In this episode, I'm back with urologist Dr. Amy Pearlman for part two of our conversation. We start with a question I hear all the time: does ejaculating often protect your prostate? She walks me through the research, why masturbation counts, and the plant-forward way of eating that protects your prostate along with every other organ.
Then we get into prostate cancer. Dr. Pearlman explains why most men die with it rather than from it, when active surveillance makes sense, and why you should get more than one opinion before choosing a treatment. Most importantly, she explains how men can protect their sex lives: starting penile rehab before surgery, seeing a pelvic floor physical therapist, practicing with a vacuum pump, and using Trimix injections when Viagra and Cialis aren't enough. She even believes many men can have the best sex of their lives after treatment.
We finish with penis size. Dr. Pearlman shares why she asks every patient about size concerns, what traction therapy can realistically do for length, why she uses dissolvable hyaluronic acid for girth enhancement, and why you should always ask what the worst-case scenario is before any procedure. Her final advice: go to every appointment prepared, with a list of questions and a goal.
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In This Episode:
00:00 – Intro
00:45 – Does ejaculating more protect your prostate?
02:05 – The diet that protects your prostate (and every other organ)
03:18 – Prostate cancer and your sex life
04:26 – Active surveillance: when you don't need treatment yet
05:00 – Why prostate cancer usually has no symptoms
06:14 – Your treatment options, and why to get more than one opinion
07:44 – Why penile rehab starts before surgery
08:24 – Pelvic floor PT before prostate surgery
09:26 – Learning the vacuum pump before you need it
10:00 – Trimix: penile injections explained
11:08 – How men learn to do their first injection
12:05 – Why injections work when Viagra doesn't
13:46 – Better sex after prostate cancer?
15:23 – Why men are obsessed with penis size
17:16 – Girth enhancement with hyaluronic acid
20:00 – Can you actually gain length?
21:30 – The worst-case question before any procedure
22:38 – What is Phallofill?
25:11 – Use ChatGPT to prep for your doctor's visit
26:47 – Where to find Dr. Amy Pearlman
27:38 – 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
YouTube: @DocAmyUrology
Podcast: Fertility and Other F Words
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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