Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.
In this segment, Dr. Mistry and Donna Lee talk about the differences between low libido and erectile dysfunction. Dr. Mistry's favorite metaphor for this distinction is his golf analogy: if you aren't good at golf, you probably won't want to play. But if you could take a magic pill to improve your game, you'd be more likely to want to hit the green! It's similar with sex--if you're afraid of how you'll perform (especially if erectile dysfunction is in the mix), your desire for sex will likely decrease as well. Luckily, there are many things you can do to improve your sex life! No matter what is cramping your style, a holistic approach to sexual health is always a good bet. At NAU Urology Specialists, we offer the full range of treatments for sexual dysfunction, from sex therapy to natural and pharmaceutical hormone supplements to wellness plans and pelvic floor physical therapy. The thing many people don't realize is that both men's and women's sexual health is interconnected to other aspects of their wellness--from self-esteem to lifestyle factors to stress, there are so many things that can impact our sex lives. That is why you need a holistic practitioner who can determine your exact needs and get you on a better path!
Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
We enjoy hearing from you! Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode!
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Speaker 1:
Welcome to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.
Dr. Mistry:
Hello, and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my very energetic, appreciative and funny co- host, Donna Lee.
Donna Lee:
That's right. That's me. I'm very energetic today.
Dr. Mistry:
Donna has been the head honcho here at our little organization...
Donna Lee:
I have?
Dr. Mistry:
...for some time.
Donna Lee:
I thought you were the head honcho.
Dr. Mistry:
Well, I mean, we've got to put, you know, a pretty face in front of everybody.
Donna Lee:
I'm a head honcha.
Dr. Mistry:
Hancha. Donna has been responsible for so much of the growth of the, of the organization, and then just giving us such a great personality and keeping our patients so well motivated and keeping our employees well motivated. And we love how committed you are to it.
Donna Lee:
Aww. Is there a, but coming?
Dr. Mistry:
No.
Donna Lee:
Oh, that's so sweet!
Dr. Mistry:
I'm always about the butt stuff, but...
Donna Lee:
But not today.
Dr. Mistry:
This is a show that's brought to you by the practice that I started in 2007, NAU Urology Specialists. I'm a board certified urologist. For those of you that don't know what a urologist is, it is a surgeon, number one, trained in treating the kidneys, bladder, prostate, penis, prostate--I said prostate twice.
Donna Lee:
You did.
Dr. Mistry:
Maybe because it's pretty important.
Donna Lee:
Must be.
Dr. Mistry:
We go down to, we deal with fertility issues. We deal with lots of hormone issues like testosterone. And we deal with erectile function, we deal with kidney stones and bladder cancer, bladder problems, prostate cancer, prostate problems. But what we've done here in our clinic is try to take it that extra notch, which is we've, we try to bring in integrative nutrition, we try to make sure that your biomechanics or your pelvic floor well taken care of, and we introduce supplements, diet and nutrition plans, really to kind of take care of the whole person.
Donna Lee:
Yup. You know, when I started with you four years ago, and you said, we talked about urology, obviously, all the time. I always just equated that to surgery--surgery, surgery, surgery, and I thought you did surgery like on every single patient. And so when I started to learn that you take this holistic approach and you didn't do surgery on everybody, it's like,"Oh, that's refreshing!"
Dr. Mistry:
And no one's more surprised than me because you know, I love to operate. And if you find a surgeon that doesn't like to operate, or doesn't believe in medicine, or doesn't want his kids to go into medicine, I'd be like,"Maybe I'll find somebody else." Because I'm passionate about what I do, and I love so much of the medicine that we practice. And what really motivated our entry into this more holistic type of care had to do with my impression of how poorly cared for testosterone patients were. And I bet you, if you're a guy out there, you, or you know somebody on testosterone.
Donna Lee:
Right. Or that wants testosterone.
Dr. Mistry:
I mean...
Donna Lee:
Everybody wants it.
Dr. Mistry:
Half the firefighters out there, you know, a bunch of police officers, a lot of men over the age of 40, even some younger people in their twenties are on testosterone or have had it checked, or these others, these centers out there, these low T centers and stuff like that wouldn't exist if there wasn't so much interest.
Donna Lee:
Right. You know, that's true. We can talk about myths versus facts.
Dr. Mistry:
Yeah. Why don't you go with it?
Donna Lee:
Well, I always get, when I answer phones, when we were a little low staffed or the phones need a little help, I'll pick up the phone and every time there's always a patient who's in the complaint is,"My libido..."
Dr. Mistry:
No, no, no. Wait, wait, wait. Do your impression.
Donna Lee:
Oh, my impression. The guy calls and he's like,"Um yeah, uh, I don't seem to have a sex drive and my libido is low. Can I get on some testosterone?" And I'm like,"Oh, sure..."
Dr. Mistry:
"I'm Dr. Donna."
Donna Lee:
"I'm Dr. Donna, let me..." So I wondered if it's always the case that if they have low testosterone--I know fatigue is a problem, but is it always the case that, that the libido is low if the testosterone is low?
Dr. Mistry:
That's a great question.
Donna Lee:
I know.
Dr. Mistry:
I thought what we would talk about a little bit is libido and sex drive and what that means. So when it comes to your desire to have sex, you can imagine that there's probably a lot that goes into it, and testosterone is just one component of a broader set of things that can lead to it. And I don't want to make this too complicated, but if you don't feel good about yourself, your, your esteem to have sex is going to be a lot lower. So that's why for many men, when they start exercising, their sex drive goes up. But that's true for women to men and women, both. How they feel about themselves, whether they feel fit, whether they feel like their endurance is good. So exercise is a great one that sometimes often relates to low libido. And during the pandemic, when a lot of people stopped working out, when...did you know that sex average encounters for sex went down during the pandemic?
Donna Lee:
It did?
Dr. Mistry:
Went down.
Donna Lee:
I thought I was going to go up.
Dr. Mistry:
Can you imagine? Birth rates are down.
Donna Lee:
Really?
Dr. Mistry:
Everybody's at home doing nothing.
Donna Lee:
They're just not having sex with each other?
Dr. Mistry:
They're just not having sex because, because of all these other things.
Donna Lee:
They're like,"Get away from me!"
Dr. Mistry:
Right? The stress of the pandemic, not exercising, not eating right, drinking too much. All of a sudden what we thought was going to be this amazing, you know...
Donna Lee:
Surge?
Dr. Mistry:
Home, you know, like...
Donna Lee:
Surge of babies?
Dr. Mistry:
...just isn't coming to fruition.
Donna Lee:
That's really interesting. I didn't know that.
Dr. Mistry:
And all the surveys have indicated that acts of, you know, intercourse have gone down on average. And so, so you can't discount the importance of stress and the importance of exercise and diet on, on that. There can be the, my classic example of libido is my golf example. Right? I have no desire to play golf because I'm terrible at golf. But if you could give me a pill in which it, it made me really good at golf, I'd probably want to play golf all the time.
Donna Lee:
You'd probably take that pill.
Dr. Mistry:
Yeah. I take that pill for sure. So if you have bad erections...
Donna Lee:
You just don't want to have sex.
Dr. Mistry:
...then you're not going to want to have sex, because who wants to get in the game and fail? No one. If you have, if you have premature ejaculation, then I'll oftentimes I'll hear like,"Oh, this guy must be really excited about having sex. He's so exuberant." But no. Right? It's embarrassing to him, to his partner. You know, his partner may give him a face or a look and, you know,"Oh, that was only like seven seconds long."
Donna Lee:
Just give it 20 years of marriage. And then it'll be a relief."Aww, sweet! Premature ejaculation. I can go back to dishes."
Dr. Mistry:
This is my fav...dishes. But if you have premature--so, so the, in those cases, the treatment for low libido is nothing to do with testosterone. It's improving erections, it's reducing stress, it's going and exercising. It is fixing your premature ejaculation, which we have multiple medicines for, so...
Donna Lee:
But they're all intertwined, aren't they?
Dr. Mistry:
They're all intertwined. And I think that if you said that about a woman, he would say,"Yeah, that's probably right." She doesn't want to have sex because she's stressed about the kids, and the dishes, and you're not picking up your underwear. And I think people would be like,"Yeah, that's probably right." But the same goes true of a man. If he has a low sex drive, he could have many like things that are kind of interfering with him. And low testosterone does play a really big role. So for us, we check a couple of hormones when somebody has low libido. We check the prolactin level as well as the testosterone level. The dilemma though, is that if you have a low testosterone and a low libido and you get, get testosterone, there's no guarantee that your libido is going to get improved. And I think that a lot of men that come to us have confused libido and erections, because they kind of feel like,"If I just wanted it bad enough, you know, my little friend down there will cooperate."
Donna Lee:
Little soldier.
Dr. Mistry:
My, my big friend, my big soldier.
Donna Lee:
Yeah. Big soldier.
Dr. Mistry:
My big soldier will help, you know, help me out. But that isn't the case. Sometimes your erections are not going to get better regardless of how much you want it. And so if you have a low desire, we start first by making sure you have good erections, making sure that you're hormonally intact and make sure that we have not missed anything obvious like medication interactions, because some guys out there on antidepressants will have a low desire.
Donna Lee:
Good point. True.
Dr. Mistry:
And then if that doesn't work, then we have all these other treatments to improve your desire, believe it or not.
Donna Lee:
We do. I do believe that.
Dr. Mistry:
For, for men and women, we have a medicine that we use called Addyi or Flibanserin that works on the brain to improve desire. We have a drug called Vyleesi that works both in men and women. We, you get an injection that rapidly improves your desire.
Donna Lee:
Do you put it in your thigh, your butt, where's it going to injection go?
Dr. Mistry:
The is a sub-Q injection, so it can go in your stomach or anywhere. Okay. And then we have a number of medications that we use in an off-label way to help improve sexual desire. One of the most common ones we use Wellbutrin.
Donna Lee:
I love it when you say,"We always wish we had a Viagra for women," and then you always say...
Dr. Mistry:
"We do have Viagra for women. It's called Viagra." Because the sexual response cycle in men and women are identical in terms of what, what is, you know, arousal, what is desire, what is orgasm, what is recovery...These things are all the same. But I think that even with all these other medical treatments, having the ability to include our sex therapist in that discussion really is what takes us, you know, the whole way.
Donna Lee:
We should have the sex therapist on the show.
Dr. Mistry:
I think so.
Donna Lee:
Let's do that.
Dr. Mistry:
Yeah. I think that if you're out there and you're struggling--if you are, there's a big difference between a 22 year old guy out there with no desire to have sex and a 40 year old guy with no desire to have sex and a 60 year old guy. So you, but, and each one needs to be treated differently.
Donna Lee:
Right. Different treatment plans.
Dr. Mistry:
So the 60 year old probably responds better to testosterone more regularly. And the 20 year old probably needs more...
Donna Lee:
Porn?
Dr. Mistry:
No less porn, probably, but more sex therapy. And the 40 year old guy is just more apt to need more help with his erections.
Donna Lee:
And a nicer wife.
Dr. Mistry:
Well, we can't fix everything on this show.
Donna Lee:
We can try!
Dr. Mistry:
Donna, how do people get our advice and find us and get an appointment?
Donna Lee:
You can call us at(512) 238-0762. Our email address to send questions that will be on answered anonymously is armormenshealth@gmail.com. And our website is armormenshealth.com. Don't you think they'll remember it if I sing it?
Dr. Mistry:
Yes. Somebody tell Joe Rogan we're available for his comedy show.
Donna Lee:
That's right. We're ready to rock and roll with some comedy, and you can check out our podcasts wherever you listen to podcasts. We have been nominated for super awesome, amazing men's wellness, sex, sexual health and prostate health.
:
Thanks, dad
Speaker 1:
The armor men's health power. We'll be right back. If you have questions for Dr. Mystery, email him at armor men's health@gmail.com.