Dr. Gabrielle Lyon: The Hidden Link Between Muscle Loss and ED

Okay, let's talk about this paper. — Okay, let's go on — because everybody loves sex and uh I think that it's uh this is a fairly novel hypothesis, right? Linking skeletal muscle to erectile function. — I mean, now we have every person's attention — and everybody loves a good boner. — I mean, yeah, — right. — And 40% of men by age 40 have erectile dysfunction. — How many? What percent? — You're lucky it didn't happen to you. 40 40% 50% of men by 50 have erectile dysfunction. — Damn. — One out of two people just go to the girls, do you have erectile dysfunction? I can fix that for you. — Probably a good way to get punched in the face probably. Yeah, — definitely. — But okay, but you've got a potential — No, not for me. For you. Punch you in the face. — No. I And I don't want that for me. But let's get to the potential solution here because this is very empowering. — Okay. So, first of all, is Sydney going to yell at us? Is are we obstructing the view? S. — No. We're good. Okay, good. — So, basically this is a paper that we published in sexual medicine reviews and it's exploring the link between muscle quality, which again we're kind of talking about and erectile dysfunction, the impact of muscle mass on strength. And I'm sure as you can imagine that there is a positive correlation, we know correlation is not causation, between erectile function and muscle health. Muscle health we defined as being able to be strong, being able to have a good metabolic profile and it says maintaining skeletal muscle with nutrition and physical activity improves erectile health and overall health outcomes. Therapies that target sexual function and muscle health simultaneously may have further benefits. — Well, yeah, because I mean erectile strength is a surrogate for cardiovascular health. — It is. Yeah. Why are we even Why are we still using grip strength? — I don't know. You know, someone asked me that. They were like, "How do you know how you're griping? " I'm thinking that's again, is this another anchoring bias is something that we've seen over and over again, — but erectile function is probably the number one indicator of a man's overall health. That and probably sperm health. — Wow. I'm good in both departments. — And testosterone. So, I want to read another statistic. Are you ready? M — the prevalence of severe erectile dysfunction is higher in sarcopenic men 73% versus 43% in one study. — Sarcopenia is a disease that we think of as a disease of aging low muscle mass and function. — I don't think it is. Sarcopenia was given a diagnosis was considered a disease 2016 10 years ago. we should have an anniversary party. Before that, it was never considered relevant. And that's really important to understand for you guys listening. Every disease gets an ICD10 code. If we think that sarcopenia is not a disease of aging, low muscle, low muscle mass, strength and function, which by the way, right now we're working on treating the obesity epidemic with GLP1s. I think that we are solving for that. And Don Ling gets very mad when I say that. I'm not saying that we've solved for obesity. 74 or so percent of us have challenges. But we are trading one epidemic for another. We're trading obesity for sarcopenia. And if I just told you that severe ED is higher, 73% versus 43%. And this is just one study in the older population. Imagine as we put younger and younger people on GLP1s in front of screens that are already sedentary, sarcopenia is not going to be the only thing that we have to worry about. — Wow. Now, but these GLP-1 drugs don't guarantee a sarcopenic phenotype, right? They don't guarantee muscle loss. It's just that they're not — well, — patients are not necessarily being instructed to prioritize protein to resist train. — And actually, I have some really good data. I'd have to pull this up, but it is very difficult. And I used to run weight loss studies. It's very difficult to lose. You're never going to lose 100% fat. Even in fat, there's connective tissue. There is lean mass in fat within there. There's blood vessels. There's all kinds of things. And the in a 12 to 16 week period of time, um, people will lose weight. And I have some really good numbers here because I was correlating the two. I'm thinking, okay, so where are we when it comes to um so this is I know people can see my screen so you see you can I don't know where my privacy screen. — No, nobody can see it. — Are you sure? — Yeah, nobody can see it. it. I promise I've see what people can see. Yeah, nobody can see it. — Totally kidding. Okay, so this is important. Um I want to look at — Also worth noting that there's solid evidence that exercise can improve erectile function. — Yeah, it can. So it's not just an

obsational finding. — No, no. We know the exercise, but this was um pretty novel because people don't think about muscle mass and strength involved in erectile dysfunction. — And I think that that's really important. — And by the way, this is not just uh of import to men and the women who love those men. It's also important directly to women because women have analogous erectile tissue in their nether regions as well. — They do. Never I have not heard nether regions in a very long time. And yes, this study didn't have women, but that would be something that we will look at because women have erectile dysfunction, too. — And it's not just in your head, ladies. — Probably harder to measure. — No pun intended. And yes, it is. — Okay. So, let me — Grip strength it is. — And back to grip strength. Yeah. — No, there is a really I wish I could find this. I have a really good analysis because I think GLP ones are here to stay and the question is if we lose muscle mass at 4% per decade and all of a sudden people are becoming better at losing weight. The reality is, are they losing body fat on GLP-1s, which by the way, I have a medical clinic. I'm a still practicing physician. We use GLP1s all the time. But you also have to recognize and acknowledge that if you are using GLP1s in a sedentary individual, you are further losing skeletal muscle mass. Again, do they have to? They don't. Do they typically could be 20%. — 20% loss of skeletal muscle mass. if in 10 years for sarcopenia it's 4%. So we have to just recognize we're talking about things separately but if we were to just compare the amounts when you're young and healthy it's easier to put on muscle but as people age and are going on GLP1s they have to have a lifestyle in place and we probably have to read adjust the dosing reevaluate hormones. — Hey if you like that video you need to check out this one here and I'll see you there.