Optimizing Sexual Health in Parkinson's: Tech, Data, and Intimacy with Dr. Elliot Justin

 In this vital conversation, host Chris Kustanbauter and physician/innovator Dr. Elliot Justin delve into an often-overlooked aspect of life with Parkinson's: sexual health and intimacy. You will learn how leveraging health technology and objective data can empower you to proactively manage your sexual function, improve your well-being, and strengthen your relationship. Dr. Justin shares cutting-edge insights on using wearables to monitor function and emphasizes the critical need for open dialogue between patients, partners, and healthcare providers. 

Key Topics Covered

• The Intersection of Health Tech & Sexual Health: How innovative tools are changing the conversation, especially in chronic illness.
• Empowering Patients with Data: Using objective measurements to reduce uncertainty and unnecessary doctor visits.
• Sexual Health as a Vital Sign: Why sexual function is a critical component of overall well-being and cardiovascular health (e.g., nocturnal erections).
• Wearable Technology for Men's Health: Insights into devices like the Tech Ring and how they provide actionable data on sexual function.
• The Importance of Open Communication: Strategies for individuals with Parkinson's and their partners to discuss sexual health, intimacy, and performance honestly.
• Addressing Erectile Dysfunction (ED): Moving beyond medication (like Viagra) to understand underlying issues and technology-based solutions.

Actionable Next Steps (Calls to Action)

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Chapters

• 0:10 From ER Doctor To Health Tech Founder
• 1:08 The Case For Home Diagnostics
• 3:37 Nocturnal Erections As Heart Signals
• 5:02 Building The Tech Ring And Database
• 7:15 Parkinson’s, Intimacy, And Medication Effects
• 10:50 Predicting Problems Before They Grow
• 13:17 Rings Versus Pills For ED
• 16:24 Why Doctors Rarely Ask About Sex
• 19:32 How The Device Works And Access
• 22:05 Research, Validation, And FDA Path
• 25:42 Using Data To Personalize Treatment
• 28:04 Communication Tips For Couples
• 30:07 Takeaways: Measure And Optimize

Transcript

SPEAKER_00: 0:10

Welcome to Live Parkinson's Live an Exceptional Life. I'm your host, Chris Kostenbotter, and I've been living an exceptional life with Parkinson's for the past 15 years. Today we have a truly exciting guest joining me. Dr. Elliot Justin is the founder and CEO of Firm Tech, a company at the forefront of innovative health technology with a background in emergency medicine and a passion for improving lives through science and design. Dr. Justin has dedicated his work to creating innovations that empower people to take charge of their health and wellness. Dr. Justin, it's an honor to have you here and welcome to the podcast.

SPEAKER_01: 0:41

Chris, great to be here.

SPEAKER_00: 0:42

Well, you have a very interesting background. I wanted to talk just before we get into what you're doing now, is just provide a little background. You went from an emergency room physician and then you've transitioned to developing innovative products. Can you tell us a little bit about that?

SPEAKER_01: 0:55

Well, you know, I spent many, many years in emergency medicine. That got me interested in what how how can we give people the knowledge and the day at home they can manage healthcare and ideally have to go to their physicians less. So specifically in remote patient management technologies. So many, many years ago, I founded a company called SwiftMD with the goal of you know of empowering people with the knowledge that doctors, frankly, would apply if they weren't motivated or limited, constrained by the electronic health record and what the insurance companies will pay for. Problems in the United States, frankly, elsewhere in the world as well too. So we get the we get the health care that can be paid for, but it's not necessarily the health care that we need. So what do people most want from a physician? What do physicians provide free to friends and family? But that's not the way it works in the real world. People, they can't just get advice for a doctor, they have to make a visit, they have to spend time and money in order to get what they most need. And it's a tragedy. My managed care and Medicare, frankly, my perspective, don't care. Because this device that we all have in our pockets is capable of managing with us almost all for healthcare for nothing. But if people could have technology at home that would allow them to better assess their healthcare. And if and if we would allow, empower people and the and the technology to make decisions for those common medical problems, the healthcare savings would be enormous. I'll give two examples. The most common traumatic injury in the company is actually something minor. It's an ankle sprain. And what do people want to know about an ankle sprain? Do I need an X-ray? Well, if you can stand on the leg, it's going to hurt, but you can stand on the injured leg. If you can take three steps without falling over, if you're not tender over the lateral part of the fifth metatosalope, which will be shown in a diagram easily, 99.5% chance it's not broken. So just put an ice back on it. But what how does the healthcare system actually work? Well, again, if a friend calls me up, I'll give them that advice over the phone. But if someone goes to an ER, an urgent care center, or the family doctor, they'll get examined. And then they'll get an X-ray. Because we have to be absolutely certain there's not there's no problem there. And if the X-ray is negative, they're still going to put an immobilizing device on it. And then they'll want to see you again. Well, all those things cost money and time for something that something that should actually be free. Why can't a woman get a prescription without having to see a doctor for a yeast infection or for a common uretract infection? Two things that affect all women pretty much some several times in the course of their lives. We end up mis and we have a mismatch in the healthcare system between the resource and the problem. Technology should be solving most of the common medical problems, but even the doctors take care of people who genuinely need to be seen by them. So I guess I've digressed a little bit, Chris, but that's you know, I really I'm really interested in helping giving people knowledge at home that uh that will keep them out of away away from doctors. So that said, about four years ago a urology professor uh came to me and said, You want to count the number of nocturnal erections that men have. And I said essentially, WGF basically, why do we care about nocturnal erections? He said, Well, uh the opinions of the canary in the coal mine of cardiovascular disease, and nocturnal erections are a leading indicator of a man's cardiovascular health. And that kind of took me aback because one, I was ignorant about this, and two, uh, what would motivate men to improve their their health more than their sexual than their sexual function? But men care a lot more about their sexual performance than they do about some fluctuation of their blood pressure or the lipoproteins. And frankly, the blood pressure and lip proteins are not even leading indicators. They're associations with disease. High blood pressure associated with stroke, for example. It's not predictive, though. Unless your numbers are really extraordinary. If you know if your blood pressure goes from 130 over 80 to you know 150 over 90, it's a signal that might be some that might be a problem, but it's not predicting a problem. Whereas if a man's nocturnal erections come down by 50% and are consistently down, that man has an up to 50% chance of having a cardiovascular event for the next two to two to three years. Well that that's that's predictive. So for for sort of a men to have technology at home that will allow them to assess their the duration, firmness, and number nocturnal erections, that would be profoundly valuable. And then so this so this doctor challenged me a way of coming up with that, and we invented the tech ring, which is the world's first smart smart wearable for the assessment of men's sexual health and their cardiovascular health. And we've had two men, we've had three men get cardiovascular cardiovascularizations that we're aware of, and the technology has revealed that the leading cause of rectile dysfunction in men is not what the doctors thought it was. We've documented out some hundred thirty-seven thousand erections on 4,000 men. We have the world's largest database now at men's sexual health. And the potential impact of this data, not just on improving cardiovascular health and inspiring men to comply with their diabetes regimen, take their hypertension pills, lose weight, be cardiovascular fit, but the potential to for people not just to have a better health span, but to have a better sex span is enormous. We all would like to enjoy longer lives of love making. And if we're enjoying longer lives of love making, we're also going to get all the other benefits of sexual health, uh, which are you don't have sexual health without cardiovascular health. Your immune system is improves with sexual health. Men who have sex regularly, and we're looking three or more times three or more times a week, having working out three more times a week, reduce their cortisol levels by up to 50%. That's the stress hormone. Uh we know from a huge study in the United Kingdom of men over the age of 70, that men over the age of 70 who have sex three times a week versus less than two or three times a month, they decrease their risk of sudden cardiac death, excuse me, cardiovascular major cardiovascular events, a heart attack, sudden death, angina by up to 50%. Uh and most important, perhaps just as importantly, we know that um and there's a reduction in uh prostate risk of prostate cancer cancer with by having at least one orgasm a week. Couples stay together. And one you know, one of the big concerns in our society today is disintegrating family. Divorce rate, as you know, is you know, is is enormous. And the impact of divorce on the children is the children in a divorced couple, the children are more likely to become alcoholics, do drugs, become criminals, not finish college, have lower incomes. I'm not saying people can't successfully single parent, but it's hard. And the benefit to people having couples that have sex in a committed relationship uh three times a week versus those that have sex less than three times a month, separation rate goes down by 50 percent. And so the impact would be enormous. So when when this doctor approached me with this with this with this technology, I might just mind start to spin about the possible benefits of it.

SPEAKER_00: 7:15

Yeah, and relating that to the Parkinson's audience, there's a lot of people with Parkinson's with rigidity and stiffness. And a lot of times we don't think about our sexual health and and in terms of the caregiver as well. So can you talk a little bit about how the device that you have at FirmTech can help Parkinson's patients and their caregivers? Because I think that's one thing that often gets overlooked is that people sexual health is kind of when people talk about sex, it almost becomes like a taboo. People don't want to talk about it. But it does like you, as you mentioned, it plays uh an important role in intimacy, mental health, and overall cardiovascular fitness and and other things as well. So can you talk about how your firm tech product can relate to people that have Parkinson's andor their caregivers?

SPEAKER_01: 8:00

Sure. Well, the you know, uh I'll just give a personal act. My father developed Parkinson's in his late years, and my mother regarded them almost like almost like damaged goods. And he would complain to me about the impact upon the intimacy and their relationship as a consequence of his getting Parkinson's. And also there are medications people take on part with Parkinson's that can have an impact upon them upon their sexual performance. So the value of the device is it gives people data not just about their cardiovascular health, but about whether they whether um about the impact of the the disease and upon but maybe more specifically medications upon their sexual health. I'll I'll just pick up myself. I'm 72 years old. I have a certain, you know, I I average four nocturnal erections per night, they're a certain duration of firmness. Uh if I start taking medicine or if I develop Parkinson's, I would want to know what's what's the impact upon my sexual health. Am I still able to perform sexually or the what's the right doses of these medications and their uh in their potential impact upon my upon my sexual health? And and then the the the obvious benefit in a relationship. Some because men and soon we're gonna we're developing device for women as well too. The fact that people have a significant chronic illness doesn't mean this that their sexual health and their sex and their passive intimacy has been so you were you were saying about your father with Parkinson's and taking medications and yeah, I mean I mean he f he felt that he felt he that he that he could that he was still enjoying sexual activity, but my my mother regarded him with some of his motor disorders as being, in his words, damaged. Uh and uh, you know, he felt you know impacted he was very stressed because he had Parkinson's and he f and it you know and he felt increased stress because of this withdrawal, you know, of intimacy from their their relationship. I mean the relationship between Parkinson's and E.D. is, you know, is interesting. And not much is really, you know, really known about. I mean it's felt the incidence of erectile dysfunction is felt to be twice as high as I recall among uh men with Parkinson's as among men of equivalent age uh overall health. Well, is that true? I mean it's that because those those are being reported by uh you know with with subjective questionnaires. Our device can actually say, well, is that really true? So I I would love to have a Parkinson's researcher actually utilize our tech our technology to further assess that, you know, whether whether that that is the case. There have also, as I recall, been reports in the medical journals about ED, about rectile dysfunction being an early sign of Parkinson's disease, not just cardiovascular disease. Well, those reports are are retrospective. They have to do with men who develop Parkinson's saying, oh yeah, well, whatever, I don't recall the study exactly, but yes, six months ago or a year ago I started to develop a rectile dysfunction. But that's subjective reporting. And so with our device, men could actually see whether whether they eventually develop Parkinson's or a cardiovascular problem, they can actually see, I I'm ha I'm developing a problem. The great thing about the the wearable technologies is that the goal is to see a problem before it becomes a much larger problem, much more difficult, you know, to more difficult to treat. We're all on the road, all of us, all men, but we're all on the road from erectile fitness, if you will, to erectile dysfunction. And we all would like to know, well, well, where am I on that road? Or I'd like to slow down, I'd like to make a U-turn. But we can't we can't lay under the hood. We don't have we don't have any data. We're drive, we're driving without data. So it's no wonder breakdowns and you know and crashes crashes occur. So our technology gives men and healthcare providers uh data, a dashboard, it tells them where they are. So with our technology, I mean we have 4,000 men in database, and most of those men between the ages of 45 and 70. So with our database, men get compared to a thousand men or more men, five years old than them, or five years younger than them, and then they know where I'm am I in comparison to these other men, and where am I in comparison to the two optimal men, to men who've optimized their sexual health in in this category? You know, I think the technology on the research side would be really valuable for physicians who are researching Parkinson's because they can figure out is this an early, is he is the an early warning sign of Parkinson's? Um and what's the impact of the medications? You know, the uh are the are the dopamine agents are they restoring sexual function? We don't know. What's the right what's the right dose that might you know be that might help to restore sexual function? And with men like my father, uh I think the value would be, okay, I'm having these these these motor problems, and it's harder for me to to to make love because the because of these motor you know motor issues, but I still can make love. Let's work you know with the partners. Let's you know, let's work you know work work work this out. Let's not be frightened of this. Let's try to try to work this out. Uh, I know it's been reported that Syldanophil Viagra is particularly effective at treating rectal dysfunction in men with Parkinson's. Well, what's the right dose? Is it objectively working? Um and that can be worked on with this technology. And the same thing with testosterone replacement therapy, which I think is controversial. I don't know why. By the way, but it seems to me that that testosterone placement therapy probably for all aging men is is beneficial and that it some or other be controversial because Parkinson's disease is something that I don't understand, Chris.

SPEAKER_00: 13:10

Aaron Powell So if if people are interested, how is how is your device different from somebody taking a medication like Viagra or Cialis? Because a lot of times pe people say, well, it's it's easy to it's easier for me just to take a pill or whatever if I'm having issues. So can you talk a little bit about how your product is different?

SPEAKER_01: 13:30

Aaron Ross Powell Because the pill actually is not that effective. It's easy, but it's not that effective. So if you go back to the original Pfizer application to uh for sodanophil um generic the FDA, there was I as I recall, there were seven studies, two of which showed no more benefit than placebo. One showed significant benefit 70 percent, but that was in men who had prostate surgery. And that group should have been excluded because that they most men don't have don't haven't had prostate surgery. And there were four studies that showed benefit 35 to 40 percent range. Well the cutter for placebo is 30 percent. Uh and so the benefit of of uh of Viagra is valuable in men who have uh arterial insufficiency. They're not getting blood into their penis, usually because of hypertension or diabetes, they're just not gonna get the blood flow in. And it's small, but it's you know it it's significant. But the vast majority of men as they get older, that's not their problem. It's keeping blood in. And this is what the you know, with this large large database we have, it's shown that what the doctors were thinking was the major cause of erectile dysfunction, they thought it was going to be heart failure, arterial insufficiency. Heart failure meaning men with angina, heart attacks, heart failure, conditions of that nature, or hypertension, diabetes, or athosclerosis, narrowing their arteries, not getting blood to the penis. But the vast majority of men, their disease, their heart disease, cardiovascular disease, is not sufficiently advanced to have an impact upon their erections. This is surprising to me, it's surprising to the academic urologist, world leading urologists on a scientific advisory board. As the incidence of erectile dysfunction goes up 10% per decade, by my age, it's 70%. The expectation was that the number of nocturnal erections will come down, firms' nocturnal erections will come down, and the firms' sex erection will come down. But we only we're seeing a little bit of tapering in the 60s and 70s, early 60s and early 70s. Not enough of a tapering, though, that men should be reporting erectile dysfunction. Well, it turns out these guys don't have dysfunction. What they have is are fading erections of aging. So the problem is on the venous side of the circulation. Doctors tend to go where they get data. So we can get data about heart function, we can get data about narrowing of arteries, we can't get data about the deterioration of smooth muscle function and hardening of the venules. How does what do I mean by that? I'll I'll draw an analogy. I'm 70 years old. If I get on a plane to visit my family in Stockholm, Sweden, sit on a plane for eight, ten hours, my rings get a little tight, my socks get a little bit tight. That didn't happen to me when I was 25 or 30 years old, probably didn't happen to you at 25 or 30 years old either. Right. Because at that age, the smooth muscles around our veins are strong and our veins are healthy and they pump blood back to the heart. As we get older, they they weaken with aging, um, and they need support. So if a man is getting an erection, yeah, putting more blood in is helpful to sustain that erection. But the major thing that'll help sustain that erection is some mechanical collusions. So what our device does is it compresses the superficial veins and provides that support. It gives men uh a longer-lasting erection. It also restores confidence because if a man gets an erection and loses it for whatever reason, you know, uh he's worried about paying the mortgage, he's worried about his grandkids, he's taking medications that we doctors prescribe that can interfere with sexual function, hypertensive, certain antihypertensites, antidepressants, anti-anxiety medications, whatever the reason is, if he's getting an erection, the goal, the primary goal of therapy should be to keep the blood in. And only there's no pill that will do that. Only a ring will do that. And that's a surprising conclusion, but that the data clearly shows that. And if you told me Chris four years ago when I started getting involved in this project, uh, that I would be promoting erection rings on a Parkinson podcast about Parkinson's disease and erectile dysfunction, I would have said, Really? I I wouldn't I wouldn't have believed it. Um now um but now the evidence is is is clear. And there are I know whether probably eight or nine published papers about the value of our device in helping men with erectile dysfunction, but it really isn't dysfunction. We shouldn't even I'm kind of at war with that word because this yeah, if a man struggles to get erection, can't obtain erection, just some Mount Parkinson's disease, man, in the general population, that's but it's only 10 to 12 percent of the of the population. That's dysfunction. That's a problem that needs to be assessed by a cardiologist and a urologist. But if a man gets an erection, or if a man has healthy nocturnal erections, or nocturnal erections at least indicate he's getting significant blood flow into his penis at night, then that is that that's not really the dysfunction. It's a problem. It's a problem that can be addressed by a ring and a pill. If a man wants to optimize his if my man can get an erection and loses it, he wants to optimize his performance. The ring should be probably first-line therapy along with the pill, though. I don't want to take away from the value of a Viagra, especially for the Parkinson's population, because there are studies that indicate its effectiveness in treating ED with Melbourne's. But they mention should also consider putting a ring on it, because Viagra puts more blood in, but it doesn't keep it there. And the ring and rectional ring will keep it there. Also, memo Parkinson's. Go ahead, talk, Chris.

SPEAKER_00: 18:22

Oh, I just wanted to ask you in terms of that, there's a a large percentage of people with Parkinson's that have anxiety and depression, which I'm sure is going to be related to sexual health as well. Do you have available, is that gonna would that be able to help people with Parkinson's that that also suffer from anxiety and depression? Or there's no data on that?

SPEAKER_01: 18:41

There's not there's we don't have you know, we don't have any data on uh men with Parkinson's. And again, I we make our device available free for researchers. I hope some researchers are listening in right now and will and will you know feel interested in reaching out to me and discussing research research opportunities, subjects for research. But to generally project from the general population to your point, the number one issue for men is is performance anxiety, is is confidence, impacted by other factors, could be impacted by worries that don't relate to sex, you know, can't pay the mortgage or medications that we doctors prescribe. The man loses his erection several times, it it has an epistemic impact upon upon their their confidence, their mental health. I mean, a background emergency medicine doctor, uh short of a heart attack or a stroke, there are a few things that alarm a man as much as sexual fail repeated sexual failure. Back in the back in the 90s when Viagra first came out, uh only urologists could prescribe, but man restricted to 10 pills a month. We had guys come into the ER on Friday and Saturday nights, like around midnight, you know, looking looking for Viagra because they had they had a problem and they and their alarm. For men with Parkinson's, if if they have if they're getting nocturnal erections, you won't know that without the data, and or you're getting you're getting erections but you're but you're losing them, the ring the ring will help you. I guess the question I have is helping with conference because the ring is going to keep you hard. And a man who's staying hard is in a very different mental state about anxiety than a guy who's losing his erection. Sorry I interrupted you.

SPEAKER_00: 20:13

Oh, that's okay. I was just thinking a lot of times sexual health is something that's difficult for a lot of people to talk about. So for people with Parkinson's, do you have any suggestions on how they might approach using using the firm tech device or talking to their care partner about sexual health and and their feelings?

SPEAKER_01: 20:30

Yeah, if that's a difficult question. I because every every relationship is different, but in a sense of our relationship is also the same and that people people need to communicate about about these about these subjects. And uh given the given the importance to uh sex of sexual performance, to mental health, and to the and to the uh intimacy we can get in a relationship, don't think the men with Parkinson's should should should give up on this. They need to you know they need to communicate with their partners that they want want to figure they want to continue to make love and they want to figure out how to do this most effectively. And obviously, if it's a mode of disorder, people need to communicate about what positions are going to work if on the other hand, the it's also important to get the data because a man is struggling, is is losing his erections, or even not getting them, to have the not the nocturnal data and see whether the potential is there to have erections. Because a man again, if a man is having uh two or more nocturnal erections per night and there's maybe one to ten scale, and the strength is is is greater than five or five or five point five, that man can still perform sexually. Uh, and that's very reassuring to the man. It's also something that obviously needs to communicate to his partner. I think that most practitioners, most doctors are are unaware of our technology, especially if they're not they're not out of the field of your of urology. Uh and you know, if they want to learn about it, it's something it's up to the patients to educate about it. Doctors don't like that. Patients, every all patients today, most old patients they go online, and doctors need to no longer have uh doctors need to accept the fact that their authority is no longer unquestionable, uh, and that the patients actually can educate them. That's a difficult conversation as well too. But I think it really starts it really starts with the with the with the with the with the relationship between the man. What are your goals? How can you achieve those goals? The goal is to is to continue to make love, getting data is valuable, the utilization of rings in addition to Viagra is is valuable. So I think the FREMP FRIPTEC can help these people.

SPEAKER_00: 22:27

So is your is your device considered a commercial product or is it uh an FDA regulated medical device?

SPEAKER_01: 22:35

Both. Um so we are it's technically, uh legally rather, it's a class two medical device and K-waved. And what does that mean? That means that we're approved by the FDA for safety. We're not approved by efficacy. We can't claim that we are a diagnostic, for example. And I use it not it's some degree it's quite getting full approval. Well, we do we are covered by FSAs and HSA plans, all the blues. In order to do that, we have to address the 510 K waved issue. We have to demonstrate efficacy, which is why we've been doing one of the reasons why we're having all this research performed and that there are several published papers about our device and its safety, its efficacy. Uh and we so we need to apply for to get that become a full class two medical device. But we're it's expensive. I know I I mean in Chris in the fantasy world, the FDA would come to me and say, hey, what you're doing is really great. How can we help how can we help you move this forward? But you and I both know that's not that's not the real world. I have to pay lawyers uh and I have to wait for things to get processed. So we're we're coming out with a version 2.0 of the of the tech ring probably next summer. Uh we're adding additional sensors uh that will increase its sensitivity and specificity. Also that will tell us about cardiac rhythm at night, give us other information. Uh so we're saving our money for that application.

SPEAKER_00: 23:47

So are there clinical studies that are being conducted to to support efficacy or yeah, many.

SPEAKER_01: 23:52

I mean I mean if you if you if you go to myframfric.com and click on the science section, you'll see them. So the gold standard for um assessing what's called nocturnal penile tumescence NPT, the gold standard is a device called the RIGISCAN, and it's falling out of favor in the United States because they cost$16,000. You basically have to go to a sleep lab and stay overnight. Our device can be used at home under real life circumstances. But the rip the readings of the RIGIS can regard as the standard in assessing sexual health by looking at nocturnal erections. And there are three papers. Um that one was in Japan, it's been presented. There's another large study that's being conducted in Egypt uh that's going to be presented at the NASA science for sexual medicine in uh in February. It's gonna have over 100 patients in it. And and and there's a third one going on in in Spain. These studies all show that our device is I've seen the I've seen the preliminary data. They show that our device is as accurate as the REGIS can this old gold standard. Urologists also use um a Doppler or ultrasound in the office to look at sexual function. It's limited because it's not being done under realized circumstances at home, it's not looking at nocturnal erectus overnight. And there are two papers, one's at the University of Utah, the other one's at Baylor, uh, that that that are that are looking at this and the data is positive. So all these um and there are studies looking at utilizing our device to to uh give tell people what the right dose of uh PD5 medication is, that's why I owe us. Do you even need it? You know, if a man has four nocturnal erectins per night, the pill's treating his head, which is fine, but the placebo effect is really powerful. Uh you know, what we do with with with with those medications right now is we just give people a pill. I mean, if a man with Parkinson's goes to a doctor and says that he has uh erectile dysfunction, they hardly ask any questions. They should ask, is there trouble that you can't take erection or you get an erection and you lose it? Because most of them get erection, they lose it. But the doctor will just give them a pill. What's the right dose? We don't treat blood pressure that day. We don't treat blood pressure without a blood pressure machine. We don't treat cardiac arrhythmias without electrocardiogram or a hold of monitor. But some in the area of men's sexual health, we just give out pills. And that's just not scientific. We want to take health care in the 21st century, sexual health care, the 21st century of objective, actionable, most important personal data, because we're all we're we're all different. So yes, the research is being done on whether we apply next summer to the FDA for the for version 2.2 to the device. I'm confident that we will achieve regulatory recognition by the FDA as a diagnostic, but then we have to go to Medicare and the Blues, Medicaid, and apply for them to cover it. It's it'll be two years, Chris.

SPEAKER_00: 26:25

Okay. No, you brought up an interesting point in terms of the device, but you also talked about medication. And I think that's one thing that, at least from my experience, is when you go to the doctor, that's one thing they don't typically ask about is sexual health, unless the patient brings it up. Why, from your perspective as a physician, why do you think that is?

SPEAKER_01: 26:44

It's to my mind, it's the word stupid and and and uncaring. So why is that? Well, you can say culturally where we're still, you know, a pruder society. That's not really true, though. Maybe doctors are. And doctors, so there I think there's several issues here. One, there's no money in it. So the whole health care right now is driven by the electronic health record. People get the care that can bill for, as I indicated earlier. Not necessarily the care that they that they need or want, but the care that can be billed for. So if I'm examining, I'm putting myself in either in in like an internal medical situation. If I'm seeing my my a Medicare patient, I don't make any, I have to have to examine or have to quit. On history, I have to query a certain number of systems. In the physical part, I have to examine a certain number of systems in order to maximize my reimbursement. There's no box for asking questions about sexual health. There's no box for examining sexual organs. So there's no financial incentive. Whatever, however, the point is how we're pretty dish, people don't want to talk about it, doctors don't want to talk about it. Uh the fundamental problem is there's no money in it. If there's money in for the doctors, every man, every woman will be asked questions about their sexual health. And sexual health is so important to our overall health. It's really appalling. The other area is doctors today don't want to spend any time with people. They don't make money that way. Average doctor, well, I'll I just focus on one study in urology done by Dr. John Mobwall, who I really admire. He's more so a cataract in New York. And he did a study looking at how long a urologist spends with a patient, talking with them. Seven minutes. Well, it's not a lot of time. So you're not going to really find out details. I'll give you an example. One, if you can ask what is a man's problem, is he can't tain erection or that he loses erection, both those situations need to lead to f to other questions as to what under what circumstances, what's going on with your partner, is it alcohol, drugs, well, you what what what else is going on? It's it it's 15-20 minutes to really take a good sexual sexual history. And the doctors don't want to do it. They're too busy, there's no money in it for them, and it's wrong. Trevor Burrus, Jr.

SPEAKER_00: 28:39

Yeah, I just thought that was interesting because that's I'm glad you provided the that perspective because a lot of times you don't get asked that when you go to the physician's office. And I d I was just wondering why that is. And because it is such an whether you have Parkinson's or not, it's such an important part of relationships and mental health and just overall fitness as well.

SPEAKER_01: 28:56

Aaron Powell Let's compare it to another problem. If I if you're all I told the doctor, I feel short of breath, the electronic health record is going to give them a list of things, conditions to rule out, a list of questions to ask. When a c man if man sells a doctor, he has ED, there's nothing. So it's you know, I I I wasn't thinking about this four years ago because I wasn't involved in the sector of health, and now it now it's it's just a glaring gap.

SPEAKER_00: 29:18

Yeah, it does make sense. So to switch gears a little bit, can you tell us a little bit about how your product works and then uh where do they have to see a urologist to get a prescription, or is this something that they can get over the counter? Sure.

SPEAKER_01: 29:32

So basically we we've embedded sensors into an erection ring. I don't like the phrase cock ring because that puts it in the one, may sound like a sex toy, a novelty. Two, it's really an erection ring because it's giving you data about your erections and it helps this to sustain along your erections. You get men with our device will get harder and will uh and will last longer uh and will have more intense orgasms because of the nature of the form. Then it sends us into a ring, one of a night. We count the number of nocturneal erections and men have the duration and firmness. 90% plus of men have have no problem with the technology. 8 to 10% of men statistically either say it's uncomfortable or they have difficulty with the app. You know, we're men, we tend we just want to put things on and have them work right away. A lot of guys don't read the instructions. Not a lot, but eight to ten percent of men don't read the instructions. And then um, in terms of discomfort, it really we encourage those men, hey, we're just wear around the house for a few hours. Forget about the data. Because men are not where used to sleep with things on their body. Women are. And yes, the device will if you gotta pull your pubic hair out of the way or trim it, or you have, or you um, I don't know, old men have probably noticed that women adjust their bras throughout the day. Someone someone launched in the fashion industry told me it's eight to ten times a day a woman will adjust, you know, adjust the bra. Well, why is that? Because the bar has silicone in it and it's pulling on, you know, kind of pulls on the skin, and the women just pull re-re-stretch it. Same thing with our device too. If you're wearing it over, I mean, I'll talk for myself. Well, you know, sometimes when we're using it, I wake up at three or four o'clock in the morning and it's like irritating me. Well, I just unhook it, re-hook it, reposition it, and the problem goes away. So the vast majority of men, now we're talking about 99, 99.8% of men after two or three uses, I you know, are you are comfortable with with wearing it overnight. So you can learn more about the device by going to my firm tech, M Y F I R M T C H dot com. Click on the sign section. If there are people out there that want to reach me personally, uh just reach I'm at Elliot Yell L Io T at MyFermtech.com. And I might I spend about four or five hours a week just answering questions from doctors or from or from custom potential customers, men about their sexual health. And go ahead, Chris.

SPEAKER_00: 31:41

I was just gonna say, based on what you're saying, it's continuously monitoring data while you sleep, and it's transferring that to an app then which you can you can transmit.

SPEAKER_01: 31:53

It's an easy to use app. It's Bluetooth enabled. The Bluetooth is often on your body because it because it concerns about radiation. This device we all carry around is is is much more dangerous than a little bit of Bluetooth in our in a in in our erection. Uh yeah, it's Bluetooth enabled. We provide notifications. Hey, it could be, hey Elliot, your your nocturnal erections are 20% less hard this month as they were last month. Have you had a change of medication? If this problem persists, you should see a doctor. Or it could be a positive something positive. It could be, hey, Elliot, your your sex erections, your sex duration is approved by 20%. No. Way to go, what's changed, you know, in in in in in your life. And on the account page, people can actually put in the name of their doctor or doctors so that the doctors can get their data. All of the data points have graphs associated with. So it's not just, hey, last night I had X number of nocturnal erections. Here's your trend over time.

SPEAKER_00: 32:49

Now, is there an age age limit or age range for the device? Because some people develop early onset Parkinson's, and then uh there's other people that are in their 70s and 80s, or is this convenient by a few years?

SPEAKER_01: 33:03

We have men in the database from 24 to 82, the vast majority of men being in the age group that you're concerned with with Parkinson's, which is men in their late 40s to their late 70s, that's where the the that no, I would say probably three-quarters of the men are in that, maybe like seven days of men are that age group.

SPEAKER_00: 33:20

Okay. And so to get the device, how would if someone in the audience that has Parkinson says, hey, I want to get the device, and do it, do they have to contact their urologist or do can they go to your website? How does that work?

SPEAKER_01: 33:34

It's direct, it's direct to consumer, like many consumer wellness products. You know, if you want a blood pressure cost or a digital scale or a pulse oximeter, you don't need a doctor's prescription. Uh we're not covered by Medicare. We are if you have a FSA or an HSA plan, you can it'll pay for it. Uh, we're not yet covered by Medicare. I said earlier earlier, I think it's gonna take two years. So you don't you don't need a prescription. It's oh you know, oh it's essentially over the over the counter online because most of our business.

SPEAKER_00: 33:59

Okay. And they would just go to the website and order it, and then it's it's delivered. You know, I guess from from my perspective, it's no different than ha wearing an Apple Watch that that's collecting data. It'll tell you w exercise where there's uh a lot of different Parkinson's apps out there that you can use that that'll measure your motor symptoms and collect data. So this is really no different than than that. It's just helping you with your your sexual and your emotional well-being.

SPEAKER_01: 34:27

Yeah, well we but we live, Chris, in this incredible age of healthcare wearables, even down to sectors, if you will, with Parkinson's. But there's a gap, and that gap is sex. And what's more important to most people that's not, you know, uh so it's really giving people the vital signs of their most vital organ. And and again, I'll go back to my father. It was frustrating to him when he was regarded as being damaged when because he had Parkinson's. He wanted to have have continued intimacy despite his motor, you know, you know, issues, but he didn't get any support from his his wife or from his doctors about this. It was just to your point, uh no one asked him about it. I'm his doctor's son, so he discussed it with me, but never discussed it with his doctor. His doctor never raised with him. He he was getting a particular message from his wife about, you know, well, you're you're ill now. And so we need to be more open about these things and recognize the importance of sex uh points of sexual health and intimacy to people's overall well-being.

SPEAKER_00: 35:21

Yeah, whether you have Parkinson's or not, I think that it's important and and uh you know, and it it also helps the caregiver as well, because sometimes I guess they have to switch roles from caregiver to intimacy partner, and and sometimes that maybe can be difficult as well.

SPEAKER_01: 35:37

Yes, yeah. And and and and Chris, it's you know, people sh I really it behooves the doctors and they and they won't do it to ask about this because it's so important.

SPEAKER_00: 35:47

So if you could leave the audience with uh two key takeaways from our discussion today, what would they be?

SPEAKER_01: 35:53

If you're if you're concerned about your sexual health, and all all men should be, whether they have Parkinson's, don't have Parkinson's, and you're over the age of 45, 50, you should get the data about your sexual health just the way if you go to a doctor, you expect them to get data about your heart. I want electrocardial. You know, go into a doctor my age or your age, Chris, and they say, Hey Chris, you look good. See you next year. No, you would expect to get baseline, electrocardiogram, little proteins, and anti-inflammatory markers, a whole series of tests to establish a baseline so we have a problem, we can then measure, assess the difference. It's the same thing with sexual health. So my first message should be if you're over the age of 45 or 50, get the data for your sexual health. If you want to optimize your performance, whether you have performance and pleasure, whether you have ED or don't have ED, whether you have Parkinson's or don't have Parkinson's, a ring is as effective, if not more effective, than Tadalaphil, Cyalis in two studies. But both the more but both work really well together. The PD5 medications were aggregate and to Dalaphil, they put more blood in. The ring helps to keep it there. We need to think about rings not as crutches, but as optimizers. So get get the ring for data, get a ring for your performance.

SPEAKER_00: 37:00

Yeah, it's just like any other technology that's out there. I mean, like we talked about the Apple Watch or any other type of watch or you know, some of the other apps out there that that track things. So to plug your product, how would you again just tell people here's here's where you can get the product, here's where you can go if you have questions, where would they go?

SPEAKER_01: 37:18

Sure. Go to myfront tech, m y-f-i-r-m t-c-h.com. Uh if you want to get answers to your question specifically, either you can go to the science section or you go to customer service at myfreptech.com, or you can reach me directly at L at MyFreamTech.

SPEAKER_00: 37:35

Great. Well, I want to thank you for being on today because I I really think this is an important topic that doesn't get addressed, especially with dealing with the Parkinson's community. But a lot of times people think, well, I'm I'm dealing with my motor symptoms and the other non-motor symptoms. This but sexual health is also an important piece of that for to maintain good mental health and intimacy with your your partner or and and or caregiver and just overall health. So I I think this was an important discussion, and I want to thank you for being on the show today.

SPEAKER_01: 38:04

Chris, well, thanks so much for having me. I really welcome the opportunity.

SPEAKER_00: 38:07

And uh, if uh people have any questions, I'll make sure I point them in your direction. So again, thanks for being on. I'll pr appreciate it. Thank you. Thanks.