Men's Sexual Health: why it matters, what can go wrong, and how to fix it | Mohit Khera, M.D., M.B.A., M.P.H.

**Peter Attia** (0:11)
Hey everyone, welcome to the Drive podcast. I'm your host, Peter Attia. This podcast, my website, and my weekly newsletter all focus on the goal of translating the science of longevity into something accessible for everyone. Our goal is to provide the best content in health and wellness, full stop, and we've assembled a great team of analysts to make this happen. If you enjoy this podcast, we've created a membership program that brings you far more in-depth content if you wanna take your knowledge of the space to the next level. At the end of this episode, I'll explain what those benefits are, or if you wanna learn more now, head over to peterattiamd.com forward slash subscribe.
Now, without further delay, here's today's episode. My guest this week is Dr. Mohit Khera. Moh is a professor of urology at Baylor College of Medicine. He is also a renowned expert in male and female sexual dysfunction, declining testosterone levels in aging men, and male infertility. This episode is a follow-up to last week's episode with Dr. Sharon Parrish, which focused on sexual health and females. This episode focuses on the other side of that conversation, all things related to male sexual health. We start by talking about erectile dysfunction. We speak about the percentage of men who deal with this issue at various ages, the way it is diagnosed, and what we know about erectile dysfunction and cardiovascular disease. We then speak about various drugs, shockwave therapy, stem cells, PRP and lifestyle modifications that can help with erectile dysfunction. We then talk about Peyronie's disease, which is a curvature of the penis, including its causes and treatments. The conversation includes discussions around penile fractures and what is known about penile enlargement treatments.
From there, we speak about what happens when a person has an erection for over four hours, why that's problematic, premature ejaculation, the causes and treatments, and an orgasmia or delayed orgasms, both causes and treatments.
We then shift the conversation to talk about testosterone, including the physiology of how testosterone, DHT and estrogen work, and how we should think about them and why they all matter. Talk about which blood panels you should use to measure your testosterone and the difference between the blood levels and the symptoms that we might see in the case of low testosterone. We talk about testosterone replacement therapy and the various ways to increase testosterone, including the use of pellets, topical formulations, injectable formulations, oral formulations, and intranasal formulations. We even discuss the role of testosterone in patients with prostate cancer. We end the conversation talking about DHT and finasteride and some of the concerns around post-finasteride syndrome.
As you can hear, this conversation is really a tour de force as it relates to various topics around sexual health in males. And I think anyone who listens to this will walk away learning something as I did. So without further delay, please enjoy my conversation with Dr. Mohit Khera.

**Mohit Khera** (3:04)
Hey!

**Peter Attia** (3:10)
Oh, thanks so much for making the trip over here from Houston. Although I know you didn't come to see me, you came for tennis, but I'll take what I can get. Anytime we can do one of these in person, it's great.
There's a lot we wanna talk about today. I will admit my insane capacity for ignorance in this domain. So when one of our analysts was working on, you know, sort of the topics we were gonna talk about, it turns out I know as little about this as I know about the contrapositive in women's sexual health. So, you know, a lot of times I go into a podcast having more knowledge about a substance and I can guide the discussion more thoroughly. So I'll be kind of leaning on you heavily, but maybe we can just start by talking a little bit about your background, your training, and how that leads you to doing what you're doing. So after medical school, what did you go and do?

**Mohit Khera** (3:55)
Sure, so first of all, thank you for having me on the show. So after I went to college at Vanderbilt and I first went to Boston University, got my MBA, got my MPH. I was a healthcare analyst for about two years. I didn't like it very much, but I met my wife in Boston. She was at BU Medical School at the time.
So I had to change, of course, the career path. Then I went to University of Texas, San Antonio for medical school.
Then after that, I went to Baylor College of Medicine, did a one-year internship in general surgery, then did five years in urology, then I did a one-year fellowship in the male reproductive medicine surgery, where I really got into sexual health and infertility, and I'm in Baylor now since 2007 on faculty.