Podcast Summary: Cate & Ty Break It Down

Episode: Urology is for Everyone! Breaking Down Sex, Surgery, and Stereotypes with Dr. Milhouse MD
Date: January 14, 2026
Host: PodcastOne
Guests: Dr. Fenwa Milhouse, MD (Urologist)
Hosts: Catelynn and Tyler Baltierra

Overview

This engaging episode dives into the world of urology, busting myths about the field, exploring the intersections of sex, surgery, and gender, and discussing disparities, sexual health, and hormone replacement. Cate and Ty—reality TV mainstays best known for MTV’s "Teen Mom"—host Dr. Milhouse (“your favorite urologist”), who champions sex positivity and inclusivity in medicine. Together, they destigmatize urology, unpack common misconceptions, address representation, and deliver candid, often humorous, advice about sexual health and the medical journeys of men and women alike.

Main Discussion Points & Insights

1. Dr. Milhouse’s TV Experience and Urology on Screen

• Dr. Milhouse recounts the journey creating a TV special about her urology practice:
  • Only one episode aired, despite nearly a million viewers and great feedback ([01:07]–[02:51]).
  • Changing TV landscape and network pivots have made "doctor shows" less common.
• Cate shares her own urology experience:
  • Details her surprise at needing a urologist while pregnant, and how common it is for women to assume urology is only for men.

2. What Does a Urologist Do—And Who Do They Help?

• Dr. Milhouse clarifies urology vs. gynecology:
  • "Gynecologists are specialists of vulva vaginal owners… urologists are specialists of the male reproductive system… but urology is truly for everyone." ([05:52])
    • Urologists handle urinary tract issues for all people.
    • Women’s urological needs often overlooked or misrouted to gynecologists.
  • “We are glorified plumbers… if there's something wrong with the part of your body that produces and excretes urine, you're coming to see us.” ([06:32])
• Representation in urology:
  • Only about 9% of urologists are women; Black women make up ~1% of the field. Representation is slowly improving ([08:41]).

3. Healthcare Disparities and Representation

• Health disparities are stark:
  • Black men are twice as likely to be diagnosed with, and die from, prostate cancer; yet are least likely to be screened ([10:14]).
• Barriers:
  • “It’s partly lack of access… you go to a part of the city that is primarily Black, like the access to specialties is very different from more well-to-do, predominantly white areas, which is so wrong.” ([10:54]–[11:21])
• Dr. Milhouse’s Background:
  • Born in Nigeria, raised in Texas, now practicing in Chicago.

4. Sex Positivity, Shame, and Sexual Health Struggles

• ED on the rise for young men?
  • More young men are seeking help for erectile dysfunction, possibly due to reduced stigma and increased information ([18:29]).
  • “Gen Zers are more informed, not as ashamed to talk about their health, and they seek health treatment…So I think part of it is just these younger people that used to 20 years ago just kind of suffer in silence, are like, no, I can go get this treated.” ([18:43])
• Role of porn, anxiety, and trauma in sexual health:
  • Early porn exposure and compulsive consumption can impact sexual function, but porn itself is not inherently a risk factor; how it's used matters ([21:41]).
  • Dr. Milhouse calls for parents to directly address porn and sex with kids: “Your kids are getting porn sent to them… you have to talk to your kids about porn and why it’s meant for adults…” ([25:29])
• Female sexual pleasure:
  • Most women (about 86%) need clitoral stimulation to orgasm—penetrative (vaginal) orgasm alone is rare (14%) ([30:32]).
  • “The clitoris needs to be your main focus… in the beginning, in the middle, and at the end. She comes first, ideally.” ([33:20])

5. Communication and Deconstructing Shame

• Open communication in relationships:
  • Cate and Ty champion candid, age-appropriate sex education for their daughters ([26:26]).
  • Dialogue about sexual pain and anatomy breaks taboos.
• Performance pressure:
  • Both men and women experience sexual anxiety, but manifestations differ. For men, it’s often erectile or performance anxiety; for women, it’s arousal or orgasmic dysfunction ([28:19]).
  • Normalize awkwardness and unmysterious realities of sex:
    • “Real life is, like, kind of awkward. Somebody might fart… or, oh wait, I gotta pee…” ([24:31])

6. Surgery, Treatment, and Common Procedures

• Range of urological surgery:
  • High variability based on subspecialty (kidney stones, cancer, sexual medicine, reconstructive, pediatric, etc.) ([16:04]).
  • For women, fixing leaky bladders is common; for men, erectile dysfunction surgery (penile prosthesis) is notable.
  • “We can get a stiff dick. Don’t you worry, fellas. Because of this implant.” (Dr. Milhouse, [17:50])
• Penile enhancement and cosmetic urology:
  • Emerging trends: fillers and surgical sleeve implants ([56:54]).
• New tech:
  • Devices to control overactive bladder via a small implant in the ankle ([55:42]).

7. Debunking Myths & Notable Facts

• Does cervix stimulation hurt?
  • Absolutely:
    • Dr. Milhouse: “Don’t touch my cervix. I want to wear a t-shirt—don’t touch it!” ([38:14])
    • Individual preferences vary, but pain is not ‘normal’: “If sex hurts routinely for you, it’s not normal…You’re supposed to enjoy it.” ([41:50])
• Vagina and penis size:
  • Average erect penis: ~5.1–5.2 in.
  • Average unaroused vaginal depth: 3–4 in, but doubles with arousal ([63:45]).
• Labia changes post-menopause:
  • Labia minora shrink due to decreased estrogen:
    • “One of the telltale signs of menopausal changes…labia will be miniature or gone.” ([60:23])

8. Hormone Replacement Therapy (HRT) – Clearing Confusion

• Strong advocacy for HRT for menopause/perimenopause:
  • Symptoms that can be improved: hot flashes, night sweats, mood swings, vaginal dryness, recurrent UTIs, sleep problems ([45:26]).
  • “If men went through menopause, we’d have a solution yesterday.” ([42:55])
  • HRT’s reputation damaged by a 2002 study; modern evidence shows risk is low and timing matters ([44:29]-[47:49]).
  • Start early for best protection (especially heart health):
    • “HRT started in perimenopause, or early menopause, actually decreases your risk of heart problems.” ([48:03])

9. Women’s Anatomy and Societal Shame

• Many women are embarrassed to ask about (or aren’t taught) their own anatomy. Dr. Milhouse stresses it’s a societal issue, not personal failing ([58:26]).
• Need for better medical education and prioritization of female pleasure and anatomy in research and medicine.

Notable Quotes & Timestamps

• “Urology is for everyone!” – Dr. Milhouse ([05:40])
• “The clitoris needs to be your main focus…” – Dr. Milhouse ([33:20])
• “If sex hurts routinely for you, it’s not normal. You’re supposed to enjoy it.” – Dr. Milhouse ([41:50])
• “If men went through menopause, we’d have a solution yesterday.” – Dr. Milhouse ([42:55])
• “Real life is, like, kind of awkward. Somebody might fart...” – Dr. Milhouse ([24:31])
• “One of the most common disparities is black men are two times likely to get diagnosed with prostate cancer… and least likely to get screened.” – Dr. Milhouse ([10:14])
• “HRT started in perimenopause, or early menopause, actually decreases your risk of heart problems. There’s an advantage.” – Dr. Milhouse ([48:03])

Key Timestamps for Major Segments

• [01:07]–[02:51]: Dr. Milhouse’s TV experience
• [03:47]: Cate’s personal urology story
• [05:52]: Urology vs. Gynecology explained
• [08:41]: Diversity stats in urology
• [10:14]: Racial disparities in prostate cancer
• [13:41]: Dr. Milhouse’s path to becoming a urologist
• [17:13]: Common urological surgeries for men and women
• [18:25]: Erectile dysfunction, young men and performance anxiety
• [21:41]: Porn, sex education, and impact on sexual function
• [30:32]: Clitoral vs. vaginal orgasm statistics
• [38:14]: The pain of cervix stimulation—debunking social myths
• [41:50]: Painful sex & when to see a doctor
• [44:29]–[48:03]: HRT misconceptions and modern best practices
• [55:41]: Tech innovations in urology
• [56:54]: Male enhancement/cosmetic urology
• [60:23]: Labia changes after menopause
• [63:45]: Average genital sizes

Tone & Style

Conversational, playful, and candid—filled with humor, real-talk, and accessible explanations ("glorified plumbers" for urologists, “We can get a stiff dick,” “Don’t touch my cervix!”). The episode is rooted in body-positivity and inclusivity.

Further Information

• Dr. Milhouse:

  • Instagram: @DoctorMilhouse
  • YouTube: Down There Urology
  • TikTok: “Your Favorite Urologist”
  • Practice: Down There Urology, Chicago

• Call to Action:

  • Cate & Ty urge listeners to advocate for medical shows about urology, follow Dr. Milhouse, and maintain candid conversations about sex and health.

Takeaways

• Urology is relevant to all genders.
• Women and people with vulvas often have urological issues—don’t overlook this!
• Communication, knowledge of anatomy, and destigmatization are key to better sexual health.
• HRT is safer than many think; seek early, individualized advice.
• Medical representation and research still need more diversity and focus on women and minorities.
• Embrace awkwardness and honesty—because everyone deserves healthy, happy sexuality.

This summary covers the key medical, personal, and social themes discussed, with ample quotes, context, and timestamps for deeper exploration.