The DUTCH Podcast

Breaking the Stigma: Men's Hormones, Sexual Health & Confidence

• DUTCH Test • Episode 130

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In this episode, Dr. Justin Houman discusses the importance of men's health, particularly focusing on urology, sexual health, and hormonal health. He highlights the increasing prevalence of low testosterone in younger men and the lifestyle factors contributing to this trend. 

The conversation also highlights:

  • Essential lifestyle changes that can improve fertility and overall health
  • The significance of vasectomy as a male contraceptive option
  • The intricate relationship between sleep, hormones, and overall men's health 
  • How hormones affect various aspects of health, including sexual function and fertility 
  • The importance of understanding hormonal balance, particularly testosterone, estradiol, and cortisol

Show Notes:

Learn more about Dr. Justin Houman and follow him on Instagram @justin.houman.md!

Check out The Blue Zones: Secrets for Living Longer by Dan Buettner mentioned in this episode.

Become a DUTCH Provider today to see how the DUTCH Test can profoundly change the lives of your patients.

00:00:00:00 - 00:00:10:12
Dr. Justin Houman
I can't tell you how many times in a given week a guy comes to me. He's trying to have a kid. And the first question I ask is, are you on testosterone? They're like, yeah, I've been on for five years. They never told me my my sperm counts go to zero.

00:00:10:17 - 00:00:36:02
Dr. Jaclyn Smeaton
Welcome to the DUTCH Podcast, where we dive deep into the science of hormones, wellness and personalized health care. I'm Doctor Jaclyn Smeaton, chief medical officer at DUTCH. Join us every Tuesday as we bring you expert insights, cutting edge research, and practical tips to help you take control of your health from the inside out. Whether you're a healthcare professional or simply looking to optimize your own well-being, we've got you covered.

00:00:36:04 - 00:00:57:03
Dr. Jaclyn Smeaton
The contents of this podcast are for educational and informational purposes only. This information is not to be interpreted or mistaken for medical advice. Consult your health care provider for medical advice, diagnosis and treatment. Hi there! Welcome to this week's episode of the DUTCH Podcast. This week I got to interview a guest and really talk about things that we've never talked about before on the podcast.

00:00:57:05 - 00:01:18:16
Dr. Jaclyn Smeaton
Our guest is a board certified urologist, predominantly, who specializes in men's health, and so we talked a lot about the issues that affect men that are hormone related, but not always hormone related. Things like erectile dysfunction, sexual health, fertility, and then later on in life, of course, men have a lot of other urological issues around different kinds of cancers and prostate function.

00:01:18:18 - 00:01:47:18
Dr. Jaclyn Smeaton
So today was really eye opening. We talked about things like the options for male birth control that are out there, and how men can take control of their own fertility. We also talked about the workup for infertility for men and what it means for their long term health. When men that are younger have reduced fertility levels. And then we of course, we spent a lot of time talking about testosterone levels in men and androgen levels in men, and how things like low testosterone symptoms should be worked up in men and managed over time.

00:01:47:23 - 00:02:15:21
Dr. Jaclyn Smeaton
I think you're going to find it to be a really eye opening episode. I surely did, and our guest was really charismatic and covering a lot of the issues and topics that men can be sensitive to. This might be a great episode to share with your partner. If you're a female listener and you have a male partner who might be considering skin care, because what was really reassuring to me was that our guest highlighted that urology used to be thought of as a specialty for men over 50, but now his practice he's in LA.

00:02:16:00 - 00:02:35:22
Dr. Jaclyn Smeaton
He's seeing younger and younger men who are coming into his practice to take care of their health much earlier in life, which is such a really wonderful trend that we're seeing. So my guest today is Doctor Justin Houman, and he's a board certified fellowship trained urologist in Los Angeles. And like I said, he specializes in men's sexual, hormonal and reproductive health.

00:02:36:00 - 00:03:04:19
Dr. Jaclyn Smeaton
He really focuses on helping men with conditions like erectile dysfunction, low testosterone, male infertility and urinary incontinence, Peyronie's disease, etc. offering a really compassionate and personalized approach. He also is a micro surgeon. Performs procedures including reduction of Bakersfield. The section is this ectomy, reversals, etc.. Always emphasizing minimally invasive techniques. He's in greater Los Angeles and Doctor Who man is really unique because he's great at explaining.

00:03:04:21 - 00:03:19:16
Dr. Jaclyn Smeaton
I'm getting what we call the right message at the right time from the right person. You'll see him on social media a lot. I mean, he really helps to blend medical expertise with empathy, to help men really reclaim their confidence in their quality of life. And it was a wonderful guest. I think you're gonna enjoy this interview. Let's get started.

00:03:19:22 - 00:03:23:05
Dr. Jaclyn Smeaton
So, Doctor Houman, welcome. I'm so glad to have you here.

00:03:23:07 - 00:03:25:02
Dr. Justin Houman
Thank you. Thank you so much.

00:03:25:04 - 00:03:45:02
Dr. Jaclyn Smeaton
So before we dive into the meat of the podcast, I always like to start by just kind of helping listeners get a better idea of your point of view, because, like, you share a little bit about your back story because you're a board certified urologist, but you you treat a wide range of conditions in your practice, but you really have kind of a more specialized perspective and how you look and how you treat men.

00:03:45:06 - 00:03:49:18
Dr. Jaclyn Smeaton
So can you share a bit about your backstory and kind of how you got to where you are now?

00:03:49:20 - 00:04:11:06
Dr. Justin Houman
Yeah. So as you mentioned, I am a urologist. So I did a urology residency where we look at, primarily the male urinary system. But with that, we do a lot of cancer with kidney cancer, prostate cancer, bladder cancer, testicular cancer. Men, women, children. At some point, everyone needs a urologist in life. And that's initially what drew me to urology.

00:04:11:08 - 00:04:31:06
Dr. Justin Houman
I still do a good amount of, you know, general Urology, but within that field, within the field of urology. Now, I specialize in men's health, which is there's a couple buckets within it. When I was in residency at the time, I noticed that there was, first of all, there was very few people who do, who were urologists who specialize in men's health.

00:04:31:08 - 00:04:49:20
Dr. Justin Houman
And the buckets within men's health, there's men's sexual health, fertility, health, hormonal health, those three things. And, you know, you really see it. I mean, and we're seeing it more and more every day. These things are very, very important for men because it's really the first touchpoint for men to get involved in the, health care system.

00:04:49:22 - 00:05:02:18
Dr. Justin Houman
So once they get involved, once these are the things that bring men to the doctor for the first time. And with that, we provide them with the obviously necessary information to address their needs now and then going forward into the future.

00:05:02:20 - 00:05:23:18
Dr. Jaclyn Smeaton
It's so interesting that you bring that up. And I guess I'd never really thought about it being such a, one of the top reasons why men seek health care, because they do. Traditionally, women pursue health care even for their partners. A lot of times it's women who drive like primary care medicine, for example. And checkups, like women, tend to do more preventive care and engagement with the health care system than men do.

00:05:23:19 - 00:05:33:20
Dr. Jaclyn Smeaton
So what I'm hearing you say is that oftentimes men are first coming in because they think they have low testosterone or they have some kind of sexual arousal disorder. Something going on. Is that kind of what you're talking about?

00:05:33:22 - 00:05:39:09
Dr. Justin Houman
Yeah, exactly. I mean, men, men won't be able to tell you when they have high blood pressure. High, you know, diabetes, they.

00:05:39:09 - 00:05:41:08
Dr. Jaclyn Smeaton
Don't really care because it's not impacting them as.

00:05:41:08 - 00:05:51:23
Dr. Justin Houman
Much. Exactly. But they'll tell you when when they can't get an erection. And I'll tell you when they when they urinating at night, when they keep swimming it bothers them. And that's again that's why we're really the first touchpoint for men.

00:05:52:01 - 00:06:00:10
Dr. Jaclyn Smeaton
Now I know that people traditionally think these are problems with older men, but from what I've read, we're seeing younger and younger men affected. Have you seen that in your practice, too?

00:06:00:12 - 00:06:18:18
Dr. Justin Houman
Oh without question. Yeah. Yeah. I mean, younger men with erectile dysfunction, younger men with low testosterone. Obviously, infertility is a whole different. Infertility is becoming more and more common. Even young men are experiencing infertility issues. And we could talk more about that, but it's really a lifestyle thing primarily.

00:06:18:20 - 00:06:51:21
Dr. Jaclyn Smeaton
Well, let's start by diving in, because I think this is such an important piece of like, groundwork for people to really understand, because when we think about some of these impacts with sexual arousal, with fertility, I mean, the data is really interesting, particularly. Fertility is the field that I was predominantly in in practice. And there's some really interesting research on mostly men with infertility having different outcomes with their health span later on in life, higher incidence of certain cancers, even all cause mortality, is higher in men who experience infertility in their 30s.

00:06:51:23 - 00:07:25:21
Dr. Jaclyn Smeaton
And it really points to, like you said, this lifestyle connection where it's not that infertility causes death, but it is a marker of the terrain of like what's happening with lifestyle, with terrain. And so it's an interesting thing. Same thing with, you know, with sexual arousal disorders that you end up seeing that there's cardiovascular reasons for that. And these underlying reasons, can you kind of paint the picture for our listeners about, you know, this urology is kind of that first point of entry, but it's like opening a door to Pandora's box, and there's a lot more behind that symptom that crops up across those different areas.

00:07:25:23 - 00:07:42:22
Dr. Justin Houman
Yeah, exactly. Very well said. So, the way I like to the, the analogy I use is these are sexual health issues, fertility issues, hormonal issues. They all, you know, they do it within the Venn diagrams. They, they share some, you know, they all share a little portion of it. But these are like canaries in the coal mine, if you will.

00:07:42:22 - 00:07:43:04
Dr. Justin Houman
Yes.

00:07:43:09 - 00:07:44:13
Dr. Jaclyn Smeaton
I use that term. Exactly.

00:07:44:15 - 00:08:05:06
Dr. Justin Houman
Yeah. Yeah. If you're experiencing any of these issues it could mean like if you're if you're a 30 year old with erectile dysfunction, a lot of times that's psychogenic or, you know, there's it's performance anxiety related, but there's plenty of times where it's actually an early sign of you have high cholesterol, where those arteries are carrying blood flow to the penis, they're clogged up.

00:08:05:06 - 00:08:27:00
Dr. Justin Houman
Or, it's a sign of cardiovascular issues, not just some arterial issue, but, you know, maybe there's something going on with your heart. Even it may be a sign of hormonal issues, right? Hormonal issues where you're having low tea because you're not exercising, you're not eating right, you're stressed out. You're not sleeping right. All of these things can be it's usually the first sign because as young as young men, our bodies are very, very resilient.

00:08:27:00 - 00:08:52:21
Dr. Justin Houman
But it can only carry you so far. And sexual health is usually one of the first things that we realize. It primarily because it's so important to us. And that's the thing that we we notice it. We're much more sensitive to noticing the impact from a sexual health standpoint. And that's why if you're experiencing any of these issues, fertility, health issues, sexual health issues, hormonal issues, to your point, the longer you wait to address it, this is when it becomes something that causes significant morbidity.

00:08:52:21 - 00:09:03:00
Dr. Justin Houman
Your quality of life gets, negatively impacted. And even longer term, the more you delay with it, even your overall lifespan can be negatively impacted.

00:09:03:02 - 00:09:14:01
Dr. Jaclyn Smeaton
How well do men receive that message when they come in? And, I think my other question is like, do most urologists think that way? Or is that something that really you're thinking about as someone who is more lifestyle oriented?

00:09:14:03 - 00:09:36:15
Dr. Justin Houman
Well, I would say most urologists, you know, we see patients the first time. Most guys coming to, to urologist are usually when they're having urinary issues. So, you know, in their 50s, 60s, Medicare age later on. My my practice is quite unique. I deal with a much younger patient population, 2030s, 40s. So, I mean, for me, it's a big thing.

00:09:36:17 - 00:09:43:09
Dr. Justin Houman
So in that sense, yeah, it is, it is it's something that I preach more, at least I could say I think I preach more than others.

00:09:43:11 - 00:10:02:19
Dr. Jaclyn Smeaton
Yeah. That's great. Now I want to talk a little bit more about, like the hormonal imbalance. So I think this is really the piece that most men are coming in, and there's a lot of signs and symptoms of low testosterone or low androgens. Can you share a little bit about what you're seeing mostly in your practice in these younger men who are coming in to see you?

00:10:02:21 - 00:10:18:07
Dr. Justin Houman
Yeah, we are seeing more and more low testosterone, I can tell you in every year. But, you know, it really started during Covid. That's when we really saw that big and I didn't I will say this, I don't think it had so much to do with. I do think some of it had to do with just Covid, and we were very sedentary during that time.

00:10:18:07 - 00:10:39:10
Dr. Justin Houman
But and this is something I do want to highlight is, younger men are more proactive about their health, which is very important. They are addressing when they are having issues, they're way more likely than previous generations of men to see a doctor, whether it's online or in person, like there's tons of health care resources out there now from at home testing.

00:10:39:15 - 00:11:07:03
Dr. Justin Houman
So it makes it quite easy for guys to engage in these conversations. But low testosterone is becoming more and more common. I'd say it's a number of things that are causing it. Again, I mean lifestyle. But within that bucket, what I tell you is obesity is a big one. Men are way more overweight, are sedentary lifestyles. We're going from, you're basically waking up, driving, you know, getting to a bus or a car, whatever it is, going to an office, sitting for eight hours, coming back home, sitting in front of a screen, watching Netflix rinse and repeat.

00:11:07:03 - 00:11:25:19
Dr. Justin Houman
Right. That idea where we're not staying active, we're not getting sunlight. We're not doing the things that are important for a healthy lifestyle. We're getting a lot of blue, blue light, and negatively impacting our sleep. Sleep's quite important for testosterone production. So all of these things are really negatively impacting our health. And then the third thing or hormonal health.

00:11:25:19 - 00:11:34:14
Dr. Justin Houman
But the third thing is processed foods. Processed foods are a big one. And we're we're eating a lot of processed foods. And nutrition is very important for healthy hormonal levels.

00:11:34:16 - 00:11:53:02
Dr. Jaclyn Smeaton
Yeah. I mean, you touched upon a lot of the kind of those core foundational pieces that we think about all the time for, you know, women as well. But and it's similar, like endocrine disrupting compounds like disruption, lack of movement. I mean, these are the things that foundationally end up contributing to chronic disease that lead us into all different specialties.

00:11:53:07 - 00:11:53:18
Dr. Jaclyn Smeaton
Medicine.

00:11:53:21 - 00:11:54:19
Dr. Justin Houman
Exactly.

00:11:54:21 - 00:12:13:06
Dr. Jaclyn Smeaton
Can you talk a little bit about your testing approach when men are coming in with these kind of complaints of low hormones and is this a let's see. The other thing I'm thinking about is like, now that I think one of the benefits of social media is that men are increasing their awareness and they're coming in to see doctors sooner.

00:12:13:07 - 00:12:31:23
Dr. Jaclyn Smeaton
I mean, I really there's a lot of bad things about social media, but I think the democratization of health information is a good thing that's happening. There's a lot of junk out there, too, that you probably have to sort through with patients sitting in front of you in your office all the time, but I generally think there's just a lot of information.

00:12:31:23 - 00:12:49:17
Dr. Jaclyn Smeaton
Like you said, this younger generation is more aware or more health conscious. They're taking more preventive action. And I think that's probably a result of what they're exposed to. But tell me a little bit about when men are coming in to see you. Like, what's the evaluation process? Let's talk specifically about mental emotional health first.

00:12:49:19 - 00:13:08:21
Dr. Justin Houman
Yeah. You put your point about social media. I do agree with you. It's great. I do wish that there were more doctors who were preaching a lot of these messages. A lot of times it's, sometimes it's the wrong message from the wrong messenger. But, people who know what they're talking about for medical doctors aren't as prevalent on social media as a they can't and they hopefully they can.

00:13:09:00 - 00:13:10:00
Dr. Justin Houman
You should be.

00:13:10:01 - 00:13:26:01
Dr. Jaclyn Smeaton
Yeah. Did you get pushback about being online so much from colleagues. This is like like an aside question, but I wonder about that. I've heard that from a couple of physicians where people thought it was a waste of time or whatever, but it seems like I think it's wonderful. I agree, I think better information would be the populous.

00:13:26:03 - 00:13:43:08
Dr. Justin Houman
Yeah, right. Message from the right messengers is probably the best. The best, view of the best way medical information can be, put on social media. But to answer your question about how hormonal health is assessed, most guys, when they come to me, I want to say they've kind of they've either already gotten tested for low testosterone.

00:13:43:10 - 00:14:06:01
Dr. Justin Houman
Come in. Coming to me for treatment options, or they're having significant symptoms where they're they want to get diagnosed. And really the key here is the way I do it is, I always want to make sure that we're providing the right testosterone, optimization program for, for each guy, we custom tailor everything. It's not every guy, whether they're 20 or 30 or 80, they get the same treatment plan.

00:14:06:01 - 00:14:21:00
Dr. Justin Houman
That's not what we do. And we don't do. Not everyone gets testosterone replacement therapy. There's ways in which we could preserve their fertility while optimizing their testosterone, which is a huge thing. I'm very, very big on that because I can't tell you how many times in a given week a guy comes to me, he's trying to have a kid.

00:14:21:06 - 00:14:43:02
Dr. Justin Houman
And the first question I ask is, are you on testosterone? They're like, yeah, I've been on for five years. They never told me my my sperm counts go to zero. So it's a big we want to custom tailor everything towards the patient's goals, their expectations, their current lifestyle. So we do a whole blood plan. We check their pituitary hormones, we check their estrogen levels, we check their testosterone, their free testosterone, which is probably the most important thing.

00:14:43:04 - 00:14:52:18
Dr. Justin Houman
Obviously, we do a physical exam just to make sure everything is looking good. And as long as things look good, we again, we custom tailor everything based on those hormone results.

00:14:52:20 - 00:15:01:00
Dr. Jaclyn Smeaton
That's great. Now, when you're looking at, you're talking about men on testosterone when they're trying to conceive, can you dive a little bit more into that concept for listeners?

00:15:01:02 - 00:15:22:02
Dr. Justin Houman
Yeah. So when the testicles do two things, they produce sperm and they produce testosterone. Any time you producing or you're giving the body synthetic testosterone or testosterone from the outside world, whether it's creams, injections, pellets, the testicles, get the signal that there's plenty of testosterone. So they shut down, they stop producing testosterone, but more importantly, they stop producing sperm.

00:15:22:07 - 00:15:51:14
Dr. Justin Houman
It is a temporary shutdown in most cases. When I say temporary, anywhere from 4 to 8 months, with some variation there. But that shutdown is quite important because guys, are they they're expecting to they're trying to conceive while they're on testosterone replacement therapy, not knowing that you can't not knowing that there's no sperm. So, the way we do it is we have a number of ways in which to do it, but we try to enhance the testosterone, function of the testicle while preserving fertility.

00:15:51:14 - 00:16:07:09
Dr. Justin Houman
So we there's different medications we do that signal the testicles to not just continue to function, but function better, boost up the testosterone production, maintain the fertility production. And in doing so, you really you're preserving that fertility while optimizing their testosterone.

00:16:07:11 - 00:16:25:14
Dr. Jaclyn Smeaton
Yeah, this is worth talking about. I saw this all the time in practice as well. And the other piece that I would say is I was looking at clients who predominantly wanted a functional medicine or integrative medicine approach, that there were a lot of men who came in on, like testosterone enhancing supplements, which is one of the dirtiest categories of supplements out there.

00:16:25:19 - 00:16:51:10
Dr. Jaclyn Smeaton
And a lot of them that I could tell. I'm like, you're on some kind of like muscle builder or growth, you know, supplement that has some kind of testosterone analog in it because you would see the same suppression, you know, and they weren't on testosterone. So I like to point that out, because if men are going to be on supplements in this category, it's so important to work with a professional grade brand and not buy like gas and supplements that are enhancing you because you do see junk on the market.

00:16:51:14 - 00:17:25:22
Dr. Jaclyn Smeaton
And whether it's, you know, weightlifting, bodybuilding, testosterone boosting, sexual enhancement, that whole category of supplements oftentimes has adulteration. Which what that means is that they'd be putting something in the product to get an outcome. But sometimes their medications we've seen like cialis Viagra type medications laced into dietary supplements and also testosterone analogs. So anyway I would come in and test men and see their testosterone quite low and sometimes find that they were either on testosterone and they knew they were or they're on testosterone and they didn't know they were through some kind of supplement protocol.

00:17:25:22 - 00:17:42:16
Dr. Jaclyn Smeaton
But it's important to know that there's other methods out there to support testosterone, like Clomid or using hCG with testosterone that can get around that problem. So there's other solutions out there for men. But, it's definitely a big, big problem that a lot of people don't know about.

00:17:42:18 - 00:17:44:12
Dr. Justin Houman
Agreed. Absolutely.

00:17:44:13 - 00:18:04:10
Dr. Jaclyn Smeaton
So I want to shift gears and talk about something that I've seen you talk about on Instagram, which is birth control. You know, birth control has obviously historically been female focused. And that's really shaped the way we think about birth control in this country. And like, who's responsibility is it. And but you've talked about like male contraceptive options as well.

00:18:04:12 - 00:18:08:10
Dr. Jaclyn Smeaton
Can you talk a little bit about why this is something that's interesting.

00:18:08:12 - 00:18:32:19
Dr. Justin Houman
Yeah. I mean, the male, the, the best version of a male contraceptive is the ectomy right. To get a vasectomy procedure done. Which, which and this is the thing that I think a lot of guys are quite fearful of it. Just because it's, it's a vasectomy and they feel like any type of procedure down in that territory can be painful, can cause side effects, can have a, a bevy of, of, of, negative outcomes.

00:18:32:19 - 00:18:50:01
Dr. Justin Houman
But in reality, it's very, very it's a very straightforward procedure. You always want to go to somebody who does it, a lot just because, you know, they're experienced with it. But I would tell you, it's, it's something that, that we do like on a daily basis, it takes about seven minutes, minimally, very little pain associated with it during the procedure.

00:18:50:02 - 00:19:09:11
Dr. Justin Houman
We have no pain associated with it during the procedure and afterwards. The recovery is a few days. No more than a week, and you're back on your feet. Ready to go. But the reason why I think it's, it's kind of the only fair way of doing things. The female contraceptives, they're they're either implants, that you have to exchange out, whether it's every 5 or 10 years.

00:19:09:13 - 00:19:31:17
Dr. Justin Houman
That process can be painful. Even the process of the implant just being in there, it can be quite painful. There's the hormones associated with it can cause a lot of issues back and forth. So, this is a very straightforward to one and done. There's no there's no, downward, late side effects. It doesn't cause any hormonal health issues, doesn't cause any erectile dysfunction, no sexual side effects, no libido issues.

00:19:31:19 - 00:19:44:09
Dr. Justin Houman
Again, very, very well tolerated. Which is the reason why I, to stand on my soapbox here. I think of a second. But anybody any couple who's done, with their fertility, the guy should undergo a vasectomy.

00:19:44:11 - 00:20:01:01
Dr. Jaclyn Smeaton
I think the best time for a woman, a female partner. To ask their partner to get a vasectomy is, like, literally after birth. Then you you've, like, just gone through the labor and you're like, okay, next it's your turn. It puts the the contribution in perspective. Yeah. You know, you have a 12 hour labor or whatever versus a seven minute procedure.

00:20:01:03 - 00:20:19:16
Dr. Jaclyn Smeaton
And it is a a tit for tat. That's right. It is a really fabulous. And I think you bring up a lot of really important points, like even a cost perspective, the hormonal implications for female birth control for the majority. I mean, there are some non-hormonal options like the copper IUD, but for the most part they will have cycle disruption.

00:20:19:17 - 00:20:40:11
Dr. Jaclyn Smeaton
I think now that we know how much, regular menstrual cycle is a marker for health, for women doing things that disrupt that, like oral contraceptives. There's downsides for a woman even knowing what the status is of her health when that cycle is overridden by, by hormones from a contraceptive point of view. So I love that you talk about this.

00:20:40:11 - 00:20:45:07
Dr. Jaclyn Smeaton
Are there other male non hormonal birth control options besides the fact me.

00:20:45:09 - 00:20:54:12
Dr. Justin Houman
You know we're the we're doing a little bit of research on this. There's a few companies out there who are trying to do like a reversible they're trying to use different like a.

00:20:54:12 - 00:20:55:19
Dr. Jaclyn Smeaton
Gel that dissolves. Right?

00:20:56:00 - 00:21:07:05
Dr. Justin Houman
Yeah. They go in the past. The jury's still out. I think the technology has to approve a little bit more to get there. But there's a few startups in that space right now trying to address, address that.

00:21:07:06 - 00:21:10:02
Dr. Jaclyn Smeaton
It's even because that would be an injection typically.

00:21:10:04 - 00:21:25:15
Dr. Justin Houman
Yeah, an injection into the lumen of the vas deferens right into that hole. And then the idea would be that they could do a reversible agent into that same, lumen in order to reverse it, rather than the way we do it now is I'll do a vasectomy on somebody. Let's say they changed their mind five, ten years later.

00:21:25:17 - 00:21:36:21
Dr. Justin Houman
We'll reverse it. And that's a whole different procedure. But again, it's it's, it's a surgery where you have to, you know, make a decision and bring those two ends back together. But they're trying to create. Say that again.

00:21:36:23 - 00:21:53:21
Dr. Jaclyn Smeaton
My husband had that done, he wouldn't mind me sharing. He's public about it. But, you know, he'd had a vasectomy before we met. And then when we got together, just like we decided to have children and he was like 7 or 8 years out from it. So it was difficult even to find someone who would do the reversal, because the rates after five years are not typically as successful.

00:21:53:21 - 00:22:00:20
Dr. Jaclyn Smeaton
But we had two children after that, so it worked for us. But that procedure was more painful for him than the vasectomy, he said. The vasectomy was.

00:22:00:20 - 00:22:07:18
Dr. Justin Houman
Exactly, exactly vasectomy. Straightforward. The reversal requires it's a longer I mean, it's a bigger surgery from from our standpoint.

00:22:07:20 - 00:22:24:08
Dr. Jaclyn Smeaton
Yeah, yeah. But it was successful. And definitely, you know, allowed us to grow our family. We think about this activities as being permanent. And typically you wouldn't want to do it unless someone wanted permanent birth control. But, you know, it's definitely a really nice option available for couples from a family planning perspective.

00:22:24:10 - 00:22:25:14
Dr. Justin Houman
For sure. Yeah.

00:22:25:16 - 00:22:35:21
Dr. Jaclyn Smeaton
If male birth control like other forms like the I mean, we haven't really talked. Have they tested oral forms of birth control for men? They have not in the past. They really weren't very successful.

00:22:35:23 - 00:22:49:21
Dr. Justin Houman
Precisely. Yeah. They're not that successful because I mean, the thing is you really want to get to zero. It's not like, all right, you're limiting the sperm because, you know, anytime a guy ejaculates a healthy male, he's ejaculate tens if not hundreds of millions of sperm. And all you need is one of those sperm to get to the egg.

00:22:49:21 - 00:23:02:11
Dr. Justin Houman
And you have an embryo. So it's you have to have a 100% success rate in terms of stopping sperm. And the only way, the best way of doing it again in modern medicine today is just blocking that path.

00:23:02:13 - 00:23:04:20
Dr. Jaclyn Smeaton
Yeah. Great.

00:23:04:22 - 00:23:27:21
DUTCH
We'll be right back. Here at Precision Analytical we've launched the biggest update to our report since 2013. The new and enhanced report puts the most actionable hormone insights right on page one making it faster and easier to interpret. You'll see a reimagined summary page, upgraded visuals for estrogen and cortisol metabolism, and an all new about your results section.

00:23:28:03 - 00:23:52:16
DUTCH
What we call the DUTCH Dozen, a 12 point framework that helps you understand your patients hormones story in minutes. It's a smarter, simpler, and more insightful DUTCH experience. From now through December 19th, 2025, all registered DUTCH Providers can order five DUTCH Complete or DUTCH Plus kits for 50% off. Give us a call or visit. DUTCH Test.com/order now. Must be a registered DUTCH Provider.

00:23:52:21 - 00:24:06:07
DUTCH
Promotion not available to distributors can mix and match DUTCH Complete and DUTCH Plus kits pre-paid only. No drop shifts cannot be combined with any other offer. Kits must be purchased by December 19th, 2025.

00:24:06:09 - 00:24:09:00
DUTCH
Welcome back to the DUTCH Podcast.

00:24:09:02 - 00:24:26:00
Dr. Jaclyn Smeaton
Well, I want to shift and talk a little bit about fertility now because I do think about men's health, kind of that second category of fertility. You know, obviously there's a hormonal component and there's also some kind of nutritional and lifestyle components. You spoke to these a little bit earlier, but can you talk about when a man is coming to improve his fertility?

00:24:26:00 - 00:24:30:16
Dr. Jaclyn Smeaton
What are the key areas of health that you think about.

00:24:30:18 - 00:24:51:21
Dr. Justin Houman
Really comes down to? I guess like the way to think about it is like you need to mashed potatoes before you get the gravy. But like the mashed potatoes, like the essence of it, you for things. Obviously nutrition is a big part of it. Not everyone is perfect with this. And, you know, you don't have to have a perfect nutritional diet plan in order to conceive.

00:24:51:21 - 00:25:17:00
Dr. Justin Houman
Well, but, really comes down to a good amount of healthy fats, lean proteins, complex carbohydrates. And the beauty of that is it's not just good for your fertility health, it's good for your overall health. If your cardiovascular health, your metabolic health, everything. So in that sense, you, you, you know, killing a bunch of you, crossing off a lot of boxes in terms of health, exercise wise, you always want to mix heavy weightlifting with or weightlifting in general.

00:25:17:00 - 00:25:38:01
Dr. Justin Houman
When I say heavy weightlifting, but weightlifting with cardio try to exercise four times a week and generally every other day for 30 minutes is a good place to start. Stay active, move around. Try to at least walk every day. Get some sunlight. That brings me to the third point, which is stress reduction. If I had the answer for you, if I knew how to tell you how to reduce your stress, I wouldn't be doing what I do.

00:25:38:03 - 00:26:03:11
Dr. Justin Houman
But find out what reduces your stress levels. Not everyone has the same thing for some people as a morning exercise, for some people, as a morning meditation. For some people, it's talking to friends and spending time with family. One of the hardest things in life is figuring out what reduces your stress levels. And I could tell you, amongst my older patients, the ones who are the happiest and the healthiest, who are literally living the longest, they know they've figured out how to make them, what makes them happy, and they've maximized that.

00:26:03:17 - 00:26:24:13
Dr. Justin Houman
They've taken that to the limit. So figure out what's important to you in terms of what makes you happy, because they don't reduce your stress levels. And then finally, sleep. Sleep is a big one. Sleep is good for everything. For mental health, for physical health, for, for even our stress levels. But try to get at least seven hours of sleep a night again.

00:26:24:13 - 00:26:29:08
Dr. Justin Houman
If I had the answer, if I took it, if I knew how to do that for myself, I would tell you.

00:26:29:10 - 00:26:47:06
Dr. Jaclyn Smeaton
I love that you bring up that like the older men, you know, they have the they've identified that kind of the ones with the most longevity they've identified. What is it that, you know, helps them really reduce stress? Interestingly, just last week I saw this article on you remember the Blue Zones book by Dan Buettner. Like they were studying.

00:26:47:08 - 00:27:03:23
Dr. Jaclyn Smeaton
If you guys, it's an older book. I came out, God, probably, maybe ten years ago, maybe more than that 20 years ago. But he looked at the blue zones, which were these areas on the planet where they had the highest number of centenarians or people that lived over 100 and evaluated. What was the what were the patterns that they saw?

00:27:04:04 - 00:27:26:16
Dr. Jaclyn Smeaton
Well, they actually put all of his data into an AI model and found they like reanalyze the data, and they actually found that, the biggest indicator across all of them was not related to like alcohol intake or even nutrition. We had some. But the largest impact by far was connection and relationships and solid relationships. And I think a lot of that is that stress reduction and pursuing joy.

00:27:26:16 - 00:27:48:08
Dr. Jaclyn Smeaton
And I mean, I really think you can meditate, you can do yoga. But when it comes to true self-care and stress reduction, I think no is our most powerful. Like two letters, right? You got to align yourself in your life for the things that bring you joy and move away from the things that don't. And so I love hearing you say in your older populations, they've nailed what produces their stress.

00:27:48:08 - 00:27:53:20
Dr. Jaclyn Smeaton
I mean, that's just another way to say the same thing, which is just how remarkably important that is.

00:27:53:22 - 00:27:56:07
Dr. Justin Houman
Yeah. Reducing chronic stress.

00:27:56:09 - 00:28:13:12
Dr. Jaclyn Smeaton
Yeah. And I want to talk a double like double click on that a little bit. Because I think there's a really deep connection with testosterone levels, which men really care a lot about between stress and sleep. And then alcohol use is another one that I would throw in there as well. What are your perspectives on those as contributors?

00:28:13:14 - 00:28:27:18
Dr. Jaclyn Smeaton
Like, I know that for some, when men have low testosterone, particularly when they're younger, assessing for sleep apnea can be a really important piece of their workup. Can you talk a little bit about some of those big contributors from that point of view of stress and sleep?

00:28:27:20 - 00:28:55:11
Dr. Justin Houman
Yeah, for sure. So, well, one thing, when you're poor, sleep obviously will lead to it'll give you a little bit less, reserve in order to, to deal with the daily stressors of life. So, what would may cause a mild impact on you if you have if you have a series of, a couple of weeks of getting good sleep, that may not negatively impact you throughout the course of the day, but, if you're running on fumes, you're getting, you know, five hours of sleep for a week.

00:28:55:13 - 00:29:13:10
Dr. Justin Houman
That's going to cause that that it's not going to let you deal with the, the, stressors of the day and the week as, as much as well as you would have, if you got good sleep. How testosterone relates to all this? I've had a number. A lot of patients will say, look, I'm just not getting good sleep.

00:29:13:12 - 00:29:40:15
Dr. Justin Houman
And when we improve their testosterone levels, obviously they feel better. They have more energy, but they're getting better sleep. They're sleep, you know, they're they're tracking their metrics. They're actually getting better sleep seven hours of sleep a night. And that's that's only helping them, in terms of dealing with a lot of stressors. So, there is a lot of, you know, everything is kind of connected in this, in this, from a hormonal health to a stress management standpoint.

00:29:40:17 - 00:29:43:06
Dr. Justin Houman
It's all kind of connected.

00:29:43:08 - 00:29:50:19
Dr. Jaclyn Smeaton
Yeah. So I'm hearing you say it's like. It's like a chicken and egg exercise. You know, the poor sleep would affect testosterone, but low testosterone can affect sleep as well.

00:29:50:21 - 00:29:52:07
Dr. Justin Houman
Precisely.

00:29:52:09 - 00:30:07:04
Dr. Jaclyn Smeaton
So beyond testosterone, like, are there other hormones? You'd mentioned that you test things like estradiol or estrogen and you talked about stress like stress hormones, like cortisol. Do you look at those as well when it comes to assessing a man's vitality and kind of hormonal balance?

00:30:07:06 - 00:30:26:03
Dr. Justin Houman
Definitely. Estradiol is a big one. I don't think cortisol gets as much credit as it should. The only thing about cortisol, this it's a little bit more difficult is like estradiol. We could play around with it. Right? We know testosterone gets converted to estrogen. Estrogen is quite important or it's important for men in general, but, estrogen can be too much.

00:30:26:03 - 00:30:45:15
Dr. Justin Houman
Estrogen is not and is not good. Right. Cortisol is a little bit more difficult because we, we can't necessarily, act on cortisol levels. We can tell if someone, if someone has a elevated, cortisol level. That's okay. Well, it's it's important to diagnostic, but, hey, try to do whatever you can to reduce your stress levels.

00:30:45:17 - 00:30:56:09
Dr. Justin Houman
How do I do that, doc? Well, I mean, again, it's, you know, you come back to these things that we just talked about, you know, figure out what brings you joy, meditate, exercise, sleep, all of those things.

00:30:56:11 - 00:31:14:17
Dr. Jaclyn Smeaton
It's interesting that you bring that up because what I'm hearing you say, which is I think really, really rings true, is that we know cortisol is impactful, but because we can't treat it, it doesn't get as much attention in medicine where. And it's so interesting because if there was a drug that could raise or lower cortisol effectively, it would be a huge market and we would.

00:31:14:17 - 00:31:15:03
Dr. Justin Houman
Like for.

00:31:15:03 - 00:31:33:20
Dr. Jaclyn Smeaton
Everybody to treat it. And that's I've never really thought about that before, about why we don't look at it and I do. I've seen it myself and talked with practitioners. It's one of the hardest areas of health to improve like that HPA axis dysfunction. But if you look in conventional medicine, it's like Cushing's and Addison's and nothing in between.

00:31:34:01 - 00:31:41:06
Dr. Jaclyn Smeaton
Yeah. Whereas if we could actually treat it, maybe we would have a different perspective if there was a pharmaceutical out there.

00:31:41:08 - 00:31:43:01
Dr. Justin Houman
To measure pill. Yeah.

00:31:43:03 - 00:31:53:04
Dr. Jaclyn Smeaton
Gosh, that's like a total insight of this podcast time. But I think you're really right. It's something that it's really hard to wrap your hands around how to help people other,

00:31:53:06 - 00:31:54:12
Dr. Justin Houman
Lifestyle interventions.

00:31:54:13 - 00:32:21:03
Dr. Jaclyn Smeaton
Yeah, like you said, which are so hard to to do. And they're so variable from person to person as well. Now I want to talk a little bit about the DUTCH Test. This is one example of how clinicians are kind of digging deeper and trying to get more hormone insights on the patterns that they see. How do you see like tasks like that, helping men connect their symptoms, let's say like low libido to what's happening hormonally like, do you consider things like metabolites, DHT levels, things like that as well?

00:32:21:05 - 00:32:38:00
Dr. Justin Houman
They're all they're all interconnected. Like any any alteration that there could be. Let's say we're testing for five metabolites or five of these hormones. If I had one, for me, maybe just being off on one of those could really negatively impact me. But for somebody else, it may take we're being low in four of those. They're deficient in four of those for them to feel it.

00:32:38:00 - 00:32:58:00
Dr. Justin Houman
So biology is different for every individual. So the more data points you have, the more valuable it is. Primarily number one. Number two, with that point, in terms of more data points, getting like a urine test is much easier than than a blood test, right? A blood test requires a lab. It requires someone to draw your blood, a urine test.

00:32:58:00 - 00:33:17:11
Dr. Justin Houman
Anyone can do so. Like anything else, the more data points you have, you're going to make a you can have more diagnostic data points, and you're going to make a more sound decision from a clinical standpoint. In order to properly diagnose and treat somebody. So, that's the beauty of, of, the DUTCH Test in that sense.

00:33:17:13 - 00:33:34:12
Dr. Jaclyn Smeaton
Yeah. And a lot of men don't realize like they probably think that when they are having issues with energy or mood or even fertility, they think first about testosterone only. But it's really like a symphony of hormones for men, just like it is for females. How do you explain that to your patients in a way that they get it.

00:33:34:14 - 00:33:36:15
Dr. Justin Houman
That testosterone is important to women?

00:33:36:17 - 00:33:52:19
Dr. Jaclyn Smeaton
No, no, that it's not just testosterone for men that they have. You've talked about estradiol. We've talked about cortisol. We've just talked about metabolites. Do men understand? I feel like they come in looking with kind of blinders on, focused on testosterone. But sometimes it's like the whole terrain, the whole environment of hormones.

00:33:52:21 - 00:34:08:19
Dr. Justin Houman
Yeah. I would say most men, when you think of like when they think about thyroid cortisol, that that resonates with them, it's not that hard to for them to understand that one. But any of them, when we do the blood test, they see estrogen or they see estradiol. They'll look it up these days and be like, well, doc, am I a woman?

00:34:08:21 - 00:34:15:12
Dr. Justin Houman
No, no. Literally like someone this weekend texted me or sent me an email like, am I a woman? Like, no, no, you're okay.

00:34:15:14 - 00:34:17:06
Dr. Jaclyn Smeaton
We all make estrogen.

00:34:17:08 - 00:34:29:16
Dr. Justin Houman
Yeah. All men need it. We need it. As men, we need it. It's important for libido. It's important for bone health. It's important for metabolic health. A good amount of it. Not too much of it. Not too little of it. But there's a nice, middle ground there.

00:34:29:18 - 00:34:47:17
Dr. Jaclyn Smeaton
But there can be imbalances where men might actually make adequate testosterone, but they're kind of their detoxification pathway pushes it through Aster diol, and it gets kind of stuck there. Same thing with estrogen metabolism where you can see their metabolism isn't great. It could be related to gut health. It could be their genetics. But things they get they end up producing too many estrogens.

00:34:47:17 - 00:35:01:04
Dr. Jaclyn Smeaton
And you kind of get that imbalance between testosterone and Astra diol. And you mentioned to that before that you don't want it to be too high. In my experience, high estradiol in men, even if testosterone is adequate, can feel a lot like low testosterone.

00:35:01:06 - 00:35:22:02
Dr. Justin Houman
Yeah. Absolutely. It compete. Well, look, it competes for one and competes for the receptors. But more importantly, it's it's the ratio that's the most important thing to us. You want at least a 10 to 1 ratio between testosterone and estradiol. Anything less than that, you're not really getting the benefits of those testosterone levels. So that's that's the that's kind of the place to start for us.

00:35:22:02 - 00:35:35:01
Dr. Justin Houman
But this brings us back to the point of everyone. Everyone's biology is different. So you really want custom tailored care towards your hormonal, picture in order to make sure you're getting, something that's tailored towards your needs.

00:35:35:03 - 00:35:45:10
Dr. Jaclyn Smeaton
No one men are on testosterone replacement. That's kind of gets a do you do any kind of monitoring ongoing for them? Definitely. We talk a bit about that. And because I think it goes beyond testosterone levels.

00:35:45:12 - 00:36:08:20
Dr. Justin Houman
Yeah. So I mean obviously look testosterone is very, very safe. We have tons of data supporting how safe it is. There's there's a lot of misconceptions about testosterone causing prostate cancer, causing strokes, all of those things. We've disproven all of those. There was a bad study that came out initially that at this point, I think we've published 27 studies, contradicting that initial study.

00:36:08:22 - 00:36:26:07
Dr. Justin Houman
But that being said, you always want to measure blood levels. You want to make sure people aren't doing too much testosterone. You want to make sure that estradiol, as we just mentioned, it's staying at a nice ratio. You want to keep an eye on their PSA? PSA is a marker for prostate cancer. So we do want to make sure you're trending there PSA.

00:36:26:09 - 00:36:46:16
Dr. Justin Houman
And then finally we want to make sure that their red blood cell count is staying stable. In in rare cases or in less common cases, I should say testosterone raises, your red blood cell count. And if it's unmonitored, that your blood can become very, very thick and incredibly rare cases you get have heart attacks or stroke.

00:36:46:16 - 00:37:05:08
Dr. Justin Houman
So you do want to make sure you're doing bloodwork. I generally at the start of treatment I see patients back every 2 to 3 months just to make sure, we're on a good path. And once they're, they found a nice routine, nice, stable, regimen we'll do every six months, twice a year. We'll check bloodwork.

00:37:05:10 - 00:37:20:16
Dr. Jaclyn Smeaton
Great. Well, now I know another reason why a lot of men come in to see urologists. You mentioned this before. Is sexual health kind of that third category. For urology, can you talk a little bit about some of the main underlying drivers? We started out with this, but I want to spend some more time talking about.

00:37:20:17 - 00:37:30:08
Dr. Jaclyn Smeaton
It is such a big concern for men. So what are the areas that you typically would evaluate when a man comes in with complaints about difficulty with an erection?

00:37:30:10 - 00:37:51:08
Dr. Justin Houman
Hormone hormones are a big one and blood flow are a big one. Obviously, depending on age, if a 20 or 30 year old comes in, we're thinking more performance anxiety or porn induced erectile dysfunction. That's majority of guys are in that bucket, when their 20s and 30s. But as men age 40s 50s hormonal health is a big one.

00:37:51:10 - 00:38:01:07
Dr. Justin Houman
Various issues that cause, decreased blood flow to the penis. So, high cholesterol, diabetes, high blood pressure, those are the things we look at.

00:38:01:09 - 00:38:08:04
Dr. Jaclyn Smeaton
Is that something that you guys work up as urologists, or would you pull in cardiovascular like a cardiologist to start to do that workup?

00:38:08:06 - 00:38:25:18
Dr. Justin Houman
So, you know, a, cardiologists, primary care doctors, they're the ones who are screening the most guys. I mean, luckily, where where I practice, it's in most guys are getting their annual physicals. Upwards of 90% of men are. So I see that data, right?

00:38:25:18 - 00:38:27:05
Dr. Jaclyn Smeaton
I see it here in LA, right?

00:38:27:07 - 00:38:28:13
Dr. Justin Houman
Yeah, exactly. Exactly.

00:38:28:13 - 00:38:30:19
Dr. Jaclyn Smeaton
A little bit more investment and healthy lifestyle.

00:38:30:21 - 00:38:49:00
Dr. Justin Houman
Precisely. So, so in that sense, it's a little, I do see that data. So, but even then. Right, let's say they are having high cholesterol issues. Their primary care is still working on it to lower those cholesterol levels. A lot of times the damage is irreversible to that, to those arteries that carry blood flow, to the penis.

00:38:49:00 - 00:39:04:19
Dr. Justin Houman
So in those situations, it's obviously it's good to know that, hey, maybe this is the reason why, but we still work them up from a hormonal health standpoint and are the most importantly, we try to treat them, to get them back to, to optimize them sexually.

00:39:04:21 - 00:39:14:19
Dr. Jaclyn Smeaton
Well, because a lot of it, it's due to microvascular damage. Is that right? Where they end up, those like my, you know, capillaries and smaller blood vessels kind of get the damage first.

00:39:14:21 - 00:39:23:06
Dr. Justin Houman
Precisely. Yep. Well said. Exactly right. Those are the smallest ones. Those those are the ones that get calcified first and those are the ones that get obstructed first.

00:39:23:08 - 00:39:30:11
Dr. Jaclyn Smeaton
Now what about some of the stuff that we I've seen on like nitric oxide support nutritionally? Is there any validity to that?

00:39:30:13 - 00:40:00:04
Dr. Justin Houman
Yeah. I mean there's there's supplements. There's amine amino acids. L Citrulline L-arginine are probably the most well-studied, amino acids in this space. They can help, right? They definitely can help. They can only help. But what I would say is usually speaking and I don't want to make this a broad, broad generalization, but, those are those supplements usually are for guys who have mild erectile dysfunction, guys who they're still able to have erections, they're still able to, to penetrate.

00:40:00:04 - 00:40:20:23
Dr. Justin Houman
They're able to still maintain, throughout the course of, maintain an erection throughout intercourse. But if a guy's really unable to get anything very little activity, these supplements really aren't going to move the needle a lot for him, or they're not going to move it to the point where they're achieving satisfying erections. So that's when you really want to think about pharmaceuticals.

00:40:21:01 - 00:40:31:20
Dr. Jaclyn Smeaton
Yeah, that makes a lot of sense. I think looking at the level of need that people need, you know, when they come in, what level of intervention is required depends upon the severity of disease in any case that you're looking at.

00:40:31:22 - 00:40:32:19
Dr. Justin Houman
Yeah, exactly.

00:40:33:01 - 00:40:55:06
Dr. Jaclyn Smeaton
Now I want to get to this like canary in the coal mine piece that we talked about before. So I think this is a really interesting element of care when you're looking at men's health, is that we've talked about how a lot of these are markers of, let's call it like development of chronic disease. It's like we can use fertility as an example, where if your fertility is poor, when you're in your 30s, it's not supposed to be.

00:40:55:06 - 00:41:20:17
Dr. Jaclyn Smeaton
It's probably. And under other underlying factors that are affecting your fertility, you're probably affecting other areas of your health. You're just not seeing it yet. You know that fertility is the first measurable thing affected. Now, what do you think about having that as being like like should semen analysis be a marker for men's health that we look at throughout different stages of life, like could there be a value to to men knowing what their status is and how it's changing over time?

00:41:20:19 - 00:41:27:14
Dr. Justin Houman
Yeah. I mean, and so I would say some, some people have said this is I don't want I've read what.

00:41:27:16 - 00:41:30:11
Dr. Jaclyn Smeaton
No, no, I've seen that. And I just find it really interesting.

00:41:30:13 - 00:41:47:18
Dr. Justin Houman
Yeah. I mean, is it, is it worth. So some people say it should be the sixth vital sign, right. I see my analysis should be the six vital signs. And I don't disagree with that, but I think any guy should get a baseline analysis right these days. You could do it at home. It's. There's a $200 kit that you could buy online.

00:41:47:18 - 00:41:59:07
Dr. Justin Houman
There's a couple there's a couple companies that do it. They mail the test kit, you house, you do it. There's a, there's a preservative in there that's almost it's incredibly precise. It's very, very accurate.

00:41:59:09 - 00:42:04:16
Dr. Jaclyn Smeaton
Give legacy is the one that I've seen or is the other one. What's the other one that you've used?

00:42:04:19 - 00:42:24:18
Dr. Justin Houman
Or there's a fellow there's legacy. There's sapiens I think is another one. There's a number of these companies. But what they do is, I mean, you do an at home test, you see where you stand, if there's any abnormalities, you work it up. The earlier you intervene. From a fertility health standpoint, I can tell you the earlier you intervene, the better the outcomes will be.

00:42:24:18 - 00:42:44:10
Dr. Justin Houman
If you have a very CA seal, for example, treating that in your early 20s versus your mid 30s can play a big role in terms of the type of damage it's caused to your testicles. And the thing is, this is the thing about fertility. No one is there's no symptoms associated with fertility, right. Or infertility. So if you let's say you you're producing severely low sperm counts.

00:42:44:10 - 00:43:04:16
Dr. Justin Houman
It's not the kind of thing that you're going to, feel throughout the rest of your body. It's not you're not going to have pain. You're not going to have a cough associated with it. You may have low testosterone associated with that because obviously low testosterone can negatively impact fertility. But the point here is getting that assessed earlier on will help.

00:43:04:19 - 00:43:09:17
Dr. Justin Houman
Big picture for your, for your reproductive health and your overall health.

00:43:09:19 - 00:43:27:20
Dr. Jaclyn Smeaton
Yeah. There's been such interesting data lately on, like, mitochondria and mitochondria are such a critical part. They're really involved in most chronic diseases, even metabolic health and things like that. And I think one of the reasons that we look at fertility as such an important marker is the testes are the richest place for mitochondria in the male body.

00:43:27:20 - 00:43:44:17
Dr. Jaclyn Smeaton
And for women, it's the ovaries. We think about mitochondria for cardiovascular health. But and that's important as well skeletal muscle. But actually our organs of fertility, our gonads are the ones that have the richest mitochondria. So I think they that's why we see them affected so early. But it is can be a sign of that kind of poor nutrition.

00:43:44:17 - 00:43:51:06
Dr. Jaclyn Smeaton
Poor mitochondrial status, which is required for energy production, which affects all of our but all of our cells in our bodies.

00:43:51:08 - 00:43:52:02
Dr. Justin Houman
Yeah, exactly. Yeah.

00:43:52:03 - 00:44:07:20
Dr. Jaclyn Smeaton
Just such an interesting perspective because I do think that in the next ten years we're going to be seeing shifts in urology, similar to other categories of health, where we're starting to look at that. But we'll see what happens. We'll see what the data shows.

00:44:07:22 - 00:44:11:14
Dr. Justin Houman
Yeah. It'll be it'll be interesting.

00:44:11:16 - 00:44:21:20
Dr. Jaclyn Smeaton
Great. Well, I really we've had the chance to talk about a lot of different things on the podcast today. What are you most excited about as far as what's happening in the field of urology?

00:44:21:22 - 00:44:52:20
Dr. Justin Houman
I do think that, well, a couple things. I think within the, I'll say within my sphere of, primarily with men's health. I do think there's a couple of things, but, men are engaging these conversations more and more, which is great because I think there's a taboo associated with some of these discussions that we talk about sexual health, infertility, younger generation men are way more willing to engage in these conversations and to see physicians, which is wonderful, because I think that's just going to help.

00:44:52:22 - 00:45:12:02
Dr. Justin Houman
Overall health of young men. Much better. It's going to it's going to help significantly in that space which which I like that idea. And then a lot of this when it comes to telehealth and some of these new technologies we're able to do at home testing, really bring what the physician does to the patient at home, make it as community and as possible for patients.

00:45:12:07 - 00:45:32:08
Dr. Justin Houman
We're seeing that I think with every decade that goes by, every five, ten years, we're seeing big improvements in that space. And again, really improving access, to men really engaged in the health care system, taking care of themselves, hopefully help with or men ultimately living longer lives because we do see, you know, men, men live shorter lives than women.

00:45:32:08 - 00:45:46:02
Dr. Justin Houman
Men have more mental health issues than women. Men are more likely to die by suicide. There's a lot of things that, We could change this for men. And I do think with with improving technology, we can make some of those changes.

00:45:46:04 - 00:45:53:01
Dr. Jaclyn Smeaton
What do you think is leading to that shift that you're seeing, that men are engaging in health care sooner?

00:45:53:03 - 00:46:18:08
Dr. Justin Houman
Social media, social media is, normalizing the conversation, seeing, seeing a celebrity talk about his infertility issues or his low testosterone issues, you know, hearing that can normalize the conversation for for a lot of guys, it gets them more willing to talk. That and, yeah, I think this is young men are engaging these conversations more than they did before.

00:46:18:08 - 00:46:33:04
Dr. Justin Houman
It was taboo to talk about, you know, having erectile dysfunction was one of those things back, I don't know, for a 60 year old guy. I was like, hey, but you bootstraps on. It's part of life. That's what it is now. Suck it up. That's. But now, you know, men are willing to talk about it. And we have treatments for this.

00:46:33:06 - 00:46:42:09
Dr. Justin Houman
So it's not it's not one of those things where it's like, yeah, you know, suck it up. We have good treatments, we have good treatment options for men, at all ages for this.

00:46:42:11 - 00:47:06:13
Dr. Jaclyn Smeaton
It's so interesting because we talk a lot about women's health, obviously in the podcast, probably more than men's health. But there is this like disenfranchizing conversation for women that, you know, perimenopause and menopause is a great example, where there's been decades of time where people have said, that's just aging. You have to just get used to that. And what I'm hearing you say is the same thing happening for men and that that it's starting to transform.

00:47:06:17 - 00:47:30:21
Dr. Jaclyn Smeaton
And I see that myself. Like I was talking with someone about the age that my grandparents passed away, which was in their 60s, of cardiovascular events, and now my parents are in their 70s and their the way they're aging is so different than the their parents were in your 60s. They were practically ancient and, you know, not as involved in their health or my parents are like golfing many days a week and out with friends all the time, and they're in their 70s.

00:47:31:03 - 00:47:53:23
Dr. Jaclyn Smeaton
It's like the aging has transformed. I think smoking, stopping smoking has probably been a huge impact on that because my grandparents smoked. My dad's used to smoke but stopped when he was probably 30. And I think that's changed the trajectory. But the expectation of health into later years has really changed. And men expect to live well. Women too.

00:47:54:01 - 00:48:05:06
Dr. Jaclyn Smeaton
We expect to live well and live healthfully and have good quality of life later into our later years. And I think that's transformed the way we engage with health care earlier on as well.

00:48:05:08 - 00:48:14:22
Dr. Justin Houman
Yeah, but there's going to be I think there's going to be different vices to this. There'll be, you know, people are drinking less too, which is good. But I do think but now vaping is becoming more popular.

00:48:14:22 - 00:48:15:12
Dr. Jaclyn Smeaton
Right. It's going to.

00:48:15:12 - 00:48:34:19
Dr. Justin Houman
Be different vices that that there's always like, the kind of a cat and mouse thing here. But I agree with you. I think this ultimately, I think there's a much bigger desire for, for younger generations to live longer with biohacking and all these, these trends which hopefully, hopefully they it's not just one of these trends. It does.

00:48:34:19 - 00:48:41:07
Dr. Justin Houman
It does it does have some, long term viability to it.

00:48:41:09 - 00:48:54:08
Dr. Jaclyn Smeaton
Yeah. Great learnings that can come from that information. Awesome. Well, it's been really wonderful having you on the podcast, Doctor Human. Thank you so much for spending the time with me today. If people want to learn more about you and your practice, what are the best places that they can connect with you?

00:48:54:10 - 00:49:07:05
Dr. Justin Houman
Yeah, they can look me up. My name is just in human nature. And, on the various social media channels on my website. But yeah, if you look up my name just in human, you'll find different ways in which you could contact me.

00:49:07:07 - 00:49:18:15
Dr. Jaclyn Smeaton
Great. Well, we'll make sure we link to all of your social on the podcast show notes. If you guys are listening, wherever you are, you can click on that episode and scroll down and get connected straight away. So thanks, Doctor Houman for joining me.

00:49:18:17 - 00:49:21:21
Dr. Justin Houman
This is great. Thank you so much.

00:49:21:23 - 00:49:34:16
DUTCH
Thanks for joining us on the DUTCH Podcast. Join us every Tuesday for new conversations with leading functional health experts. If you like what you've heard, be sure to like, follow, and subscribe wherever you get your podcasts.


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Dr. Jaclyn Smeaton, ND

Host
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Dr. Justin Houman, MD

Guest