July 17, 2025 • 45 mins
Have you ever noticed the stark difference between how men's and women's hormone issues are addressed by the medical community? Our eye-opening conversation with endocrinologist Dr. Frank Albano pulls back the curtain on hormone replacement therapy and the striking gender disparities in sexual healthcare.
Women approaching menopause are often left navigating a confusing landscape of symptoms without clear guidance. Dr. Albano explains why comprehensive blood work measuring estrogen, testosterone, and pituitary hormones is essential before starting any treatment. We explore the safety differences between oral medications and transdermal options like patches and gels, with Dr. Albano recommending the latter to avoid increased blood clot risks. For women with intact uteruses, the crucial combination of estrogen and progesterone prevents endometrial cancer—a vital distinction many don't understand until speaking with specialists.
The most shocking revelation? While men have numerous FDA-approved treatments for sexual dysfunction, women's options remain severely limited. Testosterone, the primary hormone driving libido in both sexes, isn't approved for women despite its effectiveness. Dr. Albano shares how he helps women through this treatment gap with careful off-label prescribing at about 10% of the male dose.
We also tackle surprising connections most people miss—like how sleep apnea significantly lowers testosterone in men, and how obesity affects hormone levels differently between genders. The discussion extends to weight management with GLP-1 medications (like Mounjaro and Zepbound), offering practical guidance on proper usage, potential side effects, and why medical supervision matters.
From practical tips for managing hot flashes (keep your bedroom at 62°F!) to hilarious stories about an 80-year-old judge who misunderstood his testosterone dosage (leading his overwhelmed wife to lock herself in the bathroom), this episode delivers equal parts medical wisdom and real-world humor.
Whether you're experiencing hormonal changes yourself or supporting someone who is, tune in for this essential conversation about optimizing your hormonal health and reclaiming your quality of life. Dr. Albano will return in future episodes to share more insights on health and dating—you won't want to miss it!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
Welcome to Dating Daycare, where we help you
navigate through the jungle ofjerks.
Welcome back.
Ladies and gents.
Today we're excited.
Yes, we have a guest on today,frank Albano, and he's going to
introduce himself and we aregoing to talk about hormone
replacement therapy for men, forwomen, libido.
(00:29):
We're going to cover it all.
Welcome, frank.
Speaker 3 (00:31):
Thank you.
Thank you for having me we'reexcited about this.
Speaker 2 (00:35):
I know I am with my hot stories.
This is very timely because youguys know that Melissa and I
are the same age.
We're 77 babies over here, sothere's a lot going on.
Speaker 1 (00:48):
There is.
Speaker 2 (00:49):
You need to help us.
Speaker 1 (00:50):
Yeah, and a lot of women.
Yes, you need to help us, womenand men.
We're going to discuss the men,though, too.
Speaker 3 (00:57):
It's always the men's fault, always, obviously, of
course it is.
Where do we begin my crazystories that you want to?
Speaker 1 (01:07):
Let's talk about like so a lot of women, right?
How do you say it, perry?
Speaker 3 (01:14):
They're going through their changes.
They're going through theirchanges.
They're not there yet.
Speaker 1 (01:18):
They don't know what to do.
Their periods are skippingRight.
Ladies, like you get it andthen you don't get it.
Speaker 2 (01:29):
You get it for a day and you're like what's going on?
Am I pre?
Then the panic starts andyou're like am I pregnant?
Yeah, three weeks.
Speaker 1 (01:32):
You get it for like three weeks, right, right.
So this obviously me.
You go see a gyno and they wantto put you on some sort of
hormone therapy, so how do yousuggest what is the right way to
go about doing that?
Speaker 3 (01:44):
so so, first we need blood work.
We've got to see your levels.
I want baseline estrogen bloodtest, testosterone and there's
hormones in the brain, thepituitary hormones that regulate
the estrogen.
So it's LH and FSH prolactin.
You definitely want to check apregnancy test because there's
something called polycysticovarian syndrome, that younger
girls have the opposite actuallyhigh testosterone instead of
(02:04):
low and that younger girls havethe opposite actually high
testosterone instead of low andthey come in and the first thing
you want to make sure isthey're not pregnant, because
that was something that happened.
One of my colleagues said oh,they have polycystic ovarian
syndrome.
They started them on treatment,but they were pregnant.
You know, maybe that's why theymissed their period.
Speaker 1 (02:16):
So that's first and foremost Right, of course.
Speaker 3 (02:19):
So yeah, get some levels and figure out what you
need, you know, and how much youneed.
Start slow, start low and goslow.
Speaker 1 (02:25):
And then what do you suggest?
Do you suggest I know there'screams out there, there's pills
is that dependent on your bloodlevel?
Like your blood work?
What you prescribe, like whatare just so women know, because
I think when you get there Iknow for myself.
Like we're clueless, you knowwhat I mean.
Like we're clueless, you knowwhat I mean.
Like we don't know.
None of this was discussed.
Speaker 2 (02:45):
Right, nobody told us this.
Speaker 1 (02:47):
So we don't know what the healthy route is.
You know there's, there's the,and of course you're going to be
able to dictate this betterthan me.
But I've heard of creams, I'veheard of pills, I've heard of
the little pill that getsimplanted in your tush over
there the pellet pill that getsimplanted in your tush over
there, the pellet, the pellet.
I've heard.
You know what I'm saying.
(03:07):
So there's so many options outthere.
I don't think, and I wouldimagine, that every doctor will
prescribe different things, likeI know.
I was telling you that I was on, my doctor prescribed pempro
and you're like that's not thebest because, it could cause
blood.
I don't know that yeah you know, women don't.
So how do we know what's bestfor us?
Speaker 3 (03:28):
Right.
So the best thing you ever hearwhen women are on birth control
, they say after age 35, youshould come off of it.
The risk they're thinking isblood clots because you're
taking estrogen orally.
What it does is tell the liverto produce more clotting factors
, which is not good.
So the best way to go is thetransdermal.
Like you mentioned, there's geland there's patches, like you
were on the patch.
So, that's definitely a betterroute than pills, but the pills
(03:50):
that you can take is theprogesterone.
So when a woman comes in, thefirst question is well, for her
symptoms, do you have a uterus?
That's important because if youdo, then you have to take the
opposing hormone, progesterone,because if you don't you run the
risk of endometrial cancer.
So you have to do the opposinghormone, so you got to take
estrogen and progesterone if shedoesn't have a uterus, and then
it's just estrogen without anyrisk.
(04:11):
But then it's all about howthey feel and the levels.
You know.
Some people just say oh, how doyou feel?
you know you could feel great,but you know, if you feel tired
and people like I want, I wantto.
I get this a lot with men.
I'm tired, I have lowtestosterone.
Well, did you check your level?
No, so, and how do you knowyou're not tired from you're not
eating enough, you're notsleeping enough, you're not
drinking enough water?
Speaker 1 (04:32):
the family is crazy right, you're stressed out,
you're stressed out exactly.
Speaker 3 (04:35):
So you got to look at the levels and a lot of guys
come back and their levels arenormal and then sleep apnea is
huge.
The major cause of lowtestosterone in men is sleep
apnea.
Speaker 2 (04:43):
Did not know that, yeah.
Speaker 1 (04:46):
Really not being able to sleep causes low
testosterone.
Speaker 3 (04:49):
Absolutely, Because cortisol it all comes down to
the hormones.
It's all about the hormones.
Speaker 1 (04:53):
Interesting.
Speaker 3 (04:54):
Because cortisol is a stress hormone.
When you're stressed, do youwant to have sex?
Speaker 1 (04:57):
No.
Speaker 3 (04:58):
No, because your cortisol is high and it's
dropping all your testosterone.
Women have testosterone also,and that's the libido hormone,
and then we give all these menall this testosterone and Viagra
, and what do the women have?
Because they're not in school.
We didn't learn abouttestosterone for women or
replacement, because years agothere was a study that showed
(05:21):
increased risks of breast cancer.
Speaker 1 (05:23):
Right, which we've heard that about.
Like I was just saying that toyou originally, I was nervous
because I have heard fromdifferent women who have had
breasts that this, that they'relike, oh no, the hormones can
cause cancer.
Speaker 2 (05:36):
And then you get scared and you're like well, I'm
not suffering too much, rightlike I just have a few night hot
at night, a little bit tired,so I'll just keep rolling on the
way I am I mean that, that thatimpression that it causes
different kinds of cancers,wasn't that taken from like
(05:57):
studies in the 90s, the woman'shealth initiative?
Speaker 3 (05:59):
yeah so, and it was like very, very small
percentages, very smallpercentages, and it was taken
blown out of proportion.
And we all said, ok, we can'ttouch this, and that was the
study that's left.
It's one of the biggestproblems of studies in the past
that we go back and say wescrewed up big time.
Speaker 1 (06:16):
And as a female, what should you be experiencing
besides not getting your periodmonthly to say you know what?
Maybe I should go, you know,navigate through hormone therapy
, like what are some?
Speaker 2 (06:28):
And who do?
Speaker 1 (06:29):
you go to first Do you go to your your gynecologist
, who do you go to?
Speaker 3 (06:32):
The gynecologist.
Some are more progressive thanothers, meaning they're
interested in giving youestrogen after the age of 35,
because it's all about qualityof life also.
And like we mentioned, if youtake the pills, there is an
increased risk.
If you smoke, then that's anincreased risk also, but we
don't some most of them.
That's why I'm thinking I wantto start doing this, because I'm
giving men testosterone andviagra and these poor women and
(06:53):
I see their women come in andlike he's on too much.
Speaker 1 (06:56):
Please lower his dose oh my god, she can't handle it.
She's overworked andunderwhelmed.
Yeah and then, and then she has.
Speaker 3 (07:03):
You know, women lose the estrogen.
You know they lose theirprogesterone and testosterone.
Speaker 1 (07:09):
And that's sex drive.
Speaker 3 (07:10):
It's a drive, yeah.
Right Sex drive is testosterone, yes, yeah.
So what are we doing?
So, unfortunately, in thiscountry, in most countries,
testosterone is not indicatedFDA-approved for women, so
there's no treatment for womenand that's sex treatment for
women.
And that's what sex drive,that's testosterone.
Yeah so testosterone replacementis not FDA approved.
That's why people go to thecompounding route, but what I
(07:32):
would do is just give them 10%of the man's dose, like I was
talking about earlier todayabout the test them.
There's a testosteroneconcentration that I give to men
.
It looks like a little tube ofthe travel toothpaste and you
can take a little bit out.
So I do have a story.
I have tons of stories.
Speaker 1 (07:50):
No, tell us a story, Frank.
Tell us a story.
Yeah, somebody did this a longtime.
Speaker 3 (07:54):
So I had a judge it was a Supreme Court judge years
ago in his 80s and he came inand he wanted his hormones
checked.
And when they say theirhormones I love when they say
that, because which one?
There's a lot of them.
There's thyroid hormone, butusually they mean the sex
hormone.
Speaker 1 (08:09):
Well, because he's coming in, she's like does that
mean he's not getting it upanymore?
Speaker 3 (08:14):
Yes, exactly.
Speaker 2 (08:19):
Can you imagine at 80 years?
Speaker 1 (08:19):
old, we still got to work, ladies.
I thought by 80,.
I can lay back in the bed andjust chill out.
But 80, I can lay back in thebed and just chill out.
Speaker 3 (08:26):
But no, the men still want to bang at 80.
It's unreal.
It's unreal Undo a button.
It's getting warm in here, Allright.
So yeah, so he comes in.
We check his levels and, yes,his testosterone is low, Low.
If you want numbers, I can giveyou numbers also.
So low is usually under.
They say they lab under 250.
But I have under 250.
But most men, you know, 18, 19years old, they're 800, 900.
And guys, want that same thingyou know, so I'll do what I can
(08:50):
without harming their organs.
You know you want to go slowly.
You see these bodybuilders thatare dying of blood clots Right
absolutely.
Destroying their organs, theirheart, their liver, their lungs.
Their increased risk of cancersgo up dramatically when you
overdo it.
But everything in moderation,like even the water I just drank
.
You could be intoxicateyourself of water and die
absolutely.
Salt goes too low so you startlow and go slow.
So this particular gentleman Isaid you know what, instead of
(09:12):
taking a full tube of test himevery day, because it's dosed
daily, and you just rub it onyour upper back, take a half a
tube.
He's like okay, and he comesback.
No, he doesn't even come back.
So a couple days later I'm inan exam room with a patient like
banging on the door and I tellthe medicalist don't bother
unless the place is on fire I'min the middle of a conversation.
They could be telling me they'rein for their hormones, but they
(09:33):
could be telling me thatsomeone just died.
You know, there's somethingterrible happened.
If the door's closed, don'tcome in and I get this and I
just had and I just had thisconversation just the other day
and I'm like what the fuck isgoing on.
Mr So-and-so is on the phone.
It's an emergency.
I told him you're in a room,You'll call him back, and he
said he needs to talk to me now.
Like, oh my God, what happened?
Speaker 1 (09:53):
He died Right he had a heart attack while he was
banging.
Speaker 3 (09:57):
I killed him with a little testosterone, exactly.
Speaker 1 (09:59):
Right.
Speaker 3 (10:00):
So he goes.
Frank, I got a big problem.
He goes.
My wife locked herself in thebathroom and she won't come out.
Speaker 1 (10:06):
The poor woman was on vacation, but not anymore.
I go.
Speaker 3 (10:10):
What do you mean he goes?
I think a tube and a half isway too much for me.
I swear to God, I'm like a tubeand a half.
I said a half a tube.
Speaker 1 (10:19):
He goes oh my God, wait, that makes him get an
erection.
Speaker 3 (10:23):
Yeah, so in other words, so you're saying he's
level, poor guy had a hard-onfor days.
Pop-ups.
Speaker 2 (10:27):
Come and get pop-ups For days, so I wanted to bring
up his testosterone.
Speaker 3 (10:31):
It was around 200, 300 is better.
So I gave him a half a tube,thinking we'll just put it on a
little bit.
He's an older guy.
How much want to protect thebones at that point and just
give him quality of life.
But he took triple the amount.
So his wife yeah.
So I'm like no, no, I said ahalf a tube.
Speaker 1 (10:48):
He's like oh, I don't think my hearing aid was on
when you told me oh, my god, twoand a half, so wait, will that
give him a hard-on for days likeviagra?
Speaker 3 (10:57):
well, you have to it's.
It's gonna give him the drivethat's, that's what that poor
woman left herself in thebathroom.
Speaker 1 (11:03):
He was chasing around her, around the apartment with
a walker.
He wants a bag like 10, 12times a day.
Yeah.
Speaker 3 (11:08):
So after that I'm always telling him repeat what I
just said.
How much are you going to takewhen you get home?
You know you live and learn.
Oh, that's funny.
But at 80.
At 80.
You're still looking to bang at80.
Speaker 1 (11:18):
Oh my God, Unreal that never, change, though that
doesn't surprise me, thatdoesn't surprise me.
Speaker 3 (11:22):
It's not our fault.
You know what Men never changeIn the wilderness, you ever see
women chasing men.
Speaker 1 (11:27):
Never Like the tiger or the fucking lioness.
Doesn't one chase, doesn't the?
Speaker 3 (11:33):
We gotta look that up , yeah one of them, I think.
Speaker 1 (11:36):
Doesn't the woman tiger go hunt and do freaking
everything, while the male'slaying out in the field?
I don't know.
Speaker 3 (11:43):
I don't know, but it's always the man, like the
peacock, always trying to showhis fat.
We're always trying to impressthe women.
Speaker 1 (11:48):
Of course that's the way it should be.
Speaker 2 (11:50):
So I mean you got to tell that.
Say that loud.
Speaker 1 (11:54):
Yeah, say that loud for the people in the back.
Speaker 3 (11:57):
What about where the traditional men you know they're
?
Speaker 1 (11:59):
gone Right, okay, so we went through the different
types of hormone therapy.
Now, what about like?
What about like sex drive?
Like do you find that it goesdown in women and men?
(12:20):
I feel like men always have todrive more than women.
Speaker 3 (12:24):
I'm hearing Okay, but do you find that?
Speaker 1 (12:34):
around what age do you find the men coming to you,
versus what age the women cometo you?
Speaker 2 (12:39):
Do you know what I'm trying to say?
Yeah, that's a good question.
You know how they?
Speaker 1 (12:42):
always say a man's prime is between 18 and whatever
it is 35.
And a woman's is like totallyafter the men's, supposedly like
35.
Speaker 2 (12:51):
So there's this like disparity, like who, who are the
, you know, like the women?
Well, you know why?
Speaker 1 (12:56):
because let me give you an example.
Like I'm right, we're in our40s, right?
So when I meet a guy in his 40s, I don't know, like I don't
know about men's testosteroneand their sex drive, like that's
the last thing I got going onin my life with my kids and my
whatever.
Like when I meet a man in his40s and 50s, is he?
Is he, like you know, stillbanging around like he was in
(13:19):
his third?
because you're not in your 40s.
As a woman, I can guarantee, Ican tell you that my sex drive
is completely different todaythan it was in my 20s it's more
or less Less.
I couldn't give a shit, like Icouldn't give a shit.
I mean, I give a shit but I'mnot sitting there like, oh my
God, I haven't, you know, hadsex in.
(13:39):
You know, like usually menwould be Like men can't live
without it.
Traditionally, men will saycannot live without it.
Speaker 2 (13:46):
But also we have control over ourselves.
Speaker 1 (13:48):
Everybody should have sexual discipline, but I'm
talking in general.
So do men in their 40s and 50s?
Are they still banging it outand getting hard?
Speaker 2 (13:58):
When does that end for them?
But I feel like maybe the driveis there, but the body is not.
Well, that's what I'm asking,that's where I come in, that's
what I'm asking.
So.
Speaker 1 (14:05):
I feel like when a man sees an inkling of he can't
get it up at any age, he'srunning to you Because that is
probably the biggest fear for aman.
Speaker 3 (14:15):
Yeah, so the good thing is with that.
So I treat diabetes also.
So to get people to test theirblood sugar and take their
medication, I use a differentapproach for the different age
groups and men.
All you have to say is diabetescan cause erectile dysfunction.
You never told me that.
Speaker 1 (14:27):
Wait a second Right.
They dysfunction.
Speaker 3 (14:28):
you never told me that wait a second, right, they
panic exactly.
And then I'm getting phonecalls.
He needs a refill of hismedication, he wants his testing
supplies to break his finger.
So yeah, so that's a man's that.
Yeah, you don't want to losethat but when do men usually go
down?
Speaker 1 (14:41):
do you know what I'm?
Saying like women physically noright no, like women, right,
start to lose their sex.
Not lose it, but it goes down.
They say menopause right,because your hormone levels are
off.
When does it hit for men?
Speaker 3 (14:55):
And we have menopause .
Speaker 1 (14:57):
So after 40,.
Speaker 3 (14:58):
Usually the testosterone goes down, maybe 1%
each year but every guy isdifferent.
Do you go to the gym and raiseyour testosterone?
Do you eat right?
Do you sleep right?
Do you not drink a lot?
Speaker 1 (15:06):
of alcohol.
Do you treat your body right?
Speaker 3 (15:06):
Do you sleep right?
Do you not drink a lot?
Speaker 1 (15:07):
of alcohol.
Speaker 3 (15:07):
Do you treat your body right?
Food is medicine.
I have guys that are in their30s with erectile dysfunction
and low testosterone.
Obesity major cause of lowtestosterone because the fat
cells hold estrogen and estrogenis the opposing hormone from
testosterone.
So that's why polycysticovarian syndrome.
They're high in testosteronebecause it's schizophrenic in
the body.
So men that are overweight havelow testosterone, high estrogen
(15:30):
.
Women that are overweight havehigh testosterone.
Speaker 1 (15:33):
So it's the same for the women as men.
If you go to, oh, it's that.
Speaker 3 (15:38):
Did I say that back?
So men that are overweight havehigher estrogen, low
testosterone and women that areoverweight usually have the high
as a PCO, polycystic ovariansyndrome.
So it's usually seen in younger, younger women that have high
testosterone, irregular periodsand that causes hirsutism.
Speaker 1 (15:55):
Yeah, that the hair.
We don't want it yeah, malepattern baldness okay, stuff
like that.
So if you're going to the gym,eating healthy, doing all the
things that you should do, yoursex drive, man, or should stay a
little bit more elevated.
Speaker 3 (16:10):
Yeah, absolutely, because the sex drive hormone is
testosterone for both, and I dohave guys in their 80s that
have great testosterone.
Speaker 1 (16:17):
That's crazy, and I have guys in their 30s that have
low testosterone Like you havenone, still banging it out at
90-something with bunnies.
Speaker 3 (16:24):
Well, he's probably on testosterone and viagra.
Speaker 1 (16:26):
Yeah, he's dead now, but he probably was.
He had twins at like 90.
Speaker 3 (16:34):
yeah, he had a lot of crazy, oh my god but also I
find out a lot of these placesthat are giving testosterone are
not being thorough.
I do endocrine, so I'm lookingeverywhere, so I want to find a
cause for everything, so a lotof times it's from I shouldn't
say a lot one in ten people havea mass on their brain blocking
the signal from the.
That's crazy luteinizing hormoneand follicle stimulating, which
is the two hormones to tell thetesticles and ovaries what to
(16:55):
do, blocking the signal.
That's why it's lowtestosterone.
So a lot of these places thatjust testosterone mills yeah,
that's what I call them, yeah,yeah they just have some
testosterone and we've had somein different areas that come in
and they had a two centimeter,which which is huge.
The pituitary is only twocentimeters.
Speaker 2 (17:11):
Yeah.
Speaker 3 (17:12):
So it's like halfway this way.
Speaker 1 (17:13):
So it's really important to get the blood work
done so that you know, don'tjust slap on some testosterone
gel, don't just give Viagra.
Speaker 3 (17:19):
Another cool statistic is that 50% of men
with erectile dysfunction haveheart disease.
Because, if you have blockagesin your heart, you can have it
in your penis.
Speaker 1 (17:28):
Right.
Speaker 3 (17:33):
So have blockages in your heart.
Speaker 1 (17:34):
You can have it in your penis right, so I don't
have the blood flow right yeah,it's all about blood flow.
So I don't do not give viagrato men unless they have a
cardiologist.
Interesting, yeah, because thatis really used in the market.
Speaker 3 (17:39):
I mean, it's like it's like candy yeah I did have
a guy years ago there's anotherfunny story that he came in and
he's like I want, I need viagra,I'm not, you know, and he was
vocal about it and vocal andvulgar and I'm like he had
uncontrolled diabetes.
So we talk about risk factors,right?
So there's all the independentrisk factors If you're over 45
(17:59):
as a male, if you're overweight,sedentary lifestyle, high
cholesterol, high blood sugarand hypertension family history
of heart disease.
I got seven independent cardiacrisk factors for a heart attack
and he fit the bill there andhe's like my this isn't working.
I need medication.
I said no.
First of all, we need to checkyour testosterone.
We need to check all theselevels and make sure is it
(18:21):
coming from your brain or yourtesticles?
Do you have a cardiologist?
No, I don't.
So I refused to give it to himand he stormed out of the office
, slammed the door and yelled atus like F, this guy, you know,
I just know what he's talkingabout.
Okay, I don't see the guy back.
I figured he's done with me.
Whatever he comes back in witha woman in tears.
I just got the chills In tearsand you saved his life.
(18:41):
He goes.
He wanted sex so bad he cavedand went to the cardiologist.
He he had a quadruple bypass.
Oh my God, he almost died yeah.
Speaker 1 (18:52):
That's crazy.
That's why he had ED.
So it's not all about you know,right, you never know.
You really have to.
Completely physiological.
Speaker 3 (18:55):
You've got to be thorough Is there Viagra for
women.
Speaker 2 (18:57):
Good question.
Speaker 3 (18:58):
Good question.
So again, women are always puton the sideline.
Speaker 1 (19:10):
I feel like.
I feel like.
I don't know if you feel likethis, but you're probably
usually gonna look at me likeI'm not.
Speaker 3 (19:15):
I feel like you're not keep going.
Speaker 1 (19:17):
I know right, I feel like as a woman, right, dating.
Right, since we're younger,let's you know, 18 and right
you're dating, you're having,you're sexually active, like
we're always supposed to be onpoint, like, like.
Do you know that Like?
Do you ever feel that Like when, like, women are always
expected to be like, sexy andready to?
Speaker 2 (19:37):
go Supposed to be everything to everyone at all
times.
Speaker 1 (19:40):
Like your man want.
Like you know, I had a hard dayLike I don't know, just not old
, not like aggressively, I'm notsaying demandingly, but I'm
saying when you're in arelationship I always feel like
the woman.
You know, we do all these jobsthe kids, the this, the how, the
job, what and we're always justsupposed to be like ready to
like strip down, look good andlike be sexy for you and have
(20:02):
sex yeah, that's just you knowwhat I
mean you feel like you have tobe and I don't feel like that
pressures on the man, althoughwe have different kind of
pressures.
Speaker 3 (20:09):
You know what I'm saying.
Speaker 1 (20:10):
Like I feel like you're always expecting me to be
sexy and this, and that youknow.
You go out, you go to dinner,you're wearing a hot, tight
dress.
The minute you like walk intothe car, the guy's hand's like
halfway like up your thigh inthe car.
Speaker 3 (20:26):
You know like it's a different pressure, you know
what.
Speaker 1 (20:29):
But we could go out to dinner or do whatever, or go
to a wedding or whatever, andthe man can look hot and we're
like all right, we're tired,let's go to bed.
You know what I'm saying?
I feel like the pressure isalways on women, but meanwhile
there's Viagra for men Pressureon us to perform.
Speaker 3 (20:48):
Yes To be in the mood .
Speaker 1 (20:49):
To be in the mood to perform, to look, I don't know,
I feel like that.
Speaker 2 (20:55):
I mean, it's just a symptom of like.
Speaker 3 (20:58):
Let's check your levels.
Yeah, let's go.
Speaker 1 (21:00):
Yeah, I know, but I feel like that's why.
I'm saying is there Viagra forwomen?
Speaker 3 (21:05):
Yeah, Well, Viagra doesn't do anything with the
desire.
Viagra just increases bloodflow to that area.
Oh, so it just treats thephysiology.
Speaker 1 (21:13):
So a man could be taking Viagra, have a hard-on
for 10 hours and still not wantto have sex if his levels are
off.
How does that work?
Speaker 3 (21:21):
Well, you can only so .
If I took Viagra before I camehere, I wouldn't have a hard-on.
I'd have to want to have a.
You know what I'm?
Speaker 1 (21:26):
saying Got it?
I'm not familiar with it,Although you keep opening your
jacket.
I don't know.
I'm sweating.
Speaker 3 (21:30):
I'm having a hot flash.
Speaker 2 (21:31):
It goes so many places with what you just said.
Speaker 3 (21:35):
But you have to be aroused mentally.
Speaker 1 (21:38):
Got it.
Speaker 3 (21:38):
And it just makes it easier because now there's more
blood flow, it's ready to roll.
Speaker 1 (21:41):
Because I've heard about men getting erections from
Viagra and they can't get itdown like they is.
Speaker 3 (21:46):
That true, yeah, so that's one.
In the package insert it saysif you had an erection for more
than four hours, go to thehospital.
I'm not, I'm going to the broth.
What do you mean?
The hospital, but wait a minute.
Speaker 1 (21:57):
But, and you know me, but I gotta ask the questions
how does that work?
Like it's not good you get ahard-on, we have sex.
It doesn't go, you don't comeit doesn't go down, I don't
understand it yeah, ejac,ejaculator or not, it just stays
hard.
Speaker 3 (22:10):
No, yeah, you have to actually go to the hospital
legit, I've never seen this, butI've read about it and the
urologist has to take a syringeand suck out the blood.
Sounds fun, gentlemen, if youdon't, then it might not work.
Speaker 1 (22:25):
I mean, necrosis can happen because there's no blood
flow anymore.
Then we got to cut it off.
Speaker 2 (22:29):
There's a lot of blood stuck in there.
Speaker 3 (22:31):
But that's usually super rare and it's usually when
guys if I take one, that wouldbe good.
What if I take five?
Speaker 2 (22:37):
That would be five times better.
Speaker 3 (22:38):
It's not.
It's never Slow and low as anNP.
That's what we're always taught.
Okay, Slow no start off with alow dose and go slow with it.
Speaker 1 (22:48):
Okay, so it wouldn't work on women anyway, because
it's just for blood flow butthey might get good blood flow
down in that area anecdotally.
Speaker 3 (23:03):
So anecdotally means that like if we try it and it's
not really FDA approved thefeedback I'm getting off label
exactly.
So if the man says take a pilland I've heard my patient say I
gave it to my wife, she enjoyedherself more than usual.
Speaker 1 (23:09):
Got it Because it increases blood flow to that
same area.
Got it, you can orgasm better.
Got it, yeah, because it's allabout blood flow, if you want
you know there, so it does work.
Speaker 3 (23:17):
Unfortunately, they were going to come up with a
pill, but women are not.
As like we're very mechanical,like we're easy to please, you
know, like have to be in themood and we'll get in the mood
quickly.
Speaker 1 (23:28):
Well, this is my point.
Yeah, that was my point with myother thing, so we could be
turned on like a switch 100%Women.
Speaker 3 (23:33):
that's why Viagra would 100% probably work,
because if you take Viagra, youmight get the increased blood
flow, but you don't have thedesire.
That's why you need it.
Speaker 1 (23:41):
And that's why men are more like physical right,
and women are more mental.
Oh, they're definitely mental100, but you know what?
I always say this, but I alwayssay like and not all, because
we know you quote me when I saymost, not all, but I always say
this like a man could have sexwith you know three women and
(24:03):
just, it's just an act, it'sjust a whatever.
Where we've discussed this,women are more emotional, like I
am not having sex with a manthat I'm not emotionally
attached to.
It skeeves me out, I don't wantyou touching me.
Speaker 2 (24:14):
But what happens, even if you're not into them
initially, after you have sexbecause of all the you know, the
hormones that are released, allof a sudden Oxytocin yes.
You start looking at this thingthat you thought was a beast,
and you're in a different way,because this might be the
potential father to yourchildren and then all of a
sudden you're looking at himwith a different lens.
(24:35):
So I think it's a kind of adangerous thing.
Speaker 1 (24:38):
Slippery slope, yeah, but most women have to have
some sort of emotional attachMost.
Speaker 2 (24:45):
Where men don't?
Not you, linda In thebackground, yeah, not you, linda
, who's writing into me rightnow saying I can fuck 20 guys
and it wouldn't matter, I don'tgive a shit, not you, not you
yeah, not you, linda okay, yeah,but I think that's why it's so
different and that's why thehormone replacement right is
important for women.
Speaker 3 (25:04):
Yeah, as they get older just a little bit of
testosterone.
You don't want to make them aman.
You.
Speaker 1 (25:09):
No.
Speaker 3 (25:10):
I do do also transgender, and it's a big
difference between giving awoman a slight amount of
testosterone versus what I dofor the trans community, where I
give them a boatload and givethem enough for a man, different
dosing it's a man's dose versusa tenth of the man's dose.
Speaker 1 (25:26):
Okay, okay, so Okay, and, like we said, the different
symptoms that women should begoing would be libido, tired
fogginess, moodiness, lowattention at work.
Speaker 3 (25:43):
Sometimes I hear also getting short with the kids.
You know temper stuff like that, the hot flashes, that's
usually what brings them inRight.
Speaker 1 (25:52):
No, those, a lot of women die from those.
I know I've been getting themLike.
It wakes me up in the middle ofthe night and I toss and turn.
I have to change the pillowBecause the pillow's physically
hot Right and then I got toswitch it out to the cold pillow
and it disrupts my sleep.
It's horrific.
Speaker 3 (26:08):
Also, a lot of times anxiety is at night, because
that's when your mind starts tocalm down, but all the thoughts
and the rumination startshappening.
Speaker 2 (26:15):
Oh, rumination, I'm a ruminator, are you?
Yeah, I don't know.
Speaker 3 (26:18):
I always have been Rumination at night.
Speaker 2 (26:21):
All the time, but at night, yes, especially so,
because everything you know Iused to just sleep right through
, no problems.
Speaker 1 (26:27):
Well, there's different sheets.
Speaker 3 (26:29):
You can get the cooling sheets keep the
temperature really cold.
Speaker 1 (26:31):
I got the cooling.
Speaker 3 (26:32):
PJs I got them from how cold do you keep the room?
Speaker 1 (26:35):
Like 69, 70.
You need to go lower than that.
Oh so it frees my children out.
Speaker 3 (26:41):
Oh, you don't have a separate one for you?
Speaker 1 (26:42):
No, it's all upstairs .
Speaker 2 (26:43):
You got a fan I could do.
Can you shut off their littlething in their rooms?
I have the most glorious sleepat like 62.
I'm out like a baby.
Speaker 3 (26:51):
Yeah, you need to be colder.
Remember, in school, with thecomputers, the computer room is
always colder.
Speaker 2 (26:56):
Yes.
Speaker 3 (26:56):
That's because it's like your brain is a computer.
It needs to be cold at night,especially at night.
All right, maybe I'll do it alittle lower.
I feel nervous.
69 is too high.
I'm get him another blanket.
Speaker 1 (27:08):
He's under tons of blankets.
We're all good with the fluffyblanks 69 is too hot, that's hot
, yeah.
Speaker 3 (27:15):
I didn't know.
69 is always hot, that's ournumber.
Speaker 1 (27:23):
Oh, my god.
Okay, so is there anything elsethat you think that we should
discuss?
Speaker 3 (27:28):
Well, also when you were saying about sweating and
things.
So sometimes you're going tohave an overactive thyroid.
So I think blood work and beingthorough with all the hormones
is good.
So a baseline Kidney, liver,thyroid function.
You want to check yourcholesterol also.
Speaker 1 (27:39):
Make sure that's good , but I'm sure this is the panel
when they come to you, ifsomeone comes to you when they
come to me?
Yes, yes, and we're gonna havefrank on again, but you're
opening a medis what is itcalled?
oh yes, coming soon, coming soon, yes, so someone can get all
their hormones, someone peopleare going to be able to get
their hormones from you and whatlike everything they need and
(28:04):
their botox and their botox andtheir phyllis and the phyllisers
, god knows, are my favorite, um, and then you know what else I
wanted to discuss, also becausea lot of women, my friends, have
been complaining about thiswhat's that waking, oh gop1 yeah
, that, but like that, but withprairie menopause, they say
(28:26):
their period, and you know whatthis is is another stupid
question which you probably youmay not know.
I love stupid questions, I lovethis, but this is a question I
have.
Okay, so let's say you'reperimenopausal and you're
skipping periods, or you knowhow they.
Well, the gynecologist says ifyou don't have your period for a
year, you're done right.
(28:47):
Let's say you're in that yearperiod and you know you got it
three months.
Then you didn't get it, or yougot like how do you know when
you can't get pregnant anymore?
Speaker 2 (28:59):
yeah, you might need to still take precautions.
Speaker 1 (29:02):
You might, or your two kids might have a little
baby.
I'm just saying even for likethe married women that are
listening, or the people inrelationships.
I'm not saying the hoes.
Speaker 2 (29:13):
Or the hoes out on the street Right, the hoes out
on the street.
Speaker 1 (29:16):
But let's just say you're with somebody and you're
like oh, I haven't had my periodin eight months.
Let's do like.
Speaker 3 (29:24):
And I feel kicking in my stomach.
Speaker 1 (29:26):
Do you know what I'm trying to say?
What could this be?
And then you know you don't useany precaution and you're like
I'm cool, how would you everknow?
Like, how would you ever know?
Because, right, for years,ladies it's always been like oh
shit, I'm late, yeah, right.
If you were late and you'relike, oh my God, let me go take
(29:46):
a pregnancy test, I'm late, yeah.
Or if you're trying to getpregnant, you knew.
Because you were late Right Now, I would be in pure panic mode.
When do you not like?
Because how would you know I'dbe taking pregnancy tests every
month because you're notskipping, you're not late.
I haven't got my period ineight months.
How would you ever know if youwere pregnant?
(30:07):
How do you know when you can,when you can't do that?
Speaker 2 (30:11):
when it's safe to do that, when your cycle is so
whack you can.
Speaker 3 (30:15):
If you're still getting a cycle.
That's why an IUD probably isthe best thing.
Speaker 1 (30:19):
Okay, just to be cautious.
And then, after you don't haveit for a year, you're free to go
or no.
Speaker 3 (30:25):
Yeah, free to go there or no?
Yeah, free to go there, but theIUD is still hormonal, so
that's another route.
Speaker 1 (30:29):
But you can't get pregnant anymore After a year.
Speaker 2 (30:32):
They say so they say we're going to come back to you
when.
Melissa has a bun in the oven.
Oh my God.
No, and it's all your fault,Frank.
Speaker 1 (30:45):
Oh, my God.
Speaker 3 (30:48):
So five years, Frank.
You said Five to 10 years.
That's my new thing.
Speaker 1 (30:52):
Oh my God.
Five to 10 years, okay.
Speaker 3 (30:54):
When you're 75.
Yeah, 75.
Speaker 1 (30:57):
All right, and now the weight gain A lot of women
are talking.
And they're talking about mycousin, always In the middle.
Yeah, says, says right here shegets like the pop bell.
All of a sudden her stomach wasfairly flat and now she's
getting this bulgeous pop belllove hand.
Like women are saying, theirmetabolism slows down.
So what do we take for that?
Speaker 3 (31:20):
so before I?
Even so, when I get a patientfor weight loss, what I do is
check.
You guys heard of cortisol,right?
so it's all over the place.
It's actually real.
So sometimes people talk aboutcortisol and adrenal fatigue not
real.
But there's something calledcushing's disease.
So remember I said one in tenpeople have a mass on the
pituitary.
It can be producing cortisoland it's called cushing's.
That could cause belly fat,that could cause waking and
(31:42):
cause diabetes.
So I've found a ton of peoplelately.
I would say when it's supposedto be one in a million.
In school we were taughtCushing's is super rare.
I found maybe five in the pastsix months.
Speaker 1 (31:52):
Oh wow, that's a lot, and it's a simple blood test.
Speaker 3 (31:54):
You take a pill at 11 pm it's called dexamethasone,
and then you do an 8 am cortisollevel and if it's elevated over
1.8, then and I've been- doing.
Mris and I have some in myphone.
I was checking the portal thismorning at work.
A guy has a mass on thepituitary, One has on the.
It could also be on the kidneys.
Speaker 1 (32:13):
It could be anywhere in the lungs.
And this causes weight gain.
Speaker 3 (32:16):
And it causes weight gain.
Speaker 1 (32:17):
Because some people are like I'm eating less.
I'm not the women.
I'm going to the gym.
Speaker 3 (32:29):
I have a nutritional program and I just can't.
I'm doing everything andnothing's working.
I usually check that baselineand if I don't do a baseline, if
I notice they're not losingweight on the GOP.
Once I have a patient on 15milligrams of Zepound, which is
the highest dose, hasn't lost apound.
So I did a Dexmedzonesuppression test and I'll let
you know about that.
Speaker 2 (32:41):
I've lost 15 pounds in the past three months, but I
have I've as heavy as I've beenin my life.
I've never had this likestomach thing going on well,
that's what I'm saying.
Speaker 1 (32:51):
Like it comes with the peri, I hear it comes with
the perimenopause.
Speaker 3 (32:54):
A lovely silhouette, oh my god or you should make
sure it's not cushing's you knowbecause it's, it's, it's kind
of.
It's not as rare as we thought.
We weren't checking, because ifyou google what cushing's looks
like, they'll it'll be a moonface, buffalo hump, this woman
that's just huge.
Speaker 2 (33:08):
Oh, the buffalo hump.
Speaker 3 (33:09):
Yeah, the thin arms, the thin legs, and they could
also have purple stretch markson their stomach.
They have like a red face, likestretch marks on their face.
Speaker 1 (33:18):
That's an extreme case.
Wow, and what's your if allthat's okay and they're just
normal you know there's nothingwrong with them and they're
going through menopause?
What's your take?
Because GLP-1s are huge, yeah,so let's get into that.
Speaker 3 (33:32):
Yeah, no, I definitely love them Like.
Speaker 1 (33:33):
Monjaro ZipBound.
Even microdosing is great.
Speaker 2 (33:37):
Yeah.
Speaker 1 (33:37):
And how long is it safe to be on.
You know, go through that withus.
Speaker 3 (33:44):
I always find.
I always wonder when the repscome in to detail us, we always
say who do I not give it tobefore, Because they'll love to
tell you who to give it to.
Give it to everybody who can Inot give it to?
So it's people that have ahistory of pancreatitis.
That's something that you don'twant because it can cause
pancreatitis.
So if you had it before and youdon't want to take this class
of medications.
Also, it's a super rare thingcalled medullary thyroid cancer.
(34:06):
I've never seen a case of it.
It was seen in rats, not humans.
That's one thing if they have afamily history of medullary
thyroid cancer or they havemedullary thyroid cancer.
Other than that, it's fair game.
What I like to do is make surethat triglycerides are normal,
because high triglycerides cancause pancreatitis.
So, triglycerides are in thecholesterol profile.
It's usually from genetics or alot of carbohydrates
(34:29):
consumption.
You fix that and you can fixthat with fish oil prescription.
Fish oil I use that brings itdown and then I start the
medication and you start slowand people don't realize.
Manjaro is the same thing asZetbound Same exact molecule,
just appetite.
Manjaro is marketed fordiabetes, Zetbound is marketed
for weight loss.
Speaker 1 (34:47):
Okay, and can, just that, like I know, a lot of
women can't afford it, can it gothrough insurance right?
Yeah, some of the plans.
Speaker 3 (34:56):
They're getting harder and harder.
Years ago I know some providersthat would lie and say, oh,
they have diabetes and then getit.
And then these people are goingout of business now because the
insurance company is saying Iwant the chart notes.
Where's the diabetes?
Speaker 1 (35:08):
And it's not there, right it's fraudulent.
Speaker 2 (35:10):
As I always say, I don't look good in orange Right,
so I play by the rules.
Speaker 3 (35:14):
I play by the rules.
If you can't afford it, I'msorry, but the pharmaceutical
companies do have medicationsthat are a little cheaper now,
like $300, $400 a month,depending on the dose depending
on the dose.
Speaker 1 (35:25):
And how long can you be on it?
For Forever.
Speaker 3 (35:28):
So I always ask about side effects.
Major potential side effects isnauseousness, diarrhea,
constipation, so some people canget bound up, some people can
have diarrhea.
Acid reflux is another one Ihear sometimes but they could be
on it forever, so it's agastric.
Speaker 2 (35:44):
It's manageable.
It's a GOP1.
Generally, the side effects aremanageable.
Speaker 3 (35:49):
Yeah, it's manageable .
It's a GOP1.
Generally the side effects aremanageable.
Yeah, especially the Zetbound.
So the majority is a two-in-onehormone.
It's GIP and GOP1.
That's more efficacious and ithas more weight loss and less
side effects.
So that's the one, yeah.
Speaker 1 (35:59):
And I know a lot of my girlfriends are like oh, but
you know how can you be on itforever?
It was originally for diabetes.
It forever.
It was originally for diabetes.
And the minute you come off ofit, let's say you lose all the
weight.
The minute you come off of ityou're going to gain the weight
back.
Speaker 3 (36:12):
Not necessarily.
So usually this is a tool thatonce people start losing weight,
now they're motivated to go tothe gym.
Now they're motivated toexercise and do better things,
motivated to eat the right foods.
So I like to keep them on.
You know whatever dose ismaintaining their body weight
and if you could, always Like amaintenance dose.
Speaker 2 (36:30):
It wouldn't be like at the highest dose Exactly you
would stay on indefinitely right.
Speaker 3 (36:35):
It depends.
So I have people on the 2.5 isthe lowest dose.
I have people on 2.5 and theylost what they wanted and
they're fine.
And then I'm like, okay, if youever want to come off it, if
you lose, I also if they startto lose too much weight, too
much.
Yeah, then I definitely need tocome off it.
It's not.
People get obsessed with thisstuff and they don't see
themselves their body'sdysmorphia.
Speaker 2 (36:53):
Absolutely.
Speaker 3 (36:54):
They look in the mirror and still see themselves
100 pounds heavier.
And you know a lot of thesepeople.
They need counseling and thingsto help them out get through
things Right.
But yeah, start at the 2.5.
And they say after four weeksyou can increase the dose.
But I only increase the dosewhen it goes, when their weight
(37:15):
either goes up or plateaus.
I have to hit it on my phone,rob, so a lot of people did they
do want to keep going up and upand up every month, but then
you're going to run out of dosesright you know, so you only
have you know they have to 2.5to 5 to 7.5, 10, 12.5, the 7.5,
10, 12.5, and 15.
So you have six doses to workwith.
Do you want to go every singlemonth?
Then you're six months andyou're capped out.
Speaker 1 (37:34):
Right, no, you got to wait until you, but a lot of
places they do that You've heardof the ozempic face.
Speaker 2 (37:39):
Yeah, I was just going to say you need someone
reputable like face, or perhapsa zempic butt.
Yes, and it's time to back away.
Speaker 1 (37:47):
Yes, and you should be working out while you're on
it and eating healthy 100%resistance training.
I had a woman.
Speaker 3 (37:52):
Actually this is a case study, so the schedule is
so crazy, especially with theGOP ones coming out.
And I do endocrine, so we haveeverything endocrine plus weight
loss now thrown at us.
So what I would do is I wouldsay okay, call me every month,
month tell me how you feel, tellme your weight and if you're
going up, I'll give you it.
You know.
The next, the next dose, just aquick phone call, not even a
video visit, and I and you knowyou live and learn, you make
(38:14):
mistakes and you find out.
So six months later she comes in.
She looked like she has cancer,like you could see the clavicle
bone.
Yeah, you know it's women.
You shouldn't really see thisbone that prominent yeah and, uh
, she looks sunken in.
No, no, no, I mean like, like,like the, you know the no, you
could say, but the divot, likeyou know, like the huge hole
where you could like fill adrink in there you know.
(38:35):
So it shouldn't be like thatyours is your perfect so um,
thank you, wait, let me seelet's check out the clavicle.
Good looking, all right.
So so you can't put any youcan't put any fluid in there,
you know what I'm saying.
Speaker 1 (38:46):
It looks like a hole.
I know it's sunken in.
Speaker 3 (38:48):
Yeah, and they have, like, their face sunken in, they
lose the face muscles and allthat.
So she came in and I'm like, ohmy god, she's dying you know
I'm talking to her, I'm killingher, is everything okay?
Like she's like no, I'm good,I'm doing all right.
I'm like no, you're not whathappened you?
Literally lost like 80 pounds,that's all you last you look not
good.
I said I think you should see ahematologist, oncologist you
(39:09):
know you might have cancer.
You know she's like.
I went to my primary care, hethought the same thing I did and
he told me to tell you I needto lower my dose.
I'm like, are you kidding me?
Like you lied to me all thesemonths.
I'm not losing weight, I'm notlosing weight.
Then she shows up 80 poundslighter in six months and I'm
like and the primary care isthinking this guy's a hack.
What is he doing?
Yeah, I'll never do the sixmonth thing without looking at
(39:31):
you doing a video visit, atleast it's a huge.
Speaker 2 (39:33):
I know patients who did like a busy video visit with
a provider and they put on thebiggest, bulkiest sweatshirt and
just and stuffed it with things, so they could, you know, get
their little, of course, aglute-tied fix.
Speaker 3 (39:48):
yeah, yeah and if they don't lose weight with the
insurance companies now, are nothaving the medication oh yeah,
now some of them are mailing ascale to the house.
They have to weigh themselvesand if they don't lose five
percent body weight, they takethe medication away.
Because why should they pay athousand a month if you're
really not going to lose weighton the medication?
So yeah, it's changing timesnow.
It's not like a free-for-allright how you could lie on the
(40:10):
chart notes and get it covered.
Speaker 1 (40:11):
No one's looking because now it's became ever
since elon musk started takingit and kim kardashian oh yeah,
exploded, of course, so thatthey've been taking it for years
years when we didn't know aboutall I feel like all those movie
stars that you were like howdid they lose all that weight
for that movie in six months?
Now we know how.
Speaker 3 (40:31):
These GOP ones have been around for more than 10
years.
Speaker 1 (40:32):
Well, that's what I mean.
Nobody's talking about it,right?
No, but now it got out.
Speaker 3 (40:36):
Yeah, the story's out .
All the celebrities are like.
Now we know.
Speaker 1 (40:40):
Right now we know how they all like for the Emmys or
for the.
They look so amazing.
And you're like how did shelose all that weight to fit in
that Marilyn Monroe dress?
I couldn't lose, I couldn'tlose.
Would she lose 20 pounds in amonth?
Like I couldn't do that?
Speaker 2 (40:54):
with a gun to my head .
I love when they do, I know.
Speaker 1 (40:57):
With a gun to my head .
I couldn't do it.
Like with my awesome trainer,like if I ate, you know, 100
grams of protein a day, Icouldn't do it.
Speaker 2 (41:06):
It's just horseback riding and long walks.
Yeah, right, yeah, extra sex.
Oh man, that's some moretestosterone.
Speaker 3 (41:14):
I worked it off in bed.
Speaker 1 (41:16):
Oh, my God.
Speaker 3 (41:19):
Certain tricks, like your brain doesn't know if
you're hungry or thirsty, so ifyou drink a ton of water, yes, I
do that Coffee.
Coffee's an appetitesuppressant.
It's awesome.
Speaker 1 (41:26):
I always have it every morning.
That's a little thing.
Coffee's an appetitesuppressant.
It's awesome.
I always have it every morningthere it is there, it is In the
corner.
Speaker 3 (41:30):
The half-life of coffee is going to be up to 12
hours, so maybe that's why, atnight too, if you can't sleep,
stop the coffee like around 12.
Speaker 1 (41:37):
No, I just have one, okay, and I don't even drink the
whole thing.
Speaker 3 (41:43):
Okay, good, I'm like, how do you know?
Like espresso, right, yeah,he's like I can see it.
Speaker 1 (41:47):
Yeah, not happening.
Speaker 3 (41:48):
Yeah.
Speaker 1 (41:49):
All right, good All right Do we have?
Any other questions?
Speaker 2 (41:54):
I think I covered a lot, so I think, are we going to
get workups, melissa?
Yes, should we do before andafters?
Speaker 1 (41:59):
Yeah, we should do before and afters, we'll bring
that on to the done.
Speaker 2 (42:05):
I, I need it.
I have stuff going on.
Speaker 3 (42:07):
Yeah, let's fix it, yeah and the dexmed zone
suppression test.
Remember, just make sure youknow, because everybody I'm
checking everybody for cushions,no matter what your weight is,
you know, if you're strugglingyou could have it and then, when
you open up your place, we'llhave you back on yeah, you'll be
able to promote it everybody inlong island.
You could go to frank and videovisits anybody in the country
oh awesome, yeah, okay.
Speaker 1 (42:27):
So like telehealth do we do tell absolutely okay,
awesome so um check our shownotes.
So um we'll have frank'scontact info yeah, we're gonna
have your contact info, youremail yeah, I'm at nyu now, but
I'm doing video visits also,okay perfect, so we'll have all
that in our notes and that way,if you have any questions about
hormones or sex drive oranything, you can email Frank
(42:49):
and you do video visitstelehealth.
Speaker 3 (42:51):
Yes, absolutely.
Speaker 2 (42:52):
Ladies, Frank is cute , so you might want to and
single.
Speaker 1 (42:55):
He's single that's right.
Speaker 3 (42:57):
Single.
Speaker 1 (42:58):
I'm trying to hook you up with my girlfriend.
Speaker 3 (42:59):
Single looking to mingle, let's go.
Speaker 1 (43:02):
But Frank is single Great guy.
I've known him for a little bitand no kids never married.
Speaker 2 (43:09):
No baggage ladies, which is the best?
Well, we might need you on, for, you know, just like dating
stuff.
Speaker 3 (43:16):
Oh, I could totally talk to you.
I could tell you so many datingstories.
Oh, we'd love that.
So can I.
Speaker 2 (43:19):
I'm on the dating app girl, she's on the dating app
Are you?
Speaker 3 (43:24):
on no dating up here, so there's plenty of pigs right
on the plenty of pigs there'splenty of horrible people out
there no, but no.
I don't want to be jaded withthe dating no, I try to be
positive.
Yeah, I try to be positive, butunfortunately there's a lot of
people out there that are notgenuine.
Speaker 1 (43:43):
That's true, you know , oh, we know.
Speaker 2 (43:45):
There's filters, there's married people fish
catfish, catfish, whatever it'scalled, all kinds of fish.
Yeah, I don't go into that.
Speaker 3 (43:54):
And there's women that want an ATM, not a
boyfriend.
Speaker 2 (43:56):
I'm learning kind of you know.
So there's all kinds.
Yeah, oh, there are all kinds,but there's always people out
there, though.
I'm not gonna give up yeah, no,ladies, they say there's a lid
for every pot, right?
Speaker 1 (44:08):
That's right.
Speaker 2 (44:10):
Or like someone told me their Polish babsha, their
Polish grandma, said there's aseat for every dupa.
There's a seat for every S?
Okay.
Speaker 1 (44:20):
There seems to be, I'm still looking for my seat.
Speaker 3 (44:26):
So I think going out is the best, because I've been
going to the city a lot, asMelissa knows, every weekend To
meet people there.
I think it's a little biteasier.
Speaker 2 (44:34):
Well, I think, when you change locations, I'm
working in the city now and it'sso much different.
Speaker 3 (44:39):
Yeah, of course it is , but the problem is too, women.
I feel like they'reunapproachable.
Speaker 2 (44:46):
This is true Because you have to worry about your
safety too, and safety thesafety aspect.
Speaker 3 (44:52):
But how do we know?
Just say we're at a bar.
How do I know that you'reinterested, like a lot of men
Eye contact.
Speaker 2 (44:58):
Oh, this is a whole other.
You have to come back.
Speaker 1 (45:01):
Yes, we're going to have Frank back and we're going
to talk about.
Speaker 2 (45:04):
How do you know?
Speaker 1 (45:05):
that you will get flat out rejected.
Speaker 3 (45:08):
Because yeah a lot of men are scared of that.
It's you know I'm fearless, Idon't care.
Speaker 1 (45:12):
Right.
Speaker 3 (45:13):
But a lot of men have fears yeah of course they do
the last thing they want to dois be rejected in front of their
friends or whatever.
Speaker 1 (45:18):
Right, yeah, Well, it was great having you on.
Speaker 3 (45:20):
Frank, we're going to have you on again.
Speaker 1 (45:21):
Oh, I like that let's go, it's awesome.
Frank's our resident doctor onthe show.
So when we have questions we'regonna ask Frank.
Thank you for coming and thankyou for joining us with Dating
Daycare.
Make sure to check the notesand if you have any questions,
we'll have all Frank's info andwe'll see you next week, okay,
(45:42):
bye, bye.
Welcome to Dating Daycare, where we help you
navigate through the jungle ofjerks.
Welcome back.
Ladies and gents.
Today we're excited.
Yes, we have a guest on today,frank Albano, and he's going to
introduce himself and we aregoing to talk about hormone
replacement therapy for men, forwomen, libido.
(00:29):
We're going to cover it all.
Welcome, frank.
Speaker 3 (00:31):
Thank you.
Thank you for having me we'reexcited about this.
Speaker 2 (00:35):
I know I am with my hot stories.
This is very timely because youguys know that Melissa and I
are the same age.
We're 77 babies over here, sothere's a lot going on.
Speaker 1 (00:48):
There is.
Speaker 2 (00:49):
You need to help us.
Speaker 1 (00:50):
Yeah, and a lot of women.
Yes, you need to help us, womenand men.
We're going to discuss the men,though, too.
Speaker 3 (00:57):
It's always the men's fault, always, obviously, of
course it is.
Where do we begin my crazystories that you want to?
Speaker 1 (01:07):
Let's talk about like so a lot of women, right?
How do you say it, perry?
Speaker 3 (01:14):
They're going through their changes.
They're going through theirchanges.
They're not there yet.
Speaker 1 (01:18):
They don't know what to do.
Their periods are skippingRight.
Ladies, like you get it andthen you don't get it.
Speaker 2 (01:29):
You get it for a day and you're like what's going on?
Am I pre?
Then the panic starts andyou're like am I pregnant?
Yeah, three weeks.
Speaker 1 (01:32):
You get it for like three weeks, right, right.
So this obviously me.
You go see a gyno and they wantto put you on some sort of
hormone therapy, so how do yousuggest what is the right way to
go about doing that?
Speaker 3 (01:44):
so so, first we need blood work.
We've got to see your levels.
I want baseline estrogen bloodtest, testosterone and there's
hormones in the brain, thepituitary hormones that regulate
the estrogen.
So it's LH and FSH prolactin.
You definitely want to check apregnancy test because there's
something called polycysticovarian syndrome, that younger
girls have the opposite actuallyhigh testosterone instead of
(02:04):
low and that younger girls havethe opposite actually high
testosterone instead of low andthey come in and the first thing
you want to make sure isthey're not pregnant, because
that was something that happened.
One of my colleagues said oh,they have polycystic ovarian
syndrome.
They started them on treatment,but they were pregnant.
You know, maybe that's why theymissed their period.
Speaker 1 (02:16):
So that's first and foremost Right, of course.
Speaker 3 (02:19):
So yeah, get some levels and figure out what you
need, you know, and how much youneed.
Start slow, start low and goslow.
Speaker 1 (02:25):
And then what do you suggest?
Do you suggest I know there'screams out there, there's pills
is that dependent on your bloodlevel?
Like your blood work?
What you prescribe, like whatare just so women know, because
I think when you get there Iknow for myself.
Like we're clueless, you knowwhat I mean.
Like we're clueless, you knowwhat I mean.
Like we don't know.
None of this was discussed.
Speaker 2 (02:45):
Right, nobody told us this.
Speaker 1 (02:47):
So we don't know what the healthy route is.
You know there's, there's the,and of course you're going to be
able to dictate this betterthan me.
But I've heard of creams, I'veheard of pills, I've heard of
the little pill that getsimplanted in your tush over
there the pellet pill that getsimplanted in your tush over
there, the pellet, the pellet.
I've heard.
You know what I'm saying.
(03:07):
So there's so many options outthere.
I don't think, and I wouldimagine, that every doctor will
prescribe different things, likeI know.
I was telling you that I was on, my doctor prescribed pempro
and you're like that's not thebest because, it could cause
blood.
I don't know that yeah you know, women don't.
So how do we know what's bestfor us?
Speaker 3 (03:28):
Right.
So the best thing you ever hearwhen women are on birth control
, they say after age 35, youshould come off of it.
The risk they're thinking isblood clots because you're
taking estrogen orally.
What it does is tell the liverto produce more clotting factors
, which is not good.
So the best way to go is thetransdermal.
Like you mentioned, there's geland there's patches, like you
were on the patch.
So, that's definitely a betterroute than pills, but the pills
(03:50):
that you can take is theprogesterone.
So when a woman comes in, thefirst question is well, for her
symptoms, do you have a uterus?
That's important because if youdo, then you have to take the
opposing hormone, progesterone,because if you don't you run the
risk of endometrial cancer.
So you have to do the opposinghormone, so you got to take
estrogen and progesterone if shedoesn't have a uterus, and then
it's just estrogen without anyrisk.
(04:11):
But then it's all about howthey feel and the levels.
You know.
Some people just say oh, how doyou feel?
you know you could feel great,but you know, if you feel tired
and people like I want, I wantto.
I get this a lot with men.
I'm tired, I have lowtestosterone.
Well, did you check your level?
No, so, and how do you knowyou're not tired from you're not
eating enough, you're notsleeping enough, you're not
drinking enough water?
Speaker 1 (04:32):
the family is crazy right, you're stressed out,
you're stressed out exactly.
Speaker 3 (04:35):
So you got to look at the levels and a lot of guys
come back and their levels arenormal and then sleep apnea is
huge.
The major cause of lowtestosterone in men is sleep
apnea.
Speaker 2 (04:43):
Did not know that, yeah.
Speaker 1 (04:46):
Really not being able to sleep causes low
testosterone.
Speaker 3 (04:49):
Absolutely, Because cortisol it all comes down to
the hormones.
It's all about the hormones.
Speaker 1 (04:53):
Interesting.
Speaker 3 (04:54):
Because cortisol is a stress hormone.
When you're stressed, do youwant to have sex?
Speaker 1 (04:57):
No.
Speaker 3 (04:58):
No, because your cortisol is high and it's
dropping all your testosterone.
Women have testosterone also,and that's the libido hormone,
and then we give all these menall this testosterone and Viagra
, and what do the women have?
Because they're not in school.
We didn't learn abouttestosterone for women or
replacement, because years agothere was a study that showed
(05:21):
increased risks of breast cancer.
Speaker 1 (05:23):
Right, which we've heard that about.
Like I was just saying that toyou originally, I was nervous
because I have heard fromdifferent women who have had
breasts that this, that they'relike, oh no, the hormones can
cause cancer.
Speaker 2 (05:36):
And then you get scared and you're like well, I'm
not suffering too much, rightlike I just have a few night hot
at night, a little bit tired,so I'll just keep rolling on the
way I am I mean that, that thatimpression that it causes
different kinds of cancers,wasn't that taken from like
(05:57):
studies in the 90s, the woman'shealth initiative?
Speaker 3 (05:59):
yeah so, and it was like very, very small
percentages, very smallpercentages, and it was taken
blown out of proportion.
And we all said, ok, we can'ttouch this, and that was the
study that's left.
It's one of the biggestproblems of studies in the past
that we go back and say wescrewed up big time.
Speaker 1 (06:16):
And as a female, what should you be experiencing
besides not getting your periodmonthly to say you know what?
Maybe I should go, you know,navigate through hormone therapy
, like what are some?
Speaker 2 (06:28):
And who do?
Speaker 1 (06:29):
you go to first Do you go to your your gynecologist
, who do you go to?
Speaker 3 (06:32):
The gynecologist.
Some are more progressive thanothers, meaning they're
interested in giving youestrogen after the age of 35,
because it's all about qualityof life also.
And like we mentioned, if youtake the pills, there is an
increased risk.
If you smoke, then that's anincreased risk also, but we
don't some most of them.
That's why I'm thinking I wantto start doing this, because I'm
giving men testosterone andviagra and these poor women and
(06:53):
I see their women come in andlike he's on too much.
Speaker 1 (06:56):
Please lower his dose oh my god, she can't handle it.
She's overworked andunderwhelmed.
Yeah and then, and then she has.
Speaker 3 (07:03):
You know, women lose the estrogen.
You know they lose theirprogesterone and testosterone.
Speaker 1 (07:09):
And that's sex drive.
Speaker 3 (07:10):
It's a drive, yeah.
Right Sex drive is testosterone, yes, yeah.
So what are we doing?
So, unfortunately, in thiscountry, in most countries,
testosterone is not indicatedFDA-approved for women, so
there's no treatment for womenand that's sex treatment for
women.
And that's what sex drive,that's testosterone.
Yeah so testosterone replacementis not FDA approved.
That's why people go to thecompounding route, but what I
(07:32):
would do is just give them 10%of the man's dose, like I was
talking about earlier todayabout the test them.
There's a testosteroneconcentration that I give to men
.
It looks like a little tube ofthe travel toothpaste and you
can take a little bit out.
So I do have a story.
I have tons of stories.
Speaker 1 (07:50):
No, tell us a story, Frank.
Tell us a story.
Yeah, somebody did this a longtime.
Speaker 3 (07:54):
So I had a judge it was a Supreme Court judge years
ago in his 80s and he came inand he wanted his hormones
checked.
And when they say theirhormones I love when they say
that, because which one?
There's a lot of them.
There's thyroid hormone, butusually they mean the sex
hormone.
Speaker 1 (08:09):
Well, because he's coming in, she's like does that
mean he's not getting it upanymore?
Speaker 3 (08:14):
Yes, exactly.
Speaker 2 (08:19):
Can you imagine at 80 years?
Speaker 1 (08:19):
old, we still got to work, ladies.
I thought by 80,.
I can lay back in the bed andjust chill out.
But 80, I can lay back in thebed and just chill out.
Speaker 3 (08:26):
But no, the men still want to bang at 80.
It's unreal.
It's unreal Undo a button.
It's getting warm in here, Allright.
So yeah, so he comes in.
We check his levels and, yes,his testosterone is low, Low.
If you want numbers, I can giveyou numbers also.
So low is usually under.
They say they lab under 250.
But I have under 250.
But most men, you know, 18, 19years old, they're 800, 900.
And guys, want that same thingyou know, so I'll do what I can
(08:50):
without harming their organs.
You know you want to go slowly.
You see these bodybuilders thatare dying of blood clots Right
absolutely.
Destroying their organs, theirheart, their liver, their lungs.
Their increased risk of cancersgo up dramatically when you
overdo it.
But everything in moderation,like even the water I just drank
.
You could be intoxicateyourself of water and die
absolutely.
Salt goes too low so you startlow and go slow.
So this particular gentleman Isaid you know what, instead of
(09:12):
taking a full tube of test himevery day, because it's dosed
daily, and you just rub it onyour upper back, take a half a
tube.
He's like okay, and he comesback.
No, he doesn't even come back.
So a couple days later I'm inan exam room with a patient like
banging on the door and I tellthe medicalist don't bother
unless the place is on fire I'min the middle of a conversation.
They could be telling me they'rein for their hormones, but they
(09:33):
could be telling me thatsomeone just died.
You know, there's somethingterrible happened.
If the door's closed, don'tcome in and I get this and I
just had and I just had thisconversation just the other day
and I'm like what the fuck isgoing on.
Mr So-and-so is on the phone.
It's an emergency.
I told him you're in a room,You'll call him back, and he
said he needs to talk to me now.
Like, oh my God, what happened?
Speaker 1 (09:53):
He died Right he had a heart attack while he was
banging.
Speaker 3 (09:57):
I killed him with a little testosterone, exactly.
Speaker 1 (09:59):
Right.
Speaker 3 (10:00):
So he goes.
Frank, I got a big problem.
He goes.
My wife locked herself in thebathroom and she won't come out.
Speaker 1 (10:06):
The poor woman was on vacation, but not anymore.
I go.
Speaker 3 (10:10):
What do you mean he goes?
I think a tube and a half isway too much for me.
I swear to God, I'm like a tubeand a half.
I said a half a tube.
Speaker 1 (10:19):
He goes oh my God, wait, that makes him get an
erection.
Speaker 3 (10:23):
Yeah, so in other words, so you're saying he's
level, poor guy had a hard-onfor days.
Pop-ups.
Speaker 2 (10:27):
Come and get pop-ups For days, so I wanted to bring
up his testosterone.
Speaker 3 (10:31):
It was around 200, 300 is better.
So I gave him a half a tube,thinking we'll just put it on a
little bit.
He's an older guy.
How much want to protect thebones at that point and just
give him quality of life.
But he took triple the amount.
So his wife yeah.
So I'm like no, no, I said ahalf a tube.
Speaker 1 (10:48):
He's like oh, I don't think my hearing aid was on
when you told me oh, my god, twoand a half, so wait, will that
give him a hard-on for days likeviagra?
Speaker 3 (10:57):
well, you have to it's.
It's gonna give him the drivethat's, that's what that poor
woman left herself in thebathroom.
Speaker 1 (11:03):
He was chasing around her, around the apartment with
a walker.
He wants a bag like 10, 12times a day.
Yeah.
Speaker 3 (11:08):
So after that I'm always telling him repeat what I
just said.
How much are you going to takewhen you get home?
You know you live and learn.
Oh, that's funny.
But at 80.
At 80.
You're still looking to bang at80.
Speaker 1 (11:18):
Oh my God, Unreal that never, change, though that
doesn't surprise me, thatdoesn't surprise me.
Speaker 3 (11:22):
It's not our fault.
You know what Men never changeIn the wilderness, you ever see
women chasing men.
Speaker 1 (11:27):
Never Like the tiger or the fucking lioness.
Doesn't one chase, doesn't the?
Speaker 3 (11:33):
We gotta look that up , yeah one of them, I think.
Speaker 1 (11:36):
Doesn't the woman tiger go hunt and do freaking
everything, while the male'slaying out in the field?
I don't know.
Speaker 3 (11:43):
I don't know, but it's always the man, like the
peacock, always trying to showhis fat.
We're always trying to impressthe women.
Speaker 1 (11:48):
Of course that's the way it should be.
Speaker 2 (11:50):
So I mean you got to tell that.
Say that loud.
Speaker 1 (11:54):
Yeah, say that loud for the people in the back.
Speaker 3 (11:57):
What about where the traditional men you know they're
?
Speaker 1 (11:59):
gone Right, okay, so we went through the different
types of hormone therapy.
Now, what about like?
What about like sex drive?
Like do you find that it goesdown in women and men?
(12:20):
I feel like men always have todrive more than women.
Speaker 3 (12:24):
I'm hearing Okay, but do you find that?
Speaker 1 (12:34):
around what age do you find the men coming to you,
versus what age the women cometo you?
Speaker 2 (12:39):
Do you know what I'm trying to say?
Yeah, that's a good question.
You know how they?
Speaker 1 (12:42):
always say a man's prime is between 18 and whatever
it is 35.
And a woman's is like totallyafter the men's, supposedly like
35.
Speaker 2 (12:51):
So there's this like disparity, like who, who are the
, you know, like the women?
Well, you know why?
Speaker 1 (12:56):
because let me give you an example.
Like I'm right, we're in our40s, right?
So when I meet a guy in his 40s, I don't know, like I don't
know about men's testosteroneand their sex drive, like that's
the last thing I got going onin my life with my kids and my
whatever.
Like when I meet a man in his40s and 50s, is he?
Is he, like you know, stillbanging around like he was in
(13:19):
his third?
because you're not in your 40s.
As a woman, I can guarantee, Ican tell you that my sex drive
is completely different todaythan it was in my 20s it's more
or less Less.
I couldn't give a shit, like Icouldn't give a shit.
I mean, I give a shit but I'mnot sitting there like, oh my
God, I haven't, you know, hadsex in.
(13:39):
You know, like usually menwould be Like men can't live
without it.
Traditionally, men will saycannot live without it.
Speaker 2 (13:46):
But also we have control over ourselves.
Speaker 1 (13:48):
Everybody should have sexual discipline, but I'm
talking in general.
So do men in their 40s and 50s?
Are they still banging it outand getting hard?
Speaker 2 (13:58):
When does that end for them?
But I feel like maybe the driveis there, but the body is not.
Well, that's what I'm asking,that's where I come in, that's
what I'm asking.
So.
Speaker 1 (14:05):
I feel like when a man sees an inkling of he can't
get it up at any age, he'srunning to you Because that is
probably the biggest fear for aman.
Speaker 3 (14:15):
Yeah, so the good thing is with that.
So I treat diabetes also.
So to get people to test theirblood sugar and take their
medication, I use a differentapproach for the different age
groups and men.
All you have to say is diabetescan cause erectile dysfunction.
You never told me that.
Speaker 1 (14:27):
Wait a second Right.
They dysfunction.
Speaker 3 (14:28):
you never told me that wait a second, right, they
panic exactly.
And then I'm getting phonecalls.
He needs a refill of hismedication, he wants his testing
supplies to break his finger.
So yeah, so that's a man's that.
Yeah, you don't want to losethat but when do men usually go
down?
Speaker 1 (14:41):
do you know what I'm?
Saying like women physically noright no, like women, right,
start to lose their sex.
Not lose it, but it goes down.
They say menopause right,because your hormone levels are
off.
When does it hit for men?
Speaker 3 (14:55):
And we have menopause .
Speaker 1 (14:57):
So after 40,.
Speaker 3 (14:58):
Usually the testosterone goes down, maybe 1%
each year but every guy isdifferent.
Do you go to the gym and raiseyour testosterone?
Do you eat right?
Do you sleep right?
Do you not drink a lot?
Speaker 1 (15:06):
of alcohol.
Do you treat your body right?
Speaker 3 (15:06):
Do you sleep right?
Do you not drink a lot?
Speaker 1 (15:07):
of alcohol.
Speaker 3 (15:07):
Do you treat your body right?
Food is medicine.
I have guys that are in their30s with erectile dysfunction
and low testosterone.
Obesity major cause of lowtestosterone because the fat
cells hold estrogen and estrogenis the opposing hormone from
testosterone.
So that's why polycysticovarian syndrome.
They're high in testosteronebecause it's schizophrenic in
the body.
So men that are overweight havelow testosterone, high estrogen
(15:30):
.
Women that are overweight havehigh testosterone.
Speaker 1 (15:33):
So it's the same for the women as men.
If you go to, oh, it's that.
Speaker 3 (15:38):
Did I say that back?
So men that are overweight havehigher estrogen, low
testosterone and women that areoverweight usually have the high
as a PCO, polycystic ovariansyndrome.
So it's usually seen in younger, younger women that have high
testosterone, irregular periodsand that causes hirsutism.
Speaker 1 (15:55):
Yeah, that the hair.
We don't want it yeah, malepattern baldness okay, stuff
like that.
So if you're going to the gym,eating healthy, doing all the
things that you should do, yoursex drive, man, or should stay a
little bit more elevated.
Speaker 3 (16:10):
Yeah, absolutely, because the sex drive hormone is
testosterone for both, and I dohave guys in their 80s that
have great testosterone.
Speaker 1 (16:17):
That's crazy, and I have guys in their 30s that have
low testosterone Like you havenone, still banging it out at
90-something with bunnies.
Speaker 3 (16:24):
Well, he's probably on testosterone and viagra.
Speaker 1 (16:26):
Yeah, he's dead now, but he probably was.
He had twins at like 90.
Speaker 3 (16:34):
yeah, he had a lot of crazy, oh my god but also I
find out a lot of these placesthat are giving testosterone are
not being thorough.
I do endocrine, so I'm lookingeverywhere, so I want to find a
cause for everything, so a lotof times it's from I shouldn't
say a lot one in ten people havea mass on their brain blocking
the signal from the.
That's crazy luteinizing hormoneand follicle stimulating, which
is the two hormones to tell thetesticles and ovaries what to
(16:55):
do, blocking the signal.
That's why it's lowtestosterone.
So a lot of these places thatjust testosterone mills yeah,
that's what I call them, yeah,yeah they just have some
testosterone and we've had somein different areas that come in
and they had a two centimeter,which which is huge.
The pituitary is only twocentimeters.
Speaker 2 (17:11):
Yeah.
Speaker 3 (17:12):
So it's like halfway this way.
Speaker 1 (17:13):
So it's really important to get the blood work
done so that you know, don'tjust slap on some testosterone
gel, don't just give Viagra.
Speaker 3 (17:19):
Another cool statistic is that 50% of men
with erectile dysfunction haveheart disease.
Because, if you have blockagesin your heart, you can have it
in your penis.
Speaker 1 (17:28):
Right.
Speaker 3 (17:33):
So have blockages in your heart.
Speaker 1 (17:34):
You can have it in your penis right, so I don't
have the blood flow right yeah,it's all about blood flow.
So I don't do not give viagrato men unless they have a
cardiologist.
Interesting, yeah, because thatis really used in the market.
Speaker 3 (17:39):
I mean, it's like it's like candy yeah I did have
a guy years ago there's anotherfunny story that he came in and
he's like I want, I need viagra,I'm not, you know, and he was
vocal about it and vocal andvulgar and I'm like he had
uncontrolled diabetes.
So we talk about risk factors,right?
So there's all the independentrisk factors If you're over 45
(17:59):
as a male, if you're overweight,sedentary lifestyle, high
cholesterol, high blood sugarand hypertension family history
of heart disease.
I got seven independent cardiacrisk factors for a heart attack
and he fit the bill there andhe's like my this isn't working.
I need medication.
I said no.
First of all, we need to checkyour testosterone.
We need to check all theselevels and make sure is it
(18:21):
coming from your brain or yourtesticles?
Do you have a cardiologist?
No, I don't.
So I refused to give it to himand he stormed out of the office
, slammed the door and yelled atus like F, this guy, you know,
I just know what he's talkingabout.
Okay, I don't see the guy back.
I figured he's done with me.
Whatever he comes back in witha woman in tears.
I just got the chills In tearsand you saved his life.
(18:41):
He goes.
He wanted sex so bad he cavedand went to the cardiologist.
He he had a quadruple bypass.
Oh my God, he almost died yeah.
Speaker 1 (18:52):
That's crazy.
That's why he had ED.
So it's not all about you know,right, you never know.
You really have to.
Completely physiological.
Speaker 3 (18:55):
You've got to be thorough Is there Viagra for
women.
Speaker 2 (18:57):
Good question.
Speaker 3 (18:58):
Good question.
So again, women are always puton the sideline.
Speaker 1 (19:10):
I feel like.
I feel like.
I don't know if you feel likethis, but you're probably
usually gonna look at me likeI'm not.
Speaker 3 (19:15):
I feel like you're not keep going.
Speaker 1 (19:17):
I know right, I feel like as a woman, right, dating.
Right, since we're younger,let's you know, 18 and right
you're dating, you're having,you're sexually active, like
we're always supposed to be onpoint, like, like.
Do you know that Like?
Do you ever feel that Like when, like, women are always
expected to be like, sexy andready to?
Speaker 2 (19:37):
go Supposed to be everything to everyone at all
times.
Speaker 1 (19:40):
Like your man want.
Like you know, I had a hard dayLike I don't know, just not old
, not like aggressively, I'm notsaying demandingly, but I'm
saying when you're in arelationship I always feel like
the woman.
You know, we do all these jobsthe kids, the this, the how, the
job, what and we're always justsupposed to be like ready to
like strip down, look good andlike be sexy for you and have
(20:02):
sex yeah, that's just you knowwhat I
mean you feel like you have tobe and I don't feel like that
pressures on the man, althoughwe have different kind of
pressures.
Speaker 3 (20:09):
You know what I'm saying.
Speaker 1 (20:10):
Like I feel like you're always expecting me to be
sexy and this, and that youknow.
You go out, you go to dinner,you're wearing a hot, tight
dress.
The minute you like walk intothe car, the guy's hand's like
halfway like up your thigh inthe car.
Speaker 3 (20:26):
You know like it's a different pressure, you know
what.
Speaker 1 (20:29):
But we could go out to dinner or do whatever, or go
to a wedding or whatever, andthe man can look hot and we're
like all right, we're tired,let's go to bed.
You know what I'm saying?
I feel like the pressure isalways on women, but meanwhile
there's Viagra for men Pressureon us to perform.
Speaker 3 (20:48):
Yes To be in the mood .
Speaker 1 (20:49):
To be in the mood to perform, to look, I don't know,
I feel like that.
Speaker 2 (20:55):
I mean, it's just a symptom of like.
Speaker 3 (20:58):
Let's check your levels.
Yeah, let's go.
Speaker 1 (21:00):
Yeah, I know, but I feel like that's why.
I'm saying is there Viagra forwomen?
Speaker 3 (21:05):
Yeah, Well, Viagra doesn't do anything with the
desire.
Viagra just increases bloodflow to that area.
Oh, so it just treats thephysiology.
Speaker 1 (21:13):
So a man could be taking Viagra, have a hard-on
for 10 hours and still not wantto have sex if his levels are
off.
How does that work?
Speaker 3 (21:21):
Well, you can only so .
If I took Viagra before I camehere, I wouldn't have a hard-on.
I'd have to want to have a.
You know what I'm?
Speaker 1 (21:26):
saying Got it?
I'm not familiar with it,Although you keep opening your
jacket.
I don't know.
I'm sweating.
Speaker 3 (21:30):
I'm having a hot flash.
Speaker 2 (21:31):
It goes so many places with what you just said.
Speaker 3 (21:35):
But you have to be aroused mentally.
Speaker 1 (21:38):
Got it.
Speaker 3 (21:38):
And it just makes it easier because now there's more
blood flow, it's ready to roll.
Speaker 1 (21:41):
Because I've heard about men getting erections from
Viagra and they can't get itdown like they is.
Speaker 3 (21:46):
That true, yeah, so that's one.
In the package insert it saysif you had an erection for more
than four hours, go to thehospital.
I'm not, I'm going to the broth.
What do you mean?
The hospital, but wait a minute.
Speaker 1 (21:57):
But, and you know me, but I gotta ask the questions
how does that work?
Like it's not good you get ahard-on, we have sex.
It doesn't go, you don't comeit doesn't go down, I don't
understand it yeah, ejac,ejaculator or not, it just stays
hard.
Speaker 3 (22:10):
No, yeah, you have to actually go to the hospital
legit, I've never seen this, butI've read about it and the
urologist has to take a syringeand suck out the blood.
Sounds fun, gentlemen, if youdon't, then it might not work.
Speaker 1 (22:25):
I mean, necrosis can happen because there's no blood
flow anymore.
Then we got to cut it off.
Speaker 2 (22:29):
There's a lot of blood stuck in there.
Speaker 3 (22:31):
But that's usually super rare and it's usually when
guys if I take one, that wouldbe good.
What if I take five?
Speaker 2 (22:37):
That would be five times better.
Speaker 3 (22:38):
It's not.
It's never Slow and low as anNP.
That's what we're always taught.
Okay, Slow no start off with alow dose and go slow with it.
Speaker 1 (22:48):
Okay, so it wouldn't work on women anyway, because
it's just for blood flow butthey might get good blood flow
down in that area anecdotally.
Speaker 3 (23:03):
So anecdotally means that like if we try it and it's
not really FDA approved thefeedback I'm getting off label
exactly.
So if the man says take a pilland I've heard my patient say I
gave it to my wife, she enjoyedherself more than usual.
Speaker 1 (23:09):
Got it Because it increases blood flow to that
same area.
Got it, you can orgasm better.
Got it, yeah, because it's allabout blood flow, if you want
you know there, so it does work.
Speaker 3 (23:17):
Unfortunately, they were going to come up with a
pill, but women are not.
As like we're very mechanical,like we're easy to please, you
know, like have to be in themood and we'll get in the mood
quickly.
Speaker 1 (23:28):
Well, this is my point.
Yeah, that was my point with myother thing, so we could be
turned on like a switch 100%Women.
Speaker 3 (23:33):
that's why Viagra would 100% probably work,
because if you take Viagra, youmight get the increased blood
flow, but you don't have thedesire.
That's why you need it.
Speaker 1 (23:41):
And that's why men are more like physical right,
and women are more mental.
Oh, they're definitely mental100, but you know what?
I always say this, but I alwayssay like and not all, because
we know you quote me when I saymost, not all, but I always say
this like a man could have sexwith you know three women and
(24:03):
just, it's just an act, it'sjust a whatever.
Where we've discussed this,women are more emotional, like I
am not having sex with a manthat I'm not emotionally
attached to.
It skeeves me out, I don't wantyou touching me.
Speaker 2 (24:14):
But what happens, even if you're not into them
initially, after you have sexbecause of all the you know, the
hormones that are released, allof a sudden Oxytocin yes.
You start looking at this thingthat you thought was a beast,
and you're in a different way,because this might be the
potential father to yourchildren and then all of a
sudden you're looking at himwith a different lens.
(24:35):
So I think it's a kind of adangerous thing.
Speaker 1 (24:38):
Slippery slope, yeah, but most women have to have
some sort of emotional attachMost.
Speaker 2 (24:45):
Where men don't?
Not you, linda In thebackground, yeah, not you, linda
, who's writing into me rightnow saying I can fuck 20 guys
and it wouldn't matter, I don'tgive a shit, not you, not you
yeah, not you, linda okay, yeah,but I think that's why it's so
different and that's why thehormone replacement right is
important for women.
Speaker 3 (25:04):
Yeah, as they get older just a little bit of
testosterone.
You don't want to make them aman.
You.
Speaker 1 (25:09):
No.
Speaker 3 (25:10):
I do do also transgender, and it's a big
difference between giving awoman a slight amount of
testosterone versus what I dofor the trans community, where I
give them a boatload and givethem enough for a man, different
dosing it's a man's dose versusa tenth of the man's dose.
Speaker 1 (25:26):
Okay, okay, so Okay, and, like we said, the different
symptoms that women should begoing would be libido, tired
fogginess, moodiness, lowattention at work.
Speaker 3 (25:43):
Sometimes I hear also getting short with the kids.
You know temper stuff like that, the hot flashes, that's
usually what brings them inRight.
Speaker 1 (25:52):
No, those, a lot of women die from those.
I know I've been getting themLike.
It wakes me up in the middle ofthe night and I toss and turn.
I have to change the pillowBecause the pillow's physically
hot Right and then I got toswitch it out to the cold pillow
and it disrupts my sleep.
It's horrific.
Speaker 3 (26:08):
Also, a lot of times anxiety is at night, because
that's when your mind starts tocalm down, but all the thoughts
and the rumination startshappening.
Speaker 2 (26:15):
Oh, rumination, I'm a ruminator, are you?
Yeah, I don't know.
Speaker 3 (26:18):
I always have been Rumination at night.
Speaker 2 (26:21):
All the time, but at night, yes, especially so,
because everything you know Iused to just sleep right through
, no problems.
Speaker 1 (26:27):
Well, there's different sheets.
Speaker 3 (26:29):
You can get the cooling sheets keep the
temperature really cold.
Speaker 1 (26:31):
I got the cooling.
Speaker 3 (26:32):
PJs I got them from how cold do you keep the room?
Speaker 1 (26:35):
Like 69, 70.
You need to go lower than that.
Oh so it frees my children out.
Speaker 3 (26:41):
Oh, you don't have a separate one for you?
Speaker 1 (26:42):
No, it's all upstairs .
Speaker 2 (26:43):
You got a fan I could do.
Can you shut off their littlething in their rooms?
I have the most glorious sleepat like 62.
I'm out like a baby.
Speaker 3 (26:51):
Yeah, you need to be colder.
Remember, in school, with thecomputers, the computer room is
always colder.
Speaker 2 (26:56):
Yes.
Speaker 3 (26:56):
That's because it's like your brain is a computer.
It needs to be cold at night,especially at night.
All right, maybe I'll do it alittle lower.
I feel nervous.
69 is too high.
I'm get him another blanket.
Speaker 1 (27:08):
He's under tons of blankets.
We're all good with the fluffyblanks 69 is too hot, that's hot
, yeah.
Speaker 3 (27:15):
I didn't know.
69 is always hot, that's ournumber.
Speaker 1 (27:23):
Oh, my god.
Okay, so is there anything elsethat you think that we should
discuss?
Speaker 3 (27:28):
Well, also when you were saying about sweating and
things.
So sometimes you're going tohave an overactive thyroid.
So I think blood work and beingthorough with all the hormones
is good.
So a baseline Kidney, liver,thyroid function.
You want to check yourcholesterol also.
Speaker 1 (27:39):
Make sure that's good , but I'm sure this is the panel
when they come to you, ifsomeone comes to you when they
come to me?
Yes, yes, and we're gonna havefrank on again, but you're
opening a medis what is itcalled?
oh yes, coming soon, coming soon, yes, so someone can get all
their hormones, someone peopleare going to be able to get
their hormones from you and whatlike everything they need and
(28:04):
their botox and their botox andtheir phyllis and the phyllisers
, god knows, are my favorite, um, and then you know what else I
wanted to discuss, also becausea lot of women, my friends, have
been complaining about thiswhat's that waking, oh gop1 yeah
, that, but like that, but withprairie menopause, they say
(28:26):
their period, and you know whatthis is is another stupid
question which you probably youmay not know.
I love stupid questions, I lovethis, but this is a question I
have.
Okay, so let's say you'reperimenopausal and you're
skipping periods, or you knowhow they.
Well, the gynecologist says ifyou don't have your period for a
year, you're done right.
(28:47):
Let's say you're in that yearperiod and you know you got it
three months.
Then you didn't get it, or yougot like how do you know when
you can't get pregnant anymore?
Speaker 2 (28:59):
yeah, you might need to still take precautions.
Speaker 1 (29:02):
You might, or your two kids might have a little
baby.
I'm just saying even for likethe married women that are
listening, or the people inrelationships.
I'm not saying the hoes.
Speaker 2 (29:13):
Or the hoes out on the street Right, the hoes out
on the street.
Speaker 1 (29:16):
But let's just say you're with somebody and you're
like oh, I haven't had my periodin eight months.
Let's do like.
Speaker 3 (29:24):
And I feel kicking in my stomach.
Speaker 1 (29:26):
Do you know what I'm trying to say?
What could this be?
And then you know you don't useany precaution and you're like
I'm cool, how would you everknow?
Like, how would you ever know?
Because, right, for years,ladies it's always been like oh
shit, I'm late, yeah, right.
If you were late and you'relike, oh my God, let me go take
(29:46):
a pregnancy test, I'm late, yeah.
Or if you're trying to getpregnant, you knew.
Because you were late Right Now, I would be in pure panic mode.
When do you not like?
Because how would you know I'dbe taking pregnancy tests every
month because you're notskipping, you're not late.
I haven't got my period ineight months.
How would you ever know if youwere pregnant?
(30:07):
How do you know when you can,when you can't do that?
Speaker 2 (30:11):
when it's safe to do that, when your cycle is so
whack you can.
Speaker 3 (30:15):
If you're still getting a cycle.
That's why an IUD probably isthe best thing.
Speaker 1 (30:19):
Okay, just to be cautious.
And then, after you don't haveit for a year, you're free to go
or no.
Speaker 3 (30:25):
Yeah, free to go there or no?
Yeah, free to go there, but theIUD is still hormonal, so
that's another route.
Speaker 1 (30:29):
But you can't get pregnant anymore After a year.
Speaker 2 (30:32):
They say so they say we're going to come back to you
when.
Melissa has a bun in the oven.
Oh my God.
No, and it's all your fault,Frank.
Speaker 1 (30:45):
Oh, my God.
Speaker 3 (30:48):
So five years, Frank.
You said Five to 10 years.
That's my new thing.
Speaker 1 (30:52):
Oh my God.
Five to 10 years, okay.
Speaker 3 (30:54):
When you're 75.
Yeah, 75.
Speaker 1 (30:57):
All right, and now the weight gain A lot of women
are talking.
And they're talking about mycousin, always In the middle.
Yeah, says, says right here shegets like the pop bell.
All of a sudden her stomach wasfairly flat and now she's
getting this bulgeous pop belllove hand.
Like women are saying, theirmetabolism slows down.
So what do we take for that?
Speaker 3 (31:20):
so before I?
Even so, when I get a patientfor weight loss, what I do is
check.
You guys heard of cortisol,right?
so it's all over the place.
It's actually real.
So sometimes people talk aboutcortisol and adrenal fatigue not
real.
But there's something calledcushing's disease.
So remember I said one in tenpeople have a mass on the
pituitary.
It can be producing cortisoland it's called cushing's.
That could cause belly fat,that could cause waking and
(31:42):
cause diabetes.
So I've found a ton of peoplelately.
I would say when it's supposedto be one in a million.
In school we were taughtCushing's is super rare.
I found maybe five in the pastsix months.
Speaker 1 (31:52):
Oh wow, that's a lot, and it's a simple blood test.
Speaker 3 (31:54):
You take a pill at 11 pm it's called dexamethasone,
and then you do an 8 am cortisollevel and if it's elevated over
1.8, then and I've been- doing.
Mris and I have some in myphone.
I was checking the portal thismorning at work.
A guy has a mass on thepituitary, One has on the.
It could also be on the kidneys.
Speaker 1 (32:13):
It could be anywhere in the lungs.
And this causes weight gain.
Speaker 3 (32:16):
And it causes weight gain.
Speaker 1 (32:17):
Because some people are like I'm eating less.
I'm not the women.
I'm going to the gym.
Speaker 3 (32:29):
I have a nutritional program and I just can't.
I'm doing everything andnothing's working.
I usually check that baselineand if I don't do a baseline, if
I notice they're not losingweight on the GOP.
Once I have a patient on 15milligrams of Zepound, which is
the highest dose, hasn't lost apound.
So I did a Dexmedzonesuppression test and I'll let
you know about that.
Speaker 2 (32:41):
I've lost 15 pounds in the past three months, but I
have I've as heavy as I've beenin my life.
I've never had this likestomach thing going on well,
that's what I'm saying.
Speaker 1 (32:51):
Like it comes with the peri, I hear it comes with
the perimenopause.
Speaker 3 (32:54):
A lovely silhouette, oh my god or you should make
sure it's not cushing's you knowbecause it's, it's, it's kind
of.
It's not as rare as we thought.
We weren't checking, because ifyou google what cushing's looks
like, they'll it'll be a moonface, buffalo hump, this woman
that's just huge.
Speaker 2 (33:08):
Oh, the buffalo hump.
Speaker 3 (33:09):
Yeah, the thin arms, the thin legs, and they could
also have purple stretch markson their stomach.
They have like a red face, likestretch marks on their face.
Speaker 1 (33:18):
That's an extreme case.
Wow, and what's your if allthat's okay and they're just
normal you know there's nothingwrong with them and they're
going through menopause?
What's your take?
Because GLP-1s are huge, yeah,so let's get into that.
Speaker 3 (33:32):
Yeah, no, I definitely love them Like.
Speaker 1 (33:33):
Monjaro ZipBound.
Even microdosing is great.
Speaker 2 (33:37):
Yeah.
Speaker 1 (33:37):
And how long is it safe to be on.
You know, go through that withus.
Speaker 3 (33:44):
I always find.
I always wonder when the repscome in to detail us, we always
say who do I not give it tobefore, Because they'll love to
tell you who to give it to.
Give it to everybody who can Inot give it to?
So it's people that have ahistory of pancreatitis.
That's something that you don'twant because it can cause
pancreatitis.
So if you had it before and youdon't want to take this class
of medications.
Also, it's a super rare thingcalled medullary thyroid cancer.
(34:06):
I've never seen a case of it.
It was seen in rats, not humans.
That's one thing if they have afamily history of medullary
thyroid cancer or they havemedullary thyroid cancer.
Other than that, it's fair game.
What I like to do is make surethat triglycerides are normal,
because high triglycerides cancause pancreatitis.
So, triglycerides are in thecholesterol profile.
It's usually from genetics or alot of carbohydrates
(34:29):
consumption.
You fix that and you can fixthat with fish oil prescription.
Fish oil I use that brings itdown and then I start the
medication and you start slowand people don't realize.
Manjaro is the same thing asZetbound Same exact molecule,
just appetite.
Manjaro is marketed fordiabetes, Zetbound is marketed
for weight loss.
Speaker 1 (34:47):
Okay, and can, just that, like I know, a lot of
women can't afford it, can it gothrough insurance right?
Yeah, some of the plans.
Speaker 3 (34:56):
They're getting harder and harder.
Years ago I know some providersthat would lie and say, oh,
they have diabetes and then getit.
And then these people are goingout of business now because the
insurance company is saying Iwant the chart notes.
Where's the diabetes?
Speaker 1 (35:08):
And it's not there, right it's fraudulent.
Speaker 2 (35:10):
As I always say, I don't look good in orange Right,
so I play by the rules.
Speaker 3 (35:14):
I play by the rules.
If you can't afford it, I'msorry, but the pharmaceutical
companies do have medicationsthat are a little cheaper now,
like $300, $400 a month,depending on the dose depending
on the dose.
Speaker 1 (35:25):
And how long can you be on it?
For Forever.
Speaker 3 (35:28):
So I always ask about side effects.
Major potential side effects isnauseousness, diarrhea,
constipation, so some people canget bound up, some people can
have diarrhea.
Acid reflux is another one Ihear sometimes but they could be
on it forever, so it's agastric.
Speaker 2 (35:44):
It's manageable.
It's a GOP1.
Generally, the side effects aremanageable.
Speaker 3 (35:49):
Yeah, it's manageable .
It's a GOP1.
Generally the side effects aremanageable.
Yeah, especially the Zetbound.
So the majority is a two-in-onehormone.
It's GIP and GOP1.
That's more efficacious and ithas more weight loss and less
side effects.
So that's the one, yeah.
Speaker 1 (35:59):
And I know a lot of my girlfriends are like oh, but
you know how can you be on itforever?
It was originally for diabetes.
It forever.
It was originally for diabetes.
And the minute you come off ofit, let's say you lose all the
weight.
The minute you come off of ityou're going to gain the weight
back.
Speaker 3 (36:12):
Not necessarily.
So usually this is a tool thatonce people start losing weight,
now they're motivated to go tothe gym.
Now they're motivated toexercise and do better things,
motivated to eat the right foods.
So I like to keep them on.
You know whatever dose ismaintaining their body weight
and if you could, always Like amaintenance dose.
Speaker 2 (36:30):
It wouldn't be like at the highest dose Exactly you
would stay on indefinitely right.
Speaker 3 (36:35):
It depends.
So I have people on the 2.5 isthe lowest dose.
I have people on 2.5 and theylost what they wanted and
they're fine.
And then I'm like, okay, if youever want to come off it, if
you lose, I also if they startto lose too much weight, too
much.
Yeah, then I definitely need tocome off it.
It's not.
People get obsessed with thisstuff and they don't see
themselves their body'sdysmorphia.
Speaker 2 (36:53):
Absolutely.
Speaker 3 (36:54):
They look in the mirror and still see themselves
100 pounds heavier.
And you know a lot of thesepeople.
They need counseling and thingsto help them out get through
things Right.
But yeah, start at the 2.5.
And they say after four weeksyou can increase the dose.
But I only increase the dosewhen it goes, when their weight
(37:15):
either goes up or plateaus.
I have to hit it on my phone,rob, so a lot of people did they
do want to keep going up and upand up every month, but then
you're going to run out of dosesright you know, so you only
have you know they have to 2.5to 5 to 7.5, 10, 12.5, the 7.5,
10, 12.5, and 15.
So you have six doses to workwith.
Do you want to go every singlemonth?
Then you're six months andyou're capped out.
Speaker 1 (37:34):
Right, no, you got to wait until you, but a lot of
places they do that You've heardof the ozempic face.
Speaker 2 (37:39):
Yeah, I was just going to say you need someone
reputable like face, or perhapsa zempic butt.
Yes, and it's time to back away.
Speaker 1 (37:47):
Yes, and you should be working out while you're on
it and eating healthy 100%resistance training.
I had a woman.
Speaker 3 (37:52):
Actually this is a case study, so the schedule is
so crazy, especially with theGOP ones coming out.
And I do endocrine, so we haveeverything endocrine plus weight
loss now thrown at us.
So what I would do is I wouldsay okay, call me every month,
month tell me how you feel, tellme your weight and if you're
going up, I'll give you it.
You know.
The next, the next dose, just aquick phone call, not even a
video visit, and I and you knowyou live and learn, you make
(38:14):
mistakes and you find out.
So six months later she comes in.
She looked like she has cancer,like you could see the clavicle
bone.
Yeah, you know it's women.
You shouldn't really see thisbone that prominent yeah and, uh
, she looks sunken in.
No, no, no, I mean like, like,like the, you know the no, you
could say, but the divot, likeyou know, like the huge hole
where you could like fill adrink in there you know.
(38:35):
So it shouldn't be like thatyours is your perfect so um,
thank you, wait, let me seelet's check out the clavicle.
Good looking, all right.
So so you can't put any youcan't put any fluid in there,
you know what I'm saying.
Speaker 1 (38:46):
It looks like a hole.
I know it's sunken in.
Speaker 3 (38:48):
Yeah, and they have, like, their face sunken in, they
lose the face muscles and allthat.
So she came in and I'm like, ohmy god, she's dying you know
I'm talking to her, I'm killingher, is everything okay?
Like she's like no, I'm good,I'm doing all right.
I'm like no, you're not whathappened you?
Literally lost like 80 pounds,that's all you last you look not
good.
I said I think you should see ahematologist, oncologist you
(39:09):
know you might have cancer.
You know she's like.
I went to my primary care, hethought the same thing I did and
he told me to tell you I needto lower my dose.
I'm like, are you kidding me?
Like you lied to me all thesemonths.
I'm not losing weight, I'm notlosing weight.
Then she shows up 80 poundslighter in six months and I'm
like and the primary care isthinking this guy's a hack.
What is he doing?
Yeah, I'll never do the sixmonth thing without looking at
(39:31):
you doing a video visit, atleast it's a huge.
Speaker 2 (39:33):
I know patients who did like a busy video visit with
a provider and they put on thebiggest, bulkiest sweatshirt and
just and stuffed it with things, so they could, you know, get
their little, of course, aglute-tied fix.
Speaker 3 (39:48):
yeah, yeah and if they don't lose weight with the
insurance companies now, are nothaving the medication oh yeah,
now some of them are mailing ascale to the house.
They have to weigh themselvesand if they don't lose five
percent body weight, they takethe medication away.
Because why should they pay athousand a month if you're
really not going to lose weighton the medication?
So yeah, it's changing timesnow.
It's not like a free-for-allright how you could lie on the
(40:10):
chart notes and get it covered.
Speaker 1 (40:11):
No one's looking because now it's became ever
since elon musk started takingit and kim kardashian oh yeah,
exploded, of course, so thatthey've been taking it for years
years when we didn't know aboutall I feel like all those movie
stars that you were like howdid they lose all that weight
for that movie in six months?
Now we know how.
Speaker 3 (40:31):
These GOP ones have been around for more than 10
years.
Speaker 1 (40:32):
Well, that's what I mean.
Nobody's talking about it,right?
No, but now it got out.
Speaker 3 (40:36):
Yeah, the story's out .
All the celebrities are like.
Now we know.
Speaker 1 (40:40):
Right now we know how they all like for the Emmys or
for the.
They look so amazing.
And you're like how did shelose all that weight to fit in
that Marilyn Monroe dress?
I couldn't lose, I couldn'tlose.
Would she lose 20 pounds in amonth?
Like I couldn't do that?
Speaker 2 (40:54):
with a gun to my head .
I love when they do, I know.
Speaker 1 (40:57):
With a gun to my head .
I couldn't do it.
Like with my awesome trainer,like if I ate, you know, 100
grams of protein a day, Icouldn't do it.
Speaker 2 (41:06):
It's just horseback riding and long walks.
Yeah, right, yeah, extra sex.
Oh man, that's some moretestosterone.
Speaker 3 (41:14):
I worked it off in bed.
Speaker 1 (41:16):
Oh, my God.
Speaker 3 (41:19):
Certain tricks, like your brain doesn't know if
you're hungry or thirsty, so ifyou drink a ton of water, yes, I
do that Coffee.
Coffee's an appetitesuppressant.
It's awesome.
Speaker 1 (41:26):
I always have it every morning.
That's a little thing.
Coffee's an appetitesuppressant.
It's awesome.
I always have it every morningthere it is there, it is In the
corner.
Speaker 3 (41:30):
The half-life of coffee is going to be up to 12
hours, so maybe that's why, atnight too, if you can't sleep,
stop the coffee like around 12.
Speaker 1 (41:37):
No, I just have one, okay, and I don't even drink the
whole thing.
Speaker 3 (41:43):
Okay, good, I'm like, how do you know?
Like espresso, right, yeah,he's like I can see it.
Speaker 1 (41:47):
Yeah, not happening.
Speaker 3 (41:48):
Yeah.
Speaker 1 (41:49):
All right, good All right Do we have?
Any other questions?
Speaker 2 (41:54):
I think I covered a lot, so I think, are we going to
get workups, melissa?
Yes, should we do before andafters?
Speaker 1 (41:59):
Yeah, we should do before and afters, we'll bring
that on to the done.
Speaker 2 (42:05):
I, I need it.
I have stuff going on.
Speaker 3 (42:07):
Yeah, let's fix it, yeah and the dexmed zone
suppression test.
Remember, just make sure youknow, because everybody I'm
checking everybody for cushions,no matter what your weight is,
you know, if you're strugglingyou could have it and then, when
you open up your place, we'llhave you back on yeah, you'll be
able to promote it everybody inlong island.
You could go to frank and videovisits anybody in the country
oh awesome, yeah, okay.
Speaker 1 (42:27):
So like telehealth do we do tell absolutely okay,
awesome so um check our shownotes.
So um we'll have frank'scontact info yeah, we're gonna
have your contact info, youremail yeah, I'm at nyu now, but
I'm doing video visits also,okay perfect, so we'll have all
that in our notes and that way,if you have any questions about
hormones or sex drive oranything, you can email Frank
(42:49):
and you do video visitstelehealth.
Speaker 3 (42:51):
Yes, absolutely.
Speaker 2 (42:52):
Ladies, Frank is cute , so you might want to and
single.
Speaker 1 (42:55):
He's single that's right.
Speaker 3 (42:57):
Single.
Speaker 1 (42:58):
I'm trying to hook you up with my girlfriend.
Speaker 3 (42:59):
Single looking to mingle, let's go.
Speaker 1 (43:02):
But Frank is single Great guy.
I've known him for a little bitand no kids never married.
Speaker 2 (43:09):
No baggage ladies, which is the best?
Well, we might need you on, for, you know, just like dating
stuff.
Speaker 3 (43:16):
Oh, I could totally talk to you.
I could tell you so many datingstories.
Oh, we'd love that.
So can I.
Speaker 2 (43:19):
I'm on the dating app girl, she's on the dating app
Are you?
Speaker 3 (43:24):
on no dating up here, so there's plenty of pigs right
on the plenty of pigs there'splenty of horrible people out
there no, but no.
I don't want to be jaded withthe dating no, I try to be
positive.
Yeah, I try to be positive, butunfortunately there's a lot of
people out there that are notgenuine.
Speaker 1 (43:43):
That's true, you know , oh, we know.
Speaker 2 (43:45):
There's filters, there's married people fish
catfish, catfish, whatever it'scalled, all kinds of fish.
Yeah, I don't go into that.
Speaker 3 (43:54):
And there's women that want an ATM, not a
boyfriend.
Speaker 2 (43:56):
I'm learning kind of you know.
So there's all kinds.
Yeah, oh, there are all kinds,but there's always people out
there, though.
I'm not gonna give up yeah, no,ladies, they say there's a lid
for every pot, right?
Speaker 1 (44:08):
That's right.
Speaker 2 (44:10):
Or like someone told me their Polish babsha, their
Polish grandma, said there's aseat for every dupa.
There's a seat for every S?
Okay.
Speaker 1 (44:20):
There seems to be, I'm still looking for my seat.
Speaker 3 (44:26):
So I think going out is the best, because I've been
going to the city a lot, asMelissa knows, every weekend To
meet people there.
I think it's a little biteasier.
Speaker 2 (44:34):
Well, I think, when you change locations, I'm
working in the city now and it'sso much different.
Speaker 3 (44:39):
Yeah, of course it is , but the problem is too, women.
I feel like they'reunapproachable.
Speaker 2 (44:46):
This is true Because you have to worry about your
safety too, and safety thesafety aspect.
Speaker 3 (44:52):
But how do we know?
Just say we're at a bar.
How do I know that you'reinterested, like a lot of men
Eye contact.
Speaker 2 (44:58):
Oh, this is a whole other.
You have to come back.
Speaker 1 (45:01):
Yes, we're going to have Frank back and we're going
to talk about.
Speaker 2 (45:04):
How do you know?
Speaker 1 (45:05):
that you will get flat out rejected.
Speaker 3 (45:08):
Because yeah a lot of men are scared of that.
It's you know I'm fearless, Idon't care.
Speaker 1 (45:12):
Right.
Speaker 3 (45:13):
But a lot of men have fears yeah of course they do
the last thing they want to dois be rejected in front of their
friends or whatever.
Speaker 1 (45:18):
Right, yeah, Well, it was great having you on.
Speaker 3 (45:20):
Frank, we're going to have you on again.
Speaker 1 (45:21):
Oh, I like that let's go, it's awesome.
Frank's our resident doctor onthe show.
So when we have questions we'regonna ask Frank.
Thank you for coming and thankyou for joining us with Dating
Daycare.
Make sure to check the notesand if you have any questions,
we'll have all Frank's info andwe'll see you next week, okay,
(45:42):
bye, bye.
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