with Dr. Aaron Spitz


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“If we can’t get [men] with concern over their heart or concern over cancer, we can probably get them with concern over their penis.  A plant-powered penis is the key to a plant-powered person. It is the gateway organ,” shares Dr. Aaron Spitz in this eye-opening and *ahem* uplifting conversation giving straight answers on the topic every man cares about, but is too afraid to ask.

Dr. Spitz has a clear five-step plan to improve sexual health:  Go Fork Yourself, Sexercise, Go Offline, Detox, and Snooze or Lose.  His easy-to-implement directives cover a wide range of behaviors worth examining and will dispel any concern listeners may have about forfeiting their man card in exchange for a plant-strong diet.


Featured on national television, Aaron Spitz, M.D. is a board-certified urologist and a leading expert in male sexual health and fertility. He has helped countless men overcome these challenges, including erectile dysfunction, low testosterone, Peyronie’s Disease, and low sperm count. He is a nationally recognized leader in microsurgical vasectomy reversal. Dr. Spitz is able to demystify these complex and emotional conditions for his patients as well as for the public at large. Dr. Spitz served as Assistant Clinical Professor of Urology, UC Irvine for 10 years, where he oversaw their training for male sexual health and infertility. He has published numerous articles and book chapters on these subjects.

Dr. Spitz is a national leader in health policy for urologists across the nation. He serves as the lead delegate representing all of America’s urologists to the American Medical Association (AMA). He also is in charge of pioneering the use of telemedicine for America’s urologists. He frequently meets with state and national legislators about topics of critical concern to doctors and patients alike.

Aaron Spitz, MD, is a television personality who is frequently called upon to shed light on various men’s health topics. He has appeared on Dr. Phil, the Real Housewives of Orange County, and he is a frequent guest and part-time co-host on the popular CBS talk show, The Doctors.


Rip Esselstyn: Hey, it's Rip Esselstyn. If you're jumping in midstream into the podcast I would encourage you, go back to episode 1 where we meet Joe Inga and this way chronologically, it will have a much better flow and make more sense.

Rip Esselstyn: I'm Rip Esselstyn, I am the founder of Engine 2, and I am gonna be working with Joe Inga. He's an amazing firefighter, father. He's just a really amazing human being and we're gonna go on an amazing journey and witness Joe, transform before our very eyes from somebody who's health has spiraled out of control to somebody that is gonna take back his health. And what I've done, in order to take Joe on this journey is I've marshaled together some of the most amazing doctors, inspirational leaders to help work with Joe and possibly yourself.

Rip Esselstyn: Listen in as Joe is absolutely transformed from a couch potato to a veritable sweet potato, triathlete in less than 6 months. Episode after episode Joe gains momentum and confidence and all the tools and tricks to what it means to become a Plant-Strong man. I can't wait to have you listen in on this journey. Welcome to Plant-Strong.

Speaker 2: Do you struggle with urges to find and devour this meat.

Speaker 3: Seems like everybody wants to get their paws in what they're setting out at Black Angus.

Speaker 4: I am man, hear me roar, in numbers too big to ignore! And I'm way too hungry to settle for chick food! 'Cause beef for what its worth, is the greatest meat on earth!

Speaker 5: I said a beef hot links!

Speaker 6: I said a beef hot links!

Speaker 5: I said a beef hot links!

Speaker 7: Beef.

Speaker 5: Beef!

Speaker 2: Brown sugar bacon-

Speaker 7: Jack Link's Jerky, it's what's for dinner.

Speaker 8: Texas Double Whopper, eat like a man, man.

Rip Esselstyn: You know, a lot of making this show has been about fighting this concept, that you have to have a certain type of lifestyle to be a so called real man. That if myself or Joe or anybody else chooses to live Plant-Strong, that we're somehow weak. That we've forfeited our man card, and absolutely nothing could be farther from the truth. So today, I wanna take a deep dive and discuss the one thing that men never discuss. Because if there's one thing that I know, in order to catch the attention of men, we need to talk about something that's super important to every single one of them:

Speaker 9: Penis, schlong, wood, Loch Ness, you know the monster that no one's ever really seen? Vlad the Impaler, the one-eyed trouser snake, the hickory farm's salami.

Speaker 10: Go clean yourself off.

Rip Esselstyn: And there's no one better to talk to about this, than Dr. Aaron Spitz, author of ...

Dr. Spitz: The Penis Book: A Doctor's Complete Guide to the Penis - From Size to Function and Everything in Between. I serve as the lead delegate for the American Urological Association to the American Medical Association, also delegates who represent the needs of urology patients and doctors to the American Medical Association.

Rip Esselstyn: Aaron in your book you have a five-step plan for penis health. So, number one is go fork yourself. What in the world do you mean by that?

Dr. Spitz: Perhaps the most critical thing for good male sexual health is what you put in your mouth, and I'm referring to food.

Rip Esselstyn: OK!

Dr. Spitz: So go fork yourself is all about how to eat for your best direction. And what that really means is how to eat for your best circulation. Because your erection is a reflection of your circulation. The penis is filled with all these tiny little blood vessels that are kind of like a spongy tissue of blood vessels. And the healthier those little blood vessels are, the better they're going to be able to expand, and fill, and get hard with blood flow, and give you that healthy erection.

Dr. Spitz: And foods that promote good blood flow are plant-based foods. One of the things that we've learned about erections, back in the early '90s, was that the reason we get erections largely is due to this incredible molecule called nitric oxide. Nitric oxide gets released into that spongy tissue, the penis, due to a signal from the brain, the largest sex organ, the one between your ears. But a signal is sent out through your spine to little nerve endings that enter into the penis and release nitric oxide, and then that nitric oxide sets into motion a cascade of reactions. It actually cause those little blood vessels to open up, to stretch open and allow blood to rush in. And that expands the penis, it lengthens it, it widens it. And at some point the blood can't flow in anymore, because it's flowing in so much faster than it's flowing out. And it gets trapped in there, and that's the full erection.

Dr. Spitz: And then, that chemical reaction will reverse itself after some time and the erection will go down so that you don't end up with an erection that lasts more than four hours, call your doctor immediately, etc., etc.

Rip Esselstyn: Best marketing gimmick ever, I think.

Dr. Spitz: Indeed, indeed. But it can happen and it's a long night in the ER when it does. But, given that nitric oxide has been determined to be, you know, a key molecule for erections and this is the principle upon which prescription medications like Viagra and Cialis work. They work on nitric oxide. They are able to prevent that reversal of the effect from happening as soon. So they allow the nitric oxide to do it's thing longer. Well, if you can eat in a way that promotes nitric oxide, that promotes it's formation naturally or that puts it into your body from the very molecules that are in the foods you eat, or that prevents its destruction, you're doing your penis a favor.

Dr. Spitz: But not just your penis, because it turns out that nitric oxide is really important for the health of all your blood vessels. And, nitric oxide is what increases blood flow throughout the body but, of course, this penis is focusing, this book is focusing on the penis. So, plant-based foods are often rich in the precursors of nitric oxide. Nitric oxide is actually a gas, but the precursors that we find in green leafy vegetables, in beets, in nuts, in all the great stuff that you see on the produce shelf, actually will increase our level of nitric oxide ultimately in our blood vessels in our penis. And that's been demonstrated scientifically over and over again. And animal-based foods, animal fats, and simple sugars, actually work to degrade that, to reverse that. And so, you can actually have a negative impact on your penis by eating the wrong foods, and a positive impact by eating the right foods.

Rip Esselstyn: So would it be safe to say that fruits and vegetables and whole grains and beans are very uplifting foods, and animal products and dairy products are kinda downers?

Dr. Spitz: I would agree that a fairly straightforward statement.

Rip Esselstyn: As you know my father is a huge fan of nitric oxide because of the endothelial cells and all of his heart patients so-

Dr. Spitz: Yes, I'd like to actually share some interesting information that I became aware of just in the past couple years. So, the doctor that worked out that nitric oxide was causing erections is a very esteemed urologist named Dr. Jacob Rajfer and he's a professor at UCLA. And he did this work in the early '90s, it was published in The New England Journal of Medicine. And over the years as we've all seen there have been natural Viagras that have been sold and promoted, better than Viagra, as good as Viagra. So he and his research team actually went to work to see what natural ingredients actually do have a Viagra-like effect. But in a scientifically studied way, in a validated way. And they tested a whole array of natural ingredients that have been purported to help with erections, or aphrodisiacs if you will.

Dr. Spitz: And what they found was that ginger had this tremendous ability to increase the production of nitric oxide in a Petri dish in endothelial cells compared to the other ingredients. Now we also know that there are some other ingredients that are important in the production of nitric oxide. Many people have heard of L-arginine. L-arginine is an amino acid that gets converted to nitric oxide. But the problem is is that when you take L-arginine supplements, they almost immediately get destroyed as they go through your liver and the liver breaks them down. So you can take L-arginine but not a whole lot ends up becoming nitric oxide. So Dr. Rajfer recognizes that L-citrulline gets converted into L-arginine, but after it's made it into your bloodstream. And he was working with a researcher from Brazil, and they had a long tradition of some Brazilian concoction of ingredients that were known to help with erections. So they took this combination of ginger, L-citrulline, and these Brazilian ingredients, marapuama and guarana. Guarana's in a lot of energy drinks, it has a little mild caffeine-like effect.

Dr. Spitz: And they did studies on rats and the results were amazing. They actually prevented a reversed aging of the blood vessels in the rats they were studying. It was an antiaging effect on a rat's blood vessels. They were able to get some human penile tissue and run some tests on it as well, and demonstrated that it had the same cascade of molecular action on that tissue. So, this kind of a supplement actually increases the production of nitric oxide in the vascular lining of the blood vessels. And this is something that starts declining when we reach about our mid-30s. We don't think of ourselves as aging when we're in our mid-30s. But believe it or not, starting in your mid-30s and on, you make less and less of your own nitric oxide. Nitric oxide not only allows the blood vessels to relax and allow more blood flow through them, but it also works at the level of the mitochondria to prevent aging of the cells, to prevent the fibrosis, the conversion of smooth muscle to fibrous collagen. And nitric oxide has this amazing antiaging effect that we gradually lose as we get older and older.

Dr. Spitz: And foods like plant-based foods, all those great foods from the produce section help give us more nitric oxide back since we're not making as much as we used to. And supplements like this one help us produce more of our own nitric oxide, and sort of regain some of the youthfulness of our blood flow.

Rip Esselstyn: Gotcha.

Dr. Spitz: So, this supplement was under development and is now just recently been released commercially. And it's called Revactin. And it is a combination of these ingredients and the dosing has been worked out. I sought this company out because I saw the signs presented at an academic session a couple of years before it ever got licensed or came out. And I've been very excited about it. I myself take it, I took the constituent ingredients before the formula came out. And I have been recommending it to my patients as well.

Rip Esselstyn: Step number two, sexercise.

Dr. Spitz: Sexercise, so, just like eating right, getting regular exercise also is good for your blood flow and for your penis. Not just because your flow increases when your heart's beating faster, but it actually induces a release of nitric oxide as well as other key molecules that are important for good vascular health. So exercise in general can be construed as sexercise, but there are sexercises in specific which are the Kegel exercises.

Rip Esselstyn: That's kind of stealth move, isn't it?

Dr. Spitz: It is, I'm Kegeling right now.

Rip Esselstyn: So am I, let's go to ten and see who's first one to ten.

Dr. Spitz: I'm already at 20. Can you spot me?

Rip Esselstyn: I'll spot you five.

Dr. Spitz: So the Kegel is a maneuver you make when you're trying to not have a bowel movement or trying to not pee. It's that squeezing motion. And it's just that motion in your pelvis. It's not squeezing your butt muscles or squeezing your abdominal muscles. It's just squeezing those sphincters and you can really do it as a stealth. No one would know you were doing it, but if you wanna know that you're doing it right, if you stand in front a mirror and you give a hard squeeze, and you see the base of your penis withdraw a little bit inward, then you know you're hitting those muscles properly. And these muscles surround the base of the urethra, and then contract involuntarily when you're having an ejaculation, during orgasm. But they also help trap the blood into the penis to help the erection even more rigid, to help prevent the blood from leaking out.

Dr. Spitz: And very carefully done studies of men who did Kegel exercises very deliberately, very properly in a regular fashion showed that over several weeks they had improvements in their erections similar or better to Viagra. So, if you can focus your attention on your taint and give it a squeeze, on regular basis, couple times a day, you will notice some benefits in time.

Rip Esselstyn: So maybe, after your ten, fifteen minutes of meditation do a minute of Kegels.

Dr. Spitz: Sure, and when you're just bored.

Rip Esselstyn: Yeah.

Dr. Spitz: Instead of reaching for that cellphone give yourself a little squeeze.

Rip Esselstyn: I like it. Number three, going offline.

Dr. Spitz: Yes.

Rip Esselstyn: If you're enjoying the guest on my podcast, come spend the weekend interacting with all of us. Dance with my sister Jane, hike with my mother Ann, share a meal with my father Essee, and spend time with all of our dynamic speakers: Drs. Dean and Ayesha Sherzai, the authors of the Alzheimer's Solution Paul de Gelder the host of Shark Week, Dr. Jim Lomas from The Game Changers documentary, Dr. Cyrus Khambatta and Robbie Barbero of Mastering Diabetes, Dr. Siri Stanczyk as featured in the documentary Code Blue, and my buddy John Mackey the CEO of Whole Foods Market, and many, many more. Pick and choose from a robust variety of talks, enjoy plentiful Plant-Strong buffets, take in the mountain air, and start the day with an invigorating morning dance party. Come celebrate what it means to live Plant-Strong. Onsite accommodations are still available, so join us August 9th through the 11th at our 8th Annual Camp Plant-Stock. For more information go to engine2.com and click on "Events." I look forward to doing kale shots with you.

Dr. Spitz: Going offline means getting off of pornography which is typically online. That's why I say go offline. It's not about the internet in general, but it's about pornography specifically. Pornography has become so ubiquitous and so available because of streaming. And right now, anybody can access porn, literally in the palm of their hand, or I should say the other palm of their hand. And, at first it might seem like it's just an issue of morality or proprietary, or propriety I should say. Scientific studies are showing that the frequent exposure to pornography that so many people subject themselves to, and by frequent I mean daily or several times a week which is not unusual. There are actual measurable changes in brain centers, and remember how I said how important the brain is, a sexual function, the biggest sex organ. There are measurable changes of key centers of the brain that are important for a normal sexual response, where these centers are shown to actually physically shrink on MRI studies. And, their function diminishes when measured in these studies and what test as well.

Dr. Spitz: Fortunately, it is reversible but it can take some time. And the best way to turn it around is to go cold turkey, to just cut it out altogether. And after several months it's been demonstrated that people do recover, but what this kind of high frequency viewing does, is it makes it more difficult to even get an erection. It makes it more difficult to reach sexual climax. The interesting thing about the effect of pornography on the brain is that very much mimics the effect of addictive drugs such as heroine and cocaine. Now, sex is a basic human need so you would think that we would crave it, you know for our survival. And we crave food and water, those are basic human needs. But those are different brain centers that light up when we're thirsty or hungry, than light up with porn. It's the addictive centers that light up with porn.

Dr. Spitz: And unfortunately, it really undermines people's relationships. Not just their inherent ability to physically be sexual, but also undermines their ability to be able to relate to a normal human being. Because the images and the scenarios depicted in pornography are not real, are not normal. A 20-minute video takes four or five hours to film and it involves a lot of uncomfortable scenarios and what you see is not real life. And to expect that, from a partner, is undermining to a normal happy healthy sexual relationship. And many sexual medicine specialists are starting to see a whole new array of sexual disfunction, relationship disfunction, specifically since the advent of streaming porn. Porn's been around forever but it's never been so available, so ubiquitous.

Rip Esselstyn: Alright, step number four, detox.

Dr. Spitz: Detox, so, we talked about food, and we talked about exercise and pornography. But other habits that are harmful are pretty obvious when you think about it. Smoking and excessive drinking. And detox means get off these harmful habits, get off these harmful substances. Excessive use of narcotics, amphetamines, excessive marijuana usage. All of these have been scientifically demonstrated to impair your sexual health. And they do it in a variety of ways, some neurologically, some hormonally, some vascularly. So detox is get off the drugs, get of the substances, or at least scale it way down. And then the other detox is get off the prescriptions that might be affecting your erections.

Dr. Spitz: High blood pressure is a very common problem in our population, and the medications that we use to treat high blood pressure very commonly impair your erection. Not all, but many do. If you can eat better, eat plant-based and exercise regularly. You are less likely to develop high blood pressure in the first place, and therefore less likely to end up needing those very medications that hurt your erections, and high blood pressure itself hurts your erections. So detox is see if you can get healthy off prescription medicine but for sure get off those drugs you're voluntarily putting into your system.

Rip Esselstyn: I've had a couple friends literally just in the last three weeks that have emailed me, because they have had difficulty with erections related to, they believe antidepressants. Do you know of any correlation with that?

Dr. Spitz: Yes, absolutely. Antidepressants do have, in many cases, a negative effect on sexual response. Most common antidepressants, which are called serotonin reuptake inhibitors or selective serotonin reuptake inhibitors, work by allowing serotonin, this feel-good chemical to accumulate in your brain. And it does help with depression and these drugs are very important and critical for many people, and I'm not advocating that people stop their antidepressant meds, but if you understand what might be happening, it can help you then direct how you proceed.

Dr. Spitz: So, serotonin is a chemical that actually inhibits your ability to reach an orgasm. And, we will use these very antidepressant drugs at lower doses to treat men who have premature ejaculation, to help them suppress orgasming too quickly. So, when you are on one of these medications you may notice that you are having trouble reaching sexual climax, or that you're some negative effect on your ability to have sexual enjoyment. And that's not just in your head. It can be a real side-effect. There are some medications that have far less of this effect than others, and your prescribing physician, once he or she is alerted to that, may be able to make some changes to allow you to have a better sexual response.

Rip Esselstyn: There was just an article today in the New York Times front page about antidepressants, and how this new research coming out of the UK has indicated that if you want to get off your antidepressants over the course of four weeks, they're suggesting months if not years. It has to be titrated down at a very, very slow pace.

Dr. Spitz: Yeah, and this is why I am not advocating that anybody listening to this podcast cut off their prescribed meds. That is not the right way to proceed.

Rip Esselstyn: Number five, snooze or lose.

Dr. Spitz: Yes, this is all about getting a good night's sleep. The science of sleep is very young and it is amazing what we have learned in a very short time about just how profoundly our health is impacted by a good night's sleep or not getting enough sleep. There is a condition that is very common called sleep apnea. And this is often found in people who are overweight, because the mass in their neck is compressing their airway while they're asleep. And these people can be treated with CPAP which is a device that forces air down. But, they can also improve this condition by eating plant-based and exercising. All the other things that are good for your penis, are good for blood vessels, are good for your airway.

Dr. Spitz: But, if you're not getting a good night's sleep, and it might be because of sleep apnea, or if you're deliberately not getting a good night's sleep because you're just burning the candle at both ends. You're working long hours, you're compromising on your sleep, what happens is your body produces more adrenaline, because it goes into a stress state. Not getting enough sleep is stressful to the body. And adrenaline, which is this great chemical that our bodies produce to help us do these really cool extreme sports and, you know, have a really fun time and really excited, is no good for erections. Adrenaline is a chemical that our body uses to survive stress.

Dr. Spitz: And, in the most explicit form, that would be a physical attack on your body. Perhaps and attack that causes you to hemorrhage, to bleed. And in the event that you might bleed out, adrenaline kicks in and it shunts blood to your heart, to your liver, to your lungs, to your brain, the critical core. And it shunts it away from the thing that might've just gotten mauled by, say, a saber-tooth tiger. So the blood flow gets shunted away from your legs, from your arms, from your fingers, from your toes, and from your penis. Now, when you have adrenaline at a higher level just because you didn't get enough sleep, your body doesn't distinguish that this is adrenaline from not getting enough sleep versus this is adrenaline from a physical attack. And it still shunts the blood away from your penis. And so guys who don't get enough sleep may notice less spontaneous erections, or that their penis seems like it's shrinking. It's just because that adrenaline is contracting those blood vessels.

Dr. Spitz: Furthermore, I had mentioned there are centers in your brain that are important for releasing chemicals, or hormones to stimulate your testicles to make testosterone. Well that release, that signal happens when you're in REM sleep. So our testicles are stimulated by the testosterone when we are in REM sleep. If we are not getting enough REM sleep, we will see a drop in our testosterone, and in fact night-shift workers and people who get very little sleep have been scientifically shown to have lower-than-normal testosterone, or be at risk of that. So you need testosterone for healthy sexual function, you need good blood flow and not adrenaline, and not getting enough sleep compromises both of those.

Rip Esselstyn: So of many of these things we're talking about today, they overlap with all the people that I've been talking to about being healthy, the [inaudible 00:25:45] that talk about preventing Alzheimer's, and how absolutely integral getting sleep is, eating plant-based. I mean, the list goes on and on and on. So, for maximum penis health, get that sleep.

Dr. Spitz: Get that sleep.

Rip Esselstyn: So, thank you for going over those five steps for maximum penis health. I want to say that the things that you are doing for the male penis, the fact that you are leading the charge as far as what it means to be a real man, and the best foods to eat. To be a real man for the society, for our health, and for our penises' health.

Dr. Spitz: You know, absolutely. You know, if we can't get them with concern over their heart, if we can't get them with concern over their cancer, we can probably get them with concern over their penis. And, you know, a plant-powered penis is really the key to a plant-powered person. And so, I really look at the penis as the gateway organ.

Rip Esselstyn: Yes.

Rip Esselstyn: Eating a Plant-Strong diet does more than just help you lose weight. It makes every part of you strong. Mentally, physically, and yeah, sexually. Eating eggplant, sweet potatoes, oats, or even bananas instead of a cow, it doesn't make you less of a man, in fact it might just help make you more of one. You can see more of Dr. Aaron Spitz in the upcoming documentary The Game Changers, where he conducted the most uplifting experiment on the planet, demonstrating the effects that just one plant-powered meal can have on male erections. You literally will fall out of your chair, and we'll talk more about that in one of our future episodes.

Rip Esselstyn: I'm Rip Esselstyn and I wanna thank you for listening. My hope is that this podcast has inspired you to take control of your health through a Plant-Strong lifestyle. I also wanna thank my co-creator of the podcast, Scott Battishill, with 10-Percent Media, Lori Kotowich, my produce-extraordinaire and Engine 2 Director of Events, Tina Knoll and Large Media for podcast production and creative direction, and Brandon Curtis for never minding living in the barrel and everything in between. Thanks for Whole Foods Market for giving me a platform for the last decade. Special thanks to Joe Inga for your courage to take control and change your life, and for allowing us to share your story along the way. And lastly, I wanna thank my father and mother, Dr. Caldwell Esselstyn Jr. and Ann Crile Esselstyn, and all the Plant-Strong pioneers who have been pushing this boulder uphill for more than three decades. As they say, we're standing on the shoulders of giants.

Rip Esselstyn: If you're digging the podcast, I want you to rate us. I want you to review the show and I want you to spread this message with friends and family. We wanna get this message out to as many people as possible. Join us on all of our social channels, either on Engine 2, or Rip Esselstyn, whether it's Instagram, Facebook, or Twitter. Until next time, peace, Engine 2, and keep it Plant-Strong.

Ami Mackey