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 dysfunctionTestosterone therapy: expert insights on dosing, formulations (oral vs injectable), and patient selectionAmino acids, peptides, and biologics: what they are, how they work, and where they fit in clinical practiceThe rise of peptides: regulatory changes, including reclassification during a prior U.S. presidential administration, and why demand is explodingBig Pharma vs compounding pharmacies: the growing tension shaping access to peptides and hormone therapiesPerformance-enhancing drugs and “bro science”: what clinicians can learn while prioritizing safety and evidence-based careShockwave therapy for ED: mechanisms of action, clinical evidence, and real-world outcomesKey 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 optionsPeptide 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 pharmaciesNot all compounding pharmacies are created equal—quality, sterility, and third-party testing vary widely and directly impact patient safetyThe ongoing tension between Big Pharma and compounding pharmacies is reshaping access to hormones, peptides, and regenerative therapiesA harm-reduction approach is essential when managing men using testosterone or performance-enhancing compounds—prioritizing education, monitoring, and long-term health outcomesTo 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.
