The Ultimate Guide to Male Hormones & Men’s Health

Episode of The Mel Robbins Podcast · October 8, 2026 · 1 h 11 min

Mel Robbins and Stanford urologist Dr. Michael Eisenberg discuss testosterone, erectile dysfunction, male fertility, prostate and pelvic floor health, and their links to longevity.

Summary

In the first men's health episode of The Mel Robbins Podcast, Mel Robbins interviewed Stanford urologist Michael Eisenberg, prompted by her husband Chris's deliberations over whether to start testosterone. Eisenberg explained that testosterone peaks between ages 20 and 30 and declines roughly 1% a year, that the normal range is wide (300 to 900 ng/dL), and that symptoms of low testosterone include low energy, low libido, poor mood, sleep and concentration. He described how poor sleep, sleep apnea, excess body fat, chronic stress, depression and its medications, and heavy alcohol use can suppress testosterone, and recommended screening from around age 40 to 50 via morning blood tests.

Eisenberg outlined the benefits of testosterone therapy for men with genuinely low levels and its side effects, including suppressed sperm production, acne, hair loss, breast growth and higher red blood cell counts. He cited the TRAVERSE trial as having dispelled earlier fears about prostate cancer and cardiovascular risk, and argued that men with normal levels gain little from testosterone, criticizing clinics that prescribe it for profit. He said therapy is often a trial rather than a lifelong commitment.

The conversation then turned to erectile dysfunction, which Eisenberg described as extremely common and often a marker of cardiovascular health. He explained PDE5 inhibitors such as Viagra and Cialis, intraurethral medication and penile injections, recounted a famous 1980s urology conference demonstration, and stressed that ED can always be treated. He also discussed research linking frequent ejaculation to lower prostate cancer risk, sexual activity and relationships to longevity, globally declining sperm counts, the neglect of male factors in infertility, pelvic floor health, urinary changes with age, and PSA screening for prostate cancer.

Chapters

  1. 0:00

    Introduction and why men's health matters

    Robbins introduces Eisenberg and explains her personal motivation, her husband Chris's testosterone question.

  2. 5:23

    Testosterone basics and symptoms

    Eisenberg explains normal testosterone ranges, age-related decline, symptoms of low testosterone and when to get tested.

  3. 15:33

    Lifestyle factors affecting testosterone

    Eisenberg discusses how sleep, sleep apnea, body fat, GLP-1 weight loss, stress, depression and alcohol affect testosterone.

  4. 26:16

    Testosterone therapy: delivery, risks and who should take it

    Eisenberg covers injections, gels and pellets, contraceptive effects, side effects, the TRAVERSE trial, and why men with normal levels should not use it.

  5. 35:27

    Raising the topic with a partner

    Eisenberg suggests framing testosterone screening around health, strength and longevity when bringing it up with a partner.

  6. 36:38

    Erectile dysfunction: causes and emotional impact

    Eisenberg defines ED, cites its prevalence, explains vascular and nerve causes including bike saddles, and describes its emotional toll.

  7. 43:38

    ED treatments

    Eisenberg explains PDE5 inhibitors, intraurethral medication and penile injections, including the famous 1980s conference demonstration.

  8. 52:42

    Sex, prostate cancer and longevity

    Eisenberg discusses ejaculation frequency and prostate cancer risk, sexual activity and lifespan, and Swedish registry data on partners and children.

  9. 57:56

    Male fertility

    Eisenberg describes global sperm count declines and argues that male factors in infertility are routinely overlooked.

  10. 1:02:31

    Pelvic floor, urination and prostate screening

    Eisenberg explains pelvic floor function, nighttime urination, prostate enlargement and PSA screening.

  11. 1:06:22

    Takeaways and parting words

    Eisenberg urges listeners to recognize their agency over their health and get basic checkups.

Key points

What was said, by whom, with the exact words. Timestamps jump to the moment.

  • Michael Eisenberg

    Eisenberg says testosterone peaks between ages 20 and 30 and then declines about 1% a year.

    “it probably peaks probably somewhere between 20 to 30. And then every year thereafter, it goes down maybe 1% a year”

    Listen from 6:45 · Hypogonadism

  • Michael Eisenberg

    Eisenberg recommends adding a testosterone test to routine checkups starting around age 40 to 50, or earlier with risk factors.

    “getting checked, I think, sooner rather than later is a reasonable thing to do. probably starting maybe 40, 50”

    Listen from 13:05 · Hypogonadism

  • Michael Eisenberg

    Eisenberg says chronic short sleep and shift work suppress testosterone by disrupting circadian hormonal feedback.

    “these men that kind of say they only need a little or they're, you know, four to five hours a night, we do see that suppression”

    Listen from 16:37 · Sleep and testosterone

  • Michael Eisenberg

    Eisenberg says weight loss by any means, including GLP-1 drugs and bariatric surgery, can raise testosterone.

    “Bariatric surgery reliably increases testosterone. So I think any way you can lose weight, you know, kind of getting an ideal body weight, I think that's really going to be crucial”

    Listen from 18:44 · GLP-1 receptor agonists

  • Mel Robbins

    Robbins recounts that her husband Chris has resisted testosterone, worried about long-term oil injections and unresearched long-term effects.

    “That with injections, it's a lot of oil intake for the next 30 years of my life? Oil intake? And that the long-term effects of taking it for that long of a time have not been researched?”

    Listen from 27:10 · Testosterone replacement therapy

  • Linked moment · 29:15Skip to 29:15 using a listen link in the info box.

    Michael Eisenberg

    Eisenberg explains that exogenous testosterone reliably suppresses sperm production and has been tested as a male contraceptive.

    “Testosterone has been tested by the World Health Organization as a contraceptive. So it can actually lower sperm production”

    Listen from 29:15 · Testosterone replacement therapy

  • Michael Eisenberg

    Eisenberg says the TRAVERSE trial debunked concerns that testosterone raises prostate cancer and cardiovascular risk, and that the FDA will update warning labels.

    “the FDA is actually going to update guidance on prescribing and some of the warning labels to remove those”

    Listen from 31:48 · TRAVERSE trial

  • Michael Eisenberg

    Eisenberg argues that men with normal testosterone gain little from supplementation and criticizes clinics that prescribe it for profit.

    “if your testosterone is normal and you're given testosterone, it's very unlikely to help any problem you have”

    Listen from 32:23 · Testosterone replacement therapy

  • Michael Eisenberg

    Eisenberg says most men are started on testosterone as a trial and can stop if they see no benefit after six months to a year.

    “So after six months, after a year, they're not seeing those improvements, then we can stop it”

    Listen from 35:05 · Testosterone replacement therapy

  • Michael Eisenberg

    Eisenberg cites data that over half of men over 40 have some erectile dysfunction, with prevalence rising each decade.

    “if you look at men over the age of 40, over half have some trouble with erectile dysfunction”

    Listen from 37:10 · Massachusetts Male Aging Study

  • Michael Eisenberg

    Eisenberg says some bicycle saddle designs can compress nerves and arteries and cause numbness and erectile problems in a minority of cyclists.

    “maybe 20, 25 percent of men do notice numbness, pain and erectile problems, especially after a long ride”

    Listen from 39:26 · Erectile dysfunction

  • Michael Eisenberg

    Eisenberg asserts that erectile dysfunction is always treatable given willingness to pursue aggressive therapies.

    “I always like to tell men, as long as you have a penis, we can always make it hard”

    Listen from 41:52 · Erectile dysfunction

  • Michael Eisenberg

    Eisenberg notes observational data suggesting daily low-dose Cialis may be cardioprotective, while cautioning it has not been rigorously tested.

    “if men that are taking the kind of low dose Cialis every day, the lower risk of cardiovascular events”

    Listen from 48:03 · Phosphodiesterase-5 inhibitors

  • Michael Eisenberg

    Eisenberg says penile injections work about 90% of the time despite a large psychological barrier.

    “there is a huge psychological barrier to putting a needle in your penis. But if men are willing to do it, it's very, very effective”

    Listen from 50:57 · Erectile dysfunction

  • Michael Eisenberg

    Eisenberg cites a large study finding that men ejaculating 20 or more times a month had about 20% lower prostate cancer risk.

    “men that ejaculated 20 times a month or more compared to those less had about a 20% lower risk of developing prostate cancer”

    Listen from 53:31 · Prostate cancer

  • Michael Eisenberg

    Eisenberg describes erectile problems as a 'check engine light' for overall health that warrants evaluation.

    “this can be like a check engine light. Right. That if erections are not as good, it's not just a convenience issue”

    Listen from 57:38 · Erectile dysfunction

  • Michael Eisenberg

    Eisenberg argues that a male factor is present in about half of infertility cases yet men are often never evaluated before couples move to IVF.

    “In this country, probably a third of the time, a mail's never seen by a specialist, never checked, bypassed to go through IVF”

    Listen from 58:18 · Male infertility

  • Michael Eisenberg

    Eisenberg says sperm counts are declining worldwide and the decline appears to be accelerating, alongside other signs of worsening male reproductive health.

    “the data suggests that it's accelerating in the last probably 20 years. We also see declines in testosterone levels”

    Listen from 58:49 · Decline in sperm counts

  • Michael Eisenberg

    Eisenberg says waking once a night to urinate is normal but two or more times warrants evaluation.

    “once a night is pretty normal. But when it starts to be a little more disruptive two, three, four times, I think definitely you want to get evaluated”

    Listen from 1:04:32 · Benign prostatic hyperplasia

People

In the conversation

  • Mel RobbinsAmerican author, podcast host and former lawyer who hosts The Mel Robbins Podcast
  • Michael EisenbergBoard-certified urologist, Professor of Urology at Stanford University and head of Stanford's Male Reproductive Medicine and Surgery Program

Discussed

Topics

More from The Mel Robbins Podcast

From the publisher

This is the ultimate guide to male hormones and men’s health. If a man you love has seemed a bit off lately, this episode will help you understand why. It’s for both men - and the people who love them. This conversation, the first-ever men’s health episode of The Mel Robbins Podcast, was inspired by Mel wanting to learn more about her husband Chris and what she can do to help him with his hormones. Specifically, it all began with the question: should he be taking testosterone? That led Mel to the world-renowned Stanford urologist Dr. Michael Eisenberg, who joins her today to talk all things men’s health. No topic is off limits – Mel asks the questions that may be on your mind – including everything you and your loved ones need to know about testosterone, erectile dysfunction, sexual health, and prostate health. Dr. Eisenberg explains what happens to men’s hormones as they age, what symptoms to keep a close eye on, and what you and the men you love can do about them. Dr. Eisenberg is a board certified urologist and Professor of Urology at Stanford University. He also leads Stanford's Male Reproductive Medicine and Surgery Program. He specializes in men’s health, testosterone, fertility, and sexual dysfunction. He will also explain why reproductive health is not separate from the rest of a man’s health. It isn't just directly tied, but it is also a window into what's happening throughout a man’s body. You’ll learn: -The signs of low testosterone – and when it makes sense to get tested. -Who may benefit from testosterone therapy and who probably should not be taking it. -How sleep, stress, excess body fat, depression, and alcohol can affect testosterone levels. -The side effects and fertility implications every man should understand before starting testosterone. -What erectile dysfunction is, what causes it, and why it can be an important signal about a man’s overall health. -The differences between Viagra, Cialis, and other treatments for erectile dysfunction. -Why e…

Summary, chapters and key points were generated from the episode transcript on October 9, 2026. Quotes are checked word for word against the transcript.

Categories: Medicine·Sexuality·Relationships