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The Mel Robbins PodcastThe Mel Robbins Podcast

The Ultimate Men’s Health Guide: Testosterone, Sex Drive, & Aging

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 erectile dysfunction can deeply affect confidence, intimacy, and relationships, and how a partner can help. -Why male fertility matters even if you are not trying to have children right now. -What changes in urination and prostate health are worth bringing up with a doctor. -Why pelvic floor health matters for men. If there is a man in your life who has seemed more tired, withdrawn, less interested in sex, or simply not like himself lately, this conversation will help you understand what may be going on and what the two of you can do next. And whether you are listening for a man you love, or you’re a man who wants to take control of your health, you’ll be empowered by what Dr. Eisenberg has to share today. For more resources related to today’s episode, click here for the podcast episode page: https://www.melrobbins.com/episode/episode-442/ Follow The Mel Robbins Podcast on Instagram: https://www.instagram.com/themelrobbinspodcast I’m just your friend. I am not a licensed therapist, and this podcast is NOT intended as a substitute for the advice of a physician, professional coach, psychotherapist, or other qualified professional. Got it? Good. I’ll see you in the next episode. In this episode: 00:00 Meet the Guest 03:43 Signs You May Have Low Testosterone 08:06 Do You Need Testosterone? 13:52 What Causes Low Testosterone in Men? 20:49 Can Depression Cause Low Testosterone? 25:25 The Different Ways to Take Testosterone 28:01 What Are the Side Effects of Testosterone? 30:56 What to Know Before Starting Testosterone 33:10 How Long Should You Take Testosterone? 35:47 What Causes Erectile Dysfunction? 39:56 The Emotional Impact of Erectile Dysfunction 41:58 The Best Treatments for Erectile Dysfunction 52:08 The Surprising Health Benefits of Sex 54:42 Why Male Fertility Is Declining 01:01:50 What Causes Frequent Urination? 01:05:40 The Health Signs Men Shouldn’t Ignore — Follow Mel: Instagram: https://www.instagram.com/melrobbins/ TikTok: http://tiktok.com/@melrobbins Facebook: https://www.facebook.com/melrobbins LinkedIn: https://www.linkedin.com/in/melrobbins Website: http://melrobbins.com​ — Sign up for Mel’s newsletter: https://melrob.co/sign-up-newsletter A note from Mel to you, twice a week, sharing simple, practical ways to build the life you want. — Subscribe to Mel’s channel here: https://www.youtube.com/melrobbins​?sub_confirmation=1 — Listen to The Mel Robbins Podcast 🎧 New episodes drop every Monday & Thursday! https://melrob.co/spotify https://melrob.co/applepodcasts https://melrob.co/amazonmusic — Looking for Mel’s books on Amazon? Find them here: The Let Them Theory: https://amzn.to/3IQ21Oe The Let Them Theory Audiobook: https://amzn.to/413SObp The High 5 Habit: https://amzn.to/3fMvfPQ The 5 Second Rule: https://amzn.to/4l54fah

Mel RobbinshostDr. Michael Eisenbergguest
Oct 8, 20261h 9mWatch on YouTube ↗

At a glance

WHAT IT’S REALLY ABOUT

A practical, stigma-free roadmap to testosterone, ED, fertility, and longevity

  1. Dr. Michael Eisenberg (Stanford male reproductive medicine) explains how testosterone typically peaks in the 20s–30s and gradually declines with age, with low levels becoming increasingly common after midlife.
  2. The episode details symptoms and diagnosis of low testosterone, emphasizing morning blood testing, repeat confirmation, and the major role of sleep, obesity, stress, depression, alcohol use, and sleep apnea in suppressing hormonal signaling.
  3. Eisenberg outlines benefits and risks of testosterone therapy, stressing that it’s unlikely to help men with normal baseline levels and can suppress sperm production, requiring careful physician oversight.
  4. The conversation provides a practical framework for erectile dysfunction as both a quality-of-life issue and a potential marker of cardiovascular health, with treatments ranging from PDE5 inhibitors (Viagra/Cialis) to urethral agents and penile injections.
  5. The episode highlights broader men’s health issues—declining sperm counts globally, the under-evaluation of male factors in infertility, pelvic floor function, urinary changes with aging, and prostate screening basics.

IDEAS WORTH REMEMBERING

5 ideas

Low testosterone is common, but symptoms must be confirmed with proper testing.

Symptoms like low energy, low libido, poor mood, poor sleep, and concentration issues are common but nonspecific—so the key is pairing symptoms with properly timed, repeat blood tests before concluding it’s “low T.” Eisenberg emphasizes checking testosterone like other basic health metrics (blood pressure, cholesterol, glucose), especially as men age.

Age-related decline is normal, but obesity, sleep, stress, and alcohol can push levels lower.

Testosterone typically peaks in the 20s–30s and declines roughly ~1% per year thereafter, with prevalence of “low T” (e.g., <~300 ng/dL) rising sharply with age—roughly half of men over 50 may fall into the low range. Lifestyle and metabolic health can accelerate or worsen this decline.

Many “low T” drivers are modifiable and reversible for some men.

Eisenberg describes how poor sleep, sleep apnea, chronic stress (via cortisol), depression, and heavy alcohol use can blunt the brain-to-testicle signaling loop that regulates testosterone. Improvements in sleep, weight loss (including via bariatric surgery and sometimes GLP-1–associated loss), and reducing alcohol can raise testosterone.

Testosterone therapy helps men with true deficiency—not men with normal levels seeking performance gains.

Testosterone can improve libido, erectile function, energy/vitality, bone density, anemia, lean mass, and some metabolic markers in men who are truly deficient. But he warns it’s not a general “upgrade” if levels are normal—benefits are unlikely while risks still exist.

Testosterone therapy can significantly reduce sperm production—plan around fertility.

A major downside is fertility: exogenous testosterone suppresses the signals that drive both natural testosterone production and sperm production, and it can lower sperm counts reliably (used experimentally as male contraception). This matters for men who may want children now or later.

WORDS WORTH SAVING

5 quotes

I always shake the hand of the spouse and say, "I'm so glad you're here. This is a team sport."

— Dr. Michael Eisenberg

Your body's just prioritizing survival, right? And so if there's something else going on, it wants you to survive. Like, if a tiger comes around, nothing else matters.

— Dr. Michael Eisenberg

It's such a crucial point that if you have a normal testosterone and you're given testosterone, it's unlikely to help with some of these other symptoms.

— Dr. Michael Eisenberg

As long as you have a penis, we can always make it hard.

— Dr. Michael Eisenberg

There's been lots of studies that show that sperm counts are going down globally.

— Dr. Michael Eisenberg

Testosterone range, aging, and screening timingSymptoms and diagnosis of low testosteroneSleep, sleep apnea, stress/cortisol, depression, alcoholTestosterone therapy methods (injections, gels, pellets, oral)Testosterone side effects and fertility suppressionErectile dysfunction causes and emotional impactED treatment ladder (PDE5 inhibitors, urethral meds, injections)

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