Dr. Cameron Sepah of Maximus is back with yet another must-listen episode on the PricePlow Podcast!
In Episode #062, we introduced Dr. Cam and spoke with him about the Maximus King Protocol, a better and safer way to boost testosterone with clinically significant results. This time, we talk about libido, sexual health, and optimizing male performance and mindset.
Maximus is a consumer telemedicine company for male health and hormone optimization. It comes with a highly-active community known as the Maximus Tribe, featuring men who are working to better themselves in all aspects of life.
With the Maximus Lover Protocol, they’re focusing on boosting libido, male performance, and confidence using two prescription drugs described below – 5mg tadalafil (Cialis) and 2mg PT-141 (Bremelanotide). Beyond the drugs, Dr. Cam also covers many strategies to improve libido, which is a great indicator for overall health.
The detailed show notes (with references) below, and you can watch it on YouTube or listen to it on your favorite podcast app:
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Discussion #2 with Dr. Cameron Sepah of Maximus: Libido, Men’s Health, Sex, and More
0:00 – Quick re-introduction
If you don’t know who Dr. Cam is, then you must listen to Episode #062 where he introduces Maximus and the King Protocol, which includes the drug enclomiphene!
1:30 – Recap of Episode 062
In the last episode, Dr. Sepah noted that testosterone is one of the most useful single biomarkers of overall health. But most men don’t get checked that often.
2:30 – Morning erections and libido – a very simple marker of overall health
However, libido levels are declining across the board. There’s a lot of social phenomena that’s not helping, such as pornography, and there’s a huge obesity and metabolic problem.
This causes a “perfect storm of sexual problems”.
3:40 – Anecdote of libido issues and ED drug sales
Dr. Cam shares that a telemedicine business CEO stated that his average erectile dysfunction (ED) prescription drug patient was just 25 years old!
This made him realize how bad this problem was. He attributes it to three reason:
- Young adults are no longer metabolically healthy
- “Whiskey dick” from drinking alcohol (alcohol-induced erectile dysfunction)
- Performance anxiety in young men
In the third case, they’re taking it nearly prophylactically so they have a good experience.
6:00 – Cosmetic pharmacology
The above issues — especially points 2 and 3 — are what you can call “cosmetic pharmacology”, and while Dr. Sepah doesn’t have an issue with it, the current system was set up in a way that patients had to lie to their doctors, which is a terrible thing.
These are powerful medications that can be used for a variety of reasons that go beyond sex, but we need to remove the stigma around them so we can have an open and honest converation about their overall benefits.
8:00 – ED (erectile dysfunction) drugs and nitrate supplements
Ben relates to the stigma around ED drugs, and relates back to an old PricePlow video where Mike warned users not to use too many nitrates with Cialis… and it turned out that Ben was actually on Cialis that day as we were drinking a nitrate-based supplement!
Later on in this show, Mike explains that the study warning against nitrate and ED drug use had a quite large 20 milligram dose of tadalafil (Cialis) with nitroglycerine on a repeated basis, which lowered their blood pressure too much. With smaller doses like 2.5 or 5 milligrams, we’re less concerned.
8:45 – Morning wood as a good status check?
Mike backs things up and wonders why morning wood (nocturnal erections) is a good status check for libido and health. Dr. Cam explains you don’t need one every morning, but it’s generally associated with healthy hormone function, since nighttime is when testosterone and growth hormone peak.
More important to Dr. Cam, however, is overall libido – Do you have a healthy sense of libido?
He emphasizes the word healthy with libido, because too many young men masturbate compulsively, often for non-sexual reasons. A simple question for that is, “Do you want to have sex with another person?” with emphasis on the person.
So overall, morning wood and a healthy sense of libido are the most useful psychophysiological markers of overall health. If you’re never having morning wood or don’t have much libido, then there’s usually something going on – lifestyle, diet, stress.
13:00 – Libido is bio-psycho-social
It’s not just testosterone that goes into libido. The psychological and social effects are important too. For instance, if your relationships aren’t going well, libido can have serious issues too.
15:00 – Warming up to The Maximus Lover Protocol
ED drugs were originally developed for pulmonary hypertension – they’re blood pressure reducing agents.
At the end of the research trials, the researchers asked for the drugs back from the patients, and they refused to give them back because their sex and erections had gotten so much better!
16:15 – Medications are not for any one particular purpose
Drugs can have numerous effects – however, drug companies have to get them tested and FDA-approved for certain situations. That doesn’t mean that those are the only situations they can apply to, though!
16:45 – PDE5 Inhibitors
There were no ED medications on the market before the PDE5 inhibitors like Viagra (sildenafil) and Cialis (tadalafil). PDE5 stands for phosphodiesterase type 5 inhibitor. These work on the vascular system and increase blood flow.
They got tadalafil approved for a multitude of reasons:
- BPH (Benign prostatic hyperplasia – “enlarged prostate”)
- Improvement of erectile dysfunction
18:45 – Cialis vs Viagra (tadalafil vs sildenafil)
Dr. Cam argues that Cialis is superior for a couple of reasons:
- Viagra has a problem with food. If taken with fatty food, it messes the metabolism up. This makes it trickier to dose.
- Cialis has a longer half-life. It lasts longer in the system. For instance, in France it was known as the “weekend pill”.
With this, Cialis can be used as a daily product – “set it and forget it” and get to steady state serum levels.
20:30 – Using tadalafil in the real world
The above doesn’t mean you’ll get random / spontaneous erections. You might walk around a bit “fuller” though.
If there’s stimulation or a need for an erection, Cialis will:
- Get you hard faster
- Make you harder
- Help you stay hard longer
It also helps with repeat performances.
22:00 – Side effects of PDE5 inhibitors
The main side effect is headache, but some get some flushing. Others get some GI distress and lower back pain (due to muscles firing).
23:00 – Tadalafil dosage
Some use large 20 milligram doses, which is often very unnecessary. 2.5 to 5 milligrams normally gives great effects, and with fewer side effects.
You want to take the minimum effective dose (MED) of any drug. Drugs can arguably become different drugs at high doses!
25:15 – Interaction effects and pre-workouts
Increasing blood flow and getting nutrients to the muscle is hugely important to athletes, hence the usage of nitric oxide boosting pre-workout supplements.
Dr. Cam argues that there is no better muscle pump, blood flow enhancer than tadalafil! He stands by this claim, explaining that if citrulline and beetroot, etc worked as well… we wouldn’t have needed ED medications! We’d just be taking citrulline and arginine.
However, these supplements don’t work as well as the PDE5 inhibitors. The best pump comes from the ED drugs! So Dr. Cam says not to worry about mixing with nitrates — just don’t take the NO supplement.
29:00 – Spiking NO supplements with PDE5 inhibitors?!
We’ve seen supplement companies spike their pump supplements with these drugs because they work so well. (Offtopic note: if you’re concerned about this, get a supplement that’s been tested for drugs, such as those that have the Informed Choice or BSCG certifications).
30:30 – Can you get a tadalafil prescription for gym pumps?
This is where the spectrum of medicine is interesting – it depends on the doctor. “Health insurance companies are really in the business of denying healthcare” — they’re not going to approve this — it’s not a medical condition!
Also, traditional primary care practices generally provide sick care, and don’t provide performance-enhancing medicine. Every doctor has the right to prescribe off-label medication, but many won’t do it.
Ultimately, the trick is to use Dr. Cam’s service and get the Maximus Lover Protocol, but you can also find a concierge doctor nearby. They generally won’t take insurance.
We get back to more benefits of PDE5 inhibitors:
34:30 – Tadalafil post-surgery for blood flow
Dr. Cam had a podcast with Dr. Wayne Hellstrom, who explains that he loves tadalafil post-surgery for its blood flow improvements! You can listen to this on Episode 039 of the Maximus Podcast titled “Improve Your Sexual Health and Performance”.[2,3]
36:30 – Tadalafil and PDE5 Inhibitors as nootropics
A promising area with the least amount of research is the nootropic potential of PDE5 inhibitors. Blood flow also gets improved in the brain, after all.
Correlational data shows that those who use sildenafil have lower incidences of Alzheimer’s disease. This has become an emerging hypothesis. It may be useful in delaying and preventing the onset of neurological disorders, although more research is obviously needed.
Across many studies, we’ve seen PDE5 inhibitors improve:
- Attention and focus
- Processing speed
39:30 – Caffeine vs. PDE5 inhibitors for focus and creativity
So many people use caffeine, which keeps you alert — but it’s a vasoconstrictor! This leads to the well-known side effects of anxiety, sweatiness, jitters, etc.
Dr. Cam argues that caffeine is great for boring, linear tasks — like pounding out a spreadsheet or cleaning something. But it’s not great for creative work since it’s restricting blood flow. He thinks a vasodilator has better effects as a smart drug for envisioning new things.
41:30 – Muscle protein synthesis and PDE5 inhibitors
We’ve seen studies on sildenafil enhancing muscle protein synthesis and reducing muscle fatigue. While this hasn’t been tested in tadalafil, the mechanism is roughly the same, so it should work with both drugs.
42:30 – Is tadalafil the most important anti-aging drug?
Due to all of the above benefits, many doctors are beginning to believe that tadalafil is a better anti-aging drug than anything out there on the planet!
43:30 – The Maximus Lover Protocol
Dr. Cam never had ED problems, but was told to try tadalafil for these auxiliary benefits, and was very impressed. There’s great potential here, but he’s not in the business of just selling generic drugs you can get nearly anywhere.
The thing is – ED drugs don’t make sex better. They may improve some confidence, but they don’t improve your libido.
This is where the Protocol adds its other component, next to 5mg of tadalafil: 2 milligrams of PT-141 (Bremelanotide).
44:30 – The background of sexual drugs for women and melanocortin agonists
ED drugs are for men, but researchers also wanted to create libido boosters for women. They got there through a roundabout way when looking at melanocortin agonists, specifically melanotan-1 and melanotan-2.
These drugs were originally investigated for sunless tanning,[7,8] but a doctor accidentally dosed himself twice the dose he had wanted via injection, and found that he had an 8 hour erection that he couldn’t get down!
It turns out that the melanotan drugs don’t work on the vasculature system, but instead work on the central nervous system. And its effects include sexual stimulation!
46:45 – Introducing PT-141 (Bremelanotide)
PT-141 is a melanocortin agonist[9,10] that works through a whole different mechanism of action, as it binds to melanocortin receptors 1 through 5 that are responsible for many functions like steroid genesis, the melanin system, anti-inflammatory effects, and… sexual function.
This is very useful for those who don’t get great effects from PDE5 inhibitors due to other reasons.[12-14]
48:00 – Combining PT-141 with PDE5 Inhibitors
Since one drug (tadalafil) works through the vasculature system, and the other works through the brain and CNS, researchers wondered if they worked well together. Research shows that they do work very well together — better than either alone! There is a synergistic effect on its ability to maintain erection.
48:45 – PT-141 / Bremelanotide / Vyleesi for women
As a prescription drug, Vyleesi (Bremelanotide) has been approved by the FDA for hypoactive sexual disorder in women. But it works just as well for men!
It enhances libido and sexual enjoyment is increased. Better sex and better orgasms.
50:00 – The Maximus Lover Protocol: Performance and enjoyment
Consider tadalafil the performance enhancer, while bremelanotide is the enjoyment enhancer, the latter of which Dr. Cam claims is the more “cosmetic” drug.
51:00 – Melanotan-1 and Melanotan-2 vs. Bremelanotide
We started by talking about Melanotan-1 and Melanotan-2, but skipped how the research led into bremelanotide. The melanotan drugs never made it to market because of too much GI distress and it increased blood pressure, which is obviously not what we want.
Dr. Cam tells an anecdote about the company researching those drugs – since melanotan didn’t make it to market, they published their data and chemistry. It was then picked up on the black market, but taking those aren’t suggested.
This led to further research to isolate the ED and arousal benefits but not the sunless tanning effects. Eventually, PT-141 was derived from that research, and it doesn’t have the tanning effect.
53:45 – Bremelanotide side effects?
Bremelanotide’s route of administration and dosage means a lot. This is normally an injected drug, but nausea can occur in over 10% of people and almost nobody wants to inject things every day for cosmetic reasons. Alternative delivery methods were investigated, including intranasal route – but that needs very high doses.
But what works best is taking it sublingually – under the tongue. By getting it into the mucus membranes in the mouth, this can better avoid the gastrointestinal tract and liver.
Although this isn’t as strong as injections, that’s a good thing – we’re going for minimum effective doses here, not 8 hour erections.
57:00 – Bremelanotide taken sublingually with Maximus
This provides a better, safer strategy – a “mild effect” – it’s not going to drive you “crazy horny”. There haven’t been many reports of GI side effects with this. Dr. Cam argues that the 2mg (2000mcg) dosage is the sweet spot here for the healthy libido effect.
58:45 – Healthy libido is important for successful men
Dr. Cam notes that many successful men he works with are great at channeling their libido and masculine strength into superior work. Channel it into great works of art and success.
“What makes men great is really the sublimation of that libido and channeling it in ways that are positive and pro-social and productive. So if you don’t have any libido, I would argue, it’s going to be hard for you to change the world and do anything great.”
1:01:00 – Channel libido instead of masturbate
Dr. Cam believes you should channel your libido and stop wasting it on porn and self-pleasure. You actually get a transient increase in testosterone when stopping masturbation[16,17] (It seems to peak on day 7!)
Athletes use this to their advantage by abstaining.
1:02:30 – How do you get the Lover Protocol?
Getting the Lover Protocol works the same as with the King Protocol – head over to MaximusTribe.com and get signed up for a telemedicine appointment with a real doctor.
What’s different is that there’s no bloodwork done, like there is with testosterone in the King Protocol. Libido is more subjective to measure.
Once you are prescribed, the pharmacy will send the drugs via mail.
1:04:45 – Bremelanotide half-life?
We don’t know the sublingual half-life, since most research is done on injections. It seems to be on the order of multiple hours – when taken daily, users seem to get to steady state effects.
Dr. Cam is a fan of morning dosing just because it’s when people don’t forget. However, 30-60 minutes before sex will give you the highest concentrations of both. Try to time it appropriately with your routine where you won’t forget but it’ll work best for you.
1:07:30 – Enclomiphene vs. PT-141 for Virility Purposes?
While these protocols are stackable, if you’re trying to increase your testosterone, motivation, and drive, there’s nothing like testosterone — and the King Protocol is best for that. Same goes for muscle building, at least with our current knowledge.
If trying to enhance libido and blood flow, the Lover Protocol is best. And of course, they work synergistically together.
Mike pushes for a discount if taking both, and Dr. Cam says that may be possible in the future, along with their future supplement line:
1:09:15 – The Maximus Supplements
In a future podcast, Dr. Sepah is planning on putting out some Maximus Building Blocks supplements, which has a multivitamin along with the other important compounds we discussed in the last podcast, such as geranylgeraniol (GG) and the fat soluble vitamins needed for testosterone, Vitamins A, D, E, and K. He uses 10,000IU of vitamin D3, and includes a B-complex and some added saffron.
He makes sure to note that they’re really not a supplement company, they’re a pharmaceutical medication company. Maximus is not going to sell standalone supplements — this is just for those on the King Protocol.
The goal is really to try to prevent nutritional deficiencies that would impair one of their protocols.
1:11:15 – Metabolic health is still key
Mike emphasizes that metabolic health, which is discussed more heavily in Episode #062, is still the thing to attack first and foremost (this includes abolishing omega-6 seed oils and limiting carbohydrates), as well as getting sunlight.
1:11:45 – Semen retention?!
Mike then brings up the hot topic of semen retention, and anecdotally argues that gratification abstinence absolutely puts a bit more fire in him. Dr. Cam repeats that the effects are likely transient, and testosterone numbers seem to go back to baseline (which is what happened in one study after a week). However, by the end of that week, Mike claims he’s more of an animal.
Dr. Cam thinks it’s a bit too woo-woo, and explains that he’s not against masturbation when it’s not a problem. The issue is when it becomes a disorder – when it’s causing harm or is excessive. Instead, he likens something like semen retention to dopamine fasting, a term he coined that we discuss in the previous podcast linked throughout these notes.
1:15:00 – Maximus is not a pill mill
Remember, Maximus has a community, most heavily leaning on Discord – find it at MaximusTribe.com/discord – this is where they can talk about mindset, planning, and going beyond pharmacology.
For instance, there are some discussions with premature ejaculation, and methods to limit it. While some doctors have gone so far as to prescribe SSRIs (!!!!) for this condition, the Maximus Tribe has some tricks to improve one’s stamina. For instance, the “Squeeze Technique”.
Dr. Cam believes that a lot of confidence issues aren’t around erections at all, but are more about lasting long enough. Improvements can be trained!
Again, it’s biological, psychological, and social – and the community helps support the latter two.
1:19:45 – Check your underwear! Is there polyester? Get rid of it!
As always, Mike brings up the dangers of polyester and other synthetic plastic fibers. There was some great research done in the 90s showing how terrible it is for the testicles,[18-22] but then no follow-up research was ever performed! Even crazier, if you go on Amazon to try to find 100% cotton boxers, you probably won’t even find any! It’s all plastic crap! Mike wears the Target brand (Goodfellow & Co).
Dr. Sepah instead enjoys natural silk, and suggests washing clothing before you wear them to get the dyes out. Does it work? We don’t know, but better safe than sorry!
Also don’t forget about bed sheets. Silk pillow cases can help with acne (Mike uses 100% cotton sheets).
During this, Dr. Cam drops a “Hair and Beard Protocol” they’re working on too!
1:23:00 – “Give your balls a break”
It’s best to wear loose-fitting boxers or no underwear at all in bed, and of course avoid the polyester sheets. Remember to keep the balls cooler than the rest of the body, but we’re not sure putting them on ice is remotely necessary!
1:24:45 – What states is Maximus and its partner pharmacy now working in?
You can hear the update, but it’s best to go to www.MaximusTribe.com to see the latest status when you read this.
What a great conversation. One again, listen to Episode #062 with Dr. Cam, read our article on the enclomiphene in his King Protocol, and sign up for our news alerts for Maximus Tribe below so that you can get updated when we publish our deep dive on PT-141 / Bremelanotide as well as future podcasts him!