September 1, 2018

Podcast from:  https://bengreenfieldfitness.com/podcast/lifestyle-podcasts/best-sexual-biohacks/

[00:00] Introduction/Joovv Light/GetKion

[11:15] How GAINSWave works

[16:30] How FEMIWave works

[21:45] Triple Therapy

[25:30] Fermented Beets

[28:45] Heal With Heat/Aaptiv

[33:00] Importance of L-citrulline, Red Beet Extract, Muira Puama, and Asian Ginseng

[39:30] Ben’s Unfortunate Incident with a Digital Penis Pump

[43:45] Vasectomies and Testosterone Production

[46:30] Whether a Vasectomy is Reversible

[50:00] Stopping Testosterone Treatment Once You’ve Been on It

[54:30] Erectile Dysfunction and Bike Seats

[61:00] Stem Cell Injections into the Penis

[75:48] End of Podcast

Ben:   You know, folks, I’ve got to cut this bad habit of consuming beverages and gum while I’m recording things for you.  But, did you hear that [slurp]?  That’s my first drink of the day, meaning, my first alcoholic drink of the day, my only alcoholic drink of the day.  I don’t ever get drunk, but I have a drink at the end of each day I have a drink.  I make cocktails that basically bastardize alcohol.  I’ll take wine and mix it with ice and sparkling water and sea salt or I’ll take a Zevia ginger beer and mix that with some gin, which is a really clean burning form of alcohol with some line and some fresh mint from the garden, and I’ll throw a Nuun electrolyte tablet in there or I’ll put a few squeezes of a CBD oil in and stir it up.  My wife just drinks a glass of wine.  I always got to do these crazy things to my booze.

Tonight I’m drinking wonderful, organic Rosé from this company called Fit Vine, but I have blended that with a bottle of this hangover supplement somebody sent me and some sea salt, some ice, and a squeeze of half a lemon.  So, there you go.  I wish I could remember the name of this stuff – it’s like Morning Hangover… or Hangover-free I think is the name of it?  Anyways, there’s all sorts of hangover…  Go, if you do a Google search for Ben Greenfield Hangover Pills, you’ll find this big article I wrote for Men’s Health Magazine about all these different ways you could prevent hangovers.  But, I don’t get hangovers.  I don’t ever get drunk.  I haven’t been drunk in six years because I just drink one drink a day, rarely have two drinks, and never get drunk.  I just feel better that way.  So, that’s how I roll.  Don’t judge.

Today’s podcast is a good one.  So, this podcast is with this doctor who specializes in male and female sexual performance enhancement.  He does some anti-aging stuff, some hormone stuff.  Interesting dude, Judson Brandeis.  Judson Brandeis.  So, this one ought to give you a few cool little things you can take away for the weekend, especially if you have a lover or if you have bad hormones or you like biohacking certain areas of your body.

We talk all about that in today’s show which is brought to you, speaking of biohacking your body, by this company called Joovv.  I’m standing right by my Joovv right now.  The folks at Joovv, they were actually just up at my house.  We were talking all about photobiomodulation which is this form of therapy, it’s also abbreviated PBM, that has over 3,000 different clinical studies published on it for better sexual performance, reduced joint pain, increased muscle recovery, increased skin health, collagen production.  You simply flip this light on and you stand in front of it for ten minutes.  I do it while I’m at work working at my office.  Yeah, you can pull your pants down and try it on your nether regions; you can put it on wrinkles; you can put it over scar tissue.  So many benefits to this thing.  They’ve put this particular light through some pretty strict FDA-approved, rigorous, third-party testing and came out with what I consider to be the Cadillac of photobiomodulation: this thing called the Joovv Elite which allows you to put all these lights in different configurations.  You could make a square that you could stand inside of, you could line a whole wall with the lights if you own a clinic or a personal training studio, you can have this as an upgraded function for your clients or for your patients, they have this built in Bluetooth function that, yes for you dirty electricity heads out there you can disable, but you can literally pair it with Alexa or Google and you could say, “Alexa, I want to Joovv for ten minutes, Alexa,” because everybody talks like that when they talk to Alexa.  They talk like that.  I like to talk like that when I talk to technology, “Hey, Siri.”  Anyways, you get a big ol’ cool gift that they’re going to throw in for anybody who orders a Joovv.  It’s very simple: you go to Joovv.com/Ben, that’s J-O-O-V-V.com/Ben.  Use code BEN at checkout.  That’s it.  That’s easy.  J-O-O-V-V.com/Ben.  I meant to say, “it’s that easy,” but when I say “that’s easy” I kind of like the way that sounds.  So, I’m just going to roll with it.  That’s easy, folks!

You know what else is easy?  It’s easy to eat clean and I have all these superfoods that I love: cocoa butter and things that I put into my homemade avocado organic ice cream that I make at home, white chia seeds, grass-fed gelatin for my joints and for my gut, organic honey which is just loaded with prebiotics and with immune modulating compounds, almonds which I love as a source of Mediterranean fat, coconut flakes, cacao nibs, dark chocolate.  I decided to take all this stuff and even sea salt, a special sea salt that’s got over 60 different trace minerals in it, and I managed to package all of this up into a bar and it’s like crack cocaine.  It’s rich, chocolatey, coconut-ty, mind-blowing explosions of flavor inside of your mouth.  And, I spent about two years developing this bar.  It’s available now for you to order.  It’s called the Kion Clean Energy Bar.  It is mind-blowingly amazing- even my children love it.  They ask me for these things.  They take them to school, they take them to tennis, they go to jiu-jitsu and they have their bars with them.  They just love them.  No chemical cocktails, no fart-in-a-package type of stuff.  It’s really good.  You go to getkion.com/bar to grab one or a few boxes.  Getkion, getK-I-O-N.com/bar.  You’ll find all the other fun supplements and fancy things that I designed over at getkion.com.

So, enjoy and let’s go talk to this doc.  Shall we?

Ben:  Hey folks, it’s Ben Greenfield and it probably doesn’t surprise you that I get a lot of questions on male and female sexual enhancement, most likely because I made the mistake of being the poster boy for Men’s Health a few months ago about all these crazy biohacks you can do to enhance sexual performance.  And frankly, I’ve gotten so many questions that I decided to get an actual private practice urologist on the call to talk about some of the science and some of the medicine behind not only optimizing male and female sexual function, but also a lot of the procedures that exist out there for everything from vasectomies to things like prostate cancer that obviously affects sexual performance, but also has a great deal of new research and new science behind it that I want to really get into on today’s show.

My guest is Dr. Judson Brandeis and he’s from Walnut Creek, California where I’ve actually been.  You guys have an amazing cryotherapy clinic down there that I visited…  When was I down there?  I was doing the RKC Kettlebell Certification at a place called Diablo CrossFit.  Are you familiar with Diablo CrossFit, Judson?

Judson:  I am.  They have a really good rock wall that I take my kids to.

Ben:  Yeah.  Amazing CrossFit.  For some reason I’m not much of a CrossFitter, so I probably wouldn’t know, but it seems like a pretty amazing CrossFit facility to me quite subjectively.  Anyways, Judson has been voted as the top urologist in the San Francisco Bay area for a few years in a row, I think the past four years, pioneer using technology in urology, and an early adopter of robotic surgery, lasers, and MRI targeting for prostate cancer. He does things like these GAINSWave treatments for men and the FEMIWave shockwave thing for women, which I actually want to ask you about, Judson, because I get a lot of questions from girls about how they too can shock their nether regions.  And, he also even develops special formulas for increasing your availability of nitric oxide and we’ll get into nitric oxide and how you can bump that up as well.  And, of course, as is the case with many of the guests that I have on, I go for people who are after my own heart, meaning that Dr. Brandeis has not only been involved with pretty extensively, triathlons since 1981, when I was born, but he also ran track and cross country for Brown University.  He’s a fit dude.  He even knows how to keep long bike rides from inhibiting your ability to get it up, fellas.  So, we’ll hit on that too.  So Judson, welcome to the show, man.

Judson:  Thank you!  It’s an honor to be here.

Ben:  Yeah.  I’m stoked to have you and talk about this stuff.  You know what, we might as well, I mean, I do want to ask you about your triathlon history and a little bit about specifically endurance athletes and sexual enhancement and testosterone.  But before we get into any of that, I’m just going to address the elephant in the room right away, man.  This whole FEMIWave thing for women to enhance sexual performance by blasting their crotch with soundwaves, and the reason I’m asking is twofold.  A bunch of women have been asking me about this since they found out that I go down to Florida, and there’s clinics all over the country including yours that do this shockwave treatment for men, which I’ve done podcasts on before and if you’re listening just go to bengreenfieldfitness.com/shockwave and I’ll link to my previous podcasts on this whole GAINSWave therapy for men, but there’s also this one for women and, of course, we are fine with getting explicit on this show, you can describe in great detail if you need to Judson, but what is the deal?  How does this work for women both physiologically and also logistically?

Judson:  The whole key is blood flow for both men and for women, and really for anything in the entire body the key is blood flow.  And so, for GAINSWave for men and for women, basically what you’re doing is using the shockwave to create inflammation.  Inflammation, in this case, tricks the body into creating an inflammatory response.  The inflammatory response results in a healing response.  As part of that healing response, you increase the amount of what we call VEGF for vascular endothelial growth factor which is what is responsible in the body for signaling the growth of blood vessels.  And when you grow blood vessels, you increase blood supply.  And so, for GAINSWave for men, you increase supply to the penis.  In GAINSWave for women, you increase blood supply to the clitoris, but also to the labia and the other parts of the vagina.

Ben:  So you really are causing actual damage, but it’s almost like a hormetic-style damage that results in this surge of vascular endothelial growth factor?

Judson:  The beautiful thing is that you don’t really create damage.  You use shockwaves, which are different than soundwaves because they have a higher peak and a higher descent, but basically what you’re doing is tricking the body into thinking there’s damage, but instead of having to repair the damage, the body’s response, the healing response, can go entirely towards growing new blood vessels and repairing tissue.

Ben:  So, how does that work exactly?  How does the body get blasted by the soundwaves and not actually experience damage or affectation of the actual tissue itself?

Judson:  Well, the shockwaves basically perturb the cell membranes and by perturbing the cell membranes they trick the cells into thinking that there’s actually trauma.

Ben:  Okay.

Judson:  And so, they release inflammatory cytokines, which are basically microscopic hormones that your body releases like interferons, tumor necrosis factor, those kind of things that are the signaling mechanisms that your body uses to generate inflammation.  And once you get that inflammatory response, think about it if you have a crush injury of your leg or a cut, those kind of things generate an inflammatory response which then generates a healing response which is what you need to repair an injury.  And that healing response is what we’re really trying to go for.

Ben:  Now, could you theoretically achieve this, because I know you guys have these when I go to the facility, it’s a big box with a wand coming out of it that you basically wave around my testicles, my penis, and this entire area for 20-minutes.  So, I’ve put numbing cream on first and then it’s just a brrbrrbrrbrr all around the area.  Could somebody just do that at home with, this sounds really funny, but people have asked me this before, but could you put on earplugs and basically stick your d**k between a giant set of speakers, for example?

Judson:  Yeah, so that’s interesting because I’ve been asked that question before.  But those are soundwaves.  So, soundwaves are sinusoidal.  These are shockwaves.  So, shockwaves have a high peak and a high descent.  So if that were true, you could use a regular ultrasound, diagnostic ultrasound, to do the same thing, but you can’t.

Ben:  Yeah, I guess an ultrasound is kind of similar.  So, these waves are different?

Judson:  These are different than sinusoidal.

Ben:  Can you describe that again, the difference between the sinusoidal and this form of soundwave?

Judson:  Right, so a sinusoidal or soundwave has a smooth up and a smooth down, right.

Ben:  Okay.

Judson:  It’s a gentle up and down, whereas a shockwave has a high peak and then a…  A shockwave, think of… well, we use it for lithotripsy for breaking up kidney stones, but the shockwaves that we use to break up kidney stones are 100 times stronger than the ones we use to stimulate this inflammation in the penis.  But basically, think about a jackhammer.  It’s the same type of intense up and down that a jackhammer does instead of…

Ben:  Yeah, it’s kind of like a mini jackhammer, actually.

Judson:  Yeah, instead of soft music.

Ben:  Okay.

Judson:  Soft music you would use to… and visualize things on the inside of your body, but a jackhammer is what you need to trick the body into creating inflammation.  Now, with a jackhammer, you’re breaking stuff up.  With the shockwaves, the shockwaves still go through soft tissue.  Now, if the shockwaves hit bone, it hurts, right. So, you need someone who’s experienced in doing GAINSWave to do the GAINSWave because if they hit the bone, that really hurts or if the shockwaves hit the testicle, something that has a lot of nerves, that really hurts.

Ben:  Yeah.  Hence, the numbing cream.  That stuff comes in pretty handy.  I always get a great big ol’ syringe of that handed to me and then you go into the bathroom and you smear it on and you go into the little clinic and you get it done.  Now, for women though, how exactly does this work for women?

Judson:  So with women, it’s the same shockwaves, right, but you apply it to different areas of the labia and the vagina and the clitoris.  And, basically, it does two things: it increases the blood flow because basically the clitoris is the same as the penis, they’re the same nerves, they’re just packed into a tighter package but they’re basically the same blood supply, but then also there’s evidence, not really great double-blinded scientific controlled studies, but a lot of anecdotal evidence that GAINSWave also improves nerves, improves sensitivity.  And so, women and men, after GAINSWave are more sensitive and they have much better blood supply.

Ben:  And for women, it’s called the FEMIWave, right?  F-E-M-I-Wave?

Judson:  Exactly.

Ben:  Okay.  Got it.  So, and by the way, the time we’re recording this, my wife and I are going down to do this procedure together.  We’re going to be in Florida for a couple of meetings and I’m going to get the GAINSWave, she’s going to get the FEMIWave.  And in my experience, and tell me if this is typical, after about four to six hours, after the numbing cream wears off, for me personally, I get an erection even if I’m not thinking sexual thoughts or I’m in a sexual scenario, I just get an erection almost right away.  I get that blood flowing and that continues for about a month or so, as far as me getting things like nocturnal erections or morning boners or anything like that.  Now, do women experience something similar?

Judson:  You know, I think it’s important to set expectations.  So in my clinic, we do this once a week for six weeks.

Ben:  Really?

Judson:  Exactly.

Ben:  Okay, I thought it was once every one to two months you get it done.

Judson:  At the GAINSWave Clinic they do it twice a week for three weeks; we do it once a week for six weeks.  And, the important thing to understand is that after your first or second treatment, especially in younger men, you’re going to get a big nitric oxide release and that’s the reason you’re going to get better erectile function early on.  After about the second or third week, that’s going to go away.  And so, a lot of patients, after the first treatment or two, say, “wow, that’s great.  You really fixed it!  I’m so excited,” and then after the third or fourth week, they’re like you know, it seems to go well and then all of a sudden things weren’t going well.  But, that’s normal, okay.  It’s important when you’re undergoing this treatment to understand that it’s the fifth week that really begins the good part of the journey because you’re growing blood vessels and blood vessels don’t grow in the first week or two.

Ben:  Hmm, interesting.

Judson:  Yeah, so it’s important if you’re a patient undergoing either one of these treatments, GAINSWave or FEMIWave, to set your expectations appropriately and understand that by the fifth week, that’s when things start to improve.  And they improve from the fifth week up until the twelfth or thirteenth week.

Ben:  Okay.  When you’re doing this, you’re trying to increase vascular endothelial growth factor and nitric oxide.  I know you’re kind of an expert when it comes to increasing nitric oxide from a nutritional or a supplement standpoint as well.  Would there be, for the sexual biohackers out there, things that you can consume before or after you do the treatment to either enhance the production of the endothelial growth factor or of nitric oxide or both?

Judson:  Yeah, absolutely.  I know you guys have talked about nitric oxide before on your show, but it is, in 1992, it was the molecule of the year and I think it’s still really underappreciated.  As we age, we lose our ability to synthesize endothelial-derived nitric oxide and responsiveness to nitric oxide doesn’t change as we age, only the ability to generate it.  And so, restoring nitric oxide production and supply really is the fountain of youth.  I’m 51 and even if I eat really well and exercise, I’m only getting about 80% of nitric oxide.  When you’re in your 40s, 37-40, you’re getting about 90%.  So, you really have to supplement nitric oxide in a dietary sense in order to get that second messenger that really is critical to increasing blood flow everywhere in the body.  And so, I developed a supplement called Affirm which is consistent of L-Citrulline, red beet extract, Muira Puama, and Asian ginseng.  And what this does is it boosts, from a natural dietary standard, the amount of nitric oxide available and so what we found is that it improved the ability to get an erection earlier with shockwave therapy with GAINSWave and GAINSWave was more effective on a long-term basis.

Ben:  How does that compare to something like Viagra?

Judson:  Okay, so this is really interesting.  I call this triple therapy.  So, what a firm does, what nitric oxide boosting does is it increases the amount of nitric oxide available in the synapse.  So, think of like a saltshaker.  As you get older, there’s less and less salt in the saltshaker and the important thing to do is to put more salt or more nitric oxide into the saltshaker so that when the nerve gets stimulated, there’s more nitric oxide in the synapse.  Now, what Viagra and Cialis are, are what we call PDE5 inhibitors.  PDE5 is an enzyme that lives in the synapse that scavenges or takes up nitric oxide.  And so, Viagra you’ll hear about it called the PDE5 inhibitor, what that does is it blocks PDE5 or phosphodiesterase number five and it allows the nitric oxide to sit in the synapse for a longer period of time, maximally stimulating the blood vessel.  Now, the third part of triple therapy is GAINSWave.  What GAINSWave does is it grows new blood vessels and it removes the microcalcifications from old blood vessels allowing the increase in circulation.

Ben:  Wait, so you’re using this nitric oxide precursor, then Viagra, then the GAINSWave?

Judson:  The patients that I typically see in my office are patients that have failed Viagra or failed Cialis.

Ben:  Okay.

Judson:  So the patients that have mild erectile dysfunction, they go see their primary care physician, the primary care physician puts them on a PDE5 inhibitor, and I never see those patients.  So, when the PDE5 inhibitors aren’t working anymore, I get those patients from the primary care physician.  Now, for younger patients who are basically on Viagra and it’s working pretty well, then basically all you need is a nitric oxide booster.  And I would say you’d need a nitric oxide booster in all aspects of your life.  Nitric oxide boosters have been shown to reduce blood pressure in a very natural way, they have also shown to reduce coronary artery disease, reduce hypertension, even reduce the risk of Alzheimer’s disease.  And it’s nothing magical about the nitric oxide other than it increases blood flow and blood flow obviously increases the ability to bring everything into an area to heal, to grow, etcetera etcetera.

Ben:  Yeah, and I know you brought up citrulline, for example, which watermelon is very high in citrulline.  A lot of bodybuilders will use watermelon to get a pump before they go out on stage.  I used to use red wine and dark chocolate for a similar vasodilatory effect due to the nitric oxide boosting benefits.  There’s also this concept though that you have nitrate in your mouth that can actually, from what I understand, get converted in the salivary glands along with your oral bacteria in your mouth to allow you to create more nitric oxide.  So, could you theoretically say that if you, let’s say you’re using mouthwash a lot, killing all the bacteria in your mouth, maybe you have poor bacteria profile, you’re not using probiotics, etcetera, could that potentially make a nitric oxide supplement less efficacious?

Judson:  I was actually going to say that it’s important when you’re taking a nitric oxide supplement, make sure you don’t use mouthwash around the time that you take it because the salivary gland is important and saliva is important in the production and conversion of nitrates to nitric oxide.

Ben:  Okay.  Interesting.  What about if you were to take probiotics?  Could that theoretically even increase the availability of nitric oxide levels?

Judson:  You know, that’s a great though, I honestly don’t know the answer to that question.

Ben:  Okay, I may want to look at it afterwards to see what kind of research has been done on bacterial status, bacterial profiles, and nitric oxide.  That would be interesting to see if you stack those, if those would have an effect.  But, I do know my friend Joe Mercola was telling me about fermented beets and how when you ferment a beet, from what I understand, it’s the actual bacteria that you get when you ferment a beet that are made more bioavailable, the bacteria and the enzymes that results from fermentation, and so if you have a fermented beet source, you might even get better nitric oxide availability.  Let’s say you were going to do this from a more natural or ancestral standpoint, you could just get beets and put them in a glass mason jar with whey or salt, and do just like a traditional fermentation.  As far as the type of beets you use in your supplement, do people do that in the supplement industry, actually ferment a beet before they turn it into beet powder?

Judson:  You know, chemically speaking that actually probably would work, but I don’t know how it would actually taste.

Ben:  Yeah, I don’t know either.  I actually haven’t done a lot of fermented beets.  This was a conversation I was having with Dr. Mercola just a few days ago, I think he has…  I don’t know if he has a fermented beet source on his website, hey may, obviously it’s not that difficult to make your own fermented beets, but I think it’s interesting how many things you can stack together here.  But ultimately, it sounds like, for the person who doesn’t have erectile dysfunction, who is just a guy like me who just wants to go from good to great, who wants to have longer orgasms or more firm erections or for a woman who wants more blood flow for example, the best case scenario would be you could use some time of nitric oxide boosting supplement, like the one you described with citrulline, beets, and… what was the third component?

Judson:  Muira Puama, which is a Brazilian root and also Asian ginseng.

Ben:  Alright, I want to get into those in just a second, but you could take this and at the same time do the sexual treatment, like the GAINSWave, and again, I only do it once every one to two months, but it sounds like an even better protocol would be once a week and that’s going to vastly improve the benefits that you get from it.

Judson:  Exactly.  Well, the thing is, the inflammation kind of builds on itself and the constriction of vascular endothelial growth factor and the blood vessels, that’s why it’s important to do it in a sequential way as opposed to once in a while.  I mean, if you do it once in a while, you might get some of that benefit, but also, I’ve actually written this up as an abstract that I’m submitting to the Sexual Medicine Society meeting in Miami this year, and we use what’s called the SHIM Score, which is the Sexual Health Inventory and Men Score.  And so, my SHIM Score bump was about five to six points, which basically means that if you’re a man, say in your 50s, and you’re taking Viagra and the Viagra is working well, I can get you off Viagra.  If you’re in your 60s and Viagra is not working that well anymore, I’m not going to be able to get you off Viagra, but I can get you to the point where the Viagra is actually working really well.  And, if you’re taking a supplement like Affirm, a nitric oxide booster, you may actually significantly reduce the amount of Viagra that you need to take.  There are a lot of side effects of those kinds of medication, too.  A lot of patients complain about facial flushing, about headache, about reflux, those kinds of things and so if you can reduce the amount that you’re actually taking, it may actually become tolerable.

Ben:  Interesting.  So by the way, are you saying Affirm?

Judson:  Affirm.

Ben:  How are you spelling that?

Judson:  A-F-F-I-R-M and it’s available at affirmscience.com.

Ben:  Oh, just like affirm, alright.  Clever name.  I see what you did there, Affirm.

Hello, I want to interrupt today’s show to tell you about my Jacuzzi – not my hot tub, but my actual Jacuzzi.  I have this thing called a Jacuzzi, Clearlight Jacuzzi.  I go in it nearly every day and it is a sauna, but it’s a big sauna.  I can get inside it, I can do yoga in it, I can swing a kettlebell in there, I can just meditate in there, sometimes I lay in my back and I play these Holotropic Breathwork audios.  Sauna have a lot of research behind them.  Sauna have?  Sauna has?  I don’t know how you say it, but either way, sauna, research, they go hand in hand.  Increase in heat shock proteins, red blood cells, growth hormone production, muscle maintenance, decrease in joint pain, your skin, your largest detoxification organ, and in particular, near and far infrared are what actually allows for that detoxification to occur.

The full spectrum heaters inside my sauna emit near infrared, they emit mid-infrared, the emit far-infrared, you name the type of infrared you want, boom, they’ve got it.  And, they’re the strongest in the market, 20 times over, but even better yet for me, the only infrared sauna, period.  That’s not going to microwave your body, meaning, this thing is EMF and ELF low.  So, what that means is there is, and I’ve had somebody come into my sauna and test this for me, almost no dirty electricity or electrical pollution when you’re inside this thing.  So your brain is safe and your neurons are safe and your cell membranes are safe and they even have a 100% lifetime, you counted it, lifetime warranty on the entire sauna and all its components.  And, you get 500 bucks off the regular price of this sauna and they throw in a gift with the purchase, very simple, you go to healwithheat.com, healwithheat.com.  And, I’m not joking, I am in this thing, either my wife and I are lounging in there at night, my kids go in it and meditate, I go in there and sweat in the mornings, I use my sauna almost every day.  So, healwithheat.com.  The one that I have is called The Sanctuary, the Clearlight Sanctuary.  May I recommend to you, as your sauna sommelier, the healwithheat.com Clearlight Sanctuary Sauna?  You go to healwithheat.com, use code BEN, saves you 500 bucks, they throw some extra goodies into the mix.

Also, if you want to have fitness in your phone like a personal trainer in your pocket.  There is this wonderful app, it’s called Aaptiv.  They have over 2,500 trainer-led, music-driven audio fitness workouts.  You can work out when you want, where you want, the way you want.  They’ve got treadmill, they’ve got running, they’ve got yoga, they’ve got strength training, but they pair it to really cool music, like these top artists that they have featured on playlists that are synced perfectly to each workout.  And then, they have awesome trainers that walk you through each of the workouts.  And again, you don’t have to just do it for running, it works for weightlifting, they’ve got meditation, they’ve got indoor cycling, they’ve got outdoor cycling, they’ve got indoor running, they’ve got outdoor running.  This is the… if I could say Cadillac I would, but I think I already said Cadillac, so I’m going to say the Tesla of fitness apps because all I know are car analogies.  The Tesla of fitness apps.  So, it’s called Aaptiv, A-A-P-T-I-V.  Here’s how you can get 30% off of an Aaptiv membership: you just go to Aaptiv, like active except spelled a little bit differently.  A-A-P-T-I-V, aaptiv.com/ben.  Aaptiv.com/ben.  Boom, you’re off to the races.  Everything fitness in your pocket™.

Alright, back to today’s show.

Ben:  You said there are two other ingredients: ginseng and one other.  Tell me about these.

Judson:  Yeah, ginseng and Muira Puama.  So, they are also scientifically studied and potent nitric oxide boosters with also some antioxidant.  Red beet extract also is a strong antioxidant.  And so, they have health benefits on top of also being nitric oxide boosters.

Ben:  Okay, so ginseng I’m familiar with, this other one, I’m not though.  Can you say the name of it again?

Judson:  Muira, M-U-I-R-A.  Puama, P-U-A-M-A.

Ben:  Where do you get that?

Judson:  It’s the root of a Brazilian plant.

Ben:  Okay.  Interesting.  As far as a lot of these supplements go, have you noted this idea of signature of nature how a lot of them, like if you look at ginseng root for example, it almost looks a little bit like sperm or a lot of these root-based vegetables or this root-based thing from Brazil that you’re talking about, a lot of the time it’s like this hard, firm, almost phallic-shaped object.  Do you think there’s anything to that, this idea that nature gives you clues about what type of things would be beneficial for sexual health, or for the brain, or eggs for the eyes, or anything like that?

Judson:  You know, from an evolutionary perspective that makes a lot of sense.  If you’re a cave person running around and you want something for a certain function, you would certainly grab…  That’s why people hack horns off rhinoceroses, not that it necessarily does anything, but…

Ben:  Yeah, don’t put rhino horns in your supplement.  That might get you shutdown.

What kind of things do you personally recommend for people either avoid or include in their diet for blood flow, aside from just popping pills and taking supplements, are there specific foods that you really like to see in a daily basis?  Obviously we’ve talked about something like fermented beets or watermelon, but what would be others that you would especially recommend?

Judson:  You know, to be honest, I’m not a nutritionist and I’m not an expert in those kind of things.  What we recommend typically is just increasing the amount of water consumption to not even a specific number, but just keeping the urine at a light yellow or hay color.  That’s the best way really to figure out exactly what your water consumption is, is what we call the specific gravity of the urine.  So, we can actually test what that is, but really the color is the easiest way to pick that up.

Ben:  Okay.

Judson:  In terms of making nutritional recommendations, you’re way, way ahead.

Ben:  Yeah, I can tell you this, the four hour body thing, I love Tim Ferriss, that dude is an amazing, forward thinker, and immersive journalist, and self-experimenter, but he had a recommendation, the Four Hour via this huge fatty steak with pine pollen a few hours prior to a hot date or prior to sex, and in my opinion that’s a good way to create a food baby and divert a bunch of blood flow from the crotch to the gut.  And there are certain things that I actually recommend to my clients, that I’ve recommended on the show before that guys do before sex or just to increase nitric oxide production in general like a salad that has arugula, and then pumpkin seeds, some extra virgin olive oil for the flavonols and polyphenols and the extra nitric oxide you’d get from that, some beets obviously, cubed beets or cubed watermelon, almost like a lighter salad designed to enhance nitric oxide production.  You have that with some red wine and some dark chocolate, I mean, that’s even something you can use, assuming you’re okay with the fiber content of it pre-performance.  You can use that for a time trial ride on a bike or to open up the blood vessels prior to doing a sauna detox.  There’s a lot of different ways you can use a stack of foods like that, but ultimately, in my opinion I think, for example, on a hot date night with my wife, I actually avoid the huge cuts of meat and instead go for the lighter fare: wild-caught fish, salmon, stuff like that, also very good for the omega3 fatty acids.  That can help with that as well.  But yeah, I’m not a fan of the steak approach, as popular as that is.

Judson:  I totally agree with you and I talk to my patients about this all the time.  I ask them, if you’re going to go out and play a set of competitive tennis with someone, are you going to do it at midnight after you’ve had five or six drinks and a big dinner?  Of course not!  What you’re going to do is eat right in the morning, get enough sleep, do some stretching beforehand, but unfortunately that’s a lot of time when people engage in physical intimacy is at the end of the night after a big meal, after a bunch of drinks, and so on and so forth.  So, the fact that they’re not performing the way that they want to perform is related not just decreased blood flow from atherosclerotic disease and decreased nitric oxide, but also the physical condition that they’re in at that point they’re dehydrated, they’re tired, and most of their blood flow is being devoted to the GI tract.

Ben:  Yeah, it’s interesting.  Now, in terms of other hacks or scientific protocols or medical protocols or anything else that you would do in your clinic to improve male or female sexual performance, is GAINSWave and FEMIWave the only ones?  Are there others that you would do as well?

Judson:  So the data behind GAINSWave and FEMIWave is really solid.  It’s increasing all the time.  In fact, I’m trying to put together a national registry study in the United States so that we can have tens of thousands of patients contributing data to a national registry because when you’re in private practice, if something works, 70-80% of the time you’re going to have 20 to 30 patients knocking on your door, telling you, “how come this didn’t work?”  And so, it’s really important for us to understand who it works on, but also who it doesn’t work on and then figure out, okay is this never going to work on those patients?  In which case, let’s set their expectations that it’s not going to work and let’s go to some of the other things that we have like try mixed injections or penile implant or vacuum erection device.  Urologists all sorts of tricks that we can use to get people back and active sexually.

Ben:  Vacuum erection device?  That’s a penis pump right?

Judson:  Penis pump, yeah.

Ben:  There’s not an equivalent of that for women, is there?

Judson:  No.

Ben:  Okay.  So, I actually use that.  The folks at GAINSWave gave me one, like a Cadillac of penis pumps – a digital penis pump to actually use for, I think the instructions were, every 30-days or, I’m sorry, every day for 30-days following my procedure.  And, I did that.  It was an incredible device, but the funny thing is, I got about 3-days in and decided that I wanted to go hands-free, meaning that I figured out a way to prop this thing up against my desk just so to where I could still type and have this penis pump doing its thing in the background.  I’d leave it on for about 15 minutes or so and it’s crazy.  For guys who have never used this, you can watch your d**k stretch out.  It goes 12-15 inches long inside this big tube and I remember the third time I was doing this, I was sitting there typing at my computer and there’s a seal at the bottom, like a gasket at the bottom, and you put some coconut oil or some type of lube on your penis before you put it into this pump, and I heard this sucking sound, like a slurp and my left ball got sucked into the pump.

Judson:  Oh no!

Ben:  The worst feeling on the face of the planet.  I look down and my ball is in there turning purple and getting pressurized.  And so, immediately of course, I’m trying to rip this thing off my d**k and rescue my poor little ball from getting…  I literally thought my ball was going to explode in there.  So, word of warning, if any of you go to Judson Clinic or any of these other clinics to get the GAINSWave procedure done and you walk out of there with a digital penis pump, do not try to multitask and go hands-free while you use that thing.  I do not recommend that.  So, anyways though, we digress.

Judson:  Physical intimacy is a really important part of people’s lives and we see all sorts of patients: patients who have prostate cancer that had [40:48] ______ prostatectomies or radiation therapy, or testicular cancer, all sorts of things or trauma and it’s really important and very heartwarming when we can restore erectile function to patients.  I had a patient who’s 74 years old.  He’d been my patient for about 10 or 15 years.  I’d seen him for his prostate and he was taking care of his wife who had Alzheimer’s for about 10 years and then finally she passed away.  And a couple years later, he got a girlfriend and we did GAINSWave on him and started him on Affirm.  And he came in and he had physical intimacy with his new girlfriend and it was the first time that he had that in 15 years and it was just…  He was so elated and it just made us all feel so good about what we’re doing.  It’s sad that sometimes people have to resort to penis pumps or penile implants or injection therapy or GAINSWave, whatever they need to do in order to regain that part of their life.  It’s just, honestly, it’s so rewarding to see patients who come in with that kind of glow that we all get when that part of our life has come alive for us.

Ben:  Interesting.  Yeah, it’s a good point.

Vasectomies, though, that’s another question I get a lot about or I get asked a lot about.  I haven’t had a vasectomy. It’s not because I still plan on having more kids, a part of me has a little bit of a reservation about that whole procedure and I think a lot of guys don’t understand it.  And I’m wondering if you can describe exactly, for people who don’t want to ask that dumb question, how the vasectomy actually works and then, more importantly, does it have an impact on testosterone levels?  I want you to speak to that because I was talking with somebody, I forget where it was, but they suggested that the flow of sperm, I believe it would be through the vas deferens, if it doesn’t happen in the presence of vasectomy that that could potentially decrease your testosterone production because that could be a trigger for your Leydig cells in your testes to produce testosterone.  And so, I figured I’d ask you about it.  I realize you do vasectomies.  So, you may have a slightly jaded reply, but ultimately describe vasectomies in general, how they would work, and any risk factors associated with them including testosterone.

Judson:  Absolutely.  So, I’ve done probably about 3,000 vasectomies.

Ben:  That’s more vasectomies than I’ve done.

Judson:  Yeah.  And having four kids myself, I have a vasectomy.  So, obviously I believe in it.  So, a vasectomy is a really fantastic way for men to control the reproductive process.  And typically a vasectomy will take about 15 minutes.  Most experience vasectomists use what’s called the no-scalpel vasectomy where we just make a tiny little puncture into the skin on either side and pull up the vas.  The vas itself looks like a piece of spaghetti and typically what I do is I crush the edges on either side, remove a piece of the vas, about a centimeter or two, and then cauterize the edges.  So basically, what that does is when you ejaculate, 99% of the ejaculate comes from the prostate and the prostate is upstream from the testicle and from the vas.  So, ejaculation looks and feels the same, you can’t tell any difference in ejaculation.  In terms of the testicle, 90% of the testicle is built around making sperm, 10% of the testicle is built around making testosterone.  Testosterone is delivered to the bloodstream directly.  It doesn’t go through the vasectomy or the vas tube.  So, the only thing that you’re doing when you’re doing a vasectomy is stopping the flow of sperm and if a lot of guys think that the sperm is actually the ejaculate, what I tell patients is that you get the whole swimming pool, but not swimmers.

Ben:  Okay.  So, there actually isn’t a loss of ejaculate.  All you’re missing out on is the sperm.

Judson:  Exactly.

Ben:  Okay.  So that kind of shoots that theory down, basically, that the flow of fluid through the vas deferens would somehow trigger a testosterone release.

Judson:  No, absolutely not.

Ben:  Okay.

Judson:  And, there’s a lot of urban legends that it causes prostate cancer and so on and so forth.  But when they did a study in New Zealand where they looked at everyone that had a vasectomy and looked at the rates of prostate cancer in those patients and then looked at the men who hadn’t had vasectomies and looked at the rates of prostate cancer and there was no difference in the rates of prostate cancer.  The problem is, when people get cancer, they always want to figure out like, what’s the reason I got cancer.

Ben:  Right.

Judson:  So okay, well I had a vasectomy and that must have been it.  But, men get prostate cancer at a very high rate whether you had a vasectomy or not and there’s really no difference in the incidence of prostate cancer or really any other disease.

Ben:  Is a vasectomy reversible?

Judson:  Technically it is.  So the inner tube of the vas is maybe a millimeter, maybe smaller, so you need a microsurgical procedure that takes about three or four hours in order to reconnect it.  That procedure probably costs you around $20,000.  So, technically it is.  Once you hit about 7 years after a vasectomy, it becomes more difficult to reverse.

Ben:  Okay, got it.  Interesting.  Alright so, I want to ask you also about this idea of hormone replacement therapy.  Do you do much of this at all in your clinic?

Judson:  I do.  I mean, that’s part of what we do.  It’s not extensively what we do.

Ben:  For testosterone particularly, are there things that you would recommend or things that you would combine with even the use of an injectable testosterone or testosterone lotion or cream that would enhance the effects of that kind of similar to the use of something like nitric oxide supplements to enhance the effects of a GAINSWave or a FEMIWave procedure?

Judson:  You know, once you start supplementing with testosterone, you’re basically relying on an exogenous, or outside source of testosterone to take the place of the testosterone that your body is actually making.  So, it’s either you’re taking it or you’re not taking it.  If you’re not taking it, there are some things that you can do to boost the testosterone.  But if you are taking it, basically what I tell my patients is it’s kind of like a space heater versus central heat and air.  If you set your central heat and air at 72 degrees, you’re going to produce a certain amount of heat.  Your body has a set point for testosterone that your body will produce testosterone.  Now, if you take a space heater and start cranking it up, at a certain point, the central heat and air will kick off.  So, if you’re replacing your testosterone exogenously from the outside, at some point your body’s testosterone production will stop and if you do that for long enough, the testicles will begin to shrink.  I mean, I had a patient who was an ex-Oakland Raider defensive end.  This guy was massive- 350 pounds.  He came in actually for a vasectomy and when I examined him, his testicles were the size of peas.  So, this guy must have been using high doses of steroids for years and years and years and if you saw him walking down the street, you would definitely walk to the other side.  He was gigantic, but his testicles were minute.  It’s really important to understand that when you start testosterone that that’s basically what you’re committing to.

Ben:  Well, a lot of guys will come off it though and use things like Clomid, for example, is what you’ll see.I believe it was Jon Jones that got popped for Clomid use and a lot of times guys will use that to decrease the effects of coming off of testosterone or stopping it or even people who are illegally using it because it’s banned by their sporting organization, they’ll use something like Clomid, for example, from what I understand, which is ironically enough also banned.  But are there things that guys do or that have been proven to allow you to stop a testosterone replacement once you get on it?

Judson:  Right, but then you’re simulating a pituitary hormone.  Once you begin to mess with Mother Nature, you’re pretty much committed to doing that.  We treat a lot of patients for prostate cancer and prostate cancer is a testosterone-sensitive cancer.  And so, one of the things we do is we shut down the production of testosterone by blocking the pituitary production of LH.  And so, what you’ll see, now these are older men, 50s, 60s, and above, but once they’ve been on these medications for three or four  years, a lot of times you can go to what’s called intermittent therapy which means you only give them a shot when their testosterone starts going up.  And so, sometimes the testosterone doesn’t start going up for two or three years or longer.  And so, basically what you’re doing is you shut down the production of testosterone from the testicle and so if you’re a young guy and you’re on testosterone replacement for five or six years, you can’t automatically assume that it’s going to come back.

Ben:  Wow, yeah.  I hear that over and over again from guys who claim that their decision to use TRT was a huge mistake because if your testes are still functioning, basically you’re triggering this intense drop in Luteinizing hormone that, yeah, from what I understand, it’s incredibly hard to get back.  So if you stopped cold turkey, does it ever come back?  Do you just have a very hard time for several months or how bad are we talking for guys who are on testosterone?

Judson:  Yeah, it really varies.  It depends on the age, it depends on how long you’ve been on it, it depends on the levels that you put yourself on, and then it’s just genetics.  Some people obviously bounce back better than others.

Ben:  Interesting.  How many guys are on testosterone, in your opinion, being a doctor and looking at things from a little bit of an objective standpoint?  Is it a lot of people who come into your clinic who are using testosterone?

Judson:  Because I’m a urologist, I tend to get the patients where it’s a problem rather than the patients that are just coming in for regular testosterone replacement.  And so, a lot of primary care physicians and endocrinologists have patients on testosterone.  If they’re not having a problem, I’m not seeing them.  Honestly, I don’t have a really good read on exactly how many people are on testosterone therapy, but if you’re younger and you’re just doing it for you could be a better football player or a better weightlifter or a better cyclist, there are really some very significant long-term implications of being on it.

Ben:  Yeah, especially when there’s so much low hanging fruit from zinc and creatine and mineral supplementation to the use of infrared light to a host of nutrients you can consume including things like pumpkin seeds and shellfish, even the avoidance of a cellphone in the pocket or high amounts of dirty electricity or high amounts of stress or low sleep or infrequent sex.  There’s so much low hanging fruit when it comes to things guys don’t do and they instead use that quick fix for increasing testosterone.  I see this over and over again.  And it’s just flabbergasting when there are so many things you can do to enhance testosterone naturally.

Judson:  Yeah, I agree with you entirely.  There are so many great resources on your websites and your blogs that people can tap into to figure out how to do this naturally.  And on top of it, it’s expensive.  I had a patient the other day, a nice guy, I removed his testicle for testicular cancer and he’s been on testosterone replacement because of that and he got an abscess of his leg and was hospitalized for five or six days.  So, it’s not…  Injecting testosterone is not innocuous and I can’t say strong enough that if you’re young and you’re healthy, there are many, many things that you can do to boost your testosterone and boost your energy without going on testosterone replacement.

Ben:  Yeah, interesting.  Kind of related to that is this concept of sports, particularly endurance sports and there is of course the use of things like EPO and testosterone and other things to enhance performance in that sport, for triathlon or for cycling for example.  When it comes to triathlon and cycling though, I think it’s this combination of chronic cardio plus time spent on the saddle that both men and women experience some hormonal issues and sexual issues from that, especially from the pressure in the seat.  Both populations have asked me, what do you do about some of the sexual issues that arise from simply being in a bike saddle for long periods of time?

Judson:  There’s a guy, Irwin Goldstein, down at UC San Diego.  He’s the father of this whole research and he’s a fantastic urologist, he’s a great researcher, and he said there are two types of cyclists: those who are impotent and those who will be.  Now, I don’t necessarily subscribe to this, but there was a big study published by the American Urologic Association that compared runners, swimmers, and cyclists and the amount of erectile dysfunction in those different populations.  And so, it was 1.1% of runners, 2% of swimmers, and 4.2% of cyclists with erectile dysfunction, and it was a big study with thousands and thousands of men.  So, there’s definitely something to the link between cycling and erectile dysfunction and when you look at it, it’s really the seat, the bike seat.  That is really what it comes down to.

And, I want to get a little anatomical, if you don’t mind.  Ischial tuberosity is basically your sitz bone and it evolved into basically the perfect place to bear body weight.  The issue of pubic ramus, which is the area that’s going to bear weight if you’re sitting on a conventional bike seat, is it contains a lot of erectile tissue, nerves, arteries, and the urethra.  But the ischial tuberosity has no organs attached to it, no nerves, no arteries, it’s just surrounded by fat and muscle to the buttocks.  And it’s very well vascularized and it’s evolved to allow humans to sit comfortably and safely for hours.  Most bicycle seats are not wide enough to support the ischial tuberosity and basically you end up straddling the bike and sitting on the internal part of the genitals.  So, half the penis is actually inside the body and so there are two ways you can actually injure things.  One way is traumatically, which is pretty obvious.  The other thing is a constant compression.  And they did studies looking at guys that were leaning on the nose of the bike, and 95% of the blood flow was reduced whereas if they were using a seat with no nose, it was basically 0% of the blood flow.

Ben:  So these no-nose saddles, there’s no drop in actual performance or the ability to be able to reduce torque against the cranks?

Judson:  If you’re using toe clips and you’re sitting on your sitz bone, I don’t think there should be.  Just from mountain biking for many, many years and doing triathlons and cycling, you basically use the nose of the bike to steer.  And so, for a lot of my patients I tell them if you’re doing spinning or you’re on rollers or on the stationary bike, you better not have a nose on the seat.  That’s a situation where you’re not steering at all.  So you’d be crazy not to take advantage of a wide, well-padded seat with no nose.

Ben:  Yeah, for me personally, because I experimented with this a lot when I was racing Ironman, and I tried a lot of these no-nose saddles and I found that I almost felt like I couldn’t get that bike control and power production that I wanted.  There was a brand, and they don’t sponsor the podcast or anything like that, this is just the brand that I use, it’s called ISM.  Have you seen these ISM saddles where there’s still kind of a nose, but it’s got a hole, like a gap, between the two sides of the saddle where the nose sticks out?

Judson:  Yeah, you’ve got to be careful of those though because the thing is that slit down the middle basically allows the urethra to drop down into that hole, but the neurovascular bundle on either side of the penis basically is lateral.  So basically, those things are directly putting pressure on the area that you don’t want it to put pressure on.

Ben:  Really?  What do you use for a bike saddle?

Judson:  The best seat that I find, I can’t remember the name of the brand, but basically the nose drops down.  And so, you sit on the sitz bones and then the nose of the seat drops down.  So, you still have a little bit of a nose to help you steer and so on and so forth, but most of the sitting is on the sitz bones.  The other thing is, get out of the saddle fairly frequently, take a rest every once in a while, and make sure you’re well-hydrated.  And also, GAINSWave is really an ideal treatment for these patients because part of GAINSWave it’s not just shocking the penis, but it’s shocking the perineum.  So, what you’re doing is you’re getting the internal pudendal artery as it comes medial to the ischial tuberosity.  So basically, you’re trying to get as much of that artery as you possibly can to stimulate regrowth and clearing out of blood vessels.  So GAINSWave actually, in my experience, has worked really, really well on men with cycling related compression injuries.

Ben:  Interesting.  Okay, got it.  If you find the name of your saddle or if you’re at home and you send it to me, I’ll put a link to it in the show notes because I don’t know the one you’re talking about with the nose dropping down.  But I still have the ISM on my triathlon bike upstairs that I admittedly still need to race on.  I actually have not done a single triathlon this year, but I swim and I bike and I run quite a bit for cross training and it’s irking me right now that I’m not signed up for a triathlon because I used to be known for racing Ironman triathlons and being a triathlon coach and a crazy triathlon exercise physiologist and I don’t really do much of that at all.  So, if any of you are listening in and you have a triathlon that I should really go do, let me know.  I’m looking for the flat and fast stuff now that I’ve got a little bit of Spartan racing muscle on me.  But ultimately, I’m a huge fan of triathlon, especially the sprint and the Olympic distance stuff that doesn’t involve a lot of chronic cardio and doesn’t necessarily cause a lot of the same hormonal depletion and overtraining issues that the longer half Ironman and Ironman races can, in my opinion.  I’ve seen a lot of people mess themselves up with that distance.

I want to ask you too, Judson, about this concept of stem cells.  So, I’ve had my penis injected with stem cells three times and also with PRP and even exosomes.  Do you do stem cell injections in your clinic?

Judson:  I’m just starting to do stem cell injections.  I’m very, very cautious about this.  There’s a lot of misinformation, over information, confusion about regenerative medicine.  And so, if you don’t mind I can sort things out a little bit?

Ben:  Yeah, absolutely.

Judson:  So, one thing is what’s called the P-Shot or platelet rich plasma.  So what that is, is in human blood you have three different main components: platelets, white blood cells, and red blood cells.  Okay, so what you do is you take about 30cc of blood and you spin it down.  When you spin it down, the red blood cells go to the bottom because they’re filled with iron, hemoglobin, and you don’t need the red blood cells.  You take out the red blood cells and then blood floats in, basically, water called plasma.  So, you take out the plasma and in the middle, you end up with platelets and white blood cells.  Now, most people think of platelets as just something to stop bleeding, right.  But platelets are round, so how can something round stop bleeding and make it clot?  Well, what happens is if you cut yourself, the platelets are drawn to the area where you cut yourself and then they become activated.  When platelets become activated, they put out arms, almost like they go from being a round ball to being a starfish, and they join with the other platelets and create a web.  And then, that web catches fibrin and thrombin and all the other clotting factors and you create this clot.  Now, the beautiful thing about the way that the good Lord put us together, is He put or She put what we call alpha granules into the platelets and those alpha granules contain all sorts of amazing growth factors like platelet derived growth factor, PDGF-beta, VEGF, epidermal growth factor, fibrin and fibronectin which increases bone formation, and so those growth factors are delivered almost immediately and exactly to where you need the regrowth.  And so, if you ever wondered why when you cut yourself you heal so quickly, it’s because the platelets are delivering those growth factors.

Ben:  Right.

Judson: So when you do a P-Shot, what you’re doing is you’re drawing the blood out and then you’re taking out that concentrated layer of platelets.

Ben:  And, by the way, for people who know, you’re not drawing the blood out of the penis or the vagina, you’re drawing it out of the vein in the arm.

Judson:  Exactly, exactly.  And so, a PRP is basically four to five times the amount of growth factors and platelets as the regular blood.  And when you inject the platelets, the activation, the growth factors are delivered and 75% of it is delivered in the first 10 minutes, and 100% is delivered in the first hour. And so, then basically what you’re relying on is that these growth factors will stimulate the growth of blood vessels, of epithelial cells, of the spongey tissue of the penis.  Obviously it’s used in orthopedics and wound healing and those other things, but that’s basically what the P-Shot is.  And there is evidence that if you inject it into the penis, that it improves erectile function.  But, there’s…

Ben:  Well, I did the GAINSWave with the P-Shot and without the P-Shot and I definitely noticed it more with the P-Shot, but I’ve got to be honest with you, nothing seemed to really compare to the actual stem cell injections.  Those were night and day difference as far as still lasting, in terms of the way that I feel sexually, the length of my orgasms, sexual performance, etcetera.  So yeah, I’m definitely interested in your take on the stem cells also.

Judson:  There are three different types of stem cells, currently.  One is what’s called adipose stem cells, so those are stem cells that are harvested from fat.  So, basically you do a liposuction and then you isolate the stem cells in the adipose.

Well, let me back up.  So, what is a stem cell, right?  A lot of people don’t quite understand exactly what a stem cell is and what the stem cells that we’re looking for are.  So, when a sperm meets and egg, it creates one cell.  That stem cell is what we call a pluripotent stem cell meaning it basically becomes everything that you have in your entire body.  It becomes your hair, it becomes your teeth, it becomes your kidneys, it becomes your liver, it becomes your toenails, right.  That one stem cell, with its DNA, basically can become anything.  Now, as that single cell begins to replicate, it becomes a morula, blastula, and all those kinds of things you learn in embryology.  Then it forms three layers.  It forms the ectoderm.  So, “ecto” means outside.  So, bone, skin, those kinds of things.  It forms the endoderm.  “Endo” means inside, right.  So, it forms the GI tract.  And then, it forms the mesoderm.  “Meso” means middle – blood vessels, heart, muscle, those kinds of things.  And so, what we’re looking for are what are called mesenchymal stem cells or stem cells that come from the mesoderm.  If you’re looking for ectoderm or endoderm stem cells, you’re looking for the wrong stem cells.  You want mesenchymal stem cells which are the ones that grow blood vessels, heart, and muscle.

Okay, so in adipose, you can isolate stem cells and the nice thing about those stem cells is they haven’t replicated all that much.  When you take those stem cells out of someone, they’re the same age that you are, but they haven’t replicated that much.  Another thing you can do is aspirate bone marrow, right.  So the bone marrow is producing red cells, it’s producing white cells, it’s producing platelets, it’s a fairly active stem cell population.  But when you’re looking at those stem cells, those stem cells have already differentiated themselves into stem cells that are building blood vessels.  The stem cells in the adipose and the fat are stem cells that have differentiated themselves into building fat and structural tissue.  The other thing that you can do are what we call umbilical stem cells.  Now, the disadvantage of umbilical stem cells are that they come from someone else.

Ben:  Yeah, that what concerns me is you’re looking at potentially the DNA and nucleus, if I’m not mistaken, from someone else’s body going into your body.

Judson: Exactly.  So well, I mean, we get blood transfusions and we do organ transplantation and so on and so forth.  So, it’s not unheard of to do.

Ben:  A lot of people on organ transplants, they’ve got to be on autoimmune medications or immune suppression medications for the rest of their life.

Judson: Exactly.  So, these and the women that they get these from, they’re tested for all infectious diseases before, during, and after.  And a lot of these are in quarantine for a couple of weeks to make sure everything is all clean.  So, basically you inject these stem cells, which are new born stem cells that they get from umbilical cord blood, from the placenta, from Wharton’s jelly, from the amniotic fluid, and these are mesenchymal stem cells that you’re injecting.  In addition to those stem cells, what you’re also getting is a huge concentration of growth factors.  I had an extensive conversation with… there’s a lab in Wake Forest University, a guy named Anthony Atala, who’s just an incredibly, amazing…  He’s probably the top regenerative scientist in the world.

Ben:  Anthony Atala?  How do you spell his last name?

Judson:  A-T-A-L-A.

Ben:  Okay.

Judson:  He’s growing bladders.  He’s growing vaginal tissue.  I mean, the work that he’s doing is just mind boggling.

Ben:  Wow.  Is he the guy who printed a human kidney?

Judson:  Yeah, exactly.

Ben:  Wow.  Amazing.

Judson:  Yeah.  He actually printed a vagina, which sounds kind of weird, but there’s a congenital problem that little girls are born with where they don’t develop a vagina.  And so, to be able to create vaginal tissue in the lab that you can then transplant into new born girls really is a remarkable accomplishment.  And so, he’s done amazing things like that.  But I talked to him and some of the people in his lab asking them is it actually the stem cells that are growing when you reinject them or is it the growth factor?  And they used to think it was the stem cells themselves, but now most of them are leaning towards the fact that it’s the growth factor that are actually pushing things along.  But I think it’s important to know that we don’t really know what actually is happening, but the…

Ben:  So, long story short, if you were going to do a stem cell injection to the genitals, you would go with someone’s own fat stem cells or stem cells from bone marrow, combine that with PRP, and inject that?

Judson:  Yeah, I think that the best results are going to be the umbilical stem cells to be perfectly honest and combine that with…

Ben:  Wait, the best results would be the umbilical?

Judson:  The umbilical because you’re basically using new born stem cells and a tremendous amount of growth factors that come along with that.

Ben:  And you think that would be even better than your own stem cells?

Judson:  Yeah, to be honest with you, it’s really…  That’s just my best guess.  There’s not enough science that has been done to make any sort of definitive statement.

Ben:  Interesting and the only consideration with the umbilical would be the potential, just in case, of an unclean donor or I don’t know, I guess, Lyme disease or something like that in the actual stem cell from a foreign human?

Judson:  Exactly.

Ben:  Okay.

Judson:  The safest way to go is probably the P-Shot.  It’s just drawing blood.  It’s your own blood and there’s some decent data on that.  Really the well-controlled studies haven’t been done yet unfortunately.

Ben:  Yeah, interesting.  Well, this is all fascinating.  I still think if I were going to do the stem cell injections, I personally feel more comfortable just using my own stem cells, which is what I wound up doing.  That was the one that I know has the most differences with the use of the stem cells that were harvested from my fat and then reinjected after being grown for the mesenchymal stem cells, the MSC content, and then combined with growth factor and then injected.

So ultimately, I think that we’re addressing a very small niche of the population who would ever consider doing this anyways.  For me, it was more of kind of like an immersive journalism thing where I was doing it, you have to write a story to report on the results for a guy who is doing it, rather than for erectile dysfunction, just to basically see what happens to sexual performance.  So ultimately I realized not many guys are going to rush out to do this.  I think there’s a lot of other low hanging fruit.  I think even, we discussed, GAINSWave is probably a much more affordable and less fringe thing to turn to versus getting stem cells injected into your d**k.  But, since I’m known as the guy who injected stem cells into my d**k, I figured I should bring it up.  Ultimately though, this is a…  Go ahead.

Judson: Yeah, I mean, there’s absolutely no downside of GAINSWave.

Ben:  Yeah.

Judson: Out of the hundreds of patients that I’ve treated, knock on wood, not one single patient has even had any bruising.  And so, basically it’s time and it’s expense, but there’s no downside of doing it.  And, I only use stem cells and P-Shots on patients who actually fail twelve GAINSWave treatments and really want to go for something more.

Ben:  Yeah.

Judson: And also, it’s really important to take Affirm, to take a nitric oxide booster, not just for dysfunction, but also overall physical function.

Ben:  Yeah, yeah.  Well, if there’s anything I took away from this, it would be this concept of combining a nitric oxide booster with something like GAINSWave.  When I go down to Florida…  Well, I’m leaving in four days, I’m going to grab a few of my little… I’ve got a few different beet capsules and companies send me all the time, these nitric oxide boosting supplements.  I’m going to grab a handful of those and stack them when I go down and probably give some to my wife as well.  So, we’ll have a good time down there in Florida.

In the meantime, you guys don’t have to go to Florida, you can go to anywhere if you want to go get a GAINSWave treatment done. I’ll put a link in the show notes to the GAINSWave for men and the FEMIWave for females, along with Judson’s website and his Affirm supplement.  What I’ll do is…  I talked to Judson before this podcast, if you’re listening in, and if you go to bengreenfieldfitness.com/shockwave, that’s bengreenfieldfitness.com/shockwave as in shockwave therapy, I’ll put a link also to his Affirm supplement and we’ll get some kind of a discount.  I think we can get a 15 to 20% discount on that for you guys if you want to try this blend of citrulline, red beet extract, Muira Puama, and ginseng if you want to toss that one into the mix.  And, I will also put a link to everything else that we discussed, including the article on the benefits of fermented beets and Judson will send me a link to this bike saddle that he uses and I’ll put that in there too.  And, you guys can go knock yourselves out over at bengreenfieldfitness.com/shockwave.

In the meantime, Judson, thanks for coming on the show and sharing all this stuff with us, man.  It’s fascinating, this world of sexual biohacks.

Judson: Hey, my pleasure.  It’s really been an honor to talk with you today.

Ben:  Awesome.  Alright folks.  Well, I’m Ben Greenfield along with Judson Brandeis from Walnut Creek, California signing out from bengreenfieldfitness.com.  Have an amazing week!

 

 

Since my big “sexual enhancement” article in the January 2018 edition of Men’s Health Magazine, I’ve been getting plenty of questions from both men and women about how many of these so-called sexual biohacks actually work.

So I decided to get an expert on the show to talk about this stuff.

Dr. Judson Brandeis is a private practice Urologist in Walnut Creek, California. He has been voted by his peers as a top Urologist in the San Francisco Bay area for the past 4 years. He is a pioneer of using technology in urology and was a very early adopter of robotic surgery, lasers and MRI targeting for diagnosing and treating prostate cancer. Dr. Brandeis is now a thought leader in using GAINSWave therapy for treating erectile dysfunction and developing supplements for improving male sexual function. Dr. Brandeis has always been enthusiastic about athletic performance. He ran track and cross country for Brown University and has competed in triathlons since 1981. He brings his passion for helping men achieve their goals every day to the Pacific Urology Male Performance Center in Walnut Creek, CA.

During our discussion, you’ll discover:

-How GAINSWave works for men, and why it’s different than just “sound therapy”…11:15

-How FEMIWave works for women, and what to expect during and afterwards…16:30

-Judson’s discovery of “triple therapy” to increase nitric oxide levels…21:45

 

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-Why fermented beets do such a good job boosting nitric oxide…25:30

-The importance of L-citrulline and red beet extract, Muira Puama and Asian ginseng…33:00

-Ben’s unfortunate incident with a digital penis pump…39:30

-After having done 3,000 vasectomies, Judson’s opinion on the safety of vasectomies, particularly on testosterone production…43:45

-Whether a vasectomy is reversible…46:30

-How to stop a testosterone treatment once you’ve been on it…50:00

-What to do about erectile dysfunction from long periods of time on a bike seat…54:30

-How stem cell injections into the penis work…1:01:00

-And much more!

Resources from this episode:

-Use BENG for 20% discount on the nitric oxide supplements Judson designs called “Affirm”

–GAINSWave for men

–FEMIWave for women

–The benefits of fermented beets

–The ISM saddle

–The bike saddle that Judson uses

–Anthony Atala

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