December 4, 2025 • 30 mins
Hosted by Neil Scott and Dr. Tom Walsh
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Speaker 1 (00:00):
Welcome to Men's Health Matters with doctor Tom Walsh, director
of the University of Washington's Men's Health Center and Associate
Professor of Urology at UW, featuring important topics dealing with
men's health, including prostate cancer and erectile dysfunction. Now here's
your host, Neil Scott.
Speaker 2 (00:21):
Welcome to the October edition of Men's Health Matters, dealing
with health issues that directly affect men. I'm Neil Scott.
My co host is doctor Tom Walsh, director of the
DUB Men's Health Center. As we discuss topics focusing on
men and providing resources for immediate action. Now, good health,
good men's health, must be a priority. How are your,
doctor Walsh? It is October. School is back in session
(00:44):
at the UDUB.
Speaker 3 (00:46):
I know, and it's it's cold, right like the weather, Yeah,
only changes its cold and Chris, but I appreciate you asking.
I'm excited for fall, you know. I love the summer
and the warmth. But I'm a true Seattle I'm anxious
for the rain and the cold and just bring it.
Speaker 2 (01:04):
What's happening at the Men's Health Center.
Speaker 3 (01:05):
The Men's Health Center is busy, like we always are,
seeing men day in and day out. Big concerns, little concerns,
things that you know, keep men tied to good health,
and we're doling out common sense left and right.
Speaker 2 (01:19):
I want to once again remind listeners that the ub
Men's Health Center is not just for the U dubbed
students and faculty, but for the entire community. It is
for everybody. Everyone you know. We all know there's a
direct link between smoking and cancer, but what we are
now discovering is there is a link between the smoke
from the Pacific Northwest wildfires and men's health. At the
(01:42):
height of the fires from twenty eighteen through probably twenty
twenty three, U dub lung specialist, doctor Bonnie Ruanish described
it as smoking a giant cigarette. But the fires effect
more than just lungs. UW your researchers are discovering that
it has a dramatic effect on the quality of men's sperm,
and we are fortunate to have the lead researcher on
(02:04):
a new published study, doctor Tristan Nicholson, prominent research at
the University of Washington. She is with us today to
talk about the ongoing research and the implications for men
concerned about their fertility. She's been a guest before on
Men's Health Matters and we are delighted to have her back.
But before we talk to doctor Nicholson, we'll take a
(02:25):
few questions from Men's Health Matter's anonymous inbox. Of course,
that's the opportunity for listeners to send in questions on
any men's health issue to Men's Health Matters at iHeartMedia
dot com. We will not reveal your full name or
share the information. This is one hundred percent anonymous. First
up this month is Tom, doctor Walsh. My penis is
(02:48):
slightly curved. Is there a chance I am developing Pironi's disease?
It really doesn't bother me much at this point. Will
it continue to get worse over time? Tom?
Speaker 3 (02:59):
Thank you for the question, And I feel like there's
an opportunity here for me to not just help you,
but like a public service announcement, because the answer is
it depends many many men. Probably the majority of men
are born with some amount of curvature of their penis.
The most common direction of curvature is upward, but we
(03:23):
see the male penis curving right, curving left, and curving down.
And when you are born with this amount of curvature.
It has a different name. It is not called Prony's disease,
which so many men have heard of. It's called core
d speltcho orde. And that is just a curvature that
(03:45):
you were born with. And for most men, this is
not something that demands too much of their attention. You
can go about your business. You can have a normal,
healthy sexual life. It doesn't affect your capacity to reproduce.
Nothing to be done about it. If you are born
with a curvature and it's too much for you, it
prevents you from a healthy sexual life. That can be
(04:08):
addressed surgically. We have tools. When your penis starts to
curve at a point later in life, this could be
an acquired curvature. This could be related to some inflammation
or loss of elasticity in the mechanism of erection, and
this may be Perrone's disease. I would say that if
(04:29):
you are uncertain about what is the natural you versus
something that is happening to you later in life, come
see an expert. Talk it over with your primary care provider.
Come see somebody like us in men's health.
Speaker 2 (04:43):
A question from Lawrence. I am a bisexual man. There
was an epidemic of the AIDS virus back in the
eighties and nineties. Has it been eradicated in the US?
I never hear any news stories or anecdotal stories for
that matter anymore.
Speaker 3 (04:57):
Boy, I'll tell you Lawrence, I do not belie HIV
has in any way been eradicated. But I do think
that the medications that have been developed and evolved to
help manage it as a chronic disease have really taken
it out of the spotlight. And I think we've really
(05:17):
seen people not progressing to that disease we used to
call AIDS, which was the more advanced form of HIV
that led to death and to disability. And so no,
I think HIV is still with us. I think many
people in the US and around the world especially are
managing it, some more fortunate than others, with access to
(05:40):
excellent pharmaceutical tools that keep the retrovirus suppressed. But I
think it is very much alive and well.
Speaker 2 (05:48):
And from Jackson, my dad has colon cancer and is
being treated at the U DUB. My concern is not
only for him, but for me and my two boys.
Is it hereditary?
Speaker 3 (06:00):
Short answer, Jackson, is it may be. You are now
somebody who has a first degree relative. Your father a
direct relationship to you, has colon cancer, and that means
that you are now somebody who needs some attention, and
your children may need attention too. I strongly recommend that
your father have a discussion with his colon cancer oncologist
(06:25):
talk about whether he's had any genetic screening to know
whether he has a hereditary form of colon cancer, and
that you discuss it with your doctor too. You are
now somebody who probably should be screened, just like me.
We begin screening for most at age forty five, but
you may need screening a little earlier.
Speaker 2 (06:45):
Remember, if you have a question about men's health, ask
an expert. Doctor Tom Wallas will answer your questions each
month from the anonymous inbox. Just send an email to
Men's Health Matters at iHeartMedia dot com. We use first
names and it is completely anonymous. A new study from
UW Medicine suggests that wildfire smoke exposure may reduce key
(07:08):
measures of sperm quality in patience undergoing fertility treatments. Now,
Understanding how smoke exposure impacts reproductive health is critical, and
we're pleased this month to welcome back doctor Tristan Nicholson.
She's a urologist and researcher specializing in men's health. A
research interests include laboratory optimization of sperm and the influence
(07:29):
of environmental toxicants on testicular function. She's also Assistant Professor
of Urology at the University of Washington and the Department
of Environmental and Occupational Health Sciences. Welcome back to men's
health Matters, doctor.
Speaker 4 (07:42):
Nicholson, thank you for having me.
Speaker 2 (07:44):
Let me begin by asking, are we talking about frontline
responders of those who live in nearby communities? I mean,
how close to the wildfires do you have to be
to raise legitimate concern? Is there a geographic radius of concern?
Speaker 4 (07:58):
That's a great question. I think that all individuals, everyone,
all humans are at risk from wildfire smoke exposure. Frontline
responders like firefighters, of course have risks. Most of my
research does not pertain to those, although there are a
number of other investigators working on that question. But all
of our communities are at risk. The question that I
have had is whether there's an increased risk for people
(08:20):
with infertility. And we do think that geography is important, right,
So the specific topography of where you live and where
you spend time is going to influence your exposures to
wildfire smoke and other environmental contaminant.
Speaker 2 (08:34):
How did you first discover the link between wildfire smoke
and male fertility problems.
Speaker 4 (08:39):
Well, I've been interested in sperm for a long time.
We know that there has long been a suspected link
between environmental exposures and male fertility. There is a large
literature linking air pollution from exhaust in those sorts of
sources with declines in sperm parameters. I got interested in
wildfire smoke. So you may remember that for a number
(09:00):
of years we had episodic times where there was severely
unhealthy air in the Seattle area. These were new, but
they're certainly something that became fairly commonplace over the last decade.
So I started to get interested in how wildfire smoke
might impact my patients who were struggling with male infertility.
Speaker 2 (09:18):
Doctor Walsh.
Speaker 3 (09:19):
For those who are just hearing about the implications of
forest fire smoke, you know, I can recall many a
summer going out, going to like my kids' soccer game
and feeling like this sort of like aching resentment about
you know, reading the air quality index the smell, just
the discomfort of it. I know that you're going to
(09:42):
talk to us a little today about the implications for fertility.
I swear that during those periods of time, you know,
I felt less healthy. So beyond how it may be
impacting couple fertility, have there been research suggesting that forest
fire smoke is is detrimental in other domains of health.
Speaker 4 (10:02):
Absolutely, the impacts of wildfire smoke on human health are
pretty well documented, so we know that there are a
number of acute effects. Most of those you've probably experienced,
so respiratory impacts, wheezing, shortness of breath, dinging in your eyes,
runny nose, that sort of thing. There are also some
acute impacts in cardiovascular health, so there is an increased
(10:25):
incidence of cardiac arrest, an increased incidence of hospitalizations and
emergency department visits associated with acute wildfire smoke events. There's
also been documented impacts on mental health. So I think
that these are not just your perceptions. These are well
documented impacts of wildfire smoke in our communities.
Speaker 2 (10:44):
Tell me about your recent study that was just released.
Speaker 4 (10:47):
We did a study looking at sperm parameters among individuals
who are having fertility treatments in our community. What we
looked at was individuals who underwent a treatment called intrauterine
insemination around the time of three different wildfire smoke events,
one in twenty eighteen, one in twenty twenty, and one
in twenty twenty two. We were able to compare their
(11:09):
numbers during this wildfire smoke exposure two numbers prior to
when they were exposed, so when the air quality in
Seattle was good, and what we found was a significant
decline in sperm concentration and total modal sperm count at
the time of wildfire smoke exposure compared back to their
first visit.
Speaker 3 (11:31):
Just to be clear for our listeners, So you're looking
at couples who are coming in for fertility treatment, correct
a fertility treatment that we often refer to as the
Turkey based technique or insemination, which is the idea. You know,
it is not in vitro fertilization. It's a little bit
more simplistic. But these men are getting regimented tests. Are
(11:52):
you telling me you have test results on them when
the air is clean and you have test results on
them after they've experienced one of these events. That was
significant even for me, yes, huffing that air.
Speaker 4 (12:04):
Yeah, that's correct, and they act as their own control.
And so we're able to evaluate two different measurements. And
the first measurement is at a time that the air
quality is very good, as it is most of the
time in Seattle, and then the second measurement is made
either when the air quality is unhealthy or in that
three months afterwards we know that that's the critical period
or sperm development and function.
Speaker 2 (12:25):
How long was this study?
Speaker 4 (12:27):
We looked at these three different smoke events, and we
looked back at medical records of individuals who underwent these
fertility treatment.
Speaker 2 (12:34):
How many participants there were eighty.
Speaker 4 (12:36):
Four in our study. I do want to point out
that while we found that these declines were consistent, they
were subtle changes. And what I don't know is whether
these impacted the outcomes of their fertility treatments. I think
that's really important as we think about how to counsel
patients who are undergoing fertility treatments, and that's an area
of active investigation in our group, doct waltch.
Speaker 3 (12:57):
Here in the Pacific Northwest, we are not the only
place that experiences forest fires. Has this type of work
ever been confirmed elsewhere or in other groups of men.
Speaker 4 (13:09):
This is of interest for a lot of groups, and
so I'm expecting there will be more research that comes out.
Prior to our study, there was one small study in
Oregon and they looked just at thirty patients who had
a very similar type of design as ours, and they
found a very similar result. So our results were quite
consistent with what was existing in the literature.
Speaker 2 (13:28):
Is the damage caused by exposure to the wildfires reversible?
Speaker 4 (13:32):
That's a great question, Neil. We don't know the answer
to that yet. I think that's really important to understand.
If there's a decline in sperm parameters, does it improve
when the air quality is better, And that's something that
will require longitudinal study of people.
Speaker 3 (13:47):
One of the things that comes to mind is just
day to day life in a US city. You know,
I live in an urban environment. I smell exhaust day
in and day out, and I guess I wonder is
their utility in just somehow looking at day to day exposures,
or is there something really unique to wildfires? I mean,
(14:08):
should we be more worried about wildfires than we are
about exhaust for example?
Speaker 4 (14:13):
Yeah? Great question. So we do know that fine, particulate
pollution from sources like exhaust has actually declined in the
United States over the past decades. Now the number one
contributor to find particulate pollution is wildfire smoke. And it
doesn't just affect the West Coast or the Mountain West.
It's affecting larger areas of the country than it ever
(14:35):
was before. The amount of wildfire smoke that humans are
exposed to in the United States and in the globe
has been increasing. Your question about multiple exposures, though, I
think is really important, and I want to emphasize that.
So wildfire smoke might be an exposure that a person
experiences and that might affect their sperm quality, but there's
a number of other things that they might be exposed
(14:56):
to as well. So what if they're smoking cigarettes, what
if they're vaping, what if they're using marijuana or cannabis.
Those are all things that we know impact sperm quality.
What we don't know is whether these effects are cumulative.
You know, whether you know it's worse for someone who
has multiple exposures. There are a number of other exposures
(15:17):
that affect sperm quality. When I think about the future
of research in this field, I think we really need
to be inclusive and understand all of the exposures that
our patients are having. How can we know where's where
do we get the biggest bang for our buck in
terms of lifestyle changes or behaviors that they could modify.
(15:37):
We also have to start with just measuring what people
are being exposed to. So that's a really important point.
Speaker 2 (15:43):
Whether co factors in your study with these men, there.
Speaker 4 (15:49):
Were some individuals in our study who were vaping or smoking,
although those numbers were fairly low. We also looked at
other measures that are known to impact sperm quality, like age,
their body mass index, and you know, it's not possible
to tell whether these effects are caused by wildfire smoke,
but we did see an association.
Speaker 2 (16:08):
With wildla What was the age range?
Speaker 4 (16:11):
The average age was thirty seven, with a standard deviation
of eight.
Speaker 3 (16:16):
Doctor Walsh, Well, I'm still stuck on this idea of
the uniqueness of wild fire smoke, and so I'm curious.
You know, you certainly talked about the fact that it's
the one micro pollutant I think you described it as
that's on the rise in the world. Is there something
unique about wildfire smoke itself that makes it worse, I mean,
(16:38):
is it is it a more negative influence than other pollutants.
Speaker 4 (16:41):
There is emerging evidence that the health impacts of wildfire
smoke are worse than other types of particle pollution. One
of the challenges with studying wildfire smoke is that the
composition varies dramatically, so it depends on what is burning. Right,
when vegetation is burning, that's going to produce different chemicals
than when homes are burning. The other challenges that wildfire
smoke often travels large distances and can undergo changes in
(17:06):
chemical composition. Not only is their fine particulate matter, which
we think is particularly dangerous, it is inhaled. It passes
easily into systemic circulation, and then it goes all throughout
the body to affect end organ targets, the brain, the heart,
the testicle. Of course, that's what I'm the most interested in,
But there's also other chemicals in wildfire smoke that's dangerous,
(17:28):
known carcinogens such as benzene, and other types of chemicals
that have impact on human health.
Speaker 3 (17:35):
That's fascinating. What I heard you say is this idea
that I think we add this name forest fire smoke,
but forest fires also burn down homes, and they burn
down buildings, and they burn all these petrochemicals that are
stored in those locations. What I'm hearing you say is
that those pollutants can travel great distance, and we don't
(17:57):
know if their impact is diminishing as it travels.
Speaker 4 (18:00):
In the air quality forecast, well, there will be this
unhealthy for sensitive groups.
Speaker 3 (18:04):
I often find myself scrutinizing this air quality index, the AQI,
and I think depending on what kind of smartphone you have,
it now automatically gives you that. Yet and does that
is that associated with worse health outcomes? The worse the quality,
the more dangerous the outcome. I mean, what does this
really mean?
Speaker 4 (18:21):
Yeah, it's a great question. So in terms of fertility,
we don't really know the answer to that yet. We
set a pre defined threshold of what a smoke day is,
and that AQI was actually fairly low, just above the
Washington air quality threshold, and that was for our study.
We do believe that higher AQI or higher levels of
particulate matter probably are worse for health outcomes. And we
(18:43):
get this color coding system where there's the green, which
is you're probably okay, Yellow, orange, pink and purple. There
are certainly levels of AQI where it is unhealthy for
everyone and everyone should stay inside. That's relatively rare in
our region, but it has happened. And one of the
things that I think is important to understand. You know,
we know what those sensitive groups are. Now those are individuals, children,
(19:08):
pregnant people. We know that individuals with underlying cardiovascular or
respiratory conditions such as asthma, are at higher risk. One
of the questions I have is our patients who are
trying to build their families at higher risk men with infertility,
should we think of them as being a centrist and
that might be something that really changes the behavior of
our patients.
Speaker 2 (19:28):
We're going to take a brief time out. You're listening
to Men's Health Matters. I'm Neil Scott, my co host,
doctor Tom Walsh, director of the Men's Health Center at
the University of Washington, and our guests this month, doctor
Tristan Nicholson. She's a prominent ub urologist and researcher specializing
in matters dealing with men's health. We'll continue our discussion
about the effects of wildfire smoke on men's health after
(19:50):
a brief timeout.
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Speaker 2 (20:21):
We're back on men's health matters. I'm Nigel Scott. My
co host is the director of the UDUB Men's Health Center,
doctor Tom Walsh, and we're joined by Tristan Nicholson. Doctor
Nicholson is a UDUB researcher and clinician who is vitally
concerned about the impact of environmental factors on male fertility
and testicular function. Doctor Walsh, Tristan, I think.
Speaker 3 (20:42):
This work it just strikes me as so important to
helping us understand sort of the future of human reproduction.
And I think what I'm so curious about is because
I could imagine that if I were a patient and
I were listening to this, or if I were somebody
who is experiencing fertility and I and I was somebody
who lived here in the Pacific West and I breed this,
I would want to know what do I do right
(21:05):
now to learn more and what can be done. Surely
this is going to happen again, what can I do
to mitigate it? And what can be done to mitigate
any impacts that it may have had on me and
my partner?
Speaker 4 (21:17):
Yeah, great question. I think the first thing that's important
is just a general awareness of the impact of wildfire
smoke on human health. I think many of my patients
are young men. They're healthy, Perhaps their fertility journey is
the first time that they've had contact with a doctor
in a long time, and they feel pretty invincible most
(21:38):
of the time, and so understanding that they may also
have some vulnerabilities to exposures like wildfire smoke is important.
So what I advise my patients is to pay attention
to air quality forecasts, to follow the instructions from local authorities.
When the air quality in Seattle is bad, it's a
good time to not exercise outside. If you're outside, to
(22:00):
wear a high quality mask such as an N ninety five,
and to use air filtration high quality filters in your
home if you can, and in the workplace. These are
also recommended in schools for children. In terms of exposures,
I think that wildfire smoke is one important exposure. We've
talked about some of the other ones avoidance of things
we also know that are bad for sperm, like smoking,
(22:22):
like marijuana, excess alcohol. The other big important piece of
it is getting tested and understanding what their fertility parameters
are right now in the air. In the air quality forecast, well,
there will be this unhealthy for sensitive groups, and that's
a specific amount of particulate matter that's me that you know,
that's that's in the exposure.
Speaker 3 (22:41):
I often find myself scrutinizing this air quality index, the AQI,
and I think depending on what kind of smartphone you have,
it now automatically gives you that. Yet it looks like
it's going from you know, good to bad. But I
don't know when should I really be staying out of it?
And does that AQI in a really like some exorbitantly
(23:01):
high number like two hundred or three hundred, is that
associated with worse health?
Speaker 4 (23:06):
Outcomes.
Speaker 3 (23:07):
Has it been documented that the worse the quality, the
more dangerous the outcome. I mean, what does this really mean?
Speaker 4 (23:13):
Yeah, it's a great question. So in terms of fertility
we don't really know the answer to that yet. We
set a pre defined threshold of what a smoke day
is and that AQI was actually fairly low. It was
just above the Washington air quality threshold, and that was
for our study. We do believe that higher QI, or
higher levels of particulate matter probably are worse for health outcomes.
(23:37):
And we get this color coding system where there's the green,
which is you're probably okay, Yellow, orange, pink, and purple.
There are certainly levels of AQI where it is unhealthy
for everyone and everyone should stay inside. That's relatively rare
in our region, but it has happened. And then there
are levels that are unhealthy for everyone. There are levels
(23:58):
that are unhealthy for just sensitive groups. And one of
the things that I think is important to understand, you know,
we know what those sensitive groups are. Now those are individuals, children,
pregnant people. We know that individuals with underlying cardiovascular or
respiratory conditions such as asthma, are at higher risk. One
of the questions I have is our patients who are
(24:20):
trying to build their families at higher risk men within fertility,
should we think of them as being a centrist and
that might be something that really changes the behavior of
our patient.
Speaker 2 (24:29):
Can a man find out the quality of his sperm
and is that something that men who are considering having
children can do?
Speaker 4 (24:35):
Certainly the basic cornerstone of the male fertility evaluation is
the Seman analysis. It tells us how much seman the
man is producing, what the concentration of their sperm is,
how well they're sperm are moving, and how normally shaped
they are. It's not really a test of fertility. We
don't always know how well functioning those sperm are, but
(24:56):
it gives us some basic idea about is the reproductive
tracked functioning appropriately our sperm being produced. It's a really
important starting point.
Speaker 3 (25:05):
This idea of paying attention, this idea of don't be
a bystander to your own health and don't be a
bystander when these things are happening in the environment, like
this idea of listening to local authorities and common sense
take steps for something to avoid something that we know
is toxic to the human body and especially if you're
(25:26):
somebody who's on a reproductive pathway, find out more about
your own body and what it's doing in a fertility
test is a great way to do that. I think
I would invite anyone who's listening and who has questions
about this to consider a consultation at a place like
the Mental Center.
Speaker 2 (25:40):
You are a K twelve scholar. What is that and
how does that impact what we're talking about?
Speaker 4 (25:46):
Thanks for asking. So. I'm a K twelve scholar in
the University of Washington Pediatric and Reproductive Environmental Health Scholars Program.
This is a career development pathway funded by the National
Institutes of Health. The idea is to develop the next
generation of clinician researchers who are focused on pediatric and
reproductive environmental health. My understanding is that I am this
(26:08):
sole representative of male fertility in this program.
Speaker 2 (26:11):
Wow.
Speaker 4 (26:12):
I'm just immensely grateful for the support of this program.
It's given me new mentors, it's funding my effort to
work on projects such as these, and giving me research
funds to develop my own research program. So it's been
really fundamental in developing my research program. I've also been
supported by the Urology Care Foundation, the Western Section of
(26:34):
the American Neurological Association, an institutional fund called the Royalty
Research Fund at the University of Washington, as well as
the Men's Health Counsel. So these have all been really
transformative and bringing this work one to fruition and also
out to the.
Speaker 3 (26:47):
Public, we're maybe just seeing the start of the story.
Really what comes next.
Speaker 4 (26:51):
I have lots of things coming next and a lot
of things going I'm excited about a couple of studies
that we're looking at the outcomes of these vertilsity treatments
and how they may be influenced by wildfire smoke. So
one study we're looking at how pregnancy rate is after
intrauterine insemination is impacted by wildfire smoke. We are also
(27:13):
evaluating the outcomes of in vitro fertilization. When we know
that something either impacts or does not impact that critical,
does this couple bring a baby home? That's what's important
for patients. That helps us really counsel patients, and it
also probably helps us with moving health policy and environmental
(27:33):
policy forward as well. I'm really interested in better understanding
the mechanism of how wildfire smoke might impact sperm production
and sperm quality, and also really understanding what other environmental
exposures may be influencing male fertility. And while we can
do that with these studies where we look back in
(27:54):
the medical records, I'm pretty convinced that we actually need
to study this prospectively, and to do that requires recruiting
participants from our communities, enrolling them in our studies, having
to measure their exposures, and looking at critical outcomes like
their Seeman parameters. Funding that I've talked about already has
really allowed us to do that. We did run a
(28:16):
small pilot study this summer where we recruited participants to
study environmental exposures and the impact on mail fertility. So
I'm really excited about these smaller studies that I hope
will lead to larger studies to really give us the
answers of how wildfire smoke exposure effects fertility.
Speaker 3 (28:34):
I think for everyone who's listening, you can feel sort
of the impact of this work and the personal nature
of it. And I appreciate you highlighting how you allow
this kind of work to move forward. And then we
really have a lot to thank for people who are
involved in philanthropy and over many months, we've worked together
(28:54):
to help develop an endowment that will allow work like
this to hopefully go on in a more prolonged and
definitive way, and we have donors to the University of
Washington to thank for.
Speaker 2 (29:04):
That absolutely fascinating and more research is vitally needed. That
wraps up the October edition of Men's Health Matters. To
reach the Men's Health Center at the UDB called two
six five nine eight six three five eight, I'll go
to Udubmedicine dot org. And a reminder that if you
have a question for my co host, doctor Tom walshon
(29:25):
any subject relating to men's health, please send us an
email at the anonymous inbox Men's Health Matters at iHeartMedia
dot com. We will not reveal your identity nor retain
your email address. On behalf of my co host doctor
Walsh and our very special guest, doctor Tristan Nicholson. I'm
Nigel Scott, wishing you good health and good sense in
(29:45):
matters relating to men's health. Stay safe, live in gratitude,
and be kind to one another. Thanks for listening.
Speaker 1 (29:52):
You bring Listening to Men's Health Matters with doctor Tom Walsh,
Associate Professor of Youurology at the University of Washington and
director of UW's Men's Health Center, and your host Neil
Scott on Sports Radio ninety three point three KJRFM
Welcome to Men's Health Matters with doctor Tom Walsh, director
of the University of Washington's Men's Health Center and Associate
Professor of Urology at UW, featuring important topics dealing with
men's health, including prostate cancer and erectile dysfunction. Now here's
your host, Neil Scott.
Speaker 2 (00:21):
Welcome to the October edition of Men's Health Matters, dealing
with health issues that directly affect men. I'm Neil Scott.
My co host is doctor Tom Walsh, director of the
DUB Men's Health Center. As we discuss topics focusing on
men and providing resources for immediate action. Now, good health,
good men's health, must be a priority. How are your,
doctor Walsh? It is October. School is back in session
(00:44):
at the UDUB.
Speaker 3 (00:46):
I know, and it's it's cold, right like the weather, Yeah,
only changes its cold and Chris, but I appreciate you asking.
I'm excited for fall, you know. I love the summer
and the warmth. But I'm a true Seattle I'm anxious
for the rain and the cold and just bring it.
Speaker 2 (01:04):
What's happening at the Men's Health Center.
Speaker 3 (01:05):
The Men's Health Center is busy, like we always are,
seeing men day in and day out. Big concerns, little concerns,
things that you know, keep men tied to good health,
and we're doling out common sense left and right.
Speaker 2 (01:19):
I want to once again remind listeners that the ub
Men's Health Center is not just for the U dubbed
students and faculty, but for the entire community. It is
for everybody. Everyone you know. We all know there's a
direct link between smoking and cancer, but what we are
now discovering is there is a link between the smoke
from the Pacific Northwest wildfires and men's health. At the
(01:42):
height of the fires from twenty eighteen through probably twenty
twenty three, U dub lung specialist, doctor Bonnie Ruanish described
it as smoking a giant cigarette. But the fires effect
more than just lungs. UW your researchers are discovering that
it has a dramatic effect on the quality of men's sperm,
and we are fortunate to have the lead researcher on
(02:04):
a new published study, doctor Tristan Nicholson, prominent research at
the University of Washington. She is with us today to
talk about the ongoing research and the implications for men
concerned about their fertility. She's been a guest before on
Men's Health Matters and we are delighted to have her back.
But before we talk to doctor Nicholson, we'll take a
(02:25):
few questions from Men's Health Matter's anonymous inbox. Of course,
that's the opportunity for listeners to send in questions on
any men's health issue to Men's Health Matters at iHeartMedia
dot com. We will not reveal your full name or
share the information. This is one hundred percent anonymous. First
up this month is Tom, doctor Walsh. My penis is
(02:48):
slightly curved. Is there a chance I am developing Pironi's disease?
It really doesn't bother me much at this point. Will
it continue to get worse over time? Tom?
Speaker 3 (02:59):
Thank you for the question, And I feel like there's
an opportunity here for me to not just help you,
but like a public service announcement, because the answer is
it depends many many men. Probably the majority of men
are born with some amount of curvature of their penis.
The most common direction of curvature is upward, but we
(03:23):
see the male penis curving right, curving left, and curving down.
And when you are born with this amount of curvature.
It has a different name. It is not called Prony's disease,
which so many men have heard of. It's called core
d speltcho orde. And that is just a curvature that
(03:45):
you were born with. And for most men, this is
not something that demands too much of their attention. You
can go about your business. You can have a normal,
healthy sexual life. It doesn't affect your capacity to reproduce.
Nothing to be done about it. If you are born
with a curvature and it's too much for you, it
prevents you from a healthy sexual life. That can be
(04:08):
addressed surgically. We have tools. When your penis starts to
curve at a point later in life, this could be
an acquired curvature. This could be related to some inflammation
or loss of elasticity in the mechanism of erection, and
this may be Perrone's disease. I would say that if
(04:29):
you are uncertain about what is the natural you versus
something that is happening to you later in life, come
see an expert. Talk it over with your primary care provider.
Come see somebody like us in men's health.
Speaker 2 (04:43):
A question from Lawrence. I am a bisexual man. There
was an epidemic of the AIDS virus back in the
eighties and nineties. Has it been eradicated in the US?
I never hear any news stories or anecdotal stories for
that matter anymore.
Speaker 3 (04:57):
Boy, I'll tell you Lawrence, I do not belie HIV
has in any way been eradicated. But I do think
that the medications that have been developed and evolved to
help manage it as a chronic disease have really taken
it out of the spotlight. And I think we've really
(05:17):
seen people not progressing to that disease we used to
call AIDS, which was the more advanced form of HIV
that led to death and to disability. And so no,
I think HIV is still with us. I think many
people in the US and around the world especially are
managing it, some more fortunate than others, with access to
(05:40):
excellent pharmaceutical tools that keep the retrovirus suppressed. But I
think it is very much alive and well.
Speaker 2 (05:48):
And from Jackson, my dad has colon cancer and is
being treated at the U DUB. My concern is not
only for him, but for me and my two boys.
Is it hereditary?
Speaker 3 (06:00):
Short answer, Jackson, is it may be. You are now
somebody who has a first degree relative. Your father a
direct relationship to you, has colon cancer, and that means
that you are now somebody who needs some attention, and
your children may need attention too. I strongly recommend that
your father have a discussion with his colon cancer oncologist
(06:25):
talk about whether he's had any genetic screening to know
whether he has a hereditary form of colon cancer, and
that you discuss it with your doctor too. You are
now somebody who probably should be screened, just like me.
We begin screening for most at age forty five, but
you may need screening a little earlier.
Speaker 2 (06:45):
Remember, if you have a question about men's health, ask
an expert. Doctor Tom Wallas will answer your questions each
month from the anonymous inbox. Just send an email to
Men's Health Matters at iHeartMedia dot com. We use first
names and it is completely anonymous. A new study from
UW Medicine suggests that wildfire smoke exposure may reduce key
(07:08):
measures of sperm quality in patience undergoing fertility treatments. Now,
Understanding how smoke exposure impacts reproductive health is critical, and
we're pleased this month to welcome back doctor Tristan Nicholson.
She's a urologist and researcher specializing in men's health. A
research interests include laboratory optimization of sperm and the influence
(07:29):
of environmental toxicants on testicular function. She's also Assistant Professor
of Urology at the University of Washington and the Department
of Environmental and Occupational Health Sciences. Welcome back to men's
health Matters, doctor.
Speaker 4 (07:42):
Nicholson, thank you for having me.
Speaker 2 (07:44):
Let me begin by asking, are we talking about frontline
responders of those who live in nearby communities? I mean,
how close to the wildfires do you have to be
to raise legitimate concern? Is there a geographic radius of concern?
Speaker 4 (07:58):
That's a great question. I think that all individuals, everyone,
all humans are at risk from wildfire smoke exposure. Frontline
responders like firefighters, of course have risks. Most of my
research does not pertain to those, although there are a
number of other investigators working on that question. But all
of our communities are at risk. The question that I
have had is whether there's an increased risk for people
(08:20):
with infertility. And we do think that geography is important, right,
So the specific topography of where you live and where
you spend time is going to influence your exposures to
wildfire smoke and other environmental contaminant.
Speaker 2 (08:34):
How did you first discover the link between wildfire smoke
and male fertility problems.
Speaker 4 (08:39):
Well, I've been interested in sperm for a long time.
We know that there has long been a suspected link
between environmental exposures and male fertility. There is a large
literature linking air pollution from exhaust in those sorts of
sources with declines in sperm parameters. I got interested in
wildfire smoke. So you may remember that for a number
(09:00):
of years we had episodic times where there was severely
unhealthy air in the Seattle area. These were new, but
they're certainly something that became fairly commonplace over the last decade.
So I started to get interested in how wildfire smoke
might impact my patients who were struggling with male infertility.
Speaker 2 (09:18):
Doctor Walsh.
Speaker 3 (09:19):
For those who are just hearing about the implications of
forest fire smoke, you know, I can recall many a
summer going out, going to like my kids' soccer game
and feeling like this sort of like aching resentment about
you know, reading the air quality index the smell, just
the discomfort of it. I know that you're going to
(09:42):
talk to us a little today about the implications for fertility.
I swear that during those periods of time, you know,
I felt less healthy. So beyond how it may be
impacting couple fertility, have there been research suggesting that forest
fire smoke is is detrimental in other domains of health.
Speaker 4 (10:02):
Absolutely, the impacts of wildfire smoke on human health are
pretty well documented, so we know that there are a
number of acute effects. Most of those you've probably experienced,
so respiratory impacts, wheezing, shortness of breath, dinging in your eyes,
runny nose, that sort of thing. There are also some
acute impacts in cardiovascular health, so there is an increased
(10:25):
incidence of cardiac arrest, an increased incidence of hospitalizations and
emergency department visits associated with acute wildfire smoke events. There's
also been documented impacts on mental health. So I think
that these are not just your perceptions. These are well
documented impacts of wildfire smoke in our communities.
Speaker 2 (10:44):
Tell me about your recent study that was just released.
Speaker 4 (10:47):
We did a study looking at sperm parameters among individuals
who are having fertility treatments in our community. What we
looked at was individuals who underwent a treatment called intrauterine
insemination around the time of three different wildfire smoke events,
one in twenty eighteen, one in twenty twenty, and one
in twenty twenty two. We were able to compare their
(11:09):
numbers during this wildfire smoke exposure two numbers prior to
when they were exposed, so when the air quality in
Seattle was good, and what we found was a significant
decline in sperm concentration and total modal sperm count at
the time of wildfire smoke exposure compared back to their
first visit.
Speaker 3 (11:31):
Just to be clear for our listeners, So you're looking
at couples who are coming in for fertility treatment, correct
a fertility treatment that we often refer to as the
Turkey based technique or insemination, which is the idea. You know,
it is not in vitro fertilization. It's a little bit
more simplistic. But these men are getting regimented tests. Are
(11:52):
you telling me you have test results on them when
the air is clean and you have test results on
them after they've experienced one of these events. That was
significant even for me, yes, huffing that air.
Speaker 4 (12:04):
Yeah, that's correct, and they act as their own control.
And so we're able to evaluate two different measurements. And
the first measurement is at a time that the air
quality is very good, as it is most of the
time in Seattle, and then the second measurement is made
either when the air quality is unhealthy or in that
three months afterwards we know that that's the critical period
or sperm development and function.
Speaker 2 (12:25):
How long was this study?
Speaker 4 (12:27):
We looked at these three different smoke events, and we
looked back at medical records of individuals who underwent these
fertility treatment.
Speaker 2 (12:34):
How many participants there were eighty.
Speaker 4 (12:36):
Four in our study. I do want to point out
that while we found that these declines were consistent, they
were subtle changes. And what I don't know is whether
these impacted the outcomes of their fertility treatments. I think
that's really important as we think about how to counsel
patients who are undergoing fertility treatments, and that's an area
of active investigation in our group, doct waltch.
Speaker 3 (12:57):
Here in the Pacific Northwest, we are not the only
place that experiences forest fires. Has this type of work
ever been confirmed elsewhere or in other groups of men.
Speaker 4 (13:09):
This is of interest for a lot of groups, and
so I'm expecting there will be more research that comes out.
Prior to our study, there was one small study in
Oregon and they looked just at thirty patients who had
a very similar type of design as ours, and they
found a very similar result. So our results were quite
consistent with what was existing in the literature.
Speaker 2 (13:28):
Is the damage caused by exposure to the wildfires reversible?
Speaker 4 (13:32):
That's a great question, Neil. We don't know the answer
to that yet. I think that's really important to understand.
If there's a decline in sperm parameters, does it improve
when the air quality is better, And that's something that
will require longitudinal study of people.
Speaker 3 (13:47):
One of the things that comes to mind is just
day to day life in a US city. You know,
I live in an urban environment. I smell exhaust day
in and day out, and I guess I wonder is
their utility in just somehow looking at day to day exposures,
or is there something really unique to wildfires? I mean,
(14:08):
should we be more worried about wildfires than we are
about exhaust for example?
Speaker 4 (14:13):
Yeah? Great question. So we do know that fine, particulate
pollution from sources like exhaust has actually declined in the
United States over the past decades. Now the number one
contributor to find particulate pollution is wildfire smoke. And it
doesn't just affect the West Coast or the Mountain West.
It's affecting larger areas of the country than it ever
(14:35):
was before. The amount of wildfire smoke that humans are
exposed to in the United States and in the globe
has been increasing. Your question about multiple exposures, though, I
think is really important, and I want to emphasize that.
So wildfire smoke might be an exposure that a person
experiences and that might affect their sperm quality, but there's
a number of other things that they might be exposed
(14:56):
to as well. So what if they're smoking cigarettes, what
if they're vaping, what if they're using marijuana or cannabis.
Those are all things that we know impact sperm quality.
What we don't know is whether these effects are cumulative.
You know, whether you know it's worse for someone who
has multiple exposures. There are a number of other exposures
(15:17):
that affect sperm quality. When I think about the future
of research in this field, I think we really need
to be inclusive and understand all of the exposures that
our patients are having. How can we know where's where
do we get the biggest bang for our buck in
terms of lifestyle changes or behaviors that they could modify.
(15:37):
We also have to start with just measuring what people
are being exposed to. So that's a really important point.
Speaker 2 (15:43):
Whether co factors in your study with these men, there.
Speaker 4 (15:49):
Were some individuals in our study who were vaping or smoking,
although those numbers were fairly low. We also looked at
other measures that are known to impact sperm quality, like age,
their body mass index, and you know, it's not possible
to tell whether these effects are caused by wildfire smoke,
but we did see an association.
Speaker 2 (16:08):
With wildla What was the age range?
Speaker 4 (16:11):
The average age was thirty seven, with a standard deviation
of eight.
Speaker 3 (16:16):
Doctor Walsh, Well, I'm still stuck on this idea of
the uniqueness of wild fire smoke, and so I'm curious.
You know, you certainly talked about the fact that it's
the one micro pollutant I think you described it as
that's on the rise in the world. Is there something
unique about wildfire smoke itself that makes it worse, I mean,
(16:38):
is it is it a more negative influence than other pollutants.
Speaker 4 (16:41):
There is emerging evidence that the health impacts of wildfire
smoke are worse than other types of particle pollution. One
of the challenges with studying wildfire smoke is that the
composition varies dramatically, so it depends on what is burning. Right,
when vegetation is burning, that's going to produce different chemicals
than when homes are burning. The other challenges that wildfire
smoke often travels large distances and can undergo changes in
(17:06):
chemical composition. Not only is their fine particulate matter, which
we think is particularly dangerous, it is inhaled. It passes
easily into systemic circulation, and then it goes all throughout
the body to affect end organ targets, the brain, the heart,
the testicle. Of course, that's what I'm the most interested in,
But there's also other chemicals in wildfire smoke that's dangerous,
(17:28):
known carcinogens such as benzene, and other types of chemicals
that have impact on human health.
Speaker 3 (17:35):
That's fascinating. What I heard you say is this idea
that I think we add this name forest fire smoke,
but forest fires also burn down homes, and they burn
down buildings, and they burn all these petrochemicals that are
stored in those locations. What I'm hearing you say is
that those pollutants can travel great distance, and we don't
(17:57):
know if their impact is diminishing as it travels.
Speaker 4 (18:00):
In the air quality forecast, well, there will be this
unhealthy for sensitive groups.
Speaker 3 (18:04):
I often find myself scrutinizing this air quality index, the AQI,
and I think depending on what kind of smartphone you have,
it now automatically gives you that. Yet and does that
is that associated with worse health outcomes? The worse the quality,
the more dangerous the outcome. I mean, what does this
really mean?
Speaker 4 (18:21):
Yeah, it's a great question. So in terms of fertility,
we don't really know the answer to that yet. We
set a pre defined threshold of what a smoke day is,
and that AQI was actually fairly low, just above the
Washington air quality threshold, and that was for our study.
We do believe that higher AQI or higher levels of
particulate matter probably are worse for health outcomes. And we
(18:43):
get this color coding system where there's the green, which
is you're probably okay, Yellow, orange, pink and purple. There
are certainly levels of AQI where it is unhealthy for
everyone and everyone should stay inside. That's relatively rare in
our region, but it has happened. And one of the
things that I think is important to understand. You know,
we know what those sensitive groups are. Now those are individuals, children,
(19:08):
pregnant people. We know that individuals with underlying cardiovascular or
respiratory conditions such as asthma, are at higher risk. One
of the questions I have is our patients who are
trying to build their families at higher risk men with infertility,
should we think of them as being a centrist and
that might be something that really changes the behavior of
our patients.
Speaker 2 (19:28):
We're going to take a brief time out. You're listening
to Men's Health Matters. I'm Neil Scott, my co host,
doctor Tom Walsh, director of the Men's Health Center at
the University of Washington, and our guests this month, doctor
Tristan Nicholson. She's a prominent ub urologist and researcher specializing
in matters dealing with men's health. We'll continue our discussion
about the effects of wildfire smoke on men's health after
(19:50):
a brief timeout.
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Speaker 2 (20:21):
We're back on men's health matters. I'm Nigel Scott. My
co host is the director of the UDUB Men's Health Center,
doctor Tom Walsh, and we're joined by Tristan Nicholson. Doctor
Nicholson is a UDUB researcher and clinician who is vitally
concerned about the impact of environmental factors on male fertility
and testicular function. Doctor Walsh, Tristan, I think.
Speaker 3 (20:42):
This work it just strikes me as so important to
helping us understand sort of the future of human reproduction.
And I think what I'm so curious about is because
I could imagine that if I were a patient and
I were listening to this, or if I were somebody
who is experiencing fertility and I and I was somebody
who lived here in the Pacific West and I breed this,
I would want to know what do I do right
(21:05):
now to learn more and what can be done. Surely
this is going to happen again, what can I do
to mitigate it? And what can be done to mitigate
any impacts that it may have had on me and
my partner?
Speaker 4 (21:17):
Yeah, great question. I think the first thing that's important
is just a general awareness of the impact of wildfire
smoke on human health. I think many of my patients
are young men. They're healthy, Perhaps their fertility journey is
the first time that they've had contact with a doctor
in a long time, and they feel pretty invincible most
(21:38):
of the time, and so understanding that they may also
have some vulnerabilities to exposures like wildfire smoke is important.
So what I advise my patients is to pay attention
to air quality forecasts, to follow the instructions from local authorities.
When the air quality in Seattle is bad, it's a
good time to not exercise outside. If you're outside, to
(22:00):
wear a high quality mask such as an N ninety five,
and to use air filtration high quality filters in your
home if you can, and in the workplace. These are
also recommended in schools for children. In terms of exposures,
I think that wildfire smoke is one important exposure. We've
talked about some of the other ones avoidance of things
we also know that are bad for sperm, like smoking,
(22:22):
like marijuana, excess alcohol. The other big important piece of
it is getting tested and understanding what their fertility parameters
are right now in the air. In the air quality forecast, well,
there will be this unhealthy for sensitive groups, and that's
a specific amount of particulate matter that's me that you know,
that's that's in the exposure.
Speaker 3 (22:41):
I often find myself scrutinizing this air quality index, the AQI,
and I think depending on what kind of smartphone you have,
it now automatically gives you that. Yet it looks like
it's going from you know, good to bad. But I
don't know when should I really be staying out of it?
And does that AQI in a really like some exorbitantly
(23:01):
high number like two hundred or three hundred, is that
associated with worse health?
Speaker 4 (23:06):
Outcomes.
Speaker 3 (23:07):
Has it been documented that the worse the quality, the
more dangerous the outcome. I mean, what does this really mean?
Speaker 4 (23:13):
Yeah, it's a great question. So in terms of fertility
we don't really know the answer to that yet. We
set a pre defined threshold of what a smoke day
is and that AQI was actually fairly low. It was
just above the Washington air quality threshold, and that was
for our study. We do believe that higher QI, or
higher levels of particulate matter probably are worse for health outcomes.
(23:37):
And we get this color coding system where there's the green,
which is you're probably okay, Yellow, orange, pink, and purple.
There are certainly levels of AQI where it is unhealthy
for everyone and everyone should stay inside. That's relatively rare
in our region, but it has happened. And then there
are levels that are unhealthy for everyone. There are levels
(23:58):
that are unhealthy for just sensitive groups. And one of
the things that I think is important to understand, you know,
we know what those sensitive groups are. Now those are individuals, children,
pregnant people. We know that individuals with underlying cardiovascular or
respiratory conditions such as asthma, are at higher risk. One
of the questions I have is our patients who are
(24:20):
trying to build their families at higher risk men within fertility,
should we think of them as being a centrist and
that might be something that really changes the behavior of
our patient.
Speaker 2 (24:29):
Can a man find out the quality of his sperm
and is that something that men who are considering having
children can do?
Speaker 4 (24:35):
Certainly the basic cornerstone of the male fertility evaluation is
the Seman analysis. It tells us how much seman the
man is producing, what the concentration of their sperm is,
how well they're sperm are moving, and how normally shaped
they are. It's not really a test of fertility. We
don't always know how well functioning those sperm are, but
(24:56):
it gives us some basic idea about is the reproductive
tracked functioning appropriately our sperm being produced. It's a really
important starting point.
Speaker 3 (25:05):
This idea of paying attention, this idea of don't be
a bystander to your own health and don't be a
bystander when these things are happening in the environment, like
this idea of listening to local authorities and common sense
take steps for something to avoid something that we know
is toxic to the human body and especially if you're
(25:26):
somebody who's on a reproductive pathway, find out more about
your own body and what it's doing in a fertility
test is a great way to do that. I think
I would invite anyone who's listening and who has questions
about this to consider a consultation at a place like
the Mental Center.
Speaker 2 (25:40):
You are a K twelve scholar. What is that and
how does that impact what we're talking about?
Speaker 4 (25:46):
Thanks for asking. So. I'm a K twelve scholar in
the University of Washington Pediatric and Reproductive Environmental Health Scholars Program.
This is a career development pathway funded by the National
Institutes of Health. The idea is to develop the next
generation of clinician researchers who are focused on pediatric and
reproductive environmental health. My understanding is that I am this
(26:08):
sole representative of male fertility in this program.
Speaker 2 (26:11):
Wow.
Speaker 4 (26:12):
I'm just immensely grateful for the support of this program.
It's given me new mentors, it's funding my effort to
work on projects such as these, and giving me research
funds to develop my own research program. So it's been
really fundamental in developing my research program. I've also been
supported by the Urology Care Foundation, the Western Section of
(26:34):
the American Neurological Association, an institutional fund called the Royalty
Research Fund at the University of Washington, as well as
the Men's Health Counsel. So these have all been really
transformative and bringing this work one to fruition and also
out to the.
Speaker 3 (26:47):
Public, we're maybe just seeing the start of the story.
Really what comes next.
Speaker 4 (26:51):
I have lots of things coming next and a lot
of things going I'm excited about a couple of studies
that we're looking at the outcomes of these vertilsity treatments
and how they may be influenced by wildfire smoke. So
one study we're looking at how pregnancy rate is after
intrauterine insemination is impacted by wildfire smoke. We are also
(27:13):
evaluating the outcomes of in vitro fertilization. When we know
that something either impacts or does not impact that critical,
does this couple bring a baby home? That's what's important
for patients. That helps us really counsel patients, and it
also probably helps us with moving health policy and environmental
(27:33):
policy forward as well. I'm really interested in better understanding
the mechanism of how wildfire smoke might impact sperm production
and sperm quality, and also really understanding what other environmental
exposures may be influencing male fertility. And while we can
do that with these studies where we look back in
(27:54):
the medical records, I'm pretty convinced that we actually need
to study this prospectively, and to do that requires recruiting
participants from our communities, enrolling them in our studies, having
to measure their exposures, and looking at critical outcomes like
their Seeman parameters. Funding that I've talked about already has
really allowed us to do that. We did run a
(28:16):
small pilot study this summer where we recruited participants to
study environmental exposures and the impact on mail fertility. So
I'm really excited about these smaller studies that I hope
will lead to larger studies to really give us the
answers of how wildfire smoke exposure effects fertility.
Speaker 3 (28:34):
I think for everyone who's listening, you can feel sort
of the impact of this work and the personal nature
of it. And I appreciate you highlighting how you allow
this kind of work to move forward. And then we
really have a lot to thank for people who are
involved in philanthropy and over many months, we've worked together
(28:54):
to help develop an endowment that will allow work like
this to hopefully go on in a more prolonged and
definitive way, and we have donors to the University of
Washington to thank for.
Speaker 2 (29:04):
That absolutely fascinating and more research is vitally needed. That
wraps up the October edition of Men's Health Matters. To
reach the Men's Health Center at the UDB called two
six five nine eight six three five eight, I'll go
to Udubmedicine dot org. And a reminder that if you
have a question for my co host, doctor Tom walshon
(29:25):
any subject relating to men's health, please send us an
email at the anonymous inbox Men's Health Matters at iHeartMedia
dot com. We will not reveal your identity nor retain
your email address. On behalf of my co host doctor
Walsh and our very special guest, doctor Tristan Nicholson. I'm
Nigel Scott, wishing you good health and good sense in
(29:45):
matters relating to men's health. Stay safe, live in gratitude,
and be kind to one another. Thanks for listening.
Speaker 1 (29:52):
You bring Listening to Men's Health Matters with doctor Tom Walsh,
Associate Professor of Youurology at the University of Washington and
director of UW's Men's Health Center, and your host Neil
Scott on Sports Radio ninety three point three KJRFM
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