One thing David Smith and sharing a host once again for being part of bar. Up from the front porch segment where we got to know they're beautiful neighborhood. The audit in Riverside neighborhood and the issues they face and the happiness they have loving their neighborhood. But now we're gonna do one of -- -- shifts on hold on because our guys back. Whether you're male or female there are issues many of -- faces a week. Let's say mature. And that's why we love having doctor Neil balm well known urologist. In to visit -- periodically. So whether it's pelvic pain in large prostate. Even urinary tract infections we need information. So the good doctor is in for the next hour please give us a call 2601872601. At seventy. With any questions you have. And let me ask all you great women out there let's hear from you. Is there a lot of female issue this man can address. Everything including all those things I just mentioned and things like lack of lobbied. But we're gonna start with a relatively new controversy. On the use of testosterone. In older man. So first welcome doctor Bob good to be back -- missing thank you. Our audience has an issue because you help resolve issues. And I'm always so proud of the men and women who do call in or so candid about their particular issue because it helps others who may be having that problem. Learn from you so again 260187. To what is this controversy about the use of testosterone and -- but testosterone. And use in older man is now become very very common place. And it is help literally millions of man to restore. Their energy global. It helped them restore there strength and muscle massive help them restore even their memory. Can improve with testosterone replacement. However. A study. That came out in a very credible medical journal that indicated. That testosterone. Replacement. But the man and it increased risk of heart disease. Really this was a poorly conducted its daddy. The -- Betty this study was done -- men who Wear jets. Given a prescription. Testosterone were included in the study we don't know if they filled the prescription and this is that -- They also included a hundred women. In this study said the study was really flawed. And literally. Hundreds of my colleagues throughout the nation hundreds. Wrote to the journal. And asked them to read tracked the article it hasn't been done yet but I really think. That that the journal of the American Medical Association. -- grave care in publishing this paper in the world to get published it is. It is hard to believe that such a credible journal of it it's at the pinnacle. Medical journals would it would publish such an article the truth of the matter it is. That men who have a low testosterone. Are at an increased risk of heart disease and stroke and -- restoring. Their testosterone. To a normal level. Debt you improve there risk. And improve their heart disease in new improve their cholesterol level. Improve their diabetes improve their way last and their benefits for eagle on and on and yet. They published the study that says if it was low and you raised that you increase your risk of heart disease. You know we hear you know anecdotally. Stories of the use of testosterone really more an -- and abuse it. Taking it to pump themselves up and be -- and in some cases when. I I I would like to point that we are talking about. If the testosterone level is slow to restoring it to normal the people who would abuse it. Are using testosterone to take into super high levels and I think I can. And that we don't condone that that should not should not be done. But the thing that I'd like to point out is in medicine we seek to fine. You know the the middle ground if your. Glucose or diabetes is out of control we lower. If your thyroid hormone is low we raise it. If your blood pressure is high we lower. And the same applies to testosterone. If the testosterone. Is low we will help you get it to the normal range we will not or should not. Help you get it to super high levels because that is. Deleterious to a man's health you mention about women and but women have testosterone in women can be low in -- correct. Men. That testosterone. Is made in the testicles of man. And in women. Testosterone is some aid in there -- free and adrenal glands in small amounts. When they reached -- and a middle age and particularly around menopause. Dare testosterone. Goes down and as a result this can be a cause said. Vaginal dryness. Decrease in libido. Painful. Intimacy. And by restoring. The testosterone. In women. To which is not as -- certainly not as high as in man. And also restoring their estrogen level if there ovaries had been removed or -- they have gone through. -- upon us debt has to be restored as well so women also can benefit. From testosterone and usually low dose of testosterone but it's still a testosterone replacement therapy and women. Make testosterone. As well as Smith liked we have a caller Michael I think you have a question about testosterone therapy. Michael all -- years ago. We do not just every year or work out so well you know it's a chicken. I got a book work on -- much just are -- when he sorting and almost scary. And -- started taking more shots are marked and it's the last about it -- was 12170. Feet and they energy. Just go -- tell my art look route. About 78 back but it was a blow out got it back down to bury it and all right not one slide on our artwork and everything looked great so. And make the comment that it does work at a -- -- and it's it's not. Or bodybuilder like that accomplish just because my overall thought I needed that help -- get worked out great. Michael you can be our poster boy had him quartet for -- pastor. Let me ask you a question Michael when you win in for your physical exam. And you found that yet low testosterone the -- energy level low wagers sex drive diminished. Did you have any of the signs and symptoms of low testosterone. It -- You grow it ever occur -- an. Article that. Always breaking up their I think -- said everything was being if you didn't -- and it is. Wonderful that wherever you work that the physical exam and the yet testing included a testosterone. And I think more and more men. When they come in for their annual exam like Michael did should get a testosterone level especially. If they find that they have the symptoms and and we've gone through the symptoms that that men experience when the testosterone is low. It's as simple blood test. The result usually is back in three to five days you go back to the doctor. And there are multiple options for replacing testosterone. There are injections like Michael got. There are topical gels that the man. Put a jail on in the morning after he showers that -- in about five minutes. And now there are. Injections that can be given instead of every two weeks they can be given every ten to twelve weeks that you need one injection. A unique for injections per year. And there are also pallets that can be placed underneath the skin these are right size. Pallets of testosterone. And these last for four to six months and so you need the pallets inserted twice a year -- so there are many options for men. That are available including. Injecting themselves at home or applying to -- on a daily basis. Really really appreciate Michael calling it I want meg and Tim and Henry to stand by we're gonna take a quick break we'll be right back with doctor -- -- Really appreciate everybody's holding on let's start with -- with Tim. Yeah thank you sure. -- -- What you. Get proper treatment -- thoughtful way and do. -- -- and pocketed breast cancer and mail. That's that's a good question camp and the answer. Is that if they are in remission. And if it is cleared by there on colleges. Yes I think it would it would certainly help them. But I don't think there is any risk if there if the IR. Absolutely cleared of their breast cancer. And I think it would be to their advantage did check this out with there on colleges. And then goes -- gynecologist. Or a urologist. Authentication things might -- calling him let's go to Wayne. Hello well. Yes. -- -- -- -- -- -- -- -- -- -- -- -- -- -- But describe the lights. Went out to be about forty. Well. Like walk to swallow it up like a walk around. And I went to my doctor. That -- Fans -- -- taken injections there. Opulent and. You walk into those walls again walked out. -- What that is great great to hear from you hope your wife is doing well I I I recognize your name and who you are. And it really clicked on the slot -- -- -- access. -- like this guy that we could go. Aaron has been charged but be aware of that topic but it should target bruises. -- -- -- It looked up and Syria. And at the you're. Right. Or she wanted to just what. And Asia. Would be sitting here. -- Jay Leno weighing you in your life for in our prayers were thinking that you you couldn't be going to a better institution. I think that you're going to find that that they're going to be able to help viewing get her restored back to good health. Thank you -- and just you know trial great have been aware about you know they can -- real quick you know you -- blood blood work done. Probably ought to go back and you know so much. Can happen and just you know people might be aware that shot. Tabling -- it because we will do a program on our world is looking for ideas and and you bring up a very good one thank you very very -- -- -- -- okay good luck and thank you weighing in good lack. I'll let this go to meant on the West Bank you've been holding on appreciate. Element. Yes you could comment or question. -- Atlanta and that the -- -- Like one can do out incontinence. Totally incompetent. It's not accompanied by you dynamic back in accent it's this incontinence. Can't can I ask you two questions make quickly made that's your age. -- okay and -- Ask. Do you lose the water when you're in when you have to go right away and can't wait to get to the restroom. Or do you lose the or water when you cough or sneeze or both. Okay. You have very common problem. In that middle aged. Women and you have called stress incontinence and over active Blatter. Both of these are capable of being treated very easily and simply. I think you should see a urologist and you'll start you on some medication. That will help the over active Blatter he will also recommends some exercises that we may talk about later called -- Katie. GE. -- exercises. And a combination of both the medication and the exercises. You can put your pads and your diapers a way. Let. That would be wonderful. Because they. That that that you could be away and and what activities. It didn't hit a great deal. Well that is. Common complaint and we see people becoming. House bound and failed to go socialize. Because fearing of losing their water and I. Can tell you that you can be helped and you get your life back in order. And simple visit to a urologist and getting started on the medications in the exercises. And life will look sunny and cheerful and back to the good old days. You'd. And I can't -- -- Japan. And -- in my younger years had a problem. And he dealt with it immediately. At -- particular I'll -- right there and he'd get diagnosed it immediately. And and the outlet. But got to get banned -- thought of himself -- is no longer with and I that we get blocked and. I knew doctor burns he was not only a well known local urologist he was at very famous urologist on the national scene. And we did lose a real giant in the field of urology but I think if you went back down Oxnard they have other Goodyear colleges there. And I think they can get you quickly back on track may. Thank you so much. I but now. You're saying well -- for calling. We're going to be taking a break going to the new German but I do want done. Just to stand by you've been so kind and patient but. We got to go check on what's happening in the news but we will be back with doctor -- bomb I'm Angela on WWL for the doctor is in our wonderful friend doctor -- bomb. And Jeff thank you so much for holding so well. -- After a quick question for you ire when I'm on last and you launch in the -- and com. It's quick it's got thirty years old and I recently had my you know physical and what work. And I asked them to check -- all testosterone levels. And everything came back normal all my hat and a what what came back normal I'm considered healthy thirty year old. Arm -- and my question a -- the heat exhaustion. In Lou will be and I'm concerned my it's my upper level were pretty much normally it would totally normal. Parker went with a trumpet that it -- -- -- -- you mean your rebels. After an hour. Higher level care unit of blood were normal number two through -- Yes that yeah that is true and what you need is a little more testing. That needs to be done if you are if you are having both combination. Fatigue. And decreased libido. There can be either. Causes. That that can affect your testosterone. Even though the testosterone level is normal. It's a little hard to go into detail about. Something called sex hormone binding globulin. Because if that is high. That can. Allow you to have a normal blood test. Yet death. Available testosterone. To help with your libido and energy may be decreased. If you were to go to my website www. Little bomb dot com. There is an article about that on the web site or you can call my office and I'd be happy. To go in two with few in greater detail. But there are situations not very common. Where the testosterone in the bloodstream is normal yet the amount of functioning or available testosterone is diminished. And I'd be happy to help you pursue that. Either with that article org contact my office and I can contact you go over with you in greater detail is that acceptable. I was definitely in which is some thirty years old is it. Uncommon common. Look at Cutler and. -- That testosterone. It's it is at its peak between 25 and thirty. And starting around the age of thirty it starts to go down about 1%. A year. But doesn't usually become symptomatic. In two of them late 40s10 years later than. You know from now -- a year 38 in in the late forties early fifties is when it starts to. Demonstrate symptoms so old you are on the young side if your hat having symptoms and it needs to be. Drilled in two. A little further and I am sure we can come up with with that solution for. -- -- particularly thank you so much and -- and applause. -- -- But we lost slim hopes she calls back she's been holding bless her heart Evan and bill chase. Hi got the ball and yes. The question considering my mother she's 88 year old. She definitely has -- acting career -- in over active black. She -- medications. She eat and yet -- device and we have made. I think it is like to stimulate the splattered on the -- Want an intense and -- -- device. Okay. And that hasn't helped her either at the -- of the new procedures that she -- how harm. Yes there is a procedure that is. I would say reasonably. New called that post here here. To deal nerve stimulation and that's where they stimulate. A nerve in the foot at the bottom by the ankle. And at that seems to calm down the latter and usually it is this is performed. By a urologist. Or a physical therapist. And that in combination with biofeedback. Is helpful however if she. Has overactive bladder that hasn't responded. To medications or the -- stand. Down the likelihood of any of these new -- things being able to completely solve the problem is going to be very very low and fortunately. But d.s are worth giving a try they're not invasive it is not does surgical. And it. Gets her in involved in a participating. In the in this solution. To the problem. Did she have it is she meant to the who with that there is there any evidence of any dimension because that can make it even. More difficult. Com. Oh. She may have some issues you know. With old age do -- know academics. Is she -- memory loss. And now OK and she got you know and that's probably fine. I think that's going to be a very tough ones that come to a solution for but I think it is worth whoever. Inserted the interests in device still want to make sure it's working. And then to ask him about post here your post -- here to deal nerve stimulation. Okay and what do you and Botox injections. Botox injections also are a solution usually those are done before after medication before the interests them. And Botox is a medication. That deep creases that nerve transmission. And it does work but you have to do repeated. Every four to six months it it does is not a forever treatment it's -- NC ongoing. Treatment. But you know if someone is incapacitated. And can't. Become. Socially active and it becomes house boundary inclusive. And certainly that is one option you know before -- Considering as surgical procedure. Okay are right thank you very much any information -- He can. Sign that that OK I am on hand there. Stretch and not meant. Hit that that. And I -- -- mentally in the men's expenses I didn't do anything about it and I -- -- and walks. Until a year and a I had. They're region from the match. And out into the latter hit -- drop to leave it like writing it then you know Mary. Opening of the -- yeah. Okay yeah I wonder what I'm -- Your options are. One day exercises. That I talked about just a few minutes earlier picking -- Yeah I assume you probably have tried goes in there in effect have been ineffective is that correct. -- I you know I do -- a little if you let. -- For yeah yeah yeah yeah it is very difficult for people that stay connected. To doing -- eagle exercises and the reason is. You don't see the results immediately degrees yeah it's like building up a muscle is what you're doing. And nobody can go to the gym and lift weights and the like a bodybuilder after one time. You have to do it over and over again repeatedly. To gain strength. India. Pelvis to. Cause it to improve so consequently. Most men and women who do take on exercises. Give up -- because the results are so slow in coming. But there are other things that you -- you can do one is -- history. History is ate doughnuts eyes. Device that is inserted into the vagina and you can use this. So let's say if you are gonna go play tennis you're going to go out for the evening you're going to go to the theater restaurant and you -- -- and avoid the embarrassment it's a temporary. Problem it's not a permanent problem. And it is a non surgical. Solution. Or the other thing defying the idea that things is might be consideration for you to. Is he reached peak surgical procedure with out -- Nash. Or using. What I call biologic. Material be using material from your own body instead of Nash. Two. Help support your latter's you have others other solutions and I waiting courage -- to go back to that Doctor Who. Did the original per app procedure. And -- who removed them -- and talked to him about the other solutions and at least temporarily. I would encourage you to keep with the exercises and consider a -- OK I'll do that thank you so much. -- -- literally backed Clinton will take another break but stay with this and the doctors announced 260187. Talking with doctor -- bombing of another caller Jim and Jenny in Kenner. Joining. EO. -- I don't intelligent. You had a comment or question for doctor -- If you are. -- and eat. Eat and I'll leave our VP. I'm. -- -- -- -- -- -- It. All right. -- necessary. Why they put act in my. Exactly uproar over. There and recommended that the war. In. It. At the factory. -- into. -- eat it will be. Out and eat it. Jenny -- -- -- car Jan and Jenny are you referring to the -- the plastic mesh. Yet. Yeah it is not. Repeat trip. Eric -- the actor. And kind EU. Committee the -- And you know eat eat eat eat because. You don't -- -- the court. I'm Barack Obama yet be -- an enemy and it act eat it why they don't at all. You aren't aren't yet you know or it won't repeat it too little too directory -- for Egypt to Rick Ricky. I don't recommend it. It is work we are trying you know army. Very good to hear positive results like. You know -- -- -- that it. Is what I'm collector who are eager for all -- aren't. You know -- weeks without art in you know insurance in between now. Not try and put it aren't in handy indeed -- twelve years. I can't do if he can't work. And I got beat creep up in the -- because I hit it -- be. Eaten but I am not but aren't aren't. -- -- -- -- -- -- -- -- -- You know you know we -- not an issue we need scheme that are always eat me eat it gave me. In -- and it act Igor. Is want to. I can't thank you enough for your call Jenny. You. Are an inspiration to lots of our listeners out there. And that the point that I think that you wanna make is that you don't have to suffer. From the year that condition that you have -- called pro collapsed. And you don't have to suffer from that and that discomfort from that. And the other consequences. Of pro -- that there are solutions and inserting that. Piece of plastic which is such a simple thing it's usually the past series will work. And TJ and no thank you so much Jennings we're gonna move on to Deron in New Orleans. Hello -- Are more about China have a child and down. Right that was slow and found it slow. When I guess treatment and that. Age -- A small portion of it working -- with that check all that I have a little sperm Powell. -- thank you checked all of. I think you'd need to talk to your wife's obstetrician. And ask her. Who does her. Testing on males and she will refer you to a clinic or to a urologist. Who will do a complete. Seen an examination. Because you can't not take testosterone replacement. If you are trying to have a child. And you have to take other medications. In order to improve your your sperm count so ask your. Wife's -- that tradition who she works with so there is communication. Between. That doctor or that lab. Taking care of her and the result because you have to get your situation. Working perfectly well in order to achieve a pregnancy. You can be helped but testosterone replacement there is not a solution to your problem so contact York. Whites -- tradition and find out who she would prefer you do I hope that's helpful -- Thank you very very much and very quickly Charlie in -- our last caller. We have by the minute Charlie. OK doctor I've been treated for prostate care -- What radiation. At all so while there are better than -- -- trouble at all but it can of the fully accomplish. -- object. The answer very quickly is yes you are providing -- York PS -- prostate specific antigen. Is at the lowest level and it stays low and you're willing to get the injections and yet the PSA testing a little more frequently. Your urologists will answer that for you. And you are a candidate providing the PSA is at the lowest level. That's -- -- told -- earlier in the can be you terribly injure. -- Yes there are there are greens there are shelves there's injections and there's -- And these may be a solution to your problem and the -- gels do work but you must check with your urologists first. In the order -- that they cancer is under control and then you can proceed. Charlie I'm so glad you called. And I'm so -- all of our callers called thank you so very much and thank you so very much doctor Neil -- Next month he's back can't wait to com thank you very him stay with the second one will be right.