Could eating too little fat lower your testosterone?

This research review looked at several studies in adult men to see how low-fat eating affects male hormones. The researchers used controlled studies where men were put on low-fat diets and then compared with higher-fat diets. Altogether, the review included 6 studies with 206 men, mostly from Europe and North America, and the diets lasted 2 to 10 weeks.

Here’s what they found. When men ate low-fat diets, their testosterone levels went down compared to when they ate higher-fat diets. This happened across several hormone measures, including total testosterone and free testosterone. The drop was small to moderate, but it was seen in most of the studies. Men from Western countries seemed to have a bigger drop than others. This change was not just because men lost weight, since body weight stayed mostly the same.

Testosterone helps with energy, strength, mood, and sexual health. A small drop may not cause problems for everyone, but for men who already have low levels, it could make symptoms worse. The biggest drops were seen in diets that were very low in fat. These results suggest that cutting fat too much may not be good for hormone health. I typically recommend about 19% of your diet should be composed of healthy fats.

Is menopause really the reason so many women lose interest in sex—or is it more complicated than that?

This study examined how sexual function in women relates to the severity of menopause-related symptoms. Researchers focused on women going through menopause and measured both their sexual health and how intense their symptoms were, such as hot flashes, sleep problems, and mood changes.

What they found was a clear pattern. Women who reported more severe menopause symptoms also reported worse sexual function. Problems were most noticeable in areas like desire, arousal, lubrication, and satisfaction. In other words, as symptoms like hot flashes, fatigue, and emotional distress became stronger, sexual well-being tended to decline as well. Basically, menopause symptoms affect intimacy, too.

This shows that sexual problems during menopause are closely tied to how intense a woman’s symptoms are. It suggests that treating menopause symptoms may also help improve sexual health. The findings highlight why menopause care should look beyond hot flashes and focus on quality of life, including intimacy. Ignoring sexual health means missing a major part of women’s well-being during this stage of life.

This week, someone asked me, “My wife of 52 years decided 30 years ago, with no explanation, that intimacy would be limited to infrequently sharing hand jobs. When I retired 9 years ago, frequency dropped to twice a year. Mild ED then progressed until I went a year without morning erections. Use of an automated vacuum device restored them, but I have no idea about function. What is appropriate maintenance?”. When you aren’t getting regular erections, either from intimacy or naturally at night, the penile tissue can gradually lose elasticity, making erections harder to achieve. If you're getting consistent nighttime erections, I wouldn't worry. But if you find them declining, you can continue using an automated vacuum device. Aim for regular use for about 5 minutes twice a day. Or you can consider taking a daily tadalafil 5mg, which can help increase blood flow to the genitals. Always remember to focus on your overall health, exercise, good nutrition, and managing blood pressure or cholesterol for the best maintenance.

I love hearing from you, so if there’s a question you’ve been wanting to ask, just let me know. Who knows? Your question might be the one I dive into next!

I just attended the International Society for the Study of Women's Sexuality meeting and learned more about how we can optimize women's sexual health!

There's now an FDA-approved topical Viagra that women can apply to their clitoris to help with arousal disorder! It should be available in the next couple of months. I'm excited to see how it helps!

I also watched a new documentary, "The Pink Pill," which releases on Paramount+ on March 6th. It was fascinating to see the challenges the industry faced in getting a medication for women with low sexual desire onto the market. I strongly encourage everyone to watch it!

I dove into the wild world of “nutmaxxing”—that’s internet lingo for guys trying all sorts of things to boost their semen volume—and broke down what really works and what doesn’t. “Can you increase semen volume? Sure, through delaying ejaculation, proper hydration, pelvic floor strength, and taking care of your health. The evidence for supplements is weak, and in most cases it's really non-existent.”

Here are some quick takeaways:

Remember, most partners don’t care about semen volume, and focusing on health wins every time. If you’re curious, check out the full episode for science-backed tips and why less is sometimes more!

I had such a great conversation with Dr. Vonda Wright all about keeping our bones, muscles, and joints healthy as we age. She really opened my eyes to how much our skeleton does for us! As Dr. Wright put it, “Bones are the storehouse of all the minerals our bodies use—calcium, magnesium, phosphorus. They are an incubator…where all of our baby blood cells are made.”

Here are a few quick takeaways:

Trust me, you’ll want to keep your bones happy for a strong, mobile, and independent life! So listen on Apple Podcasts, Spotify, or here and see why people are commenting, “Doctors/ ladies, thank you both!”.

Putting off a urology visit because it feels awkward? Check out my new Substack: What Every Man Should Know Before Visiting a Urologist.

In this article, I walk through exactly what happens at a urology appointment, why symptoms like urinary changes or sexual issues shouldn’t be ignored, and how getting checked can protect your health, confidence, and quality of life—based on what I see every day as a urologist.