Treating sexual dysfunction with regenerative medicine and a holistic approach? If you thought the little blue pill (or one of its many competitors) was the path to sexual function, you will want to listen to Dr. Farshad Shafizadeh. Dr. Shafizadeh is a urologist based in New York City who specializes in male and female sexual dysfunction and he will change how you think about the way it should be treated.

In this deep dive, you will learn …

Introduction and what Dr. Shafizadeh does (0:00)

• The role Viagra has played in sexual dysfunction solution awareness
• Sexual dysfunction includes men and women
• Happy life, happy sex life

Treating the condition, not just the sexual organs (5:10)

• Viagra is a Band-Aid
• Modern medicine has failed us
• His focus is on regenerative medicine
• General wellness and diet for treating sexual dysfunction

How does Dr. Shafizadeh treat his patients (15:11)

• Identifying causes through full medical evaluation
• Penile doppler study to test blood flow to the penis
• Make the determination if the patient is a candidate for regenerative treatment
• How platelets are used and their impact

Reversing the age of the penis and outcomes (18:38)

• Exosomes and stem cell injections
• Prescription pills vs restoring penile tissue
• When can a patient expect to see results?
• How much of an improvement will there be?
• Using shockwaves as a treatment
• How it works and what it does

Non-Physical affects of sexual dysfunction (27:28)

• Mental impact, relationship impact, professional impact

Female sexual dysfunction (29:44)

• How men are different from men
• Physical vs psychological
• Hormonal fluctuations
• What gets treated and how
• Male vs female orgasm

The role of happiness in sexual function (38:15)

• Enjoyment and the goal of this treatment
• The connection to longevity

The three things that are free and will improve sexual function immediately (43:11)

• Eat fewer carbohydrates
• Exercise
• Meditation

Full Transcript

Dr. Shafizadeh: 00:00

My name is Farshad Shafizadeh. I’m a general urologist in a practice in New York City for almost 20 years. I work at New York Presbyterian as well. My area of expertise is in male and female sexual dysfunction. And I’m also a female pelvic medicine and reconstructive surgeon, board certified in both. My focus of practice mainly treatment of both male and female sexual dysfunction. It’s very interesting. The whole thing started almost 20 years ago when Viagra came in the picture. And the whole field of medicine, especially urology, changed into the treatment of male sexual dysfunction. And by that, means that everything became so simple.

Dr. Shafizadeh: 00:50

We thought that just writing a prescription for Viagra would solve everything. And that by itself created a major problem. It became like a bandaid to any wound, and we forgot about the female side, because as long as we could keep the men happy, that’s all matters. And the second problem is that once Viagra came, we forgot to really go deeper to find out what’s causing the problem. And instead of treating the cause, we just like giving a Tylenol to somebody who has no fever. And that slows us down in terms of how we’re gonna treat the problem for people not needing to take the medication in order to perform.

Dr. Shafizadeh: 01:45

And the whole field of sexual dysfunction for men and women is not just performance. In order to have a happy sexual life, everything has to be in the right spot. You have to have a good life. You have to have the good health. You have to be in the right mood. For women particularly, the environment has to be right. Okay? And if you’re stressed, you’re overworked, your life is not good, you’re having a lot of medical problems, issues, your sexual life is not gonna be happy. It’s not gonna be a good sexual life. It’s not gonna be satisfactory.

Dr. Shafizadeh: 02:28

So in order to treat people who have sexual dysfunction, I’m saying the dysfunction, it’s not an illness. It’s all your life. Everything has to be right in order to be happy sexually. On the other hand, having a happy sexual life, that means that your entire life is in order. Okay? Imagine your life is like going on vacation. You go two, three, four times a year on a family vacation, or you take a vacation time from work time. And that’s the time that you enjoy the most, probably. You work three, four months looking forward, “I’m going away in Cancun or here, there for one week.”

Dr. Shafizadeh: 03:18

That’s not our life is all about. You have to live your life as if you’re on vacation every single day of your life. You have to work to carry this vacation. You cannot just live in order to work. And this is what we do right now. And that’s the main problem for patients who have very poor sexual life, because we see them all when you get deep into their life, you realize that what’s really the main problem? Yesterday I saw this patient. He’s 40 year old, has absolutely no medical problems, and he’s been having sexual problems.

Dr. Shafizadeh: 04:03

He asks me, “Doctor, why am I having this problem?” And I say, “I’m checking everything. I can’t find a problem.” There is no medical reason. I can never find a problem, because the problem that he has is not medical. His entire life is a problem. Okay? And you have to address that. My vision is creating a center who patients coming in. And, not just getting them medication and walk out. Create a center that we can address every aspect of their lives. Place that you can focus in your diet, your exercise, your activities, the way you carry your work, your relations with your friends and people, relationship between you and your partner.

Dr. Shafizadeh: 05:10

Everything has to be addressed. That’s the main focus of my practice, not just patients coming in and taking medication and walk out. Okay? It’s very easy to write a prescription. The second thing I am, again, will go back to what I said before is the whole concept of Viagra. You know, when Viagra came in, everything changed. Instead of focusing on treating the cause of a problem, we start just Band-Aid-ing the problem. When Viagra came, market became so hot that we had Cialis, that we had Levitra. All these drugs came in to help you to have an erection, but none of these medications treat the condition.

Dr. Shafizadeh: 06:02

Now, modern medicine absolutely failed men and women with sexual dysfunction, absolutely. The patients coming in, if medication, Viagra doesn’t work, then what’s the next step? We do injection therapy. You’re walking around with this syringe, with these medications, some of them very painful, inject yourself into the penis in order to have an erection. What kind of, conceptually this is what I do. I give these people these prescription every day, five, six, 10 times a day. And I teach them how to give yourself an injection.

Dr. Shafizadeh: 06:41

Oh, doesn’t hurt. It’s crazy. And then if that doesn’t work, what’s the next step? Going into the operating room, putting in penal implants. Penal implant is great. It’s 95% satisfaction. But it’s like walking around with a prosthesis, walking around. Yeah, you walk. You can even run a marathon. But you could have had your leg, you could have your sexual function back if the problem has been addressed properly. So our focus here is to get into more of a regenerative concept, because from modern medicine’s standpoints, we are doing nothing.

Dr. Shafizadeh: 07:32

We are going to try to focus on the stem cell therapy, focus in the regenerative medicine to improve both male and female sexual disorder. So when you go back into the concept of ED for men’s side, what are the problems? Main problem is blood flow issue. Okay? Any kind of disease, chronic conditions that you have, I wouldn’t call it disease, a chronic condition that you have, diabetes, high blood pressure, high cholesterol, the first thing they do, damage the microvascular. So it damages the blood flow to the certain organs could be …

Dr. Shafizadeh: 08:20

The organs are your heart, your kidneys, blood flow to your toes, and also to your sexual organs. Okay? When they, patients with chronic conditions coming in with erectile dysfunction, the first thing we look into is that do they have any heart problems. And the young men coming in, when I come into my office and seeking help, we do a test caused penile doppler study, and we see that there is a decrease in the blood flow to the penis. The first thing I think is that where else they’re having a problem. And the most important organ is what? Your heart.

Dr. Shafizadeh: 09:03

So overwhelmingly when you go through a cardiac assessment you find out they also have coronary artery disease, they have some other issues. So the problem is your entire body. Erectile dysfunction is a sign which something is wrong. Okay? And when something is wrong, what we do today is just give Viagra. It’s crazy. So we need to go back and treat. What we do here, obviously, they go to a comprehensive vascular assessment to see if there is any other problems. We have to address those. Diabetes has to be well-controlled, cholesterol well-controlled.

Dr. Shafizadeh: 09:56

And none of just medication is not the answer. You really have to change your diet. You have to change your lifestyle. You have to get into exercise habit. And more importantly mentally you have to change. Okay? And this is the whole concept of wellness centers coming in the picture. People have to change their life in order to change their diet, in order to get into exercise habit, in order to reduce the amount of medications they take in a daily basis, so they can get better. It’s regenerative, going back. We want to carry you from where you are to where you were before.

Dr. Shafizadeh: 10:47

And that’s the goal for us, that bring you back where you were in your 20’s and 30’s when you were most vibrant in your life. And go back in the treatment of erectile dysfunction, we’re focusing on a special treatments of bodies, self, healing. Your body is potentially very strong in healing its problems. Your body fights cancer every day. You walk in the street. Sunlight damages your skin. Cancer cells produced every day. You create cancer cells every day as you walk in the street, exposure to radiations, so forth.

Dr. Shafizadeh: 11:37

Your immune system goes and destroy these cells and sometimes they fail, and that’s where the cancer comes from that. But really is your body has the ability. You cut your finger, three days later the wound has healed. All the stem cells coming in and rebuild the tissue. And so the concept of regenerative medicine is based on creating a damage, a controlled damage that stimulate your own body to bring the healing process. And that’s what we do in man and female sexual problem. We create these damages to their sexual organs, to the penis, to the certain areas, and it’s stimulating your body to revascularize these structures. The circulation has to be restored.

Dr. Shafizadeh: 12:32

Circulation is your electrical system. Your brain controls it. Your brain flips the switches inside of your body, but the circuits around all damaged. And we have to replace those. All right? It’s like your TV. Nowadays we don’t repair TVs anymore. If it breaks, you throw it out. In the past … Or look at your computer. You want to improve the performance, you take a card and put a new card. And this is what we do in your body. We want to remove that damaged card and put a new card. And that new card has to be made by your own body, but not somebody else.

Dr. Shafizadeh: 13:10

So that’s what we do. We create these micro-damages to the structures to stimulate your body to bring the healing process. And it’s been very, very successful. The problem is that the process is slow and time consuming and may not be very durable. So in order for us to expedite this process and enhance the effect, we also have to sort of stimulate your own dormant stem cells to come in that area. It’s like bringing all these workers with the breaks, fresh breaks to repair that healing process. So we’re using a stem cell therapy, not directly, but we can use the stem cells from outside or your own body stem cells to the certain mechanism to wake them up to bring the healing to certain organs.

Dr. Shafizadeh: 14:14

And when I say organs, my area of focus is in the male and female sexual problems, but it could be anywhere in your body. It’s not just this. This is just one area that I know. Okay? But this concept can be implemented anywhere in your body. So that’s the whole concept here, and we work one end. We have colleagues to work on the other end. We want to have you eat properly, socialize properly, live your life properly. Without that, no matter how much I do, I will fail, no question about it.

Saad Alam: 15:04

Tell me about, more specifically, how are treating men? What are the outcomes that you’re seeing?

Dr. Shafizadeh: 15:11

Obviously we go through the steps. The most important thing is to identify the causes. Without knowing the causes we cannot really address the issue. So we go through a comprehensive medical evaluation, but it’s just asking questions, we know a lot of answers. And we go to the social history, to the medical history, through their medications, a comprehensive physical examinations, checking the circulations. And then we go to some … focused neurologic examinations to check for nerves, sensations. And then check into the circulations, blood flow to the penis. So we do a test called penile doppler study where we stimulate the erections and see the blood flow to the penis.

Dr. Shafizadeh: 16:09

And we see if there is a decrease in the blood flow. Obviously we go to even more details. People who been smoker for many years. We looked at more circulations further up, doing an angiography mostly with a MRI and so forth to see if there’s any blood circulation problems, check their hearts. And once after doing a good comprehensive cardiac evaluation, vascular evaluation, if we see the problem is just local, and we go into the treatment of the problem. Obviously, we still use a lot of Viagra because that can help in the very beginning. But we go into the concept of healing the process.

Dr. Shafizadeh: 16:51

If the patient’s a candidate for regenerative treatment in terms of the severity of their condition and based on our ability, so not everybody is … Some patients are really cross the line so far, and bringing them closer to line may not be very easy. Okay? So those who are a candidate, we offer them this regenerative treatments. And what that entails is it’s a series of shockwave treatments to the penis and create that controlled damage that we have. And then we’re using the certain stem cell techniques. We’re using something called PRFM, which is taking your own blood cells, the platelets from your own body, and process these platelets and then inject it into the corporal body, the core of the penis.

Dr. Shafizadeh: 17:51

And what this PRP does, the platelets have very strong growth factors. And these growth factors expedite the healing process. That’s number one. Number two is make the treatment more durable. We don’t want to treat you just you be good for about a six month, a year. We want to have a treatment which is durable for many years. And that’s the concept here. It’s not just six months. We want you to be good for many years when you walk out of this office eventually for your last visit. That PRP has helped a lot to expedite the healing process. But what makes it more durable is that you’re also using, and you look in different elements.

Dr. Shafizadeh: 18:38

We’ve been looking at exosomes. We’ll be looking at amniotic stem cells to bring those breaks that we need to repair the blood vessels. What are the exosomes? Exosomes are actually … It’s driven from the stem cells. The stem cell secretions that carry very strong growth factors, antiinflammatory factors, and more importantly they have these messenger RNA and DNA. And what these messenger, they’re working at the signaling elements that attract your own stem cells and bring it to the area that you injected.

Dr. Shafizadeh: 19:23

Now, these can be injected intravenously if you focusing your whole body, or can be administered locally just to bring this to your own stem cells into that area. So this is the concept. Waking your own body and stimulating your own body to repair and replace those cards that damaged and replace them with the new chips, new elements, new tissue and bring you back to where you were many years earlier.

Saad Alam: 20:02

Is it crazy to say that you’re actually reversing the age of the penis?

Dr. Shafizadeh: 20:07

You’re absolutely correct. That’s what we do. You’re reversing the age of your penis. You’re replacing it with a new tissue. Okay? So modern medicine is replacing it with a piece of silicon cylinder. We try to replace with your own tissue, your natural penile tissue the way that you were born.

Saad Alam: 20:33

Do you have … What are the kind of … One, how long is onset before you start seeing some kind of clinically relevant outcome? And then two, what are the kind of things you’re hearing from people that are going through this process?

Dr. Shafizadeh: 20:51

It varies from patient to patient. We opted to be very selective in our patients, people we know that we can help them. Okay? I still do very much surgeries on these patients, those who I know that they’re not gonna respond, based on my experience, to this regenerative therapy or the response may not be as satisfactory. People with a mild to moderate condition are the best people to respond. Typically, we see the improvement within six weeks to 12 weeks after the treatments. This healing process takes time. Let me just give you an idea. When you undergo a surgery, there is a cut in your skin, let’s say.

Dr. Shafizadeh: 21:39

You will see that scar for several months after surgery if you look at it. Two years later the scar’s still there, but it’s covered with relatively healthy tissue. There might be some discoloration. And that takes time. When you look at it three months later you see the wound, which is pretty much still fresh. And this is the whole concept, that the response will be really somewhere between six weeks to 12 weeks after the treatments. And depends on the conditions. We have patients who have absolutely not able to have any erections at all, but we know that there is a good circulation who have responded tremendously.

Dr. Shafizadeh: 22:19

I’m talking about 75 to 80% improvement from where we were in the range of 5 to 10%. And some of the patients who were a little bit more severe condition who even did not respond to oral medications, they’re responding very well. Now, again, we use the oral medications because we have to. This is something that we use it as a stimulation. It helps by itself as some sort of rehabilitation process. So we see patients who have absolutely no response to oral medications. Now they’re responding very well.

Dr. Shafizadeh: 23:00

They still have to use it at times. And I think that has to do with the psychology and their confident level, which we love to work on that as well. But also we see a significant improvement to response … And, yes. So depends on the patient. Their response will be somewhere between six weeks to 12 weeks. In those who are mild to moderate we’ll see about somewhere between close to about 80 to 85% improvement.

Saad Alam: 23:29

And tell me about, so you have a specific perspective … Actually, let me ask that question in a second. Tell me more about when you say you use shockwaves to damage the penis so your body can begin healing itself. What does that exactly mean?

Dr. Shafizadeh: 23:50

The whole concept came from using this actually a pneumatic device. There are different devices right now. So in field of urology, the first time you use a shockwave was treatment of kidney stone. So we use this acoustic size energies to break the kidney stone. And the podiatrist use this special shockwave to treat plantar fasciitis. And also this shockwave’s being used for treatment for muscle spasms and everything else. So we brought this machine in to using this for low intensity shockwaves that can sort of create this microfractures beyond the skin level, not on the surface.

Dr. Shafizadeh: 24:46

The energy can be focused in different targets, certain depth. And we create these microfractures with the certain energy levels that’s not too strong to cause a major damage but also not too weak to cause no effect at all. So we’ve been looking. We have been looking in this. We’re still looking at it. We constantly is studying it. We’re constantly changing our protocols to see what’s their sweet spot. And obviously one does not fit everybody. So every person might be different, but at least we can categorize patients into the groups and see who will respond to and figure it out which protocol fits which group of people.

Dr. Shafizadeh: 25:35

So the whole concept is creating these microvascular fractures that immediately responds to your immune response to bring the healing. And then what we do is after doing sort of somewhere between four to five treatments, which could be on a weekly basis or twice a week basis, we bring the stem cells. Once everything is so excited, we inject these platelets, platelet rich plasma, what we call PRFM because it mix into the fibrin matrix. It traps the platelets in place so they don’t disappear. They stay in one place for almost two weeks continuously releasing this growth factors and also at the same time doing the stem cell therapy to assist your body to heal the process.

Dr. Shafizadeh: 26:32

And we continue the process for additional one or two shockwave treatments after that, and then we stop. We stop and monitor the patients and sometimes giving them certain exercises. We’re using vacuum pumps all the time. And we assess the response down the road with repeating the vascular studies to see if there’s an improvement in the blood circulation. We go through certain validated questionnaires to see how they perform outside.

Saad Alam: 27:09

What are the kind of things you hear from men that go through this that have not been able to find relief any other way?

Dr. Shafizadeh: 27:14

I’m sorry. I’m not …

Saad Alam: 27:16

What are the kind of things that men tell you, qualitatively about the quality of their life and who they are as a person after they find this therapy and nothing else was able to help them previously?

Dr. Shafizadeh: 27:28

So not being perform is a very, very frustrating for many of these patients. Sometimes their life has changed. Relationship is ruined. They cannot meet new person. So this therapy is a first thing after many years that I’ve realized that give them their confident that they can meet people, maintain their relationship. It’s creating a completely new life for yourself again. You were in the dark. You were depressed. You were focused on the problem, and that’s created a vicious circle. You cannot stay focused at your work. You’re afraid of talking to people. It really is your life has changed so much.

Dr. Shafizadeh: 28:33

And when you find a way to treat this, to overcome the problem, it’s something that they say … It’s like a new beginning for them. It really is something that, A, also they don’t have to be dependent on their medications. They don’t have to be dependent on that needle injections. They don’t have to be dependent on the pump that they have to go in the bathroom and pump, the prostheses. So it’s just amazing. It’s amazing. Yeah. Particularly patients in their 40’s and 50’s, sort of a mid-age group of people, it’s like a new beginning for them again. It really is going back to refresh your life again. It’s like you’re married again, and the day that you got married you’re in a honeymoon. So that’s how it becomes.

Saad Alam: 29:33

Tell me about, you have a very specific perspective on sexual function for females and what it does for them and how you should approach it. What’s your perspective there?

Dr. Shafizadeh: 29:44

Female sexual dysfunction is a whole different ballgame. The biggest problem with female sexual dysfunction, treating women, you have a hard time to assessing your response. In men it’s very simple. You see erection, you hit the jackpot. In woman, it’s not that simple. We’ve been trying to use MRIs and certain imaging technique to see increased blood flow. The second problem with treating women with sexual dysfunction is the problem is multifactorial. There are many things involved. We’re talking about the hormonal status. We talking about the whole anatomy of women after childbirth has changed. We dealing with pelvic organ prolapse. We’re dealing with women who underwent multiple vaginal operations, menopause.

Dr. Shafizadeh: 30:53

And also about 40% of women around age between 30 to 50, the cause of sexual dysfunction is not organic. It’s more of a psychological factors. So that brings a very, bring the complexity to the situation. So we have to find a way to assess the response. We have to see if there is a psychologic factors. We have to look at the hormonal factors. You have to look at the anatomy. So believe it or not, from anatomical is very simple for us. We can fix the problems decent. Hormonal is very important, and I think we have to have a very focused on that aspect.

Dr. Shafizadeh: 32:00

Fluctuations in hormones are very, very drastic in women. And to assessing the response is another thing. So we look at women who have, especially around the age of menopause, we look at the regenerative techniques very similar to a man. All right? People who are menopausal, vaginal atrophy, those who had undergone removing ovaries being removed for whatever reason, they have hysterectomy, those who have pelvic organ prolapse after multiple childbirth. So there are a lot of damages, so we use the same regenerative technique in women as men.

Dr. Shafizadeh: 32:48

We’re using this micro shockwave therapies to … and also we’re using laser therapies now. One of the lasers we use is called a fractionated CO2 laser. We create these tiny damages to the vaginal epithelium, these tiny holes which is not burn. They’re very controlled. Micro damages to the vaginal tissue. It brings the revascularization process again. We’re using the same shockwave therapy to the crura of the sort of erectile tissue to improve the blood circulation. We are using the same concept of the stem cells and PRFM to expedite and enhance the healing process.

Dr. Shafizadeh: 33:47

This is just from anatomical standpoints to provide a ability to reach sort of arousal. And also we go back on a hormonal level. We stimulate. We control the estrogen and testosterone level. And also we have the assistant therapies. We go into their psychological aspect of it. So with that, whatever we do on this side, it’s useless. Okay?

Saad Alam: 34:17

What are you seeing when a women reexperiences sexual pleasure versus a man? Is there a difference?

Dr. Shafizadeh: 34:30

Absolutely. Absolutely. For women’s standpoint, it’s funny. Women cannot easily reach an orgasm until everything is right. Okay? And it’s a very complicated situation if you only fake orgasm. And for men there is no fake orgasm. Okay? So once we treated these patients, the most important end result is that if they be able to reach an orgasm. Okay? Is pleasurable intercourse, very satisfying intercourse, well-lubricated, and reaching an orgasm moment. So there is a big difference between the two.

Dr. Shafizadeh: 35:41

Men can have an orgasm even without having erection. Okay? Sometimes they can reach an orgasm even before it gets to the bedroom. So it’s called premature ejaculation. It’s a completely different ballgame. There’s no such a thing in women. So there is a completely different.

Saad Alam: 36:03

When you see a woman, when a woman has said, “Hey, Doc, you have helped me reach an orgasm,” or, “The work that we’ve done together has helped me get there,” is their reaction different than a man?

Dr. Shafizadeh: 36:23

We actually …

Saad Alam: 36:23

Is the way they describe it different from a man?

Dr. Shafizadeh: 36:28

Well, how they describe their orgasm different than the describe men orgasm? There’s no possibility of ejaculation. There is a pelvic contracture and there is a lubrication process. So, yes. Their orgasm will be more pelvic contractures, and that’s what they reach an orgasm. For men, orgasm is when they ejaculate. So this is a two differently … Whole thing is because anatomically differently. They’re created in the same pathway, but then diverted to different species, I would say. They’re man and woman. So, yes. There is a big difference between the two. Their description is that. Orgasm for some women is different than the other.

Dr. Shafizadeh: 37:25

Each of them are described orgasms in different ways. Some is majority starts with a pelvic contractures the sort of muscle contractions that they get. Some perceive it as more lubrications and so forth. And some just reaching in some sort of wow sort of feeling. Unfortunately, it’s not all the same, so it’s hard to assess that. We just have to go what the patient described and knows and perceived as orgasms.

Saad Alam: 38:06

What about qualitatively? How do they describe the other facets of their life? What are you really doing at the end of the day? Yes, you’re helping sexual dysfunction, but what is it really giving to people?

Dr. Shafizadeh: 38:15

Happiness. What we want and the happiness. Be satisfied. Are you satisfied? Bottom line is that you’re coming here. You spend so much time in this process going to some of these exercise, some of these treatments are tough, especially shockwave for men. It’s not that easy. The bottom line is that do you think that you are 25 again? Do you enjoy? Enjoyment to you is different than enjoyment to this person or this person. My goal is not to define your enjoyment. “This is considered enjoyment.” My goal is to get you where you think that’s your enjoyment. Is it what you used to be? Okay?

Dr. Shafizadeh: 39:17

And this is what I consider success. So I cannot come to tell you, “Oh, if you did not have five orgasms during this, I failed you.” Incorrect. Some women can have five orgasms, some can barely have one. Multiple orgasms common in women, not very common in men. But if that’s your enjoyment, that’s where you were, our goal is to put you back where you were, okay, before all these things happened.

Saad Alam: 40:02

Tell me about when you say you make someone … Let me ask you this. Do you think that improving someone’s sexual function and giving them happiness back in their life can actually not only improve the quality of their life, but increase their longevity? Or is that a leap?

Dr. Shafizadeh: 40:20

No. You’re absolutely correct. Like I said, it depends on how you provide a treatment. If you go ahead with modern medicine, giving the Viagra, Cialis only helping them now, but the condition just progresses. What we’re doing here is just, yes, longevity. This is the goal. Your well-being, as I mentioned to you before, the goal is not just genital. The goal is your entire life has to be changed. Okay? You eat healthier, you’ll live longer, because you’re not gonna have those bad diseases down the road, okay? You lose weight. You become more fit, and … Example of fit, myself, I used to be very active, and I had some injuries. I stopped physically becoming active for many, many years.

Dr. Shafizadeh: 41:26

I had back surgeries and all kind of things. And going through the whole process of going to medical school, residency, nine years of training, so forth. And my life was like, I just worked 24/7. I still work 24/7, but it really is just different. Get into a cycling habit, getting a better diet, exercise. I feel like … People look at me and say, “You look younger. You lost weight?” I did not lose weight. I’m same weight. Same weight I had before. But you feel, but the way that you carry yourself is better. The way you look better, the way you talk better, the way you express yourself is better.

Dr. Shafizadeh: 42:16

No, I did not lose any weight at all. “Your hair was very gray last time I saw you.” I said, “No, my hair is even more gray. I can show you the pictures.” I’m sort of aging, but you look younger, because I changed my life. Okay? And this is what I want to give to my patients. Okay? Yes. This is the whole concept of regenerative medicine for you to get younger and age slower.

Saad Alam: 42:57

This is great. If you had to do three things that don’t cost you a dime to improve your sexual function tomorrow, what are those things?

Dr. Shafizadeh: 43:11

It’s very funny. I’m from Iran, and many years ago it was just this clip that I watched. It was a Persian doctor talking to his patient. And she was asking the doctor, “So what’s the best food I can have?” And this is very old. The doctor says, “Whatever is white and tastes good is bad for you.” So the concept is this. Eat right. That’s the first thing. And it’s very simple, all right? Gid rid of the carb, too much of the carbohydrates. Whatever is white and tastes good, just put it aside and look at this. I need to have a healthy food. All right? And with that healthy food, put yourself outside of New York City.

Dr. Shafizadeh: 44:10

Imagine yourself in the jungle. Okay? Everything is raw. In the wild, wild world you have to feed yourself off the trees, vegetables, and this is it. Nothing is processed. And that’s where … And it’s very simple. It’s actually cheaper that way. All right. That’s number one. Eating right. Number two, exercise. Not crazy. I didn’t say just go on, join expensive gym and then do these things. No. Just get yourself a pair of sneakers. Look at your watch. For 20 minutes just don’t think about anything. Don’t think about any direction.

Dr. Shafizadeh: 45:10

This street, I’ll walk for next 20 minutes, walk as fast as I can. And then 20 minutes later you can set up an alarm so you don’t think about your time. Once your alarm goes off, you turn around, walk as fast as you can to same wherever you started. That’s not gonna cost you nothing. Okay? And the third, I think is the best thing to do you can meditate. Now, meditate could be just sit there, just don’t think about anything or think about something that makes you most happy. Some people, meditation comes by praying. Depends on your religion, whatever you believe.

Dr. Shafizadeh: 46:02

Some people have any means, just close your eyes and don’t think about anything. That’s probably takes about 20 minutes. Now, you can do this thing at a certain time. It could be middle of your day, your office. Put a sign on your door, “Do not disturb.” Turn off your cell phone. Turn off your computer monitor. Shut the lights. Close the curtains. 20 minutes, do nothing. That’s all.

Saad Alam: 46:49

What about if you had to give us that same three list specifically for sexual dysfunction, for improvement of sexual function? Is it as easy, or is it really those things?

Dr. Shafizadeh: 47:02

Right. Again, these three things is a three concept of your entire life, you think about it. What you get into your body, what you put into your body, how to use your body. On top of that, how you control your body with your brain. So really that’s what it comes down to, all right? And I believe is that many problems that we deal with, medical conditions or nonmedical conditions that we deal with in our lives is caused by ourself. There are genetic factors. I don’t want to take that away. There truly is genetic factors involved or things can unfortunately happens.

Dr. Shafizadeh: 48:01

But you’re still able to control, because you have such a strong body that can heal itself. You have the ability to fix that problem. And, again, your sexual life, the way I understand, the way I believe is that that’s only reflects who you are as whole. If you are not able to perform sexually, that means everything else is wrong. Okay? So it’s the very same concept. It’s the very same concept. Eat right, doing exercise that it’s considered you know … and is something that are different than you do every moment. And have a good control over your mind. Have a peaceful mind [inaudible 00:48:59] so it can help you to focus.

Dr. Shafizadeh: 49:02

Your psychology’s so important, because it controls everything else. Okay? If you’re anxious, you’re nervous, people crave more carbohydrates, they cannot exercise. They’re overwhelmed. You need to control this. Without that, there’s nothing else. You can get the penile prosthesis, get the pump in there. Choice.

Saad Alam: 49:25

Awesome. Thank you.