Peptides, Profits, and the Future of Medicine—What’s Really Happening

The Men's Health Revolution: Testosterone, Peptides & Shockwave Therapy Explained

Episode 16 | Fertility and Other F Words In this episode of Fertility and Other F Words, Dr. Amy Pearlman and Dr. Larry Lipshultz sit down with Alex Tatem, MD to discuss one of the most talked-about topics in men’s health right now: testosterone, peptides, and regenerative therapies for erectile dysfunction. Dr. Tatem is a board-certified, fellowship-trained urologist specializing in men’s health, sexual medicine, and male fertility. He earned his medical degree at the Medical College of Georgia, completed his urology residency at Indiana University School of Medicine, and went on to complete fellowship training in Male Sexual and Reproductive Medicine at Baylor College of Medicine, where Dr. Lipshultz had the opportunity to work alongside him. He now practices in Indianapolis, helping lead a high-volume men’s health program focused on erectile dysfunction, Peyronie’s disease, male infertility, and complex prosthetic surgery. Beyond the clinic and operating room, Dr. Tatem is also a standout educator on social media, known for breaking down nuanced men’s health topics into clear, practical, and highly engaging content for both patients and clinicians. In this episode, we cover: * Innovations in men’s health: steroids, peptides, and shockwave therapy for erectile dysfunction * Testosterone therapy: expert insights on dosing, formulations (oral vs injectable), and patient selection * Amino acids, peptides, and biologics: what they are, how they work, and where they fit in clinical practice * The rise of peptides: regulatory changes, including reclassification during a prior U.S. presidential administration, and why demand is exploding * Big Pharma vs compounding pharmacies: the growing tension shaping access to peptides and hormone therapies * Performance-enhancing drugs and “bro science”: what clinicians can learn while prioritizing safety and evidence-based care * Shockwave therapy for ED: mechanisms of action, clinical evidence, and real-world outcomes Key Takeaways: * Testosterone therapy must be individualized—symptoms, lifestyle, and patient goals matter more than a single lab value when treating low testosterone  * All androgenic therapies (including testosterone and anabolic steroids) suppress fertility—family planning should always be part of the conversation  * Shockwave therapy for erectile dysfunction (ED) is safe and biologically plausible, with the strongest evidence supporting low-intensity shockwave therapy (LiSWT)—not all devices are equal, and many “radial wave” machines lack evidence for ED  * Best candidates for shockwave therapy are men early in their ED journey, when vascular changes are just beginning and outcomes are more favorable  * Peptides, amino acids, and biologics are rapidly growing in popularity, driven by patient demand, accessibility, and gaps in traditional treatment options * Peptide regulation and reclassification have shifted the landscape, fueling a surge in patients sourcing therapies from gray and black market online vendors rather than regulated compounding pharmacies * Not all compounding pharmacies are created equal—quality, sterility, and third-party testing vary widely and directly impact patient safety * The ongoing tension between Big Pharma and compounding pharmacies is reshaping access to hormones, peptides, and regenerative therapies * A harm-reduction approach is essential when managing men using testosterone or performance-enhancing compounds—prioritizing education, monitoring, and long-term health outcomes To watch content by Dr. Alex Tatem subscribe to his YouTube channel, @DrAlexTatem Notice:  The Fertility and Other F Words webcast and YouTube channel are intended for general informational purposes only. They do not constitute the practice of medicine nor do they provide medical advice or create a doctor–patient relationship. Use of the information provided through this webcast, YouTube channel, or any linked materials is at the listener’s/viewer’s own risk. The content is not a substitute for professional medical advice, diagnosis, or treatment.  Listeners/viewers should never disregard or delay seeking medical advice for any health condition and are strongly encouraged to consult their own qualified health care professional with any questions or concerns. All content from the Fertility and Other F Words webcast is the property of PODCAST WITH DRS. AMY AND LARRY LLC. Listeners and viewers may not use, distribute, re-distribute, reproduce, alter, or edit any portion of this content without the express written permission of the webcast owners. The views and opinions expressed in this webcast are those of Drs. Amy Pearlman and Larry Lipshultz and do not reflect the official positions or responsibilities of Prime Institute, Baylor College of Medicine, or any affiliated institutions.

Peptides, Profits, and the Future of Medicine—What’s Really Happening

Episode 15 | Fertility and Other F Words In this episode of Fertility and Other F Words, Dr. Amy Pearlman and Dr. Larry Lipshultz sit down with Brigham Buhler to unpack one of the most talked-about (and controversial) topics in modern medicine: peptides, and the healthcare system surrounding them. Brigham is a healthcare entrepreneur on a mission to challenge and rebuild what he sees as a fundamentally broken medical system. He is the founder and CEO of Ways2Well, a functional and regenerative medicine clinic, and the owner of ReviveRx Pharmacy, where he is working to create more transparent, patient-centered models of care. With firsthand experience navigating pharmacy benefit managers (PBMs), insurance companies, and regulatory frameworks, Brigham offers an insider perspective on how the system often works against patients and what it would take to fix it. He has become a vocal advocate for exposing the realities of corporate-driven healthcare and pushing for solutions rooted in prevention, innovation, and patient empowerment. You may also recognize him from The Joe Rogan Experience, where he shared his perspective on the future of medicine and the urgent need for change. In this episode, we cover: * Why peptides are gaining traction outside of traditional medicine * Barriers to adoption within the current healthcare system * The role of PBMs, insurance, and pharmacy infrastructure in drug pricing * Common misconceptions around compounded vs FDA-approved therapies * How to evaluate peptide sourcing, quality, and safety * What a responsible, medically guided peptide program should look like * The risks of the growing DIY peptide trend Key takeaways: * The current healthcare system often prioritizes treatment over prevention, creating misaligned incentives * Drug pricing is heavily influenced by intermediaries, making costs less transparent to patients * Compounding pharmacies can improve access and affordability, but require proper oversight * Peptides represent a growing area of interest, but education and quality control are critical * Patients need guidance to safely navigate an increasingly complex and decentralized landscape This episode is a candid, behind-the-scenes look at healthcare, innovation, and the future of patient-driven medicine. Notice:  The Fertility and Other F Words webcast and YouTube channel are intended for general informational purposes only. They do not constitute the practice of medicine nor do they provide medical advice or create a doctor–patient relationship. Use of the information provided through this webcast, YouTube channel, or any linked materials is at the listener’s/viewer’s own risk. The content is not a substitute for professional medical advice, diagnosis, or treatment.  Listeners/viewers should never disregard or delay seeking medical advice for any health condition and are strongly encouraged to consult their own qualified health care professional with any questions or concerns. All content from the Fertility and Other F Words webcast is the property of PODCAST WITH DRS. AMY AND LARRY LLC. Listeners and viewers may not use, distribute, re-distribute, reproduce, alter, or edit any portion of this content without the express written permission of the webcast owners. The views and opinions expressed in this webcast are those of Drs. Amy Pearlman and Larry Lipshultz and do not reflect the official positions or responsibilities of Prime Institute, Baylor College of Medicine, or any affiliated institutions.

Doctors Break Down Penile Fillers: Results, Risks, and Reality

Episode 14 | Fertility and Other F Words In this episode of Fertility and Other F Words, Dr. Amy Pearlman and Dr. Larry Lipshultz sit down with Alex Tatem, MD to discuss one of the most talked-about topics in men’s health right now: penile girth enhancement. Dr. Tatem is a board-certified, fellowship-trained urologist specializing in men’s health, sexual medicine, and male fertility. He earned his medical degree at the Medical College of Georgia, completed his urology residency at Indiana University School of Medicine, and went on to complete fellowship training in Male Sexual and Reproductive Medicine at Baylor College of Medicine, where Dr. Lipshultz had the opportunity to work alongside him. He now practices in Indianapolis, helping lead a high-volume men’s health program focused on erectile dysfunction, Peyronie’s disease, male infertility, and complex prosthetic surgery. Beyond the clinic and operating room, Dr. Tatem is also a standout educator on social media, known for breaking down nuanced men’s health topics into clear, practical, and highly engaging content for both patients and clinicians. In This Episode, We Discuss: * Penile girth enhancement using hyaluronic acid (HA) dermal fillers (off-label use) * Non-surgical options for penile enlargement and how they compare to permanent procedures * The risks and complications of permanent penile girth enhancement treatments * How HA fillers work for increasing penile girth and improving appearance * What patients should know before considering penile filler procedures Key Takeaways: * Hyaluronic acid (HA) fillers are a temporary, non-surgical option for penile girth enhancement * These fillers are FDA-approved for facial aesthetics, but are commonly used off-label for penile enhancement * Product selection matters—viscosity, durability, and reversibility (ability to dissolve with hyaluronidase) are critical * Injector technique and post-procedure care are essential for achieving a smooth, natural, and symmetric result * Compared to permanent options, HA fillers offer greater safety, flexibility, and reversibility Research Highlights (SMSNA 2025 – PhalloFILL Study) Study overview * 432 men treated by 28 providers using a standardized protocol * Focus on relationship quality, intimacy, and self-confidence * Real-world data collected via anonymous survey Key findings * 80% reported improved satisfaction during intimacy * 75% reported improved partner satisfaction * 52% reported increased frequency of intimacy * 81% reported improved self-confidence and overall well-being Bottom line * Most men reported meaningful improvements beyond aesthetics, including confidence and relationships * A small subset reported no change or worsening * Reinforces the importance of patient selection, counseling, and setting realistic expectations To watch content by Dr. Alex Tatem subscribe to his YouTube channel, @DrAlexTatem Notice:  The Fertility and Other F Words webcast and YouTube channel are intended for general informational purposes only. They do not constitute the practice of medicine nor do they provide medical advice or create a doctor–patient relationship. Use of the information provided through this webcast, YouTube channel, or any linked materials is at the listener’s/viewer’s own risk. The content is not a substitute for professional medical advice, diagnosis, or treatment.  Listeners/viewers should never disregard or delay seeking medical advice for any health condition and are strongly encouraged to consult their own qualified health care professional with any questions or concerns. All content from the Fertility and Other F Words webcast is th

Inside the Peptide Industry: The Truth About Safety, Sourcing, and Results

Episode 13 | Fertility and Other F Words In this episode of Fertility and Other F Words, Dr. Amy Pearlman and Dr. Larry Lipshultz sit down with Rick Manuel to pull back the curtain on peptides and regenerative medicine. Rick is one of the owners of Optimal Balance Pharmacy and the owner of Houston Regen Consultants. He works with physicians around the world, helping them implement evidence-based protocols and navigate the rapidly evolving peptide space. In this episode, we cover: * Rick’s journey from the supplement industry to personal training to the stem cells and compounding pharmacy world * Concerns and real-world issues with SARMs (Selective Androgen Receptor Modulators) * The logistical challenges of conducting clinical research in this space * Side effects seen in clinical practice with certain peptides * Behind-the-scenes look at peptide sourcing, including: * FDA-registered facilities in other countries * The “Green List” * What proper due diligence actually looks like * Method suitability testing and sterility testing * Potency and quality control testing Key Takeaways: * There is very limited high-quality research on the safety and effectiveness of many peptides * That said, real-world clinical experience treating hundreds of patients suggests there may be a role for peptides in select individuals with specific goals * When sourced from reputable compounding pharmacies and used with appropriate oversight, peptides appear to be generally well tolerated To learn more about Optimal Balance Pharmacy, check out https://obprx.com/ [https://obprx.com/] Notice:  The Fertility and Other F Words webcast and YouTube channel are intended for general informational purposes only. They do not constitute the practice of medicine nor do they provide medical advice or create a doctor–patient relationship. Use of the information provided through this webcast, YouTube channel, or any linked materials is at the listener’s/viewer’s own risk. The content is not a substitute for professional medical advice, diagnosis, or treatment.  Listeners/viewers should never disregard or delay seeking medical advice for any health condition and are strongly encouraged to consult their own qualified health care professional with any questions or concerns. All content from the Fertility and Other F Words webcast is the property of PODCAST WITH DRS. AMY AND LARRY LLC. Listeners and viewers may not use, distribute, re-distribute, reproduce, alter, or edit any portion of this content without the express written permission of the webcast owners. The views and opinions expressed in this webcast are those of Drs. Amy Pearlman and Larry Lipshultz and do not reflect the official positions or responsibilities of Prime Institute, Baylor College of Medicine, or any affiliated institutions.

Obesity Is a Symptom—The Real Problem Is Unhealthy Muscle

Episode 12 | Fertility and Other F Words In this episode of Fertility and Other F Words, Dr. Amy Pearlman and Dr. Larry Lipshultz sit down with Gabrielle Lyon—a healthcare disruptor reshaping how we think about muscle, strength, and longevity. A board-certified physician, bestselling author, host of The Dr. Gabrielle Lyon Show, and founder of Strong Medical, Dr. Lyon brings a fresh, evidence-based perspective to modern health. With training in family medicine and fellowship experience in nutritional and geriatric medicine, she has pioneered a muscle-centric approach that challenges conventional thinking. Her message is simple but powerful: muscle isn’t just about how you look—it’s a critical driver of metabolic health, resilience, and long-term survival. In this episode, we cover: * The newly released dietary guidelines—and what they actually mean in real life * How these guidelines could impact institutional food systems like schools and nursing homes * The politics of food: where science ends and policy, lobbying, and influence begin * The myth that eating healthy is always more expensive—and what the data really shows * How her research on muscle mass and brain aging reshaped her entire philosophy on health Key Takeaways: * Prioritize whole, nutrient-dense foods * With the release of new dietary guidelines and updates to the food pyramid, there’s still a need for more nuanced research on saturated fats and individual carbohydrate tolerance * Muscle health is central to overall health: her work in body composition and brain aging led to the foundation of muscle-centric medicine * Resistance training is non-negotiable—it’s one of the most powerful tools for longevity and metabolic health * The real concern isn’t just obesity—it’s the rise of sarcopenic obesity, where low muscle mass and high fat mass coexist * Her book Forever Strong reframes muscle as an essential organ and serves as both a scientific and nutrition manifesto for building long-term health To learn more about Dr. Gabrielle Lyon, check out the following resources YouTube @DrGabrielleLyon The Forever Strong™ PLAYBOOK: A Six-Week, Science-Based Plan to Sharpen Your Mind, Strengthen Your Body, and Get Healthy at Any Age available on Amazon Notice:  The Fertility and Other F Words webcast and YouTube channel are intended for general informational purposes only. They do not constitute the practice of medicine nor do they provide medical advice or create a doctor–patient relationship. Use of the information provided through this webcast, YouTube channel, or any linked materials is at the listener’s/viewer’s own risk. The content is not a substitute for professional medical advice, diagnosis, or treatment.  Listeners/viewers should never disregard or delay seeking medical advice for any health condition and are strongly encouraged to consult their own qualified health care professional with any questions or concerns. All content from the Fertility and Other F Words webcast is the property of PODCAST WITH DRS. AMY AND LARRY LLC. Listeners and viewers may not use, distribute, re-distribute, reproduce, alter, or edit any portion of this content without the express written permission of the webcast owners. The views and opinions expressed in this webcast are those of Drs. Amy Pearlman and Larry Lipshultz and do not reflect the official positions or responsibilities of Prime Institute, Baylor College of Medicine, or any affiliated institutions.