Justin J. Houman, MD

Justin J. Houman, MD Comprehensive Men’s Health clinic focused on improving men’s s*xual performance, fertility optimization, and hormone management.⁣⁣
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08/02/2026

A common question I get almost weekly: what do GLP-1s do to men's testosterone and fertility?

Comment TESTOSTERONE and I'll DM you my low T evaluation guide.

Up until recently, we didn't have a clean answer. New research this week does.

Researchers reviewed multiple clinical trials on long-term GLP-1 use. The finding: no harmful effect on hormone levels, s*xual function, or s***m quality.

For men with obesity-related low testosterone specifically, GLP-1s may actually improve testosterone levels. And more importantly, improve s***m quality.

Excess weight is not good for physical health, metabolic health, hormonal health, or fertility. When a GLP-1 helps address the underlying weight issue, the hormonal and reproductive downstream often improves too.

For men considering a GLP-1 as part of a weight-management plan, this is a meaningful shift. Concerns that these medications might hurt testosterone or fertility have been holding some men back. The current evidence does not support those concerns, and the picture may actually be favorable for the subset with obesity-related hypogonadism.

If you're considering a GLP-1, consult with a physician who can prescribe it and walk through the tradeoffs.

Los Angeles and across the US.

Most male fertility workups stop at test one. Here are the 4 every guy should actually have.Comment FERTILITY and I'll D...
08/01/2026

Most male fertility workups stop at test one. Here are the 4 every guy should actually have.

Comment FERTILITY and I'll DM you the full fertility workup guide.

Male factor is about half of every fertility story. That's per AUA and ASRM data. Yet the vast majority of workups stop at a single semen analysis. That is part of a workup. It is not the whole workup.

Test 1. Semen analysis. Measures three things: s***m count, motility (how many are moving), morphology (how many are shaped correctly). Necessary. Not the whole picture.

Test 2. Hormone panel. FSH, LH, total and free testosterone, and prolactin. The plumbing report. FSH and LH tell you whether the brain is signaling the testicles to work. Testosterone tells you whether they're responding. Prolactin rules out a pituitary issue. Drawn in the morning.

Test 3. Scrotal ultrasound. A physical exam misses about 35% of varicoceles that ultrasound catches. Varicoceles are one of the most common treatable causes of male infertility. Skipping this test means a treatable problem stays undiagnosed for years while a couple keeps trying.

Test 4. DNA fragmentation index. A normal semen analysis can still have s***m with damaged DNA. High DNA fragmentation is one of the biggest reasons IVF fails and early pregnancies do not stick. If the standard tests look fine but conception is not happening, ask about DFI.

I run all four on every new couple. Fellowship-trained microsurgery in male reproductive medicine and surgery is held by fewer than 2% of urologists in this country. That's the whole practice here, and the workup reflects it.

If you have been trying for a year and only had a semen analysis, you have had part of a workup, not a workup.

Save this. Send it to your partner before the next appointment.

Los Angeles and across the US.

***mAnalysis

07/29/2026

On the Unboxing Careers Podcast with talking about what actually makes this job satisfying, this far into a career.

For me right now, it comes from solving the tough problems. Patients who've already been to a handful of other doctors without answers. Surgical cases where a guy walks in and says, "I've seen 3 or 4 other urologists, I have this problem, I need it fixed."

Those cases take a lot more time to think through. Sometimes I lose sleep the night before a complex surgery running the plan back in my head. But when the outcome lands, when the patient walks out with something no one else could give them, that's what makes this work feel meaningful.

If you're a pre-med student, med student, or resident thinking about what makes a medical career worth the training runway, this is one honest answer. The satisfaction shifts as you go. Early on it's about mastering the craft. Later, it starts to be about the cases nobody else could solve.

Full episode on 's YouTube.

You've been on TRT. You want kids. Don't just stop.Comment TRT and I'll DM you the full guide on protecting fertility on...
07/28/2026

You've been on TRT. You want kids. Don't just stop.

Comment TRT and I'll DM you the full guide on protecting fertility on TRT.

Stopping cold doesn't restart fertility. It stalls it. After months or years on exogenous testosterone, the brain has been quiet the whole time. Stopping doesn't wake it back up. Testicles sit idle, s***m counts stay near zero, and you crash from the T drop while you wait.

There is a better way. The 2-step exit protocol.

Step 1. Clomid or enclomiphene. First-line for men who want fertility. Blocks estrogen feedback so the pituitary keeps sending LH and FSH signals. Your body raises its own testosterone, and s***m production is preserved. Enclomiphene is the more targeted single-isomer version.

Step 2. Add hCG. Mimics the LH signal that tells the testicles to work. Used alone during the exit, or alongside TRT to keep the testicles producing during the transition.

Fallback. If you genuinely need supplemental T through the transition, Natesto (nasal T) creates less axis suppression than injections or gels. Fertility-friendliest form when TRT is still on the table.

Timeline. S***m production usually restarts within 3 to 6 months. Full recovery typically 6 to 12 months, longer for long-term users. Most men fully recover. A small percentage don't.

Monitoring: labs at 3 months, then every 6 to 12 months. Total T, LH, FSH, estradiol. Track s***m-count recovery. You're not done when you feel normal. You're done when the numbers say so.

We don't stop TRT cold. We pick a protocol matched to your fertility timeline. Then we watch the labs, not the calendar.

Almost nobody has to just hope.

Save this. Send it to the guy on TRT about to start trying for kids.

Los Angeles and across the US.

07/24/2026

What's the best way to take Vi**ra?

Comment HARD and I'll DM you my full ED assessment guide.

I see this constantly. A guy comes in and says he took Vi**ra, it worked the first time, worked the second time, third time nothing. Then it worked again. The inconsistency drives them crazy.

Here's the thing about Vi**ra that most guys don't hear at the pharmacy counter. It's very digestion-dependent.

Take it on an empty stomach. Don't eat for 30 to 45 minutes after taking it.

Then give it time. Vi**ra typically takes about 2 hours to kick in. For some men, up to 4 hours.

Empty stomach. Wait. Then you get the real benefits.

If you've been taking Vi**ra and getting inconsistent results, this is probably the reason.

Save this. Send it to the guy who's frustrated with unreliable results.

Los Angeles and across the US.

**ra

07/23/2026

On the Unboxing Careers Podcast with talking about what a men's health urologist actually does day to day.

Two main focuses in my practice: guys who can't have s*x and guys who can't have babies.

On the s*xual side, a lot of my surgical work is inflatable pe**le implants. It's a prosthetic device that goes into the p***s with a pump contained under the skin. When a man wants an er****on, he squeezes the pump. When he's done, he releases it. Life-changing procedure for men who've exhausted every other option.

On the fertility side, most of my surgical work is microsurgical varicocelectomies. Varicoceles (varicose veins of the testicles) are the biggest single cause of male infertility, and microsurgical repair has the best outcomes. Vasectomy reversals too, plus a fair number of vasectomies.

And because I'm still a urologist first, I do plenty of general urology. Kidney stones. Prostate. Endoscopic surgery.

There's a big demand for urologists across the country right now, and men's health as a subspecialty has grown fast.

If you're a pre-med student, med student, or resident thinking about urology as a career, the full episode with is worth a listen.

07/21/2026

Just told the New York Post: ED is a check engine light for your heart.

If you are experiencing ED, comment ED below and I'll send you my full assessment.

Here's what that means. For most men, ED is a vascular event. The pe**le arteries are small, so any damage to your vascular system shows up there first.

We've proven that damage shows up on average 3 to 5 years before any cardiac event. Men with ED have a 44% higher risk of heart disease.

It doesn't matter if you're s*xually active right now. Your vascular system may be telling you something worth listening to.

Los Angeles and across the US.

Half the men on TRT hit zero s***m. Within months. Here's how to avoid it.Comment TRT and I'll email you the full TRT + ...
07/20/2026

Half the men on TRT hit zero s***m. Within months. Here's how to avoid it.

Comment TRT and I'll email you the full TRT + fertility protocol.

TRT and s***m production run on the same switch. When testosterone comes in from outside the body, the brain reads the signal and tells the testicles to stop. Stop producing testosterone. Stop producing s***m. In most men, s***m counts drop very low within a few months. In about half, they hit zero entirely.

Usually reversible after stopping TRT. Not always. Not fast. It can take months to over a year for s***m production to come back, and a small percentage of men never fully recover baseline. If kids might be in the picture someday, "I'll deal with it later" is a real gamble.

Three ways to do TRT without killing your fertility.

Nasal testosterone (Natesto). Short-acting and pulsatile, which means your natural hormonal axis stays partially active instead of getting fully shut down. Three-times-a-day dosing is the tradeoff. This is the fertility-friendly option for men on the family-planning timeline.
Add hCG to standard TRT. hCG mimics the brain signal that keeps the testicles producing. Added to standard testosterone injections, it preserves s***m production for most men on TRT. Standard protocol at any fertility-aware urology practice. If your TRT clinic has never mentioned it, that is a flag.
Skip TRT. Use Clomid or enclomiphene instead. These raise your own testosterone by blocking the estrogen feedback loop, so the brain keeps signaling the testicles. Fertility-preserving by design. Works well for men whose T is low but not gone. Often the first line for younger men.

The question your TRT clinic should be asking in the first five minutes of your consult is simple. Do you want kids in the future? If they don't ask, they are not the clinic to be on TRT with.

Save this. Send it to the guy about to walk into a TRT mill without a fertility plan.

Los Angeles and across the US.

07/19/2026

Does a vasectomy impact your testosterone levels?

Comment VAS and I'll DM you my full vasectomy prep and recovery guide.

No. It doesn't. And it also doesn't impact your erectile function or pe**le sensitivity. Nothing.

These are the three things nearly every guy walks into the vasectomy consult worried about. Here's what's actually happening.
A vasectomy blocks the pathway of s***m coming out of your ej*****te. That's it. The testicle itself, which produces both s***m and testosterone, is untouched. It keeps producing testosterone at the same levels. It keeps producing s***m too. The s***m just doesn't reach your ej*****te anymore.
You won't notice a drop in ej*****te volume either. S***m makes up about 1% of the total volume. The other 99% comes from the seminal vesicles and prostate. Which are also untouched.

So the numbers hold. Testosterone the same. Erections the same. Sensitivity the same. Volume the same.
The only thing that changes is the one thing you came in for.
Save this if you're considering a vasectomy. Send it to your partner too.

Los Angeles and across the US.

Address

Los Angeles, CA

Opening Hours

Monday 8:30am - 5pm
Tuesday 8:30am - 5pm
Wednesday 8:30am - 5pm
Thursday 8:30am - 5:05pm
Friday 8:30am - 5:05pm

Telephone

+13108549898

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