@Dr. Cristina Romero-Bosch : 我认为许多女性的性欲下降并非源于真正的兴趣丧失，而是因为她们太忙，无法抽出时间享受性生活。女性需要身心放松，才能充分投入性生活。 此外，我们还发现，许多年轻女性（20多岁）即使身体健康，也可能出现情绪低落、焦虑、肌肉增长困难、性欲低下或性高潮质量差等问题。低剂量的睾酮可以帮助她们改善这些问题，拥有更健康快乐的生活。 在激素替代疗法方面，对于女性来说，激素丸是最佳选择，因为它能维持更健康的雌二醇与雌酮比例。而对于局部问题，如阴道萎缩，雌激素霜可能有效，但对于全身性问题，则不推荐使用。注射疗法也十分有效，且依从性高，女性只需每周注射一次。 长期维持性关系的关键在于亲密关系，而不仅仅是肉体关系。随着时间的推移，外貌会发生变化，但通过关注自身健康和美丽，保持性生活，并与伴侣保持亲密关系，可以保持长久的性感。
@Dr. Johnny Robinson : 我和我的妻子从一开始就专注于整合医学，关注人体功能，特别是新陈代谢和荷尔蒙。男女患者的主要诉求都是想要更多能量和更好的性生活。 许多男性在50岁以后会经历不同程度的勃起功能障碍，其根本原因与循环问题、新陈代谢问题（如肥胖和缺乏运动）以及炎症有关。勃起功能障碍的症状从缺乏性欲开始，逐渐发展到勃起困难，最终可能完全无法勃起。 影响男性性功能的因素包括睾酮水平、性激素结合球蛋白和睾酮转化为雌激素。睾酮补充疗法通常可以克服睾酮转化为雌激素的问题，但需要监测和调整剂量。对于男性来说，注射疗法比激素丸更方便，依从性更好，我们通常采用皮下注射的方式。 近年来，勃起功能障碍的发病年龄正在提前，这与睾酮水平的下降、环境毒素、生活方式和社会因素有关。我们倡导一种以长寿为目标的整合医学方法，帮助人们过上更健康、更充实的生活，并通过治疗夫妻双方来增强夫妻关系。
我与我的妻子，两位医学博士，多年来一直致力于整合医学，关注人体功能，特别是新陈代谢和荷尔蒙在性健康中的作用。我们的临床经验表明，无论是男性还是女性，最主要的诉求都是渴望更多能量和更满意的性生活。
女性性健康：超越性欲下降的迷思
许多女性认为性欲下降是年龄或婚姻的必然结果。然而，我发现，许多女性的性欲下降并非源于真正的兴趣丧失，而是因为她们太忙，无法抽出时间享受性生活。女性需要身心放松，才能充分投入性生活。 此外，令人担忧的是，即使是年轻女性（20多岁），即使身体健康，也可能出现情绪低落、焦虑、肌肉增长困难、性欲低下或性高潮质量差等问题。低剂量的睾酮可以帮助她们改善这些问题，拥有更健康快乐的生活。
在激素替代疗法方面，对于女性来说，激素丸是最佳选择，因为它能维持更健康的雌二醇与雌酮比例。对于局部问题，如阴道萎缩，雌激素霜可能有效，但对于全身性问题，则不推荐使用。注射疗法也十分有效，且依从性高，女性只需每周注射一次。
男性性健康：勃起功能障碍及应对策略
许多男性在50岁以后会经历不同程度的勃起功能障碍，但近年来，发病年龄正在提前。这与睾酮水平的下降、环境毒素、生活方式和社会因素（例如，过度使用色情内容导致的脱敏）密切相关。勃起功能障碍的根本原因与循环问题、新陈代谢问题（如肥胖和缺乏运动）以及炎症有关。症状从缺乏性欲开始，逐渐发展到勃起困难，最终可能完全无法勃起。
影响男性性功能的因素包括睾酮水平、性激素结合球蛋白（SHBG）和睾酮转化为雌激素。睾酮水平下降是主要因素，而SHBG会结合并失活睾酮，降低其生物活性。此外，脂肪组织中的芳香化酶会将睾酮转化为雌激素，过多的雌激素也会影响性功能。睾酮补充疗法通常可以克服睾酮转化为雌激素的问题，但需要监测和调整剂量，以避免雌激素过高。对于男性来说，注射疗法比激素丸更方便，依从性更好，我们通常采用皮下注射的方式，以确保激素水平稳定。
长期关系的基石：亲密与持续的自我关爱
长期维持性关系的关键在于亲密关系，而不仅仅是肉体关系。随着时间的推移，外貌会发生变化，但这并非性吸引力的终结。通过关注自身健康和美丽，保持性生活，并与伴侣保持亲密关系，可以保持长久的性感。积极主动地寻求专业帮助，改善荷尔蒙平衡，并关注身心健康，是保持活力和性福的关键。 我们通过整合医学的方法，帮助夫妻双方共同改善健康状况，从而增强夫妻关系，并促进家庭的整体幸福。
Finding Genius Podcast⋅15h ago
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01:43 我们夫妻俩从一开始就专注于这种类型的医学，即关注人体功能的整合医学。
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02:23 我们专注于新陈代谢，这与内分泌学和生物化学有关，从我们的角度来看，这实际上是人体功能。
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03:11 男女患者比例大致相同，近年来男性患者数量显著增加。
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04:04 男女患者的主要诉求都是想要更多能量和更好的性生活。
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05:37 女性性欲下降可能是因为她们分心于太多事情，难以抽出时间进行性生活，而不是真的失去了兴趣。
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06:47 许多男性在50岁以后会经历不同程度的勃起功能障碍。
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07:31 勃起功能障碍的根本原因与循环问题、新陈代谢问题（如肥胖和缺乏运动）以及炎症有关。
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09:09 勃起功能障碍的症状从缺乏性欲开始，逐渐发展到勃起困难，最终可能完全无法勃起。
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12:12 勃起功能障碍的发病年龄正在提前，以前通常在40岁以后出现，现在20多岁就可能出现。
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12:34 多种因素导致男性睾酮水平下降，包括环境毒素、生活方式和社会因素。
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14:20 尽管社会上充斥着性，但人们却普遍缺乏亲密关系。
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14:42 长期维持性关系的关键在于亲密关系，而不仅仅是肉体关系。
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16:09 保持性感的关键在于保持性生活，并关注自身健康和美丽。
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17:04 影响男性性功能的因素包括睾酮水平、性激素结合球蛋白和睾酮转化为雌激素。
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19:32 睾酮补充疗法通常可以克服睾酮转化为雌激素的问题，但需要监测和调整剂量。
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23:31 女性性功能障碍的主要原因是睾酮缺乏。
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24:13 女性体内产生的睾酮比雌激素多，并且直接用作睾酮，而不是转化为雌激素。
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25:34 雌二醇是卵巢产生的主要雌激素，而雌酮和雌三醇则相对较弱。
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27:03 对于女性来说，激素丸是最佳的激素补充方式；对于男性来说，注射是最佳方式。
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29:27 对于局部问题，如阴道萎缩，雌激素霜可能有效；但对于全身性问题，则不推荐使用雌激素霜。
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30:41 对于男性来说，注射疗法比激素丸更方便，依从性更好。
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35:37 我们倡导一种以长寿为目标的整合医学方法，帮助人们过上更健康、更充实的生活。
00:00
Forget frequently asked questions. Common sense, common knowledge, or Google. How about advice from a real genius? 95% of people in any profession are good enough to be qualified and licensed. 5% go above and beyond. They become very good at what they do, but only 0.1%. 语法解析
00:16
Hello, this is Richard Jacobs with the Finding Genius podcast. I have two guests today, a husband and wife, Dr. Christina Romero-Bosch. She's a medical officer. 语法解析
00:45
and Dr. Johnny Robinson. He's a chief medical officer, naturopathic medical doctor that specializes in hormone replacement technology called HRT, abbreviated that way sometimes, anti-aging medicine, functional medicine, and longevity medicine. So we're going to talk about sexual wellness and possibly some thyroid-related issues and hormone replacement therapy. So welcome, both of you. Thanks for coming. 语法解析
01:07
Thank you. Thanks, Rich. Glad we're here. Yeah. Just give me a little bit of background. Where did you guys just have like a typical clinical practice that it's evolved now into these new areas of focus? Or, you know, what's been your path so far? I guess that's a good way to put it, your question there. I mean, we've always done this. And, you know, I… 语法解析
01:25
Christina, she did a residency that kind of was that had a broadness to her residency, but in what was a year, almost two years, but then immediately went into this type of medicine. Same thing for me. I mean, I just came straight out of school and went right in to hormone replacement therapy and this therapy. 语法解析
01:43
advanced way of approaching health. So it's always been this. I mean, sometimes you do hear that. I say it was an interesting question because sometimes you hear doctors say, you know, I practiced a certain way for a while. I got, you know, a little bit upset about how things were working in the regular conventional model. And then I woke up one day and said, I want to do this type of medicine. But for us, 语法解析
02:04
It's always been what we've done since the very beginning. So when you say this type of medicine, is it just under the umbrella of functional medicine, whatever goes on with somebody? Or is it always hormone focused? Like, you know, like how would you describe in your own words the type of medicine you guys practice? Well, we've always specialized in metabolism, essentially has to do with 语法解析
02:23
with endocrinology and biochemistry and from our perspective, really the function of the body. So functional medicine, I think, is just one of those terms that comes in and out of FAD, like longevity medicine or anti-aging medicine. But really at the core is what John and I have always practiced, which is this idea of understanding the way the body works in an 语法解析
02:45
in an integrative fashion so that you're not separating the different systems of the body. But we do specifically on metabolism. And as I said, that tends to be mostly hormones. Okay. And is it more men or women that you work with or both equally? Pretty equal on that. Yeah, for sure. Especially over the past five to 10 years, I would say that men are doing a much better job of speaking up and advocating for themselves. So the practice has moved much more into a 50-50 relationship. 语法解析
03:11
to women ratio where we're getting a lot of men really saying, what can I do to feel better and to age with much more grace? Okay. So when women come to you, what are their complaints? And when men come to you, what are their complaints typically? The same. They just have different parts. Right. That's true. Yeah. So we always say, you know, you can follow Dr. Bosh and I on Instagram at the sex doc. And we coined that definition. 语法解析
03:36
name because, not because we just thought it was kind of fun, but because that's what patients want. Both men and women want more energy and they want more sex. And that's just generally what most people want. And so when they come to see us, they're talking with us about those types of things, asking us to help with those types of issues that they may have related to metabolism and energy and inevitably their sexual well-being. And when you think about having more energy, you can think of 语法解析
04:04
of anything, really the person who's complaining that they want to lose weight or the person that they want to gain muscle or have better orgasms or perform better at work or just have a better mood. All of that comes back to really those two symptoms of loss of energy and loss of good quality. 语法解析
04:20
It's real. It would be funny if you guys' voicemail when you're not in the office, you're like, yeah, you reached the office of the sex docs. We're out having amazing sex right now. You'll have to get back to us later. Bye. We're practicing what we preach, and, yeah, we'll get back to you. We're earnestly practicing. Hopefully at this point, this is what people assume when we don't answer the phone. 语法解析
04:40
It's funny. I don't know. I guess just being out and about and talking to people and being a guy myself, it seems like women would have different interests than men do, especially as they get older. I'm not saying all women, of course, but it just seems like a lot of women in their 40s and up, they'll say, oh, my husband's bugging me for sex, and fine, I'll do it. They don't seem like they want to. It seems like the men more of it's still a need. It's still like a 语法解析
05:04
a feeling but the women i don't know it just seems like um i'm just speaking through what i've seen and heard every life but is that the case or is that not true i mean john says you're right but i don't know that you are in fact i often mention that i think a lot of times it's the woman that comes to us first and then brings her partner 语法解析
05:19
What do they say? Like, what's the common thing they'll tell you? Yeah, they're saying, well, they will say that their libido is not what they want it to be. So you're not wrong about saying women start to seem to lose interest. And we've talked a lot about this on our podcast, and we've even done a couple shorts about it. This idea of are women really losing interest? 语法解析
05:37
their libido? Or are they just so fragmented in the different things that are drawing their attention that they have a hard time carving out space for sex? Because we've talked about the idea that for a lot of women, they may be mentally and emotionally want to have sex, but women need to be, quote, in the mood and they need peace and they need to know that their list of things to do has been settled before they start to take their clothes off. Whereas perhaps stereotypical 语法解析
06:00
typically men don't have that need. Men can drop whatever they're doing in the house around them can be burning down and the guy will say, okay, let's have sex. But I, I don't know, John, don't you think that it's a good percentage of, of the women that are saying I want better sex, but my husband's libido is dropped. I wanted that. That's why I said, Rich, you know, you're right. And also it, 语法解析
06:20
it's definitely guys. I mean, so women will come in and say, I want to get help. I'm going to fix myself. And then, oh, by the way, I'm going to get my husband in here too, because he's got issues. He's having erectile jade or just simply doesn't have libido. He doesn't want to, he's fatigued out. But a lot of guys are contending with erectile dysfunction on many different levels, meaning they're mild cases of it. There's moderate and it's a severe cases of 语法解析
06:47
of erectile dysfunction. And it's a huge percentage. I mean, really once men get over about the age of 50, it's about one in three, one in four, they're going to have some form of erectile dysfunction. Yeah. Wow. So, well, that is a manifest. It manifests in erectile dysfunction. But what are like the underlying biomarkers that would tell you, oh, I see why this person is having a problem. 语法解析
07:10
What do you see when you do blood work and things like that? Well, the number one thing would be testosterone. That's kind of the elephant in the room, the concept. But in terms of metabolically, obesity and lack of exercise, having poor cardiovascular health, and we're talking about erectile dysfunction for men, the penis is the weather vane of the cardiovascular system. So if you… 语法解析
07:31
It's a circulatory issue. And the penis is just the first place where you begin to see it manifest. But by the time it's manifested there, you had already had issues from a circulation problem within the rest of the body. So circulation is really at the top of the list. We look at, we always measure nitric oxide levels, which is really simple to actually test at home and very simple to replace that to keep lining of the blood vessels optimized, whether we're saying the lining of the blood vessels in your 语法解析
08:00
In your brain or in your penis? And also other class inflammatory that we think of associated with men, you already said cardiovascular, diabetes or pre-diabetes, an increase in abdominal, belly fat and abdominal obesity. These are things we're starting to see in men younger and younger. So I would say if you're a guy in your 30s and you're already starting to have blood sugar issues and you're not managing stress well, you're starting to have those signs of high blood pressure that you want to also start thinking, oh, like… 语法解析
08:29
What do the next five to 10 years mean for my sexual wellness? So it's a good time to get checked even if you're starting to have those other chronic inflammatories. I mean, it's a silly, obvious question, but what does erectile dysfunction look like when it first happens, when it's mild versus severe? Will someone be erect and then they start having sex and they just go limp when they don't want to or they can't even get enough? 语法解析
08:49
the first place. Nile sort of versions of that. Yes, it's sort of all of the above. So it kind of starts first with forms of lack of libido. I just don't want to. That's the beginning sort of, that's when you're smelling it a little bit. It's not even mild ED just because you don't feel like it. But that's where it's going to start. Then from there, let's just say with 语法解析
09:09
defining mild erectile dysfunction. Sometimes it fails. Most of the time you can achieve an erection once every out of five or 10 times, you might have an inability to get there, but if it takes more time or you're in the middle of the act and then it fails, but then you can kind of get it back even in the middle of the act. So it's happening, but it's mild. And then it just 语法解析
09:31
it manifests to more severe iterations of what I just described to the point where a guy goes, you know, I don't know, let's say I was attracted to Asian women and I went to a strip club and there was a gorgeous Asian stripper. I wouldn't even begin to get hard. That would be like a really, would that be like a really advanced form of it? Or like, what would be a, you just have no directions at all or what? 语法解析
09:56
Before we continue, I've been personally funding the Finding Genius Podcast for four and a half years now, which has led to 2,700 plus interviews of clinicians, researchers, scientists, CEOs, and other amazing people who are working to advance science and improve our lives and our world. Even though this podcast gets 100,000 plus downloads a month, we need your help to reach hundreds of thousands more worldwide. Please visit findinggeniuspodcast.com and click on support us. We have three levels of membership from 语法解析
10:23
from $10 to $49 a month, including perks such as the ability to see ahead in our interview calendar and ask questions of upcoming guests, transcripts of podcasts you're interested in, the ability to request specific topics or guests, and more. Visit FindingGeniusPodcast.com and click Support Us Today. Now back to the show. 语法解析
10:42
Well, I can't really say if you're just sit there looking at her, that's one thing, but it usually comes down to manual stimulation. If you can't manually stimulate, she can't manually stimulate to get an erection and it just doesn't happen no matter what, then that's, we would call severe erectile dysfunction. Have answers for that. Yeah. And now- 语法解析
11:01
Well, scenario like you're describing, especially where there's no physical touch involved yet, where you would think, oh, I used to be able to have an erection just through imagining or, you know, like that song from SNL, you know, the breeze blues and the man has an erection. Right. I don't know if anybody else has either. Oh, I don't know. 语法解析
11:20
Anyway, then there may also be mental and emotional components to that, right? Which is a big problem that we're seeing in younger men, that younger men that are experiencing ED are often having a high mental and emotional stressor, which really correlates to women. Young women that are nowhere near being perimenopausal, that are having a hard time with libido and orgasm, often there's a mental and emotional component there as well that needs to be addressed and is always better addressed when it is treated in conjunction with hormone replacement. What is young? What, like… 语法解析
11:48
What were the typical ages where dysfunction used to happen? When did that change? And like, what are the typical ages now? Uh, I would say if we're talking about men, uh, the typical ranges back in the day would have been, you know, after 40, it starts to rear its head. Certainly at the eight, 50 is like the magic number, uh, for so many. And, uh, now, uh, it is in the twenties. Yeah. 语法解析
12:12
Reasons. There's many reasons, but testosterone is lowering. We're seeing a generational decline of testosterone over the past three generations. Multifactorial, the air we're breathing, the water we're drinking, the food we're eating, the food we're not eating, plastics, environmental toxins, social implications. We always say the pussification of food. 语法解析
12:34
America, treating boys like defective girls in the school setting, you know, these kinds of things that are the fact that there's no competition and these types of things in society and encouraged as much in the general youth as it used to be. So we're seeing more and more pornography use in really, really young kids today. 语法解析
12:55
And because they have such access to it and that's actually leading to in younger generations, it's leading to erectile dysfunction in older generations. It's leading to premature ejaculation. Yeah, I guess the intensity of what you see is so much beyond just looking at, you know, like girly magazines and 30 years ago that you need like these crazy scenario scenarios. 语法解析
13:16
in order to get off, I guess is what's happening. And that's, yeah, they're literally commonplace and desensitized to it. To where, let's say, you know, Gen X and above, what's happened to them is that they're seeing these things and they already are hypersensitive and then they see something like that and then they're getting premature ejaculation as a result. Yeah, I remember I saw these two pictures that said the 1890s and the 1990s. And they said, oh, how times have changed. Yeah. 语法解析
13:43
This is many years ago, obviously. But the 1890s, you saw women in a dress down to their ankles on the beach with parasols. And then in the 1990s, you saw two women in string bikinis on the beach. And that's why they say, oh, look at how times have changed. But now with porn, it's gone way beyond that, I'm sure. So I understand what you're talking about with desensitization. And on TV and music and just everything is like sex, sex, sex, sex, sex everywhere, it seems like. Yeah. 语法解析
14:09
Yeah, it's true. Everyone's talking about sex, but everyone's sort of deprived all at the same time. It's this weird dichotomy. We've mentioned we live in a hyper-sexualized society. Horrific lack of it. So… 语法解析
14:20
A big part of sexual arousal, true good sexual arousal that can last the ages, the types of things that keep couples turned on to each other after 30, 40 years of marriage has to come with intimacy. It can't just be a physical thing because, first of all, you're both in pretty in shape according to each other's preferences, right? With time, that does change. You mean over time, you don't look so good. Neither of you look so good. 语法解析
14:42
Right. That's right. So, you know, no matter what your physical bodies will change with time, even if shape. So what is it that you want in each other? What is it? 语法解析
14:51
coming back to each other and only each other. It has to be the entity. It has to be the ability to explore each other sexually in a way that is so satisfying that can come only through vulnerability. You know, it's funny. I remember in college, I told my friend Paul, I said, Paul, what happens when you're like 55 and you're married and your wife don't look good and you don't look good? And he goes, I'm a hideous turn away. And I said, oh, stop it. So you're just cracking up. So it's kind of like that, you know? 语法解析
15:16
Stupid things you wonder when you're in your, you know, 1920. And now I'm about to be 50, so it's very different. Yeah, but you're right. I mean, there's plenty of people in their 50s that feel hideous. You know, you've seen those pictures of like the Golden Girls versus like women in their 50s now? Oh, no, I haven't. I've seen the Golden Girls, but I haven't seen that comparison. Oh, they have? Because I think the Golden Girls were like in their 50s and early 60s, right? The characters meaning, not necessarily. 语法解析
15:40
Not necessarily. Well, no, even the actors. I mean, they do that with Cheers. You ever see, you know, and people just age different now. With Cheers, like, I don't know, Norm was like in his late 40s, but he looks like he's in his late 50s or in his 60s. It's, 语法解析
15:54
different kind of process of aging. But you know how you avoid that? You know how you avoid your wife's and hideous? First of all, I mean, have sex all the time, all the time so she never has to feel undesired and so that you never get a chafal out of habit feels like and looks to make your woman feel desired. And from the woman first 语法解析
16:09
perspective, come to places like ours where you're getting your hormones checked. You're doing what we refer to as regenerative aesthetics. So you're amplifying your assets. You're amplifying your beauty in a way that feels in line with your goals for health. Don't go out there and get these aesthetic interventions that make you look like someone else because then people can't tell whether you're young or young looking old. It's a confusing thing. So take good care of yourself. Play a lot. I 语法解析
16:36
I don't know, live life and have fun. And I think that's how you stay sexy. Makes sense. So what are, so for men, it'll be, you said one of the first problems is a reduction in testosterone. What else for men? Like I've heard there's sex binding globulin hormone and a few, you know, like some of them will, the testosterone will get converted to estrogen. And, you know, there's a lot of complication of biochemistry. So for men, can you talk a little bit more about what happens with them to cause them dysfunction? And then we'll talk about women too. 语法解析
17:04
Sure. Yeah. So you've mentioned kind of the three aspects of testosterone analysis for men. It's the total testosterone, something called the free testosterone, and then the estradiol or the estrogen level. You mentioned sex hormone binding globulin. That is a protein that carries the testosterone through the blood. He's bound up. 语法解析
17:26
And so that sex hormone binding globulin binds up the total testosterone and sort of inactivates it. Because when it's being traveled in the blood, it's not doing anything. It isn't until it's unbound off that protein and it is free, they can actually do something. So that's why we call it free testosterone. 语法解析
17:42
It is unbound from sex hormone binding block. And that's the version that does work. So for some guys, their total testosterone is kind of okay, but they have a lot of that SHBG and that binds up their testosterone, makes their pre-testosterone low, and they don't feel as good. And some of the reasons why SHBG will go up, one is just age. 语法解析
18:01
little bit of genetics, but alcohol is probably one of the best ways to increase sex hormone binding globulin. Obesity in and of itself, it just being inflamed will cause sex hormone binding globulin to go up. And I mean, I know you said it, but just to be crystal clear, we don't want it to go up because then it means you have less testosterone available to function the way you testosterone. Correct. And then finally, the total testosterone will convert into estrogen. And that does that through an 语法解析
18:27
hormone, excuse me, an enzyme called aromatase. And so testosterone converts into estrogen through aromatase. And that aromatase enzyme comes largely from fat tissue. Again, it happens as we get more of it as we get older. But the more fat we have, the more we convert our testosterone into estrogen. So yeah, and when you think about alcoholic alcohol, it's a double whammy. Alcohol is increasing your bowel testosterone and alcohol is also increasing fat deposit, more fat 语法解析
18:56
less testosterone so you just end up getting these like multi-factorial detriments to your overall testosterone and it could it even cause a problem like um you know let's say i have problems with my sex binding globulin hormone and i produce i tend to convert really badly um you know most of my testosterone gets turned into estrogen and then let's say i started doing injections of testosterone could that even could that make it worse because my body's not going to convert it properly 语法解析
19:22
Correct. I mean, it could. Generally speaking, the replacement tends to override some of those things. That's this advantage of replacement when it's done correctly and it's being monitored. But 语法解析
19:32
But yeah, sometimes the estrogen just in and of itself goes up. A guy already comes in, got a good amount of fat tissue. He may convert that testosterone replacement into estrogen, and then we can monitor that. We can control that with certain medications to keep the estrogen low if it's needed. I will say over the years, I've gotten more conservative about worrying about estrogen. And man, guys, we want some. We actually need it. Evil in and of itself. But 语法解析
19:57
it's still in excess if it's deported. It depends on what numbers we're talking about. If it goes really high, nonetheless, it can be a problem for breast tissue growth and a man as a process. And wouldn't you say that treaties have observed that with hormone place in a testosterone, you find that men, because it's affecting their, they're in a better mood, they have more energy, they have more libido, they start desiring workout, and then the muscle gets formed more easily. So burn the fat. Usually, like you said, usually that gets overridden through the 语法解析
20:24
benefits of the testosterone, right? Correct. So testosterone will give people often that impetus or that almost act like a catalyst to change in lifestyle factors that were otherwise taking away from their testosterone. I could say a little bit of my own experience. I was just feeling like 10 years ago. And so, you know, I decided to get testosterone shots. I went to the clinic and got them. And yes, your, you know, your libido goes up, but also your cognitive function goes up, which they don't say anything about. Like I felt like 语法解析
20:51
I was able to think, I don't know, I felt like 20, 30% smarter, which is really cool. I enjoyed that. But then I said to the clinic, like, do you have people's wives come in or partners and all that? And they're like, no. And I thought, well, if one person in a relationship gets this stuff, it could be very destabilizing. The other one is like, what the hell is going on all of a sudden? Why are you bothering me? And, you know, why do you want to have sex all the time? And they don't want to. It could destroy the relationship. What were your thoughts? Countless times, destabilization was a great word that you used. 语法解析
21:17
That is exactly what happens. And we've seen it either way where guys, if they fix themselves first, then there's a destabilization because she needs to get fixed or vice versa. She comes in and gets fixed up and then she's feeling better. She has more libido, everything's, you know, she's rocking and rolling and he's still down in the dirt. So it's really fantastic when you're, 语法解析
21:36
A couple comes in and sits in front of us and we help both of them at the same time. It's really. It's so fun. Yeah, it's a lot of fun because they both get well and they support one another and they're inspiring to one another, which helps with patient compliance. This is great. So I have, we have two clinics in Oklahoma, one in Oklahoma City and one in Tulsa and they're Oklahoma Men's Clinic and Tulsa Men's. So we treat women there. We absolutely do because it takes two to tango. And so it did for me. 语法解析
22:02
sense to us, even though it's a men's clinic, it didn't make any sense to us to not treat the partner. Even a gynecologist that treats women generally will have an ability or should have an ability to treat the male part of some degree of their training. So we always get it that way, that it's both. And we don't want, for us, we want the opposite of destabilization when it comes to intimacy. Yeah, because again, that John said about sex, why did choosing the word or the name, the sex tox is because couples, couples, 语法解析
22:29
We're always talking to us about sex. We really deal most, in our practice, it happens to be mostly heterosexual monogamous relationships. So it's been such a wonderful part and such a wonderful byproduct of 语法解析
22:39
of our career together, almost 20 years of doing this, where we say, oh, not only are we taking individuals to a place where they feel so much better as themselves, but we've helped countless of couples become stronger as a unit. And you know what's great about that, Rich, is that in turn then you have kids. These are kids growing up in health where the parents are more connected, the parents are more health conscious, food choices start changing, and that's how we get that generational health benefit. 语法解析
23:06
Well, that's great. That's excellent. What about, you know, we haven't, we've been talking to men the whole time. What about women? What hormones do they tend to lack that will cause them sexual dysfunction? Testosterone. Yeah, testosterone. Yeah. I always say if I had to choose between estrogen and testosterone for all of my female patients, I would force choose. What would be better to replace? I would choose the testosterone. So would I. It also gives us a broader range of patient work. I think some testosterone, even in my youngest, I've 语法解析
23:31
patients, young women in their low 20s, even the ones that are in pretty good health, if they're having that low grade feeling blue, if they're having anxiety, if they're having a hard time putting on muscle mass, their libido is low or the quality of the orgasm isn't there. So low dose testosterone can do so much to bringing them to a happier health place. Estrogen for men. Women need a little bit of testosterone to be okay, right? Yes. Yeah. 语法解析
23:54
In fact, women make more testosterone than they do estrogen. Are they better converters then? No, producers in this case. They actually produce more through their ovaries and the adrenal glands. Overall, the amount of testosterone and what's called just androgens like DHA, androstenedione, androstenediol, some of these other androgens. 语法解析
24:13
are produced more in a woman's body than the amount of estrogens being produced. Yeah, and they're producing more not for the purpose of converting into estrogen. They're producing more testosterone because they actually use it as testosterone. Interesting. Okay. Yeah, but yes, we do check estrogen. Of course, estrogen is important. It's extremely important. Yeah, for women, it's going to have all kinds of benefits. 语法解析
24:32
benefits again similar to what the benefits can actually be for men bone brain mood stability these types of things again men just need a fraction of the amount that women would generally need but i've also heard it's not just estrogen there's like astriol estradiol estrone 语法解析
24:49
there's different forms of it, which I rarely hear people speak, talk about pregnenolone. I mean, I guess there's a whole bunch of hormones that I don't know if they play a ton of roles, but you have to look at a whole panoply of hormones to help somebody. Or there's a few, you know, big ones like you just mentioned that can fix stuff. Yeah, we do look at the whole array. We focus on, let's say, the, the, 语法解析
25:09
the heavy hitters. Three main estrogens you had mentioned, there's estradiol, and that's the main estrogen that's produced by the ovaries. Then from there, the estradiol is converted into estrone, and that's more of a byproduct. It doesn't really have a whole lot of positive. It has some positives once it starts getting metabolized, but for the most part, it's the bulk of a benefit comes from estradiol. Then there's a weaker estrogen called estriol. 语法解析
25:34
And that is a very weak estrogen. It has been over the years touted as, you know, safer than in terms of the breast cancer risk, which now we thankfully understand that the breast cancer risk was largely a bunch of nonsense. So the estriol, it just, we haven't found that clinically to be that effective. And so mostly we're dealing with the estradiol 语法解析
25:53
And we are mitigating and ensuring that estrone levels are kept low because estrone in excessive amounts can perhaps be a setup towards problems, not just with breast tissue, but potentially uterine tissue, ovarian tissue. So we like to keep estrone low and estradiol relatively high. And we do that through using hormone pellets. One of the main things that we use to replace hormone is using hormone pellets for women. And that will maintain the natural estradiol to estrone ratios that are healthier for women. 语法解析
26:22
You know, I was going to ask you about efficacy of creams versus implanted, you know, seeds or pills versus, well, I don't even know if there's just a pill form versus injections for men and women. Like, what have you seen as the trade-offs? I have some experience. Mine, I'm sure, is I give other people, but 语法解析
26:37
What have you seen? So for both men and women, generally speaking, at the top of the list is certainly for women, it's pellet. But, you know, Christina and I have been doing pellets for 18 years. There's not many people in the country that have been doing pellets longer than we've been doing pellets. We were just, you know, doing this one of the first to do it. And so we really know how to wield that tool. So it really is a superior way to do it when you know what you're doing. Then to that, second to that, or… 语法解析
27:03
almost primary to even that for men, we think it's injection. So we can do injections for women and we do a lot of injections for men, but we do it subcutaneous. So if we're doing injections for men or women, these are smaller needles that are injected into the abdomen. For women, it's only a once a week injection. For men, we do it twice and it keeps the levels incredibly stable. It prevents big shoots or hot, you know, spikes up of estrus or dip down. I've done injections, but I think it was the carrier oil 语法解析
27:32
It was like cotton seed because I would get lumped. And then I tried to split it into two and three, had less each time, but I was still in the lumps. And, you know, I got acupuncture in the lumps to get them down. And sometimes it would release a lot. And I'd be like, really like on a given day. 语法解析
27:44
And I was like, oh, yeah, it just, I don't know. It just was a, and I couldn't get enough expertise to help me at the time. Maybe now there's more, but just, you know, there's that complication, at least for me with the injection. Yeah. You can try different carry oils. There's, um, you know, the cottonseed oil, there's MCT oil. You'll even see it put in triglyceride oil, MCT oil. 语法解析
28:02
Grape seed oil is probably one of the most common carriers. So if it's cotton seed, maybe grape seed would be better for you if you're having that issue. So the technique of injecting it the way we recommend allows for slower release so that you're avoiding some perhaps in valleys that were more typical. 语法解析
28:19
But Rich, were you doing it sub-Q or were you doing it intramuscular? I tried into like the delts of the arms. That's where it gave definitely the most lump. At first they did like in your, you know, like I write it like kind of the top of your butt cheek and that gave lumps. And then I tried it in the, you know, the delts. I tried it in the stomach. That was probably the best. 语法解析
28:37
And again, split it up so it's less amount of fluid each time. A lot of times the lumps… The sheer amount that's being forced into the area. So yeah, I would recommend smaller amounts subcutaneous with the right type of needle and the right type of needle technique. So a lot of times patients, you know, we have to really instruct them because they will self-administer and we really have to show them sometimes a couple of times, you know, we 语法解析
28:59
We do it the first time, then you get a little experience, and we come back and give them some more pointers. But a lot of times, if they're having issues, it's just needle technique. Okay. And what about palates versus creams? Do creams… I try to cream, they say, like, put it on your, you know, on your scrotum because it absorbs better, but I don't know if it does… Well, we don't really use… Well, we never use creams for men, and we don't really use creams for women either. I think when we find estrogen replacement in a cream to be useful, I think it's going to be… 语法解析
29:27
if you're using it locally, like in the vaginal tissue, that's going to help perhaps with itching, cracking, atrophy, then perhaps more useful. And we've also more recently started experimenting with using estrogen cream on the face and the neck or just like for skin, you know, for aesthetics, because estrogen definitely will have a large role in aging the skin. When estrogen is going down, you get that loss of collagen and elastin and that crepiness in the skin. So I think from those two perspectives, creams are… 语法解析
29:55
really good. But if a person's got systemic concerns, if they're looking at longevity benefits like bone health, heart health, muscle health, just all the brain, like you said, cognitive, I don't think you're going to get there with cream. You just don't. The levels are never consistent with it. The skin just won't 语法解析
30:13
absorb the hormone over time. We have found over the years, again, almost 20 years of seeing the labs of patients who come to us on the cream, it was just worthless. And that's why they come to us and then we put a pellet in them or we do an injection and then we change the labs instantly and change how they feel. And we do pellets with men as well. The reason I think that we focus on the injections a little bit more is just because pellets have a longer downtime for the man and compliance can be a 语法解析
30:41
problem. Just from a compliance perspective, I mean, as far as it as a procedure or as a delivery system for very effective TRT, I think pellets are also extremely good for men. Oh, so you'd say pellets better than cream? What about pellets versus injections? Yeah, if we're saying we're talking about a guy pellets versus injections, if you're going to make me choose, I'm going to go with injection. But that's after doing this for so many years. And that kind of what Christine was saying, that there's more potential 语法解析
31:05
potential of complication and compliance issues with testosterone pellets for a man than there would be for a woman. For a woman, the pellets are very, very small. They're like the size of a grain of rice. So you're putting a couple of little rice pellets in them and it's an easy procedure. The downtime is very short. Compliance is very high. So for women, without question, if I had to choose, I'm going pellet. But I got to say, even with women, the injections we've figured out 语法解析
31:30
A once weekly injection using that's really, really small needle, the smallest needle that they make for women is what we have figured out. Unique and compliance is really high. Women love it. And they only have to do it once a week. I think if we're talking like if you're asking us to compare pellets to injections clinically, like from a therapeutic perspective, I would say they're 语法解析
31:50
They're on par. They're pretty equal. They both have some pros and some cons that have more to do with compliance and comfort for the patient than actual therapeutic value. Where's the compliance of pellets? Once they're in there, they're in there. You know, they may… Yeah, right. There's the downside. Yeah, you got a patient who's maybe a little bit sensitive. They're a little bit timid about the whole thing. You know, pellets might not be the best clinical choice for them because they just might… 语法解析
32:13
be nervous about the whole thing. So you might choose something that, like an injection, that is out of their system within a week or less. And also, we're very good at dosing pellets. I mean, we're very good at dosing all of it. Like John was explaining, we've been doing it longer than most people in the country. And there is a delicate analysis of not only the labs, but the patient that you really must develop. 语法解析
32:33
We've been very lucky to have thousands and thousands of patients who have trusted us in that journey. And we've gotten extremely good at determining what kind of doses you need because I have seen pellet patients here in the office. There were other people's patients. There were holy moly where they overdose on some things and then ridiculously underdose on others. And you can really make a mess of it, especially since you can't take them out. So what, I don't know, where can you help people? Like what areas do you serve? Is it all country or just your state or where? 语法解析
33:01
Well, we're in Arizona. We're sitting here with you right now in Scottsdale, Arizona. The name of our private practice is the hormone zone, the hormone zone. So we can be seen here, but we do also have a management company that has several other 语法解析
33:16
locations that we also own. We've got a location in Livermore, California, which is the East Bay, and we do hormone replacement therapy there. It's a med spa as well, so all kinds of longevity-based regenerative aesthetics. We have two men's clinics in Oklahoma, Oklahoma City and Tulsa, where we treat both men and women there as well. We have a location in Northern Arizona that's a med spa 语法解析
33:37
and also a hormone zone location. And then also we're in Orlando. We've got a regenerative medicine and med spa hormone replacement therapy in Orlando. Oh, wow. Okay. So the best way for people to take action that are listening is to, you know, how should they, what's like one place they could look you up and then see all the locations and everything you guys can do for them? Yeah, we have a link tree for our podcast called 语法解析
33:59
the Longevity Protocol podcast. And that's the link tree is the Longevity Protocol podcast. So when they go there, they can see links to our private practice, to all of our social media channels, to all of the different locations that we serve all over the country. So it's the Longevity Protocol podcast, that link tree for Longevity Protocol podcast. And of course, the podcast itself is going to also give you just a lot of these topics, a lot of these interesting topics that we're 语法解析
34:25
reviewing with you here, Rich, where we talk about hormones and metabolism and sexual health and intimacy. And so that will also give your listeners an opportunity to get a better flavor for us. And of course, we do treat patients out of state if they have doctors that they are working with, but they want a second opinion in the form of a consultation, a lifestyle consultation per se, then that's sometimes a step that patients like to start with as well. They don't think they can make it out here or they're not sure that that's where they want to start. 语法解析
34:50
Okay. Well, very good. Any other last topics that we could address that we haven't? I know we're just about at the top of the hour. Well, I was going to ask, do you think we found the genius here? Did we find it? No, you guys have a lot of experience with it, and it's great. It's better to hear. There's a lot of urban legends and myths around it. Oh, steroids are bad for you, but the physiological levels that you get people to are nowhere near where I understand. And you're taking steroids to be a weightlifter. So. 语法解析
35:15
This is all about biomedicine. And it is about prevention and long-term use of this in a positive way for the sake of longevity. So, yeah. Yeah, this is, I mean, we always say this is about living a well-lived life. This is not chasing fantasy numbers or anything like that. But it is definitely about listening. And if you have someone out there who says, you know, I just don't feel like I am healthy. 语法解析
35:37
living my best or I'm not feeling my optimized self, then don't settle. I think that we're just, we're such a hardworking society here in this country that we're used to settling for mediocre when we just don't have to. And you guys have been doing it for, you said, at least 18 years or how long have you been? Well, 18 years practicing medicine and then school. And I've been involved in wellness one way or another since 1991. Massage therapy. I worked at the Spa Camelback Inn right here in Arizona. 语法解析
36:05
The reason I ask is like if someone's afraid of doing this long term, you know, what is long term? Oh, I've been doing it longer than 18 years. I have patients with doing pellets for 25 plus years. I mean, there's a lot of studies, you know, the studies in medicine, you can find whatever you want to support your theory. Let's be honest about that. Right. Especially with everything we learn about the controversies of sponsors for research. But when you're talking about something like this, these are tried and true studies that have been followed. 语法解析
36:32
following real live people over the decades to see how are they doing. And the two of us, like you said, two decades of monitoring our patients. We've had our patients since really I've had patients that came to see me when I first opened my practice. They're still with me. My mom, John's mom, like this is something we ourselves, like we do it because we believe in it. We believe in it because we've had the pleasure of seeing people's lives change. Perfect. 语法解析
36:54
Okay, well, that's great. Well, thank you so much, you know, both for what you do and for coming on the podcast. If you like this podcast, please click the link in the description to subscribe and review us on iTunes. You've been listening to the Finding Genius Podcast with Richard Jacobs. 语法解析
37:14
If you like what you hear, be sure to review and subscribe to the Finding Genius Podcast on iTunes or wherever you listen to podcasts. And want to be smarter than everybody else? Become a premium member at FindingGeniusPodcast.com. This podcast is for information only. No advice of any kind is being given. Any action you take or don't take as a result of listening is your sole responsibility. Consult professionals when advice is needed. 语法解析
Edit:2025.05.06
