Podcast Summary

The Human Upgrade: Biohacking for Longevity & Performance

Host: Dave Asprey
Guest: Dr. Justin Hooman (Urologist, Cedars-Sinai, Men's Health/Fertility/Sexual Medicine)
Episode: Your Penis Is a Longevity Organ (Here's How to Hack It) [#1430]
Date: March 12, 2026

Episode Overview

This episode dives deep into the role of male sexual health, testosterone, and reproductive biology as cornerstones of overall longevity and performance. Dave Asprey and Dr. Justin Hooman tackle the modern testosterone epidemic, erectile function, enhancement techniques, hormone optimization, and actionable biohacks – all with candor, humor, and clinical insight. The episode balances science, practical advice, and myth-busting, aiming to help listeners optimize both health span and bedroom performance.

Key Discussion Points & Insights

Declining Testosterone: Trends & Consequences

[00:00-03:21]

• Modern men have 30% lower testosterone than their fathers at the same age.
• Causes: More processed food, obesity, stress, blue light, plastics, microplastics.
• Low T linked to anxiety, depression, poor metabolic health (cholesterol, glucose), low energy, diminished libido, erectile dysfunction.
  • Quote (Dr. Hooman, 02:06):
    "A 40-year-old today, his testosterone levels are about 30% lower than a 40-year-old, like their father when he was 40 years old."

Relationship Between Testosterone and Relationships

[03:24-04:16]

• Low testosterone can harm sexual performance and relationships.
• Stable, happy relationships are associated with higher, more stable testosterone due to lower stress (cortisol).

Ejaculation Frequency, Prolactin, and "Ejaculation Hangover"

[04:16-07:02]

• Frequent ejaculation is important for fertility (keeping "the pipes clean").
• Some men may benefit from less frequent ejaculation for energy, mood, and even professional success ("ejaculation hangover" due to prolactin).
  • Quote (Dave, 06:20):
    "There's an ejaculation hangover from the prolactin...it just makes you slow, depressed."
• Sensitivity to prolactin post-orgasm varies; some experience "post-orgasmic illness syndrome (POIS)."
• "Post-nut clarity" is a real phenomenon; not fully understood neurobiologically yet.

Age, Refractory Period, and Testosterone's Role

[07:10-09:38]

• Refractory period increases with age—linked to nerve sensitivity, prolactin clearance, and declining testosterone.
• Maintaining healthy testosterone and limiting masturbation may help reduce refractory period.
• Porn-induced erectile dysfunction (ED) is rising in young men; reducing or eliminating porn can quickly improve ED.

Pharmaceutical Biohacks: Cabergoline, TRT, and Personalized Dosing

[10:22-16:27]

• Dave describes using cabergoline (a prolactin blocker) after ejaculation to maintain energy.
• Oral testosterone supplements like Kaisertrex are discussed; optimal numbers vary per individual—focus on symptom relief, not just lab values.
  • Quote (Dr. Hooman, 13:09):
    "I don't so much chase the number. My whole thing is I chase the symptoms."
• TRT dosing is influenced by individual size, symptom presentation, and method (injection vs. oral vs. cream).

Supplement Stacks for Testosterone Optimization

[16:27-20:08]

• Top recommendations: ashwagandha, tongkat ali, fadogia agrestis.
• Ashwagandha: effective for lowering cortisol and supporting test production, but can cause emotional flatness or orgasm difficulty if overused.
  • Quote (Dave, 20:08):
    "People swear by it [ashwagandha] in terms of just cooling their anxiety levels."
• Tribulus terrestris: minor effect except in bodybuilders cycling off steroids.

Psychological Factors in ED – Anxiety, Porn, Therapy

[20:39-23:30]

• In young men (<35), ED is 98% psychological, usually anxiety-based, especially post-COVID social stress.
• Social media and pornography can set unrealistic standards, fueling performance anxiety.
• Non-pharmaceutical interventions: sex therapy, mindfulness, hormone checks.

Enhancement Tech: Stem Cells, PRP, Botox, Devices, Shockwave

[23:30-34:28]

• PRP & exosomes (not stem cells) and Botox are offered for erectile function; Botox increases blood flow via smooth muscle relaxation.
• Vacuum devices, RestoreX: Can physically increase penis length (~1-2cm) with regular stretching.
• Shockwave therapy:
  • "Best option out there" for regenerative erectile enhancement—stimulates new blood vessel growth.
  • Can restore lost length due to aging/fibrosis; potential for increasing both length and girth.
• Cosmetic procedures: fat or hyaluronic acid injections for girth, penuma silicone implant. Results can be variable or uneven.

Cialis (Tadalafil) as a Longevity Drug

[34:28-36:37]

• Low-dose daily Cialis (2.5-5mg): Vascular benefits, reduces dementia risk, enhances erections with minimal side effects.
• Quote (Dave, 36:04):
  "Cialis is a longevity drug in my book... at the low dose, very well thought, and it's generic now. It's dirt cheap."
• Side effects (e.g., heartburn, back pain) mild; micro-dosing helps.

Sexual Performance Stacks & Real-time Biohacks

[36:37-40:46]

• Cialis preferred over Viagra for flexibility (Viagra must be taken on an empty stomach).
• Nitric oxide supplements (e.g., N101) amplify effect.
• Apomorphine (not related to morphine) enhances desire and blood flow, often used as a lozenge 30-60min before.
• Always "trial run" any new regimen at home first to avoid side effects at crucial moments.

Exercise, Cardio, and Libido

[40:46-41:37]

• At least 1 day of cardio (high intensity / sprints) and 2-3 days of heavy weightlifting to maintain optimal erectile health.
• Sex doesn’t quite count as cardio unless very vigorous.

Red and Near-Infrared Light Therapy

[43:14-45:16]

• Red light (660 or 850 nm) benefits penile blood flow, reduces fibrosis, and supports nocturnal erections.
• Shown to boost testicular function, sperm quality—especially relevant for fertility.
  • Biohack: Apply red light to reproductive area for 10-20 min (not too close, avoid overheating).

Heat, Plastics, and Underwear

[45:16-47:16]

• Overheating testes—saunas, hot tubs, laptops—hinders fertility and testosterone.
• Cooling (even with ice/blueberries) in sauna is beneficial.
• Natural fibers (cotton, wool) for underwear recommended; plastics (nylon, polyester) linked to decreased sperm/testosterone.

Testosterone Replacement and Fertility—Myths & Solutions

[47:16-51:30]

• Exogenous testosterone (TRT) suppresses sperm production due to FSH/LH shutdown.
• Solutions: Clomiphene, enclomiphene, or HCG can maintain fertility while on TRT.
  • Quote (Asprey, 49:17):
    "I was taking Clomid every other week... turns FSH and LH back on."
• Fertility usually returns after stopping TRT and/or using fertility drugs.

Long-term Testosterone Safety

[51:30-53:04]

• Earlier studies linking testosterone to cancer/heart disease have been widely debunked—modern research confirms lower all-cause mortality with adequate T.
• Aim for “normal” levels, not bodybuilder highs.

Natural Hormone Stacks & Circadian Timing

[53:04-55:51]

• Dave uses a stack: Crisin (aromatase inhibitor), Fadogia/Fidosia (increase FSH/LH), calcium D glucarate (clear estrogen).
• Testosterone is circadian: best dosed in the morning and at lunch.

Creatine, Overtraining, and Libido

[56:07-59:08]

• Creatine supports ATP, boosting testicular and brain energy, indirectly improving sex drive—especially when combined with exercise.
• Chronic cardio can suppress libido and fertility (marathoners = low T).

Peptides for Sexual Health

[59:08-61:41]

• Optimize hormones first, then consider peptides:
  • PT141: Increases libido, works for ~50% of men, more for older men.
  • Melanotan: Related; also boosts tanning.
  • CJC/Ipamorelin: Boosts growth hormone like Clomid does testosterone, but requires cycling and caution.

Diet for Fertility & Libido

[61:41-66:08]

• Mediterranean-style diet:
  • Breakfast: egg whites, Greek yogurt, berries, walnuts (15-20/day for sperm health)
  • Lunch: complex carb (sweet potato), salmon or chicken, veggies
  • Dinner: Red meat 2–3x/week, veggies, little evening carb
• Protein: 0.6–1g per pound bodyweight; adjust for genetics, dietary type.
• Fat: Favor grass-fed meats, butter, tallow, olive oil. Avoid processed oils.

Notable Quotes & Memorable Moments

• "That's kind of a laundry list of how to make your life suck."
  – Dave Asprey, [02:14]

• "If you don't use the penis, you lose it."
  – Dr. Hooman, [30:05]

• "I like to just use [stretching] during meetings at work because, you know... No one will see it."
  – Dave, joking about penis-lengthening devices, [29:01]

• On sauna & fertility:
  "No sauna, steam rooms, jacuzzi is what I say if you’re trying to..."
  – Dr. Hooman, [46:16]

• On plastic underwear:
  "All in all, trying to minimize that [plastics]... especially around your family jewels, you know, wearing cotton... can only help you."
  – Dr. Hooman, [47:16]

• Dave’s libido stack:
  "I take crisin... I take Fadogia, which raises FSH and LH, and I also take calcium D glucarate... and that stack seems to have worked really well for me."
  – Dave, [54:19]

• "Cialis is a longevity drug in my book.”
  – Dave, [36:04]

• “Creatine improves ATP...so it's going to be in the testes, it's going to be everywhere. So I would say it's secondary. But having more energy is good for better sex.”
  – Dave, [56:44]

Practical Protocols & Hacks (w/ Timestamps)

• Ejaculation Frequency for Fertility:
  [04:48] – Ejaculate regularly to ensure sperm health; saving up for long periods is counterproductive.

• Curbing Porn-Induced ED:
  [09:41] – Eliminate or reduce porn consumption; improvement can be rapid.

• Supplements for Testosterone:
  [16:27] – Ashwagandha (before bed), tongkat ali, fadogia agrestis.

• Red Light Therapy:
  [44:54] – Use 660/850nm red light for 10–20 minutes (not too close), especially before bed for fertility/erection health.

• Protecting Fertility on TRT:
  [48:10] – Combine TRT with Clomid or HCG to maintain sperm function.

• Low-dose Cialis for Vascular Health:
  [34:28] – 2.5mg or 5mg "microdosed" daily for systemic benefits; can reduce risks of vascular dementia and cardiac disease.

• Workout for Optimal Sexual Health:
  [41:15] – At least 1 day/week cardio (HIIT/sprints) + 2–3 days heavy resistance training.

• Testosterone Stack:
  [54:19] – Crisin (blocks estrogen conversion), Fadogia (raises FSH/LH), calcium D-glucarate (estrogen clearance).

• Cool the Testicles:
  [45:16] – In sauna/hot environments, ice/cooling packs preserve testosterone and fertility.

Additional Resources

• Dr. Justin Hooman's Website:
  houmanmd.com

• Get Your Hormones Tested:
  axohealth.com (Upgrade Labs)

Episode Takeaways

• Sexual health is central to male longevity: Optimize testosterone for mind, mood, heart, and reproductive function.
• Lifestyle is the best foundation: Move, sleep, limit plastics, eat clean, and manage stress.
• Don’t chase bloodwork values—track symptoms.
• Modern enhancement options are powerful, but basics come first.
• Testosterone therapy is safe when done with knowledge for both health and fertility.
• Frequent, open-minded discussions (even about taboo topics) unlock better health outcomes.

For Further Learning

• Explore previous and upcoming episodes focusing on mitochondrial health, hormone optimization, peptides, sleep, and advanced sexual performance biohacks on The Human Upgrade with Dave Asprey.