Libsyn Directory

#260 ‒ Men’s Sexual Health: why it matters, what can go wrong, and how to fix it | Mohit Khera, M.D., M.B.A., M.P.H.

Release Date: 06/26/2023

#391 ‒ Colorectal cancer screening: importance of early screening, colonoscopy as a screening and preventive tool, and how to build a personalized strategy

The Peter Attia Drive

In this episode, Peter takes a deep dive into colorectal cancer (CRC) screening, explaining why it is one of the most preventable cancers and why getting screening right can have life-saving implications. He walks through how colorectal cancer develops and why it is uniquely well-suited to early detection and prevention, with a particular emphasis on the dual role of colonoscopy as both a diagnostic and therapeutic tool. Peter also examines the concerning rise in early-onset CRC among younger adults, highlighting why awareness and timely screening matter more than ever. The episode provides...

#390 ‒ AMA #84: Family health history, preventing heart disease, metabolic health, strength training efficiency, dementia risk reduction, NAD supplements, and hydration

The Peter Attia Drive

In this “Ask Me Anything” (AMA) episode, Peter answers listener questions across a wide range of topics, focusing on how to think through real-world trade-offs and apply scientific evidence in practice. He explores how to build and interpret a meaningful family health history, how individual risk tolerance influences decisions around testing and treatment, and why heart disease remains poorly prevented despite available tools. He also examines whether it’s possible to carry excess body fat while remaining metabolically healthy, outlines the minimum effective dose for strength training...

#389 - Thinking scientifically: why it's hard, why it matters, and a practical toolkit

The Peter Attia Drive

In this episode, Peter explores one of the most foundational topics underlying nearly everything discussed on the podcast: how to think scientifically. Framed as an introspective deep dive, he examines why scientific thinking is inherently difficult for humans, the cognitive biases and tendencies that make it challenging to separate belief from evidence, and why these challenges are even more consequential in today’s environment saturated with misinformation. He also offers a framework for improving our ability to evaluate claims, question assumptions, and identify a personal panel of...

#388 — Prostate cancer screening: why current PSA guidelines are failing men and how modern tools improve early detection and save lives

The Peter Attia Drive

In this episode, Peter takes a deep dive into prostate cancer screening, explaining why advanced and metastatic diagnoses continue to rise despite the availability of screening tools, and what can be done to reverse this trend. He breaks down what PSA actually measures and why it is far more informative when tracked over time rather than interpreted as a single value, and he explores how tools like MRI, PSA density, PSA velocity, and improved biopsy techniques can both reduce unnecessary procedures and improve the detection of aggressive cancers. Peter also discusses the role of active...

#387 - AMA #83: Peptides—evaluating the science, safety, and hype in a rapidly growing field

The Peter Attia Drive

In this “Ask Me Anything” (AMA) episode, Peter explores the topic of gray-market peptides, one of the most requested and most confusing topics he’s covered on The Drive. Peptides sit at the intersection of biological plausibility, clinical promise, and aggressive commercialization, and are often marketed as cutting-edge therapies for everything from muscle repair and longevity to cosmetic enhancement. Rather than promoting or dismissing peptides wholesale, Peter lays out a clear, repeatable framework for evaluating any peptide or drug—covering mechanism, intended effects, safety,...

#386 - Aging clocks—what they measure, how they work, and their clinical and real-world relevance

The Peter Attia Drive

In this episode, Peter takes a deep dive into the science and application of aging clocks, unpacking what they are, the differences between chronological age, biological age, and the pace of aging, and what epigenetic clocks may actually be measuring. He explores key research in the field, including a randomized controlled trial that tested simple lifestyle interventions against several commonly used aging clocks, as well as a study using brain MRI to assess the pace of aging and its relationship to dementia risk and mortality. Throughout the episode, Peter highlights the promises and...

#385 - AMA #82: Applying the tools of longevity in the real world: disease prevention, DEXA scans, artificial sweeteners, injury recovery, stability training, habit formation, protein intake and mTOR activation, and more

The Peter Attia Drive

In this “Ask Me Anything” (AMA) episode, Peter answers listener questions across a wide range of topics, focusing on practical decision-making and real-world application. He explores how health priorities and strategies should evolve across different decades of life, which chronic diseases are most challenging to manage and how to think about risk hierarchies, and which emerging interventions—beyond exercise—show the most promise for dementia prevention. Peter also breaks down the utility of wearables and explains how to use and interpret DEXA scans effectively. He discusses the...

#384 - Special episode — Obicetrapib: The CETP inhibitor with cardiovascular benefits and potential Alzheimer's prevention

The Peter Attia Drive

In this special episode, Peter takes a deep dive into obicetrapib, an investigational drug that has captured his attention and renewed interest in an entire class of therapies known as CETP inhibitors. He explains what obicetrapib is and how it works, revisits the history of CETP inhibitors and why earlier versions of these drugs failed—sometimes dramatically—and breaks down the key clinical trials designed to evaluate their impact on cardiovascular risk. Peter examines how obicetrapib influences major lipid biomarkers, including LDL cholesterol and lipoprotein(a) [Lp(a)], and discusses...

#380 ‒ The seed oil debate: are they uniquely harmful relative to other dietary fats? | Layne Norton, Ph.D.

The Peter Attia Drive

Layne Norton is a nutrition scientist and accomplished power athlete,who returns to The Drive for a conversation that departs from the show’s usual format. In this episode, Layne presents the evidence-based case that seed oils are not uniquely harmful under isocaloric conditions, while Peter steelmans the strongest versions of the opposing argument that seed oils are inherently harmful. They examine how scientific bias and evidence are evaluated, revisit the historical randomized controlled trials that shaped the seed oil controversy, and explore the mechanistic biology underlying LDL...

#379 - AMA #79: A guide to cardiorespiratory training at any fitness level to improve healthspan, lifespan, and long-term independence

The Peter Attia Drive

In this “Ask Me Anything” (AMA) episode, Peter brings together his most up-to-date thinking on cardiorespiratory fitness into a single, practical guide designed to help listeners structure training for maximal impact on healthspan, lifespan, and long-term independence. He explains why cardiorespiratory fitness is one of the strongest modifiable predictors of longevity, clarifies what zone 2 training actually represents and how it differs from higher-intensity work, and addresses persistent confusion around exercise volume, intensity, and time constraints. The discussion covers how to...

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Mohit Khera is a world-renowned urologist with expertise in sexual medicine and testosterone therapy. In this episode, Mohit provides a comprehensive overview of male sexual health. He begins with an in-depth exploration of erectile dysfunction, shedding light on its prevalence across different age groups, diagnostic methods, and its intriguing connection to cardiovascular disease. He then ventures into Peyronie's disease, penile fractures, penile enlargement treatments, prolonged erections, premature ejaculation, and anorgasmia. Shifting gears, Mohit delves into the intricate workings of testosterone, DHT, and estrogen, emphasizing their physiological significance and interplay. He explains blood tests for diagnosing low testosterone, the correlation between symptoms and blood levels in cases of low testosterone, and the pros and cons of different methodologies for increasing testosterone. He concludes with a thought-provoking conversation about the role of testosterone in patients with prostate cancer and addresses concerns surrounding DHT, finasteride, and post-finasteride syndrome.

We discuss:

Mohit’s career path and interest in sexual medicine and infertility [3:00];
The anatomy of the male genitalia [5:45];
The prevalence of sexual dysfunction, its impact on quality of life, and the importance of seeking help [7:15];
Erectile dysfunction (ED): definition, diagnosis, pathophysiology, and more [11:00];
The history of medications to treat ED and the mechanisms of how they work [15:30];
Relationship between aging and erectile dysfunction and Mohit's approach to treating patients and prescribing medications [20:00];
The impact of lifestyle on sexual health and the association between ED and cardiovascular disease [29:30];
Causes and treatments for Peyronie’s Disease, penile fracture, and more [37:30];
The value of ultrasound for ED diagnosis and management strategies [47:45];
Various treatment options for ED: injections, penile prosthesis, and more [50:15];
Priapism (prolonged erection): what is happening and when to seek treatment [57:15];
Shockwave therapy as a treatment for ED [1:02:45];
Stem cell therapy for ED [1:08:15];
Platelet-rich plasma (PRP) injections as a treatment for ED [1:12:00];
Premature ejaculation (PE): prevalence, pathophysiology, and treatment [1:14:45];
Anorgasmia: causes and treatment [1:22:00];
The interplay of sex hormones, the impact of aging, symptoms of low testosterone, and considerations for testosterone replacement therapy (TRT) [1:26:45];
Methods for increasing endogenous testosterone [1:38:45];
Testosterone replacement therapy: various forms of exogenous testosterone, weighing risk vs. reward, and more [1:52:30];
The physiology and purpose of testosterone and DHT, why some men feel fine even with “low” testosterone, personalized approaches to treating low testosterone, and more [2:02:30];
Post-finasteride syndrome [2:09:00];
The role of testosterone in prostate cancer and addressing the notion that TRT could increase risk [2:16:15];
The effects of testosterone as an adjunct to therapy for estrogen-sensitive breast cancer in women [2:27:15];
Resources for those looking for healthcare providers [2:28:45]; and
More.

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