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59: Men's Health Essentials — Erectile Disfunction and Your Health

Nov 03, 2020

It's a common problem that is generally easily solved. Urologist Dr. John Smith talks about how he diagnoses and treats erectile dysfunction. He also tells us why, even though men can get pills on the Internet, they should still see their doctor.

Episode Transcript

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Here we go. Did I maintain? Troy, are you still there?

Troy: I'm here.

Scot: Dr. John Smith, you there?

Dr. Smith: I am here.

Scot: Did you hear John, Troy?

Troy: What?

Scot: Did you hear John, Troy?

Troy: Yes.

Scot: Troy, did you hear John? John, did you hear Troy?

Dr. Smith: I hear everything.

Troy: I think we're good, Scot.

Scot: Okay. Here we go. The podcast is called "Who Cares About Men's Health," providing information, inspiration, and motivation to understand and engage in your health so you feel better today and in the future. My name is Scot Singpiel. I am the manager of, and I care about men's health.

Troy: And I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah, and I care about men's health.

Dr. Smith: And I'm Dr. John Smith, a non-surgical urologist at the University of Utah, and I care about men's health.

Scot: Second time we've had Dr. Smith on the show. The first time, Troy, it took a little warming up to Dr. Smith, but finally at the end of the episode, gave him some applause. So we've become fast friends. It's great to have you back on the show, Dr. Smith. Sure do appreciate you coming on and talking about some urology, urological sort of issues.

Dr. Smith: Thanks for having me back.

Scot: Quick question before we get to the topic, and today we're going to talk about erectile dysfunction because Dr. Smith was telling me that that's a reason, one of the reasons, one of the big things that he sees on a daily basis is guys coming in with some sort of an issue. So we're going to talk about that. We're going to give you the real information. So it's not like you're getting it from the friends on the playground. That's the internet, by the way, in case you're not catching my reference there. You're going to get it actually from the doctor's mouth. So that's going to be awesome.

Troy, I have a question for you. So at one point, you talked about how in the ER, you call urologists sometimes to do some procedures.

Troy: We do.

Scot: What are some of the reasons that you have urologists come to the ER? One time you said that if you're having difficulty inserting a catheter, you might have to have a urologist come and then do that for you. What other reasons?

Troy: Sometimes we call them for kidney stones. That's probably one of the more common reasons. If it's a very large stone that's just likely not going to pass on its own or an infected stone where the patient has a big kidney stone, or even a smaller kidney stone and a bladder infection, kidney infection, along with it. We do call them for trauma-related injuries, whether that's a tear of the urethra or sometimes even a penile fracture. Scot, you may hear that and say, "Wait, is there a bone in the penis that gets fractured?"

Scot: There's not.

Troy: Was that your thought?

Scot: I mean, I know there's not though. I mean, sixth grade Scot would have thought that.

Troy: Sixth grade Scot.

Dr. Smith: Seventh grade Scot knew better.

Troy: He wised up quickly.

Scot: He did.

Troy: It's referred to as a penile fracture. It's a tear in . . . John can describe it in more detail, but a tear in the . . .

Scot: Or not.

Troy: It's an incredibly painful thing. I will say that. Having seen men with penile fractures, it looks incredibly painful. So we will call them for that as well.

I will say along the lines of erectile dysfunction, I was working a night shift once and a man came in at 6 a.m. and he said, "My woman said, 'You leave the house and you go to the ER and you don't come back until you get that fixed.'" We did not call urology for that. We didn't do that to them. But I have seen "erectile dysfunction" emergencies, at least in the mind of the individual in the ER, as well. So again, I did not call urology and push that on them, but it would have been funny.

Scot: Dr. Smith, you would actually handle some of that stuff though, even though you don't necessarily go into the ER. But don't they use . . . for kidney stones, don't they use sound waves now for a lot of that sort of thing?

Dr. Smith: So they can. There are multiple different ways to treat kidney stones. We could probably do a show on that, but . . .

Scot: Well, let's do that.

Dr. Smith: Fair enough. I'll come back.

Scot: Not right now, but yeah, someday. We've got more pressing topics to get to.

Dr. Smith: That's fair. But yeah, there is something called a lithotripsy. and they use a machine where they put a little bag of . . . it feels like a bag of water, like a gel bag, against your back and they find the stone with an X-ray and then they send shockwaves in to break it up.

Scot: Wow. That's pretty cool. Technology is awesome. So let's talk about erectile dysfunction, one of the main reasons guys come and see you. Just want to break it on down. So help us kind of understand what's going on, what you as a urologist do to help men solve their problem, and I think, in general, makes men that are struggling with this feel that it's okay because it is okay.

Dr. Smith: It is okay.

Scot: Yeah, so where should we even start this conversation? I'm not good with sensitive conversations.

Dr. Smith: You just start by digging in. There's no way to just waltz around this thing and hope that it comes to you. I would say a lot of men come in with erectile dysfunction. It can be a . . . well, there are multiple different reasons, but overall erectile dysfunction, the definition of it is the inability to achieve or maintain an erection that's adequate for sexual function.

And so it's estimated that about 18 million men in the United States have erectile dysfunction. So guys, you're not alone. That's a pretty sizable number. Some of them seek treatment, some don't. This condition can affect people in a lot of different ways in their relationships. So it's one of those things where you might as well come in and have a conversation.

Scot: So it's not just about erectile dysfunction. It can cause psychological issues. Are there other health issues that men should be aware of?

Dr. Smith: Sure. So it can be a harbinger of cardiovascular problems, other things like that. Folks with longstanding diabetes often have erectile issues. There are multiple health problems that can cause or precipitate erectile dysfunction. And so those are good reasons to come in as well.

Scot: So my ability to not get or maintain an erection is not because I've become less of a man. It could actually be a medical symptom to a bigger problem, or it could just be mental. What are some of the other causes?

Dr. Smith: Absolutely. So it could be psychogenic, which means that . . . guys like to think if it doesn't work once, it's never going to work again. And so that brings in some gentlemen. Again, diabetes can be a problem, people with known vascular problems, people who've had prostate cancer and had surgery or radiation oftentimes have a decreased quality of erections.

And then sometimes we don't know. We call it idiopathic. There's not a reason for you to have erectile dysfunction but you do. It's not necessarily an age thing, but as men age, generally, the quality of their erection declines some.

But those are kind of the things that we kind of overview with folks when they come in to have a chitchat.

Troy: John, it sounds like there are a lot of different things that maybe could cause it. But how do you really determine if someone has erectile dysfunction? What do you use just to say, "Yeah, it sounds like this is definitely an erectile dysfunction," versus, "Maybe you don't have a problem"?

Dr. Smith: So, generally, I ask a few questions. "Do you have a decreased ability to attain or maintain an erection?" Oftentimes, it's not one or the other. It's both for folks. I ask them how rigid their erection is compared to an erection that they had when they were having quality erections. And one of the big ones for most people is, "Is it adequate for sexual function?" And so if it's not, that's a good indication that it's erectile dysfunction. That's true erectile dysfunction.

Scot: And when a guy comes in and you ask him the questions, how often is the next word out of his mouth or the first word actually when he even walks into your office, "Yeah, I have a problem and I need some pills"? I mean, is that kind of the first thing that you get asked?

Dr. Smith: Not always. Some men come in and that's kind of what they want, and in a way, that's not a bad way to look at it because the pills generally work for all comers of erectile dysfunction. It doesn't matter why you have it. Seventy percent to 80% of patients with erectile dysfunction are treated adequately with medication. So again, that's not a bad way to go, but it does warrant a little bit of investigation at times.

Scot: So there are two different types, it sounds like, getting and maintaining, and then maybe even a third, having the quality of an erection that is adequate enough for sex. You give the man the pills, and then you send him on his way. Is that that, or are there other potential treatments that you might have to look at?

Dr. Smith: If you're going to come to me, I'll generally do a workup for you. The American Urologic Association has guidelines that they put out for everything, and I tend to try to follow those guidelines. One of them is to make sure that there's not a hormonal issue. I'll check a hypogonadism panel, make sure that everything's working as far as testosterone, hormones, things like that.

If I feel like after getting a history from you that there's maybe a cardiac issue, or you're a diabetic that may struggle with controlling your diabetes, I may refer you back to other folks before we get you started on medications, things like that.

But generally, looking at all those reasons, it's not just as simple as saying, "Here are some pills. Go and let me know how it works out." But in certain cases where we do the workup and we don't really find a reason and they do well with pills, it's not a bad way to treat them as long as we work it up and look at it the right way.

Troy: Speaking of pills, John, and the workup you mentioned, I'm sure we've all seen the ads on TV. You're seeing them more and more now, especially if you watch sports, for some of these online things where you basically, it sounds like, probably chat online with someone and then get medication for erectile dysfunction. What's your thought on that? Is that a reasonable route to go for someone who's maybe embarrassed to go into see a physician or any insight into that?

Dr. Smith: I think those companies have a place. One of the companies, I think one of the guys that started it actually had a cardiac issue and that's why he had erectile dysfunction. So they kind of mention that in some of their advertising where it makes sense to maybe talk to your primary doctor as well.

The big thing for me is making sure that people are taken care of the right way. If you were my dad or my brother, how would I want you treated? And I think that sometimes those guys may miss some steps. I've never used them to know a 100%, but I think looking at everything as a whole and making sure that there's not some underlying problem is important.

However, if it's impacting your relationship or there are different reasons, I could see a reason why you would utilize those services. No question.

Scot: You said the pills take care of a majority of men's problems. In the instance that pills don't work, what do you start looking at, at that point?

Dr. Smith: So in general, the algorithm that I use is if oral medication isn't effective, I'll generally refer you to have an ultrasound done, a penile Doppler ultrasound where I'll look for a possible cause of your erectile dysfunction at that point.

And the reason that I don't do that first is it requires us . . . we usually do it with a medication called Trimix, which is three medications that will produce an artificial erection. And most men aren't jumping to get a needle put into their penis. Granted it's a small needle, it's like a diabetic needle that you would use, but most men aren't interested in trying that first.

So I'll generally look at that next and see if I can come up with the actual reason that they may have an issue, and see if there's a blood flow problem and different things like that. And then after that, the options that we have for treatment are, again, if that medication works well to give an artificial erection, you can continue to use that. And then there are other surgical options that are out there as well.

Troy: John, I guess getting back at treatment, obviously medication, injections, surgical options, what if someone comes to you and just says, "Hey, I just don't like taking medications. Is there anything else I can do?" Is there anything you recommend in that situation, or do you just say, "Probably want to try some pills first"?

Dr. Smith: So there are always things you can do. Diet and exercise has been shown to be effective in helping mild erectile dysfunction, to improve the quality of an erection. It's not as effective as medication, as the Viagra/Cialis/Levitra medications, but it has been shown to provide some benefit to improving the quality of erection.

And I think the whole purpose of this podcast is "Who Cares About Men's Health" and you guys often speak about taking care of yourself. And I think if we're all smart about that and we take care of ourselves and take care of our diet, different things like that, make sure that we're healthy, it does improve the quality of your sexual function.

Scot: Does the pill also help in the instances of maintaining or can that be other things?

Dr. Smith: Absolutely. So for some folks who have difficulty maintaining, sometimes a constriction band . . . the layman's term that everyone uses is a cock ring. You can utilize that to help maintain an erection if you have a venous leak where more outflow of blood is coming out of the penis than the inflow can support. And that can be very effective for men with that issue. I would say that's a lower percentage of the patients that you see with erectile dysfunction, but when it works, it works really well for folks.

Troy: Too many stories from the ER with the cock ring, too many. We won't go there. Like things gone wrong, but we won't go there.

Dr. Smith: I'll give you a two-second story that you can edit out.

Troy: Or not.

Dr. Smith: We took a family vacation when I was in residency, out to Hersheypark. I was in New York, so it was a close drive. And we stayed in a hotel, went to Hersheypark the next day. We were going for two days, which if you ever go, don't go for two days. You only need one.

Troy: Been there.

Dr. Smith: But I wake up in the morning, we're getting ready to go to the park, and my kid comes over and she goes, "Dad, look at this ring I found in the drawer." And it's this silicone, spiky little ring. And my wife's jaw just drops. I look over and I go, "Drop it and go wash your hands immediately, child."

Troy: Our department chair in residency was doing teaching rounds. And they had a patient whose complaint was he had a cock ring on, he couldn't get it off, and the department chair did not know what a cock ring was. All the residents there were just totally silent, did not say a word to try and tell him, "This is what it is." He says, "So we'll just look this up," and goes over to the computer and types in and all these images just start coming up. And it's like, "Oh, okay. Let's shut this down." Anyway, yeah, we've seen some crazy things.

Scot: I feel a little left out. I'm the only one without a story.

Troy: Scot, you can make one up. You could just tell one.

Scot: I haven't lived apparently because I don't have a story to share. Both of you sound like you've got even more of them and I have none.

Troy: Unfortunately, yes. But we won't go there.

Scot: Troy, actually I do want to ask you, do you have any advice if somebody is using one, based on what you've seen in the ER, that you want to avoid?

Troy: My advice . . .

Scot: Are we going to get into some argument here with Dr. Smith about you don't think they're safe and he says they are?

Troy: I don't think Dr. Smith will argue with this. My one piece of advice is if you use a cock ring, don't leave it on for three days. It's a bad idea.

Dr. Smith: That's a fact.

Troy: It's a bad idea. I think we're all on the same page there.

Dr. Smith: A hundred percent. Follow the directions.

Scot: Oh, they come with directions?

Troy: Read the directions.

Dr. Smith: Well, they should come with directions. If they don't, you should probably get one that does.

Scot: Have we covered the topic well enough? I mean, I don't know for sure. It seems like we've covered the important points that somebody might have. Did we leave anything out, Dr. Smith?

Dr. Smith: I talk about this all day, every day, so there's always plenty more to talk about, but I think that gets the ball rolling. If you haven't seen a urologist by that point, you probably should.

Scot: Sounds good. And if you have further specific questions, of course, you can reach out to us here at the "Who Cares About Men's Health" podcast. A lot of different ways to do it, which we will put in the links to the show notes, including You can call our scope line 601-55SCOPE. You can do Facebook direct messages, and you can use the name John Smith and just asking for a friend if you feel a little shy about the whole thing.

You know what? I'm proud of us. We really more or less got through this without making a lot of jokes. We've kept the jokes to a minimum, so that's good. Or is that bad? It could be bad.

Dr. Smith: I mean, it depends on the viewership, what they think. If they wanted more jokes, they should probably ask for them.

Scot: Do you find when a man comes in to talk to you about erectile dysfunction that they tend to have a little bit of a different personality? Do they tend to deal with it by joking a lot more than you think they might normally in real life? I mean, what's the demeanor of your average patient?

Dr. Smith: Average patient I would say comes in a little bit gun-shy. Most of them don't want to come in and talk about it, especially the older generation of men that I see in the office. The ones that are just "throw caution to the wind" don't care are generally the guys who've had prostate cancer, where they were told before they had their treatment that this is likely going to cause erectile dysfunction. So they come in and they're like, "Hey, I just had surgery. I have erectile dysfunction. What are you going to do?"

Scot: And it makes sense, because they've got a medical reason now. Getting back to this whole stigma about "Are you less of a man if you can't get it up?" and those sorts of things, there's not a stigma there anymore, right?

Dr. Smith: Right.

Scot: There was a medical procedure that was done beyond their control that caused this to happen.

Dr. Smith: Right. They've already been through a wild roller coaster of being diagnosed with cancer and the unknown there. And so a lot of times they're coming in and they're just like, "Hey, is there anything we can do? I hope so." But they're very happy to kind of be through that mental roller coaster.

Troy: John, along those lines, you mentioned our listenership. A large number of our listeners are women. How often do you have where people are coming in with their significant other, or they say they've been encouraged to come in? Is that something you see often?

Dr. Smith: Prior to the pandemic, yes. A lot of couples would come in together. And oftentimes, the spouse/partner is very supportive of the individual coming in because that intimacy is an important part of their relationship that they've kind of lost and they want it back. And so I did see quite a bit of that.

Now, with the visitor policies and things being different after the pandemic, I've even had a couple of patients say, "Hey, can we FaceTime or can we WhatsApp or whatever with my partner so that we can have this conversation together?" so they're all on the same page, which is great.

Scot: Dr. Smith, as we wrap this up, just kind of give us your final thought. I think you've given the men that listen to this show that might be suffering from this problem hopefully some good information to go seek help and know what to expect. But any kind of final thoughts on this for a guy that's on the fence?

Dr. Smith: There's just no reason to feel bad in any way about it. This is a normal thing. Like I said earlier, 18 million men in the United States have this issue, so you're one of a big group. And there's no reason to wait to feel better and improve your relationships and your confidence in that area.

Scot: Fine work. Thank you so much for being on the podcast, Dr. Smith, and thank you for caring about men's health.

Time for "Odds and Ends" on "Who Cares About Men's Health." We just have one item, and that is in reference to last week's episode about kettlebells. Possibly something you might want to do. A lot of people, their gyms are closed, or you don't want to go to the gym. That was certainly the situation I found myself in. I also used to do just traditional weight training, and I wanted to see if I can get more of a full body, natural movement sort of exercise routine going. So I wanted to do kettlebells, and Caleb helped get me started.

Troy, I'm happy to report that those kettlebells that I bought in that parking lot at the Walgreens in Bountiful, Utah, looked like some sort of a drug deal going down, but no, it was for kettlebells. I have started sniffing around them kind of like a dog sniffs around stuff. So I have started using them. I've started implementing some of the swings and the squats and the deadlifts that Caleb recommended.

And I'll tell you, I really like them. Now, I'm moving really slowly because it's a different type of exercise than I've done before. So I'm watching how heavy of a weight I'm using. I'm also just really not trying to do too many reps.

I've got a really light one up in my office. So I take little breaks while I'm working. I stand up, because you can sit for so long, and I'll do some exercises with that little light, 10-pound one. I've got an 18-pound one in the office. And then the big boys, those are out in the garage and I go outside and I do the swings and the cleans . . .

Troy: Your 35-pounders?

Scot: Yeah, and my full pood as they call it in Kettlebells. The 35 pounds is called a pood.

Troy: That's when you swing the pood in the garage.

Scot: Well, I do it out in the backyard. But I am really enjoying it, and I just wanted to update you that I'm really digging kettlebells. So if you haven't been doing some sort of strength training routine, and they say you should do 30 minutes at least three times a week of strength training, go back and listen to the last episode about kettlebells. Get some do's and don'ts, get a basic little routine, and check out that episode.

Troy: Well, I have not bought my kettlebells yet, but it was very convincing. I'm thinking about it. Like you said, supply and demand right now. Supply is not in our favor. Demand is definitely high. So it's a challenge getting kettlebells right now, but I would like to try them out.

Scot: I highly recommend it.

Troy: I would sing it, but I . . .

Scot: Na-na-na-na-na-na-na-na.

Troy: Thunder!

Scot: Troy, do the honors of singing, "You've been Thunder debunked!"

Troy: I can't do that, Scot. Come on.

Scot: Thunder debunked!

Troy: I kind of have to maintain some sense of dignity.

Scot: Thunder debunked!

Troy: I'm sorry. I can't. I think you already did it.

Scot: Eat this. Don't eat that. It can be really confusing out there when it comes to nutrition, and there's a lot of stuff on the internet. Is it true or is it false? Well, we're going to try to find out again with Thunder Jalili. He's our nutrition expert here on the "Who Cares About Men's Health" podcast. And this is a segment we call "Truth or Thunder Debunked?" So I'm going to give Thunder a statement here and I want him to tell us if it's truth or if he is going to Thunder Debunk it.

Frozen fruits and vegetables are less nutritious than fresh ones. Truth or Thunder Debunked?

Dr. Jalili: I'm going to have to go with Thunder Debunked on that one.

Troy: That surprises me.

Dr. Jalili: Depending on the context, it could be somewhat similar. Let me just give you a really quick background. So if we think about fresh fruits and vegetables that you buy in your grocery store, you've got to remember that product is not as fresh as you think. It was probably picked days or weeks before it found its way to the grocery store, and it was probably picked before it was ripe and it ripened during transit and delivery. So that means you're probably not getting the optimal nutrients in that in the first place.

Now, frozen fruits and vegetables, they're picked when they're actually ripe and then they're subjected to the freezing process. And so they may have a little better nutrient content. But of course, the process of freezing them and blanching them, that may degrade some of the nutrients.

So at the end of the day, when you look at both, they're about the same.

Now, the one exception for fresh is if you have a farmer's market close to you and you go there to buy fruits and vegetables, chances are you're buying something that was just picked in the last couple of days. In that case, that is the most nutritious version of the fruit or vegetable you can get because a ripe fruit has the peak nutrient content. And those were picked when they were ripe before they came to the farmer's market.

Scot: So the statement as it stands, frozen fruits and vegetables are less nutritious than fresh ones, again, Thunder Modified.

Troy: Thunder Modified. It sounds like if you've got the fruit tree in your backyard and you're picking it off the fruit tree and eating it, that's the best you can get. But otherwise . . .

Dr. Jalili: That's the best you can get. Or farmer's market. You've got to make a pitch for farmer's markets, especially when stuff is in season. That's really the highest quality produce you're going to find anywhere.

Scot: Fascinating, though, that frozen fruits and vegetables and fresh ones that you perhaps might get at the grocery store because they were picked and ripened on transit are essentially equal though.

Thunder, as always, thank you very much. We appreciate your participation on the "Who Cares About Men's Health" podcast with "Truth or Thunder Debunked?"

Time for "Just Going To Leave This Here" on "Who Cares About Men's Health." Could be something to do with health, might be something random. I'm going to start.

Just going to leave this here. I am going to encourage you, Troy and our listeners, to unleash your inner puppy. I want you to unleash your inner puppy.

So we have a brand-new puppy. His name is Murphy. I say puppy. He's in the body of an adult dog at this point. He's six months old. You look at him and it's hard to remember this is still a puppy. He behaves like an adult dog, but every once in a while you see the puppy in him. And the moment you see the puppy in him is like when we're outside and he will find a leaf and pick it up and throw it around and chase it and bite it and try to keep it away from you.

There are other little moments where he does puppy things, and that made me think back to times that we've talked about that for your own sanity and mental health, you should play.

And whether that's a hobby that you get into that flow state because you enjoy it so much, whether that's a sport that you like to play either by yourself or with other individuals, I think we forget to play. And we forget the benefits of playing on our mental health and our emotional health.

I've talked to psychiatrists who say that this can actually recharge you. We always talk about taking days off or vacations to recharge you, but it's also about what you do. So I'm encouraging you to release that inner puppy because it can help you unwind and be ready to take on what's going to happen the next day or the next week.

I can speak from personal experience that I find myself recharged after doing that. And maybe if you have kids, maybe that just means when you play with them, just get totally lost in it. Just get totally lost as a kid in it. And it can be hard because our adult brains kick in and we go, "Oh, I'm being silly. I'm being stupid." But just try it. Unleash your inner puppy.

Troy: Great advice. Well, since you have a new puppy, Scot, I'm going to share my puppy advice with you. We have Charlotte who you know. She's a pretty young dog. We guess she was probably maybe eight or nine months old when we got her. She had puppies herself, but we joked that she was like a teenage mom. She wanted nothing to do with her puppies. She'd feed them and then she would come up and play. She was a very young dog.

And Charlotte had a habit, and still has a habit, of eating our remote control for our TV. So what I do now is I keep a spare remote. The original remote I was trying to buy . . . I bought this stupid magic remote a couple of times that cost $50 after she ate it. And then I just said, "Forget it," and found some cheap $8 remote on Amazon.

So each time she eats the remote, I buy a new remote, and I then have a spare remote for when she eats the next remote. So then it takes us a week to get the next remote.

The good news is, I just looked, we've gone through three months now without her eating a remote. So I hope your puppy does not eat your remotes, but if you do, I can share my advice on stocking on remotes and making sure you have a steady supply so you can continue to watch your TV with your puppy.

Scot: Our dog does have a little bit of a chewing thing, but we've kept just chew toys around, and so far that has satiated his need to chew. So we'll see.

Troy: Good. That's great.

Scot: We'll see. But good advice on the remote.

Time to say the things that you say at the end of podcasts, because we are at the end of our podcast. Troy, kick it off with the how you can hear us. Of course, that's kind of redundant because somebody is hearing us right now. They already know.

Troy: Well, you can subscribe. Please subscribe anywhere you get your podcasts, whether it's Google Play, iTunes, Spotify, Stitcher, Pocket Casts. I'm going to mention Pocket Casts, Scot, because you don't like them but my sister uses Pocket Casts.

Scot: So does Producer Mitch.

Troy: So does Producer Mitch.

Scot: They're like the four people that . . . or two people. They're two of the four.

Troy: Two of the four who are still using . . . they probably still have Hotmail accounts as well. Actually, Hotmail doesn't even exist anymore I found out.

Scot: AOL accounts, they probably have.

Troy: Yeah, they have AOL accounts.

Scot: All right. And also then if you want to get in contact with us, there's a couple of ways to do that. And that entails if you have a question you want to ask about a health topic, a suggestion, anything of that nature, That's the email. The Facebook page is And there's also a phone number you can leave a recorded message, and that's 601-55SCOPE. That's 601-55SCOPE. Whatever you're comfortable with, we would love it if you'd reach out and say hi.

Thanks for listening and thanks for caring about men's health.