesenchymal stem cells that you're injecting. But in addition to those stem cells, what you're also getting is a huge concentration of growth factors.

And I had an extensive conversation with. There's a lab in Wake Forest University, a guy named Anthony Atala, who's just an incredibly amazing. He's probably the top regenerative scientist in the world.

Anthony Atala. How do you spell his last name?

A T, A L, A.

Okay.

He's growing bladders, he's growing vaginal tissue. I mean, the work that he's doing is just mind boggling.

Wow. Oh, is he the guy who like, printed a human kidney?

Yeah, exactly.

Amazing.

Yeah, he actually, he printed a vagina, which sounds kind of weird, but there's a congenital problem that little girls are born with where they don't develop a vagina. And so to be able to create vaginal tissue in the lab that you can then transplant into newborn girls really is a remarkable accomplishment. And so he's done amazing things like that. But I talked to him and some of the people in his lab asking them, is it actually the stem cells that are growing when you re inject them, or is it the growth factor? And they used to think it was the stem cells themselves, but now most of them are leaning towards the fact that it's the growth factor that are actually pushing things along. But I think it's important to know that we don't really know what actually is happening.

So, long story short, if you were going to do a stem cell injection into the genitals, you would go with. With someone's own fat stem cells or stem cells from bone marrow. Combine that with PRP and inject that.

Yeah. I think the best results are going to be the stem shot, the umbilical stem cells, to be perfectly honest. And combine that with.

The best results would be the umbilical.

The umbilical, because you're basically using newborn stem cells and a tremendous amount of growth factors that come along with that.

And you think that would be even better than your own stem cells?

Yeah, to be honest with you, it's really. That's just my best guess. There's not enough science that has been done to really make any sort of definitive statement interesting.

And the only consideration with the umbilical would be the potential just in case of an unclean donor or, I don't know, I guess, like, you know, Lyme disease or something like that in the actual stem cell from a. From a foreign human.

Exactly.

The safest way to go is probably the P shot. It's just drawing blood. It's your own blood and there's some decent data on that. But really the well controlled studies haven't been done yet, unfortunately.

Yeah, interesting. Well, this is all fascinating. I still think if I were going to do the stem cell injections, I personally feel more comfortable while just using my own stem cells.

Which is what I wound up doing. That was the one that I noticed the most differences with was the use of the stem cells that were harvested from my fat and then re injected after being grown. For the mesenchymal stem cells, the MSC content and then combined with growth factor and then injected. So ultimately I think that we're addressing a very small niche of the population. Who would ever come consider doing this anyways? You know, for me it was more of kind of like an immersive journalism thing where I was doing it, you know, to write a story to report on the results for a guy who is doing it rather than for erectile dysfunction just to, you know, basically see what happens to sexual performance. So ultimately I realized not many guys are going to rush out to do this. I think there's a lot of other low hanging fruit. I think even something like we discussed, like Gainswave is probably a much more affordable and less fringe thinking to turn to versus getting stem cells injected into your dick. But since I'm known as a guy who injected stem cells into my dick, I figured I should bring it up.

Ultimately though, this is a. Oh, go ahead.

Yeah, I mean there really, there's absolutely no downside of Gainswave. Yeah. In the hundreds of patients that I've treated, knock on wood, not one single patient has even had any bruising. And so, you know, it's basically it's time and it's expense but there's no downside of doing it. And I only use stem cells and P shots on patients who actually fail 12 gains weight treatments and really want to go for something more. And also, you know, it's really important to take a firm to take a nitric oxide booster not just for dysfunction but also overall physical functioning.

Yeah, yeah. Well, if there's anything that I took away from this, it would be this concept of combining like a nitric oxide booster with something like Gainswave. And when I go down to, to Florida here, well, I'm leaving in four days, I'm going to grab a few of my little, you know, I've got a few different, you know, beat capsules and you know, companies send me all the time these nitric Oxide boosting supplements. I'm going to grab a handful of those and kind of stack them when I go down and probably give some to my wife as well. So we'll have have a good time down there in Florida. But in the meantime you guys don't have to go to Florida. You can go to anywhere if you want to go get a Gainswave treatment done. I'll put a link in the show notes to the Gains wave for men and the Femi wave for females along with Judson website and his Affirm supplement. What I'll do is I talked to Judson before this podcast if you're listening in and if you go to BenGreenfieldFitness.com shockwave that's BenGreatFitness.com shockwave as in shockwave therapy. I'll put a link also to his his Affirm supplement and we'll get some kind of a discount. I think we can get like a 15 to 20% discount on that for you guys if you want to try this blend of citrulline and red beet extract and Marua puama and ginseng if you want to toss that one into the mix. And I will also put a link to everything else that we discussed including the article on the benefits of fermented beets. And Judson will send me a link to this bike saddle that he uses and I'll put that in there too and you guys can go knock yourselves out over@BenGreenfulFitness.com Shockwave in the meantime Judson, thanks for coming on the show and sharing all this stuff with us. Man. It's fascinating this world of sexual biohacks.

Hey, my pleasure. It's really been an honor to talk with you today.

Awesome. Alright folks. Well I'm Ben Greenfield along with Justin Judson Brandis from Walnut Creek, California signing out from BenGreenfieldFitness.com have an amazing week.

You've been listening to the Ben Greenfield Fitness podcast.

Go to BenGreenfield Fitness.com for even more cutting edge fitness and performance advice.

Sa.