In this episode of Pearls and Perspectives from Urology Times, host Amy Pearlman, MD, sits down with Helen Bernie, DO, MPH, at the American Urological Association's (AUA) 2025 Annual Meeting in Las Vegas for an in-depth discussion on some of the biggest questions facing men’s health and urology today. Bernie, Director of Male Sexual and Reproductive Medicine at Indiana University, discusses her team’s impressive research output, including 10 abstracts presented at AUA. She offers an inside look at the year-long, collaborative process behind their studies, emphasizing the critical role of dedicated research fellows, medical students, and multi-institutional collaborations. The conversation shifts to research on the safety of testosterone therapy in men with prostate cancer. Bernie and Pearlman explore how traditional thinking is evolving, highlighting new data that supports continuing testosterone therapy even during prostate cancer diagnosis, surgery, and recovery—challenging long-held fears and offering patients better quality of life. Both stress the importance of early conversations with urologic and radiation oncologists to ensure shared decision-making that centers patient wellbeing. The episode also delves into clomiphene use in men and its impact on lipid profiles. Bernie shares insights from her practice, explaining how routine lipid and hormone panels can uncover hidden cardiovascular risks in young men presenting for issues like erectile dysfunction or infertility. She underscores the need for a broader, more preventive approach to men's health, rather than simply treating isolated symptoms. Finally, they discuss the real-world challenges of oral testosterone therapy. Bernie explains findings from a phase 3 study suggesting that starting at higher doses could minimize lab monitoring burdens, reduce treatment delays, and improve patient satisfaction — a critical point for busy clinicians managing testosterone therapy in large practices. Relevant disclosures for Pearlman include Boston Scientific Corporation. Relevant disclosures for Bernie include Boston Scientific and Coloplast.

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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