World-renowned biohacker Bryan Johnson is raising eyebrows for his shocking approach to erectile health.
Johnson — whose mantra is, “Don’t Die” — takes Cialis, receives penile Botox and even undergoes low-intensity shockwave therapy to his, uh, johnson to improve blood flow, enhance erections and achieve sexual performance comparable to a teenager’s.
“Nighttime erections are, like, a really important health marker,” Johnson, 48, said in 2024. “Men who do not have nighttime erections are 70% more likely to die prematurely. It predicts death.”
He’s not the only longevity-seeker making waves with his rigid regimen.
Fitness guru Ben Greenfield, 44, has experimented with acoustic wave therapy and, stunningly, stem cell injections to optimize sexual performance and vitality.
So is penile health a true barometer of longevity? Are these biohackers playing the long game — or overextending themselves for a pipe dream?
The Post spoke with two experts about the rising interest in biohacking the penis — they shared their tip-down philosophies for protecting the crown jewels for the decades to come.
How does penile health reflect overall health?
“Penis health is measured in many ways, [namely] erectile dysfunction (ED), orgasmic function, libido, satisfaction with intercourse and overall satisfaction,” Dr. Ryan Welter, a pioneer in regenerative cellular therapy and founder of Regeneris Medical, told The Post.
Declines in penile health — particularly ED — have been established as an early predictor of cardiovascular disease, often appearing two to five years before a heart attack, Welter added.
Penile arteries are significantly smaller than the arteries that supply the heart and brain, meaning they often show the first signs of plaque buildup.
High cholesterol and plaque buildup reduce the blood flow needed for an erection.
Nerve damage is also a major reason for ED because it affects signals from the brain to the pelvis.
Nerve degeneration is common with age — it’s also a hallmark of diabetes, multiple sclerosis, spinal cord injury, Parkinson’s disease, stroke and Alzheimer’s disease.
And finally, imbalances in sex hormones can pave the way for ED. Low testosterone reduces libido and the ability to get and maintain erections.
“Furthermore, and this is important, happiness is one of the best predictors of longevity,” Welter said.
“Sexual dysfunction and depressed sexual satisfaction are indicators of unhappiness and need to be treated if longevity is the goal.”
What are the red flags of poor erectile health?
“Typically, men, over time, will experience erections that are not as firm as they used to be, difficulty maintaining the erection over time [and] changes in nocturnal and morning erections,” aesthetic nurse practitioner Chris Bustamante, founder of the NYC men’s clinic Lushful Aesthetics, told The Post.
“It might take them longer to ejaculate or [they] may ejaculate faster. Typically, longer is more normal with age.”
Sudden, drastic changes to the quality, frequency and duration of erections — especially when accompanied by symptoms like rapid weight gain, shortness of breath or fatigue — should warrant an urgent visit to the doctor, who will evaluate the cardiovascular system, hormone levels and the presence of any tumors, Bustamante said.
That’s why it’s important to track morning and nocturnal erections and their general hardness.
For his part, Johnson uses an Adam Health sensor ($249) to measure his nighttime erections, garnering data on their duration, frequency and quality to generate an erection health score.
He said he also tracks his sperm count, movement and shape, penile blood flow, urination speed and prostate size.
Bustamante said erections are stronger benchmarks than semen characteristics.
“It is just kind of normal sometimes for [the] volume of semen to decline with age,” he explained.
“It also varies a lot from man to man, already from the beginning. So some men naturally have higher volume loads of semen versus others.”
What are the common treatments for ED?
“The single most important treatment for longevity and health span, particularly for the penis, is diet and exercise and maintaining good metabolic health,” Welter said.
As a hard-and-fast rule, Bustamante said, you need to focus on consuming fruits, vegetables and fiber and limit red meat for its saturated fat content and processed foods for their trans fats.
Red meat and processed foods can raise blood pressure because of their high levels of sodium, saturated fats and preservatives. High blood pressure causes ED by damaging and narrowing blood vessels.
In terms of exercise, Bustamante said it’s important to build muscle since “muscle is the organ of longevity.”
He recommends 30 minutes of daily cardio, but warns against one popular activity.
“We do see a higher correlation of ED when it comes to cyclists,” Bustamante said.
“It doesn’t matter if you have a special, fancy seat or not,” he added. “Putting all that pressure on your perineum (the skin and tissue between your genitals and your anus) does sort of damage these nerves and vessels over time.”
Lifestyle changes aside, Bustamante said low doses of Cialis relax smooth muscles in the prostate, bladder neck and penis to boost urine flow and facilitate erections.
What about those expensive biohacker tools?
“Over time, men’s penises become desensitized — part of that is through sex and masturbation, and part of it is just through general aging,” Bustamante said.
“Helping to resensitize that tissue is a really important factor in terms of overall performance.”
That’s why some biohackers are going so far as to embrace low-intensity focused shockwave devices.
Bustamante said these gizmos emit sound waves that cause micro-injuries in penile tissue, triggering the growth of new blood vessels and increased blood circulation to improve penile sensitivity and function.
Shockwave therapy and acoustic wave therapy are often used interchangeably, so it’s important to know what you’re really getting.
In general, shockwave therapy uses intense, high-energy acoustic waves, while acoustic therapy often refers to gentler, lower-intensity waves.
“It is not going to be strong enough to actually penetrate the depth of this tissue,” Bustamante said of acoustic wave therapy.
“It’s going to be very, very superficial, and so, therefore, it just really is not impactful.”
For its part, Botox temporarily relaxes muscles by blocking nerve signals that cause muscle contraction.
Bustamante said that when it’s injected into the penis, patients tend to notice they can achieve firmer, quicker erections. But Botox typically lasts only three to four months.
“This treatment is really great to just improve someone’s quality of life when it comes to erectile function,” Bustamante said, adding that it can enhance the effectiveness of Cialis and Viagra.
As for penile stem cell injections, this treatment has not been approved by the Food and Drug Administration.
It’s considered experimental, with no strong evidence of safety or effectiveness.
Bustamante also warns against the increasingly popular practice of injecting salmon sperm derivatives into the penile area, as it can cause infections, allergic reactions and probably some funky smells.
Instead, he recommends and administers “P-shots,” injections of platelet-rich plasma from the patient’s own blood into the penis to boost blood flow and stimulate tissue repair.
“These modalities, such as shockwave and P-shot, are really beneficial in terms of people experiencing better sex lives,” Bustamante said.
Worth a shot — or a shock — to get up and running?
