In this episode, I sit down with urologist Dr. Amy Pearlman to talk about what men actually need from their doctors and so rarely get. We start with the urology visit most men dread: why she spends an hour or more just talking before she ever asks for an exam, what a prostate exam actually checks, and why your colonoscopy isn't telling you anything about your prostate. She explains why erectile dysfunction is so much more than a quick questionnaire and a Cialis prescription, and why she sees it as a door into a man's overall health.
Then we get into testosterone. Dr. Pearlman explains why she's seeing low T in healthy-looking men in their 20s and 30s, why it's about health and not age, and what testosterone really does for mood, muscle, energy, and brain fog. She shares the question she asks every man before prescribing it, no matter how old he is, why so many men are turning to the black market, and why there's no age at which a man stops being a candidate.
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In This Episode:
00:00 – Intro
00:40 – Meet Dr. Amy Pearlman
02:17 – What's a woman's role in men's health?
06:52 – Why men dread the urologist
08:29 – The opt-in exam: what a visit should really feel like
09:55 – The prostate exam, explained (and the colonoscopy myth)
11:38 – Why ED is more than a questionnaire
12:29 – FirmTech
12:58 – When should men start seeing a doctor?
15:27 – The warning signs men shouldn't ignore
16:47 – Why men need a "well man" visit
17:21 – Viagra with no exam: when ED is a warning sign
18:58 – Why testosterone is dropping, even in young men
21:16 – What testosterone actually does
22:41 – The fertility question before any testosterone
24:30 – Black market testosterone and why men go there
25:50 – Is low T the new Viagra?
27:45 – Testosterone after 55: is there an age cutoff?
28:36 – Outro
To watch the video version of this episode, head over to YouTube!
About The Guest:
Dr. Amy Pearlman is a board-certified urologist and fellowship-trained specialist in sexual medicine, male hormonal health, and genitourinary reconstruction. She is the co-founder of Prime Institute in Miami, where she takes a modern, evidence-based approach to optimizing sexual health, hormones, and longevity. A nationally recognized educator and speaker, Dr. Pearlman is passionate about making conversations around sexual health more practical, approachable, and engaging. Her work bridges traditional medicine with emerging therapies and technologies, helping patients better understand their bodies and the growing number of options available to improve sexual function, confidence, and quality of life.
Connect with Dr. Amy Pearlman:
Website: https://www.primeinstitute.us
Instagram: https://www.instagram.com/amypearlmanmd
About The Host:
Karen Bigman, a Sexual Health Alliance Certified Sex Educator, Life, and Relationship Coach. She tackles the often-taboo subject of sexuality with a straightforward and candid approach. On this show, we explore the intricacies of sex in midlife, offering insights and support for all those experiencing this transformative phase.
This podcast is not intended to give medical advice. Karen Bigman is not a medical professional. For any medical questions or issues, please visit your licensed medical provider.
Looking for some fresh perspective on sex in midlife? You can find me here:
Email: karen@taboototruth.com
Website: https://www.taboototruth.com/
Instagram: https://www.instagram.com/taboototruth
YouTube: https://www.youtube.com/@taboototruthpodcast
Substack: https://karenbigman.substack.com
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