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Rebuild, Recharge, Reignite: Optimizing Men’s Midlife Health With Dr. Judson Brandeis
2025/4/11
Finding Genius Podcast
J
Judson Brandeis
R
Richard Jacobs
Judson Brandeis: 我是一名泌尿科医生，专注于男性健康，特别是性功能的恢复和优化。我的职业生涯始于对肾移植的兴趣，后来转向了前列腺癌和机器人手术。大约六七年前，我开始对男性的性功能再生治疗产生兴趣，例如低强度冲击波疗法、高强度聚焦电磁波、干细胞和PRP。我的诊所专注于男性的整体健康，包括性功能、荷尔蒙功能和身体优化。我撰写了《21世纪男人》一书，总结了50位顶级医生和男性健康专家的建议，旨在帮助男性在中年及以后保持身心健康。
我发现90%的性功能障碍是血管生成的，这意味着阴茎的血管开始堵塞，这可能是由衰老、吸烟、饮酒、久坐不动的生活方式、饮食不当和遗传因素造成的。性功能障碍是一个连续的过程，从丧失晨勃和夜勃开始，然后发展为勃起功能障碍，最终可能导致心血管疾病。勃起功能障碍是男性健康状况的预警信号，提示循环系统可能存在问题。
为了改善整体健康和勃起功能，男性应该戒酒、戒烟、戒毒、控制饮食、每天锻炼、每天拉伸、每天冥想、保证充足的睡眠以及善待他人。在诊所中，我会为患者进行全面的实验室检查、病史记录和身体成分扫描，以制定个性化的治疗方案。睾酮替代疗法有多种途径，例如注射、贴片和乳膏，但注射和植入疗法能达到更高的睾酮水平，对于想要改善身体和性功能的男性来说，是更好的选择。
睾酮注射后，男性几乎可以立即感受到改善，包括提高动力、性欲、肌肉增长能力、脂肪燃烧能力、睡眠质量和情绪。一项大型研究表明，睾酮替代疗法对心脏健康有益，不会增加心脏病发作或中风的风险。睾酮注射可能会导致肿块，但可以通过旋转注射部位以及使用冲击波疗法来缓解。皮下注射系统，如Zyastad，可以提供约700-750的睾酮水平，对于难以进行肌肉注射的人来说是一个不错的选择。睾酮是一种大分子，很难通过皮肤吸收，因此睾酮霜的效果有限。
长期服用外源性睾酮会抑制下丘脑-垂体-睾丸轴，导致睾酮和精子的产生减少。为了维持睾丸功能，我会让我的患者服用克罗米芬等药物来阻断负反馈回路。进行睾酮替代疗法时，需要监测睾酮和雌激素水平以及睾丸功能。滥用性能增强药物可能会导致不育和其他严重的健康问题。勃起功能主要取决于血液循环，因此评估血管状况比单纯关注睾酮水平更重要。超声检查可以评估阴茎血管的状况，这对于评估勃起功能非常有帮助。心脏钙化评分可以评估血管堵塞的程度，这与勃起功能障碍密切相关。
VO2 max测试可以评估心血管健康状况。勃起功能障碍可能是心脏疾病的早期预警信号。低强度冲击波疗法可以促进阴茎血管新生。富血小板血浆（PRP）可以促进阴茎血管的生长。一氧化氮可以促进血管扩张，而补充剂如西特律林和甜菜可以增加一氧化氮的产生。伟哥通过抑制PDE5酶来维持环鸟苷酸（cGMP）的水平，从而保持血管开放。一项临床研究表明，将伟哥与一氧化氮增强剂联合使用可以增强疗效，并减少伟哥的副作用。服用非那雄胺或度他雄胺等药物可能会导致严重的勃起功能障碍。可以通过阅读我的书、访问我的网站和YouTube频道以及咨询性医学专家来获得更多关于勃起功能障碍的信息和帮助。关注男性性功能不仅关乎生活质量，也关乎身心健康，勃起功能障碍可能是其他健康问题的预警信号。
Richard Jacobs: 我是理查德·雅各布斯，主持《寻找天才》播客。我的嘉宾是Judson Brandeis博士，他是一名泌尿科医生和性医学专家。我们将讨论他的新书《21世纪男人》，以及如何帮助男性在中年及以后保持身心健康。大多数专业人士只是合格的，只有极少数人才能做到卓越。勃起功能障碍的早期症状是什么？
supporting_evidences
Judson Brandeis: 'Well, you know, I'd say 90% of sexual dysfunction is vasculogenic, meaning that the blood vessels to the penis start to get clogged. And that can become from aging, from smoking, from drinking, from sedentary lifestyle, from not eating the right foods, from genetics...'
Judson Brandeis: 'Yeah, well, I mean, you know, there are 10 things that I recommend men do that will improve their health in general and certainly will also improve erectile function. And that is don't drink alcohol, don't smoke, don't do drugs, don't eat too much, exercise every day, stretch every day, meditate every day, get enough sleep and be nice to other people.'
Judson Brandeis: 'Yeah, actually, I've heard that it can raise your risk of like, you know, I don't know what the circumstance would be, but, you know, stroke or heart attack. Yeah. So actually, there was a recent study that came out called the Traverse Study, which was a massive study that showed that testosterone replacement actually was heart healthy...'
Judson Brandeis: 'So you get nighttime erections so that your penis is ready to have daytime erections. So it would be rare to just have a guy who only gets erections when he needs to get erections. So typically you'll get 30 to 60 minutes of erections every night when you're sleeping, and that brings oxygenated blood and nutrients into the penis...'
Judson Brandeis: 'So I think that really is the best way for me to assess with a single test what someone's erectile function is going to be, is to actually look at the blood vessels in the penis and assess what those blood vessels look like.'
Judson Brandeis: 'Yeah. So one of the most popular ones and one of the best ones is called low-intensity shockwave therapy. And what that is is pulsed You can think of them as sound waves or energy waves that go into the penis...'
Judson Brandeis: 'And then that's also how Viagra works, right? So Viagra targets a specific enzyme that's only in the penis called PDE5, and PDE5 is breaks down cyclic GMP. So if you inhibit PDE5, which is what Viagra does and Cialis does, then you maintain cyclic GMP and keep the blood vessels open.'
Judson Brandeis: 'Yeah. So, you know, one super easy thing to do is just to buy a copy of my book, The 21st Century Man. So it provides information on really all the topics that are related to sexual function...'
Richard Jacobs: '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%.'
Richard Jacobs: 'Hello, this is Richard Jacobs with the Finding Genius podcast. My guest today is Dr. Judson Brandeis. He's a urologist and a sexual medicine expert. So we're going to talk about the 21st century man, advice from 50 top doctors and men's health experts to help you feel great, look good, and have better sex. His book.'
Richard Jacobs: 'Yeah. But again, what does this mean? So is the average man supposed to get multiple erections a day or in the night or... You know, what is a normal circumstance and what is a non-normal one that you run into?'
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