00:00:00
Is there a way to enlarge the
00:00:02
>> So, you can put your penis in this
00:00:04
device. They've actually done research
00:00:05
on this. So, 30 minutes twice a day and
00:00:07
it does show improvements in length
00:00:09
about 2 cm.
00:00:11
>> Tada.
00:00:12
>> And that's not all. So, they actually
00:00:13
did a study on pistachios where guys at
00:00:15
100 g of pistachios every day and they
00:00:17
saw a decrease in erectile dysfunction
00:00:19
because if you're not having erections
00:00:21
now, you're no longer getting blood flow
00:00:22
to your penis and it will shrink over
00:00:24
time. And the same goes for women with
00:00:26
their clitoris because it's the same
00:00:27
type of tissue. But also, when you look
00:00:29
at people who have sex once a week, they
00:00:31
live 49% longer than people who only
00:00:34
have sex once a year.
00:00:35
>> 49% longer.
00:00:37
>> Yeah. And for every 100 orgasms men had,
00:00:40
they lived like 13% longer.
00:00:43
>> Be right back.
00:00:45
>> Dr. Reena Malik has become the world's
00:00:48
most watched urologist.
00:00:49
>> After sharing everything you need to
00:00:51
know about hormones, sexual health,
00:00:53
>> and how to have better sex based on the
00:00:55
data. So, how can you have the best sex
00:00:57
possible? So, there's four main pillars
00:01:00
of sexual health. So, pillar one is
00:01:02
fuel. So, how you nourish your body, and
00:01:04
it's a huge part of sexual activity. And
00:01:06
then pillar two is strength. When people
00:01:08
think about strength, they always think
00:01:09
about going to the gym and lifting
00:01:11
weights. But it's much more than that.
00:01:12
So, when you look at the data, any sort
00:01:14
of cardiovascular exercise is going to
00:01:16
improve sexual function. It's going to
00:01:17
improve blood flow to the penis and to
00:01:19
the clitoris. And then also if you do
00:01:21
150 minutes a week, it is the same
00:01:23
amount of improvement as you would see
00:01:24
when you take a medication like Viagra.
00:01:27
And the other part of it is the pelvic
00:01:28
floor. It's under evaluated, under
00:01:30
discussed, and we'll get into that. But
00:01:32
pillar three is environment. So things
00:01:34
like stress, sleep, and endocrine
00:01:37
disrupting chemicals. For example, they
00:01:39
looked at data on men sleeping 5 hours a
00:01:41
night versus 8 hours a night. Guys who
00:01:43
sleep 5 hours a night, their
00:01:45
testosterone drops by 15%. Yeah.
00:01:47
>> And then the last of the four pillars
00:01:48
that we don't talk about enough is, and
00:01:52
that's still important,
00:01:53
>> I want to talk about morning erections,
00:01:55
squirting, clitorol stimulation, and
00:01:57
certain positions that are going to
00:01:59
increase the probability that my partner
00:02:01
has an orgasm.
00:02:02
>> Let's talk about all of that. First of
00:02:04
all,
00:02:07
>> this is super interesting to me. My team
00:02:09
given me this report to show me how many
00:02:10
of you that watch this show subscribe.
00:02:12
And some of you have told us, according
00:02:13
to this, that you are unsubscribed from
00:02:15
the channel randomly. So, favor to ask
00:02:17
all of you. Please could you check right
00:02:19
now if you've hit the subscribe button
00:02:20
if you are a regular viewer of the show
00:02:21
and you like what we do here. We're
00:02:23
approaching quite a significant landmark
00:02:25
on this show in terms of a subscriber
00:02:26
number. So, if there was one simple free
00:02:29
thing that you could do to help us, my
00:02:30
team, everyone here to keep this show
00:02:32
free, to keep it improving year over
00:02:35
year and week over week, it is just to
00:02:36
hit that subscribe button and to double
00:02:38
check if you've hit it. Only thing I'll
00:02:39
ever ask of you, do we have a deal? If
00:02:41
you do it, I'll tell you what I'll do.
00:02:43
I'll make sure every single week, every
00:02:45
single month, we fight harder and harder
00:02:46
and harder and harder to bring you the
00:02:48
guests and conversations that you want
00:02:49
to hear. I've stayed true to that
00:02:50
promise since the very beginning of the
00:02:52
D of Sio. And I will not let you down.
00:02:55
Please help us. Really appreciate it.
00:02:56
Let's get on with the show.
00:03:05
Dr. Reena Malik, if somebody was to come
00:03:09
up to you in the street, having watched
00:03:10
your videos online, and they were a a
00:03:13
follower of the content you've produced
00:03:14
over the last couple of years, if you
00:03:16
had to guess the question they would ask
00:03:18
you, because it's probably the most
00:03:20
frequent, popular question you get
00:03:21
asked, what do you think they would say?
00:03:23
>> They would say, "What can I be doing
00:03:25
right now to improve my sex life?"
00:03:27
>> Who would be asking you that question?
00:03:29
And why do you think they'd be asking
00:03:30
it?
00:03:31
>> I think everyone can agree that sex is
00:03:33
something we enjoy. It's something
00:03:34
that's important that we want to have,
00:03:36
right? And there is um a desire to have
00:03:41
good sex or feel like maybe you're
00:03:42
missing out on something that could be
00:03:44
even better. So, how can you have the
00:03:46
best sex possible? Because you hear all
00:03:48
these people talking about amazing sex
00:03:50
in the media. You might see it on
00:03:52
pornography. You might feel like this is
00:03:54
something amazing. Why am I not having
00:03:56
that? I want that. Right.
00:03:57
>> So, on that point, you said it's obvious
00:03:59
that it's important. I think it appears
00:04:02
to be increasingly not obvious that it's
00:04:04
important because when you look at some
00:04:06
of these stats and I'll throw this graph
00:04:07
that I've I found here up on screen and
00:04:10
it shows that people are becoming more
00:04:12
sexless especially young adults between
00:04:14
18 and 30. This graph is pretty stark.
00:04:17
>> Mhm. Think about 50 years ago. There was
00:04:19
no cell phones. There might be some TV
00:04:21
programs but there was ads in between TV
00:04:23
programs and there was only certain TV
00:04:25
shows you could watch at a certain time
00:04:26
that you enjoyed and then there was
00:04:28
nothing to watch. There was no email.
00:04:30
So, you went to work and you came home
00:04:31
and there was really not a lot of
00:04:32
communication between you and your
00:04:34
co-workers or your job. They made dinner
00:04:35
with their family. They hung out and
00:04:38
then maybe they watched a program or two
00:04:40
and then they lied down in bed. They
00:04:41
didn't have a phone to scroll on. They
00:04:43
didn't have anything to keep them up.
00:04:45
And so then they were like next to their
00:04:46
partner and maybe they're talking, maybe
00:04:48
they're cuddling. And so there was more
00:04:50
like opportunity and space for sex,
00:04:52
right? You it was a thing that you did
00:04:54
for enjoyment, for pleasure, for fun.
00:04:56
Now we have all these distractions that
00:04:59
keep our mind away from sex. In order to
00:05:02
enjoy sex, you need to have space for it
00:05:04
to be able to enjoy your partner and
00:05:07
feel like you want that, right? And now
00:05:09
we're sort of there's not as much room
00:05:11
for it. That's one. Two is younger
00:05:14
people, how are they dating, right? How
00:05:16
are they meeting each other? They're
00:05:17
meeting each other through apps, through
00:05:20
um DMs. And so they're not actually like
00:05:23
really having these deep meaningful
00:05:25
connections. there have there's a big
00:05:26
hookup culture. There's a big like fling
00:05:29
culture. And imagine first time sex for
00:05:31
most people is not great. You don't know
00:05:33
your partner. You don't know what they
00:05:34
like. And you may not be able to express
00:05:36
what you like. You're never taught how
00:05:38
to talk about sex, right? So you don't
00:05:40
know how to say like, "Hey, I like it
00:05:41
like this." And you may be
00:05:43
self-conscious cuz it's your first time.
00:05:44
So you have like mediocre sex or bad
00:05:46
sex. And they're like, "Well, I don't
00:05:48
really want that." And there's just no
00:05:49
like follow through, right? There's
00:05:51
there's not a lot of um education on
00:05:54
what sex should look like. like the only
00:05:55
education people are getting are from
00:05:57
often erotic films and so they're seeing
00:06:00
sex that's not real that's curated and
00:06:03
they're trying to emulate that and
00:06:04
that's not pleasurable for most people
00:06:06
and younger people these days are um
00:06:08
actually having a rise in more what we
00:06:11
call rough sex so choking has become
00:06:14
very very common as common as like they
00:06:16
call choking almost like vanilla sex so
00:06:19
young people if you look at data like
00:06:21
60% of women and I think 20% of men have
00:06:26
been choked during sex of that age
00:06:28
group, like college age group. And of
00:06:30
those people who get choked, 20% have
00:06:32
been choked 25 times or more. Now, I
00:06:35
think it's fine if you're into that, but
00:06:36
I can't imagine that that many people
00:06:38
are into choking. And there's data to
00:06:40
support that. So, when you look at
00:06:41
qualitative data, and this is by uh
00:06:43
Debbie Herbick, she's a sex researcher,
00:06:45
and she did qualitative research, and
00:06:46
she asked people like, "What is it like?
00:06:47
Do you enjoy being choked? Tell us about
00:06:49
it." Right? Women were like, "Yeah, it's
00:06:51
okay. Sometimes I'm scared because my
00:06:53
partner is big and strong and I'm, you
00:06:55
know, smaller and they have big hands.
00:06:57
Sometimes it's fine and sometimes I
00:06:59
don't really care for it, but like it's
00:07:00
just a part of sex. It's just as normal
00:07:02
as as kissing, for example. And so if
00:07:06
you're having sex and you're doing
00:07:07
things just because you think that's
00:07:09
what your partner wants or what it
00:07:10
should look like and you're not enjoying
00:07:12
it, well, that's not going to be sex
00:07:14
that you want to have. that point you
00:07:16
said about the the lifestyles we lead
00:07:18
and how that might be impacting our sex
00:07:20
lives I thought was really interesting
00:07:21
because we don't talk enough about this
00:07:23
but when you look at some of the data on
00:07:24
this demographic um you know people 30
00:07:27
and below around that age the extreme
00:07:30
outliers are spending 8 to 10 hours on
00:07:33
their phones on social media and on the
00:07:35
internet and roughly about 15 to 20% of
00:07:39
young people describe their usage as
00:07:41
almost constant effectively scrolling
00:07:43
during all waking hours while they're
00:07:46
eating, while they're in the bathroom,
00:07:47
and before they go to sleep. So, and I
00:07:49
was wondering from a dopamine
00:07:50
perspective if there's correlation
00:07:52
between these like dopamogenic
00:07:54
activities that are now like hijacking
00:07:57
our lives, whether it's short form
00:07:58
videos on social media, whether it's
00:08:00
pornography or food, whether it's having
00:08:03
an impact on what then happens in the
00:08:05
bedroom and our performance in the
00:08:07
bedroom.
00:08:08
>> If you think about what you need to have
00:08:10
good sex is you need to be sort of in
00:08:13
the mind space for sex. And if you're
00:08:14
constantly like hijacked by all these
00:08:17
other things, you're never like really
00:08:18
getting in the mood, right? You're just
00:08:20
like, "Oh, I'm going to be turned on
00:08:21
when I see my partner and we're going to
00:08:23
have sex and it's going to be over." And
00:08:25
it's just really a mechanical thing at
00:08:27
that point, right? You're not actually
00:08:28
you're just trying to get an orgasm.
00:08:30
You're not actually like spending the
00:08:32
time to enjoy and to experience that
00:08:34
fully because you're just so like you're
00:08:36
just your brain is always doing
00:08:38
something else, right? because people
00:08:39
are constantly scrolling like every 60
00:08:41
seconds there's a new video, there's
00:08:43
something else. And so it's really hard
00:08:44
to focus. And so that can translate to
00:08:47
the bedroom where you're like you're
00:08:48
having sex, but your brain is somewhere
00:08:50
else thinking about something else you
00:08:52
saw or something you have to do or
00:08:53
something you want to see or something
00:08:55
you want to look up, whatever it is, but
00:08:57
you're not really in there in the
00:08:59
moment. You're just going through the
00:09:00
motions. And so I think that's really
00:09:02
where the challenge is is that people
00:09:04
are becoming increasingly distractable.
00:09:07
I find it really hard, I got to be
00:09:08
honest, to have sex if I've had like a
00:09:09
really really busy day or if I'm really
00:09:11
really thinking about something. I
00:09:13
almost have to I have to like
00:09:14
intentionally create quite a lot of
00:09:15
space.
00:09:16
>> Exactly.
00:09:17
>> In order to be able to be in the mood.
00:09:20
>> Yeah. Be aroused, right? It takes like
00:09:22
time and energy. I think I appreciate
00:09:24
you for saying that because a lot of
00:09:25
people think that men are just ready to
00:09:27
go at any moment and that's not fair,
00:09:29
right? Because everyone needs time to be
00:09:32
aroused. It's not just instant for
00:09:34
everybody, especially when you have a
00:09:35
lot of work stress or life stress or
00:09:37
other things going on. It's actually
00:09:39
like you have to make time and space for
00:09:41
it.
00:09:42
>> Yeah. Because as a man, you got to get
00:09:43
an erection. And I I always think that
00:09:45
an erection is a consequence usually,
00:09:47
especially when it comes to sex. And I'm
00:09:49
not talking about morning glories here,
00:09:50
but an erection is a consequence of like
00:09:52
a story.
00:09:54
>> You use the word aroused.
00:09:55
>> There's like a story in my head which
00:09:57
makes me go, "Oh, that's kind of hot."
00:09:59
>> Yeah. You need something. You need some
00:10:02
stimuli, right? You need to think about
00:10:04
something, see something, smell
00:10:05
something, feel something, right? You
00:10:07
need to just be together and and sort of
00:10:09
allow yourselves to be intimate before
00:10:11
that sort of desire and arousal come
00:10:13
together.
00:10:14
>> And for me as well, it's not just touch
00:10:16
like that doesn't necessarily for me, it
00:10:17
really is quite like a psychological
00:10:19
thing. I was wondering if this is
00:10:21
there's any data around this or I mean
00:10:23
just even anecdotally like people get
00:10:25
aroused in very very different ways,
00:10:26
don't they?
00:10:27
>> Yeah, absolutely. I mean some people um
00:10:30
are very like visual so they you know
00:10:32
they see their partner and they get
00:10:34
aroused very quickly. Basically when you
00:10:36
get aroused you need to be in a
00:10:37
parasympathetic nervous system state. So
00:10:39
in order to get an erection you need to
00:10:41
be in the state which is like rest and
00:10:43
digest. So if you're stressed if you're
00:10:45
thinking about other things if you're
00:10:47
essentially on the go you are not
00:10:49
allowing your nervous system to calm
00:10:51
down. And so for some people that's a
00:10:53
whole bunch of different things. Some
00:10:54
people can switch more easily into that
00:10:56
state and some people need more of like
00:10:59
uh you know to feel either mentally
00:11:03
stimulated or they need to have some
00:11:05
associations like it might be like they
00:11:07
need a certain scent, they need to like
00:11:09
relax their body, they need to like go
00:11:10
take a bath, whatever it is, but some
00:11:13
people need different things and knowing
00:11:15
what that is for your partner is super
00:11:18
important, right? Because then you can
00:11:19
incorporate that. Everything is
00:11:21
scheduled in our lives, right? And then
00:11:22
you're like, "Oh, but now sex is like
00:11:24
the last thing on the schedule, right?"
00:11:25
And like I don't even think about it.
00:11:26
Like, "Oh, okay. Now, yeah, maybe let's
00:11:28
have sex." But it's like, if you
00:11:29
actually make time to be intimate, allow
00:11:31
yourself to be in that brain space, be
00:11:34
together, that's when it can actually
00:11:36
happen. Especially when you've been in a
00:11:37
long-term relationship, it doesn't come
00:11:39
as easily like spontaneously, which we
00:11:41
call spontaneous desire. It it comes
00:11:43
more as a response to these other cues
00:11:46
that allow you to feel desire and to
00:11:48
feel aroused.
00:11:50
H I also think I was thinking about a
00:11:52
previous relationship I had where on the
00:11:55
days where I'd been like working very
00:11:57
hard and I was like tired or stressed or
00:11:58
I've been traveling and I was jetlagged.
00:12:00
I think there was also because I didn't
00:12:03
see this person often there was also an
00:12:05
expectation that when I did see them we
00:12:06
were going to have sex
00:12:07
>> and um that was that was very hard
00:12:11
because actually the expectation of it
00:12:14
stressed me out more.
00:12:16
>> Yeah. And that can happen like if it
00:12:18
becomes the elephant in the room it can
00:12:20
become a little bit heavy which then is
00:12:21
sort of counterproductive to performance
00:12:24
>> and this is you know sort of a variation
00:12:26
on performance anxiety. So when you feel
00:12:29
like you have to perform on demand and
00:12:31
maybe you're worried it might not happen
00:12:33
it creates this vicious loop right so
00:12:35
you may maybe have trouble with an
00:12:36
erection or maybe it's like I I'm
00:12:38
expected to have sex but I really can't
00:12:39
get there mentally. whatever it is. Now,
00:12:41
you're thinking about that, right? And
00:12:43
then you're with your partner. You're
00:12:44
like, "Oh my god, am I going to have
00:12:45
trouble?" You're not enjoying the
00:12:46
pleasurable sensations or the visuals or
00:12:48
like feeling each other. You are
00:12:50
literally thinking in your own head
00:12:51
about how you're going to respond. And
00:12:54
then that anxiety makes it so that you
00:12:56
can't get an erection or you can't be
00:12:57
aroused. And so now you're like anxious
00:12:59
and you're not focused. You're almost
00:13:00
spectatoring. You're just watching
00:13:02
yourself have sex. You're not actually
00:13:04
like in the moment. So then, you know,
00:13:06
you have a negative outcome because when
00:13:08
you're stressed, your sympathetic
00:13:09
nervous system is on, right? You can't
00:13:10
really get an erection or you can't
00:13:12
really get aroused. And so then you're
00:13:15
like, "Oh man, now I've let my partner
00:13:17
down. Now I haven't performed," which I
00:13:19
hate that word, but like performed the
00:13:21
way I should or or I'm expected to. And
00:13:24
now something's wrong with me. And now
00:13:26
that just keeps going in a vicious
00:13:27
cycle.
00:13:28
>> Have you spoken to people that have
00:13:29
experienced this?
00:13:30
>> Absolutely.
00:13:31
>> It's common.
00:13:32
>> Very common. I tell people anytime you
00:13:34
have problems in the bedroom, it stays
00:13:37
with you.
00:13:38
>> So, how do you break the cycle?
00:13:39
>> Yeah. So, I tell people when you're with
00:13:41
your partner, take the pressure off um
00:13:44
penetration. Just explore each other's
00:13:46
body. Do what's called like sensate
00:13:48
focus. Like explore the rest of your
00:13:50
body. Figure out other arogynous zones,
00:13:52
other things that can turn you guys both
00:13:55
on that don't involve erections and
00:13:57
penetration. And then once you realize
00:13:59
you're focused on that, you're really
00:14:00
like exploring, enjoying, playing,
00:14:02
you're having a good time, and you're
00:14:04
not thinking about your erection, now
00:14:05
you'll notice, oh, the erection just
00:14:07
comes, right? And then once you get to
00:14:08
that point, then you can start even
00:14:09
touching genitals, but still hold off on
00:14:11
penetration. And then after you've
00:14:13
realized like the genitals are, you
00:14:15
know, it's always working the way I want
00:14:17
it to. I'm not thinking about it. I'm
00:14:18
not stressed. Then finally, you can then
00:14:20
introduce penetrative sex again. So,
00:14:23
it's just sort of like a gradiated sort
00:14:24
of slow advance into um you know, having
00:14:28
sex again, but now kind of focusing on
00:14:31
being more present and mindful and
00:14:33
enjoying those sensations.
00:14:34
>> I think a lot of people will be able to
00:14:37
do that, but there's also a big
00:14:38
contingent of people that just avoid
00:14:41
sex.
00:14:42
>> Mhm.
00:14:42
>> It's it's a sore subject in their
00:14:44
relationship for whatever reason. Both
00:14:47
partners don't know how to communicate.
00:14:48
They haven't got the tools to talk about
00:14:49
these kind of things openly and
00:14:50
honestly. Do you see that a lot as well?
00:14:53
>> Absolutely. I mean, what do you hear in
00:14:55
this regard?
00:14:55
>> So, I think it's really sad. I see
00:14:58
people come in and they're like, I ask
00:15:00
every patient like, "Are you are you
00:15:02
having sex? Why not?" Right? Because
00:15:03
sometimes they'll say no. And most
00:15:05
doctors will be okay. But I always say,
00:15:06
"Why not?" Right? Why are you not having
00:15:08
sex? Is it because you're having an
00:15:09
issue? Is it because you're having pain?
00:15:11
What's going on? Right? And often times
00:15:13
I'll hear from people that my partner is
00:15:16
just not into it and I just sort of gave
00:15:18
up and I'm just we just don't have sex
00:15:21
anymore. You know, for me that's a red
00:15:23
flag because sex is a huge important
00:15:27
part of our lives. It is a way we
00:15:29
connect with another human being. It's
00:15:32
also telling that things are working
00:15:34
really well. So, when you have good
00:15:36
sexual function, meaning you get an
00:15:38
erection well or you get aroused well
00:15:40
and you have a good orgasm and
00:15:41
everything feels good, that tells me
00:15:43
that, hey, you've got great blood flow
00:15:45
to your genitals, your nerves are
00:15:46
working great, your hormones are sending
00:15:48
signals, like all these things are good,
00:15:50
right? But also, sex is more than just
00:15:53
the act of sex. It also helps you live
00:15:56
longer. So, there's been a few studies
00:15:58
looking at sex and longevity. And when
00:16:01
you look at people who have sex once a
00:16:03
week compared to people who have sex
00:16:05
once a year, the difference in all cause
00:16:07
mortality is 49%. They live 49% longer
00:16:11
than people who only have sex once a
00:16:13
year.
00:16:14
>> 49% longer.
00:16:15
>> Yeah. Yeah.
00:16:18
>> Be right back. No, I'm joking.
00:16:20
>> So, and but even if you're doing like
00:16:22
less than once a week, but more than
00:16:24
once a year, it still improves your
00:16:26
longevity. There was actually
00:16:27
interesting study in 1997, I think it
00:16:29
was, where they looked at the number of
00:16:31
orgasms men had, and they found that men
00:16:34
who had for every hundred orgasms men
00:16:37
had, they lived like 13% longer. They
00:16:40
had a 13% increase in life expectancy.
00:16:43
And so, it was really interesting to me
00:16:45
just just showing you that like this is
00:16:47
not just an act of pleasure and fun. It
00:16:50
is obviously, but it's much more than
00:16:52
that because people who are having sex
00:16:54
clearly have better health and there
00:16:56
this connection with people. I mean,
00:16:58
loneliness is a big issue right now. The
00:17:00
the WHO made loneliness like an
00:17:02
epidemic. So, they've said that
00:17:03
loneliness is as bad as having like 15
00:17:06
cigarettes. And so, sex is a way to feel
00:17:09
connected to another human being.
00:17:11
>> On that data, we're not saying that it's
00:17:13
the sex itself that's causing people to
00:17:15
live longer. We're I guess it's it's
00:17:16
hard to establish causation in terms of
00:17:18
>> Yeah. It's not necessarily sex, but
00:17:21
they've looked at like they try to
00:17:22
control for other things like age and
00:17:24
coorbidities and all these studies and
00:17:27
um it's also like sex is a
00:17:28
cardiovascular workout, right? For many
00:17:30
people is a cardiovascular workout. You
00:17:32
are getting a phys physical physical
00:17:33
activity with your partner. Um you are
00:17:35
increasing your heart rate. You are
00:17:37
doing these things that are also good
00:17:39
for your body. And the fact that you're
00:17:41
able to have sex, right, tells me a lot
00:17:43
about it, right? You're you're able to
00:17:45
hold a certain position. you're able to
00:17:47
u maintain this level of activity
00:17:49
without getting short of breath, right?
00:17:51
Like these are things that having sex,
00:17:53
you know, keeps you healthy to some
00:17:56
degree.
00:17:56
>> If I want to make sure that I have great
00:17:58
sex, what are some of the foundational
00:17:59
things that I need to be thinking of in
00:18:01
terms of my lifestyle?
00:18:02
>> Yeah. So, there's four main pillars of
00:18:04
sexual health. I like to think of it
00:18:06
like your sexual health is your house.
00:18:08
And these pillars are the foundation.
00:18:09
And if you don't have the foundation, it
00:18:11
doesn't matter what else you do. Um, you
00:18:13
can try to do everything else to patch
00:18:15
up your house, but it's always going to
00:18:16
break again because the foundation's not
00:18:18
there. So, you've got fuel, and fuel is
00:18:22
how you nourish your body. A lot of the
00:18:23
data I'm going to talk about is about
00:18:25
men because there's just a lot more data
00:18:27
on men and sexual health, but that
00:18:29
doesn't mean that the same things don't
00:18:30
apply to women. There's just less less
00:18:32
robust data on it. So, when you talk
00:18:34
about fuel, the Mediterranean diet is
00:18:37
the most studied diet. So, including
00:18:39
things like healthy fats like avocados,
00:18:43
leafy greens, nuts, and we're going to
00:18:45
talk about nuts in a little more detail.
00:18:47
These things are super helpful. And
00:18:49
obviously having lean proteins, having
00:18:52
an abundance of fruits, which we're
00:18:53
going to talk about as well. There's a
00:18:54
study called the Health Professionals
00:18:56
Follow-up Study. They look at 20,000
00:18:57
men, and they saw that men who adhered
00:19:00
to a Mediterranean diet had a 22% lower
00:19:03
risk of erectile dysfunction. So what
00:19:07
specific things in that diet, right?
00:19:08
People always like, "What are the
00:19:09
superfoods I need to have?" Almonds are
00:19:11
great, but pistachios, they actually did
00:19:13
a study on pistachios where they looked
00:19:14
at 100 grams of pistachios. Guys ate 100
00:19:16
grams of pistachios every day and they
00:19:19
saw a decrease in erectile dysfunction.
00:19:21
>> So pistachio nuts will make my penis
00:19:23
harder.
00:19:23
>> I mean, so I always say like I don't
00:19:25
love to talk about superfoods because
00:19:27
then people like, "Oh, I just got to eat
00:19:28
pistachios and it's all good, right?"
00:19:29
It's it's part of a whole diet, but
00:19:31
certainly having nuts because they have
00:19:33
great omega-3s, they have healthy fats.
00:19:35
These are the reasons that they they
00:19:37
really sort of improve diet.
00:19:39
>> Fruit um anything that has sort of
00:19:42
flavonoids, so like colorful fruit like
00:19:44
blueberries, citrus fruits, um lycopine,
00:19:47
which is red fruits, all of these things
00:19:49
improve antioxidants and also have been
00:19:52
shown to reduce the incidence of
00:19:53
erectile dysfunction. So having stronger
00:19:55
erections. specifically blueberries
00:19:57
actually came out to have I think
00:19:59
something around 20% also improvement in
00:20:01
erectile function when you're eating
00:20:03
blueberries regularly. So lots of I
00:20:06
think things in the diet that can be
00:20:07
helpful. Also fiber is one that we don't
00:20:09
talk about enough. When you eat fiber in
00:20:12
your gut it converts to short- chain
00:20:13
fatty acids. These short- chain fatty
00:20:15
acids then sort of have these endothelop
00:20:18
protective mechanisms. They protect the
00:20:20
blood vessels. They make them healthier.
00:20:22
And so when your blood vessels are
00:20:24
healthier, you get better metabolic
00:20:25
health. So you get less diabetes, less
00:20:27
high blood pressure, less high
00:20:28
cholesterol. And these all of these
00:20:30
things together improve erectile
00:20:32
function.
00:20:33
>> So I think making sure that you meet the
00:20:36
criteria for fiber, which is 38 grams
00:20:38
for men, 25 grams for women, um, is
00:20:41
really really important. And then
00:20:43
obviously managing your calories and a
00:20:45
maintenance, right? because we don't
00:20:46
want to gain weight because excess
00:20:48
atapost tissue or excess fat also puts
00:20:50
you at higher risk for erectile
00:20:52
dysfunction and other sexual
00:20:54
dysfunctions. Next we have uh strength.
00:20:58
All right.
00:21:00
So there's strength where we think about
00:21:02
cardiovascular and resistance exercise
00:21:04
but there's also pelvic floor strength.
00:21:06
So we'll start with cardiovascular
00:21:08
exercise. The one study that's quoted
00:21:10
very often is 150 minutes of exercise of
00:21:13
cardiovascular exercise moderate
00:21:14
intensity. when you look at the
00:21:16
improvement in erectile function scores,
00:21:19
it is the same amount of improvement as
00:21:21
you would see when you take a medication
00:21:23
like Viagra. So, literally, if you do
00:21:26
150 minutes a week, you are getting the
00:21:28
same improvement as you could get with a
00:21:30
medication potentially. And so, I tell
00:21:32
people like, look, if you don't want to
00:21:34
take a pill, this is a great way to
00:21:36
improve sexual function. Now, you might
00:21:38
say, okay, well, I, you know, maybe
00:21:40
you're listening and you have heart
00:21:42
issues and you can't really do moderate
00:21:43
intensity exercise. They actually looked
00:21:45
at that too. So there was a group where
00:21:46
they looked at men who had heart disease
00:21:49
and they weren't really able to do
00:21:51
moderate intensity exercise. So they did
00:21:52
like a 5minute warm-up. They did 20
00:21:54
minutes of walking and 5 minutes of a
00:21:56
cool down. And with this supervised
00:21:58
protocol, they still improve erectile
00:22:00
function by 70%. So it's all relative to
00:22:03
where you're starting. But any sort of
00:22:06
cardiovascular exercise that's above
00:22:08
what you are capable like what you're
00:22:10
doing now is going to improve sexual
00:22:12
function particularly erectile function
00:22:14
cuz it's going to improve blood flow to
00:22:15
the genitals going to improve blood flow
00:22:17
to the penis. It's going to improve
00:22:18
blood flow to the clitoris for women. So
00:22:20
that's where cardiovascular exercise is
00:22:22
so so important in terms of resistance
00:22:24
exercise. I know these little weights
00:22:26
are probably not sufficient for doing
00:22:28
much, especially for men, in terms of
00:22:30
improving um muscular health, but
00:22:32
obviously we're not going to bring like
00:22:34
really heavy weights to the table here.
00:22:36
So, one, we know that resistance
00:22:38
training is significantly correlated
00:22:40
with testosterone. So when you do heavy
00:22:43
resistance training of your large muscle
00:22:45
groups, so like your lower extremities,
00:22:47
your glutes, you're doing like Olympic
00:22:49
deadlifts, squats, that sort of stuff,
00:22:51
you actually see improvements in
00:22:53
testosterone. Now, it's not going to be
00:22:55
like you do it once and you get this
00:22:57
sustained improvement, but continuous
00:22:59
sort of regular resistance exercise
00:23:01
improves testosterone.
00:23:03
There's also data that shows that when
00:23:05
men do resistance exercise to maintain
00:23:07
muscle mass. So, we know that muscle
00:23:09
mass decreases about 7% every decade of
00:23:12
life after around 40. When you maintain
00:23:14
it through resistance exercise, they're
00:23:17
three times less likely to have erectile
00:23:19
dysfunction.
00:23:19
>> Oh, really?
00:23:20
>> Yeah. So, they maintain erectile
00:23:21
function, they maintain sexual desire,
00:23:24
they maintain um satisfaction with sex.
00:23:27
>> I read a quote yesterday that said
00:23:28
muscle is medicine. And I thought,
00:23:30
that's really true based on everything
00:23:31
I've learned on this podcast around, you
00:23:33
know, like glucose control and and
00:23:36
testosterone. And now you're telling me
00:23:38
about your sex life.
00:23:40
>> Yeah, it is. I think people push back
00:23:43
because they think like, why should I
00:23:44
have to go to the gym? But our lives
00:23:46
have changed. We sit at a computer or we
00:23:49
sit at podcasts or we sit all the time.
00:23:51
We're not moving. We're not doing manual
00:23:53
labor, which is what a lot of our
00:23:56
historic history is, right? doing manual
00:23:58
labor, farming, doing things outside,
00:24:00
being physical, and we're meant to be
00:24:02
physical. We're meant to lift heavy
00:24:04
things. We're meant to move our bodies,
00:24:06
and we're just doing less and less of
00:24:07
it.
00:24:08
>> So, I think it's so important. Um, the
00:24:10
other thing is we want to prevent
00:24:11
sarcopenia. So, sarcopenia is muscle
00:24:13
loss. And when you have muscle loss, um,
00:24:16
that also increases your risk of having
00:24:19
sexual dysfunction.
00:24:20
>> What about the pelvic floor? Like, how
00:24:21
does that come into this story of
00:24:23
>> Oh, yeah. So, we missed that part. So,
00:24:25
um, the pelvic floor, here's your
00:24:28
pelvis, right? It's this bony structure
00:24:30
where all your organs live. This is a
00:24:32
female. So, I'm taking out the, uh,
00:24:34
internal structures, which is the
00:24:36
uterus, the rectum, and the bladder. And
00:24:38
so, that's what sits inside the pelvis.
00:24:41
And so, you can see this bowl of muscles
00:24:43
here, right? Interesting. I've never
00:24:44
seen.
00:24:44
>> And you can see them from the inside,
00:24:45
and you could see them from the outside.
00:24:47
That's your anus. And in this person,
00:24:49
there's a vagina. So, that's the hole
00:24:50
for the vagina. So you can see that your
00:24:52
anus and your vagina run through the
00:24:54
pelvic floor. And in men, your penis
00:24:56
runs through the pelvic floor. And so
00:24:58
this, let me see if I can show you on
00:24:59
this model. In this model, you can see
00:25:02
they kind of show you the muscles here
00:25:03
on the side.
00:25:04
>> Yeah.
00:25:05
>> So these are your pelvic floor muscles
00:25:06
that are around the penis and the anus.
00:25:10
>> Okay.
00:25:11
>> Okay. These structures are very
00:25:14
important for a variety of things. um
00:25:16
they attach to your bony landmarks here,
00:25:18
your hips, your sacrum, your pubic
00:25:21
symphysis. They attach to all these and
00:25:24
they sort of just work in the background
00:25:26
for most people. How they affect your
00:25:28
sexual function is when you orgasm,
00:25:31
these muscles contract and release at a
00:25:35
at a rhythmic contraction of8 seconds.
00:25:37
And so you may feel that, right? There's
00:25:39
like this pulsing feeling when you
00:25:40
orgasm. And that's these muscles sort of
00:25:42
doing that. And when men ejaculate, the
00:25:45
pelvic floor muscles are contracting to
00:25:47
help shoot the ejaculate out. They
00:25:49
squeeze when you need to keep things in.
00:25:51
So they'll keep urine in, they'll keep
00:25:53
um your stool in, and they relax when
00:25:55
you need to pee in, when you need to
00:25:57
defecate.
00:25:58
>> So when you're trying to hold a wee,
00:25:59
you're like tightening your pelvic
00:26:00
floor.
00:26:01
>> Correct. Correct. But these are also
00:26:03
responsive to stress. So, just like
00:26:05
people get TMJ where they get tense in
00:26:08
their jaw cuz they are stressed and they
00:26:10
like sleep at night and they clench up
00:26:11
their jaw. They don't really know
00:26:12
they're doing it, the same thing can
00:26:14
happen. These muscles can get very tight
00:26:16
or they can get misaligned. So, say you
00:26:18
have a hip injury or say you have a back
00:26:20
injury, the muscles can compensate by
00:26:22
tightening up. And so, a lot of people
00:26:24
unknowingly have tension in these
00:26:26
muscles and it can present in a multiple
00:26:29
different ways. It can present with back
00:26:31
pain. It can present with constipation.
00:26:35
It can present with urgency frequency
00:26:37
because remember your bladder is sitting
00:26:39
right here on top of these muscles. So
00:26:41
when the muscles are tense, your bladder
00:26:43
is feeling like there's something
00:26:46
something activating it. And so it's
00:26:47
like, oh man, I got to pee. That means I
00:26:49
have to pee. This tension is telling my
00:26:50
bladder I have to pee. But it's really
00:26:52
that your bladder is not that full. It's
00:26:53
that these muscles are telling you to do
00:26:55
that. You can also have trouble peeing
00:26:57
because you can see that your urethra
00:26:58
goes through here. And if the muscles
00:27:00
are really tight, sometimes it can be
00:27:01
difficult to urinate because it clenches
00:27:03
off the pee. And then with sex, it can
00:27:06
cause pain. If they're really tight, it
00:27:08
can prevent blood from getting to the
00:27:10
genital organs. So for men, they can
00:27:12
have erectile dysfunction. For women,
00:27:15
they can have difficulty getting orgasms
00:27:17
or difficulty getting arousal because
00:27:19
they're not getting blood flow to the
00:27:21
clitoris. Sometimes they can also cause
00:27:23
premature ejaculation in men. And so
00:27:25
these muscles are so important and all
00:27:28
we hear about is keigull and keigull are
00:27:30
exercises to strengthen these muscles.
00:27:32
But keigull are good when you have a
00:27:34
normal pelvic floor. Meaning like
00:27:36
there's no tension. It's completely
00:27:38
normal. It's acting normal. You're not
00:27:39
having any symptoms at all. But if you
00:27:41
have any of the symptoms I talked about,
00:27:42
doing keles might make it worse because
00:27:44
you're now tightening muscles that are
00:27:46
already tight.
00:27:47
>> We also talked about pelvic floor
00:27:49
relaxation. Doing exercises to
00:27:51
specifically relax these muscles. So
00:27:53
that can be diaphragmatic breathing.
00:27:56
That can be doing like a figure four
00:27:58
stretch. That can be doing happy baby
00:28:01
pose which are yoga poses or child's
00:28:03
pose. All these things can sort of
00:28:05
stretch and lengthen these muscles so
00:28:07
they can learn to relax again. Now when
00:28:09
it's really bad, you have to go see a
00:28:11
pelvic floor physical therapist who can
00:28:13
really work with you to identify which
00:28:14
of the muscles are maybe more
00:28:16
dysfunctional and maybe work
00:28:17
specifically on those. Um but I think
00:28:20
it's it's so important. that's under
00:28:21
evvaluated, underd discussed when it
00:28:24
comes to sexual function. It's a hugely
00:28:26
important part of sexual function.
00:28:29
>> How many people are struggling with
00:28:31
these issues, specifically the like
00:28:34
erectile dysfunction issues and what age
00:28:36
are they?
00:28:37
>> Yeah. So, it starts early. I think
00:28:39
there's always been a sort of a
00:28:40
disconnect where we think young guys
00:28:42
don't have this or if they have it, it's
00:28:43
all in their head. That's not
00:28:45
necessarily true. Many young men do
00:28:47
develop erectile dysfunction because of
00:28:49
biologic factors, but the data is really
00:28:52
robust on older guys. So above the age
00:28:54
of 50, we see 52% of men having erectile
00:28:58
dysfunction, which is
00:28:59
>> 52%.
00:29:01
>> And it goes up 10% every decade. So 60%
00:29:05
of 60-y olds, 70% of 70 year olds. So
00:29:07
erectile dysfunction continues to
00:29:09
worsen. This happens because one, you
00:29:12
know, our blood vessels get older, they
00:29:14
get stiffer, they're not functioning as
00:29:16
well as they should. And we're seeing
00:29:18
also a rise in all these other comorbid
00:29:20
conditions like diabetes, cholesterol,
00:29:22
high blood pressure. All these affect
00:29:24
how healthy your blood vessels are. And
00:29:26
so with these, they see the problem in
00:29:29
their penis or in in women's case in
00:29:31
their clitoris before they see heart
00:29:33
disease or strokes or brain issues or
00:29:35
dementia. And I think this is worth
00:29:37
pausing on which is a erectile
00:29:40
dysfunction problem is a often a symptom
00:29:43
of a cardiovascular issue. Right.
00:29:45
>> Yeah. We call it a canary in a coal
00:29:47
mine. So it is like telling you that
00:29:49
something bad is coming. So the data
00:29:51
would support that when you have
00:29:53
erectile dysfunction if it's because of
00:29:56
an organic reason, right? not
00:29:57
psychoggenic but most people I think
00:29:58
have a combination of both that within 3
00:30:01
to 5 years you will start developing
00:30:03
issues with your heart and so it
00:30:06
precedes those issues and if 7 years
00:30:09
later 14% of those guys will have a
00:30:12
heart attack and so it's really an
00:30:14
opportunity sexual problems are an
00:30:17
opportunity to look inside to figure out
00:30:20
what's going on and to investigate and
00:30:22
to change your life
00:30:23
>> and when you say erectile dysfunction we
00:30:25
should probably define what that means
00:30:26
because there's going to be a lot of
00:30:27
guys sat at home now thinking, "Oh my
00:30:29
god, like my penis is a bit softer than
00:30:31
usual."
00:30:31
>> Yeah. So, erectile dysfunction is
00:30:34
defined as the inability to maintain an
00:30:36
erection that's sufficient for
00:30:38
intercourse. So, you can get an
00:30:40
erection, but it goes away before you
00:30:42
ejaculate or climax.
00:30:44
>> And so, that's typically and I think
00:30:45
it's really important to differentiate
00:30:46
that from something like premature
00:30:48
ejaculation where you climax too soon.
00:30:51
So, you ejaculate before you're want to.
00:30:54
Uh, but that doesn't mean that you have
00:30:56
a problem maintaining your erection.
00:30:57
That's a whole different process.
00:30:59
>> I've got a friend, people are gonna
00:31:01
think I'm talking about myself because I
00:31:02
use that phrase a lot. I've got a
00:31:03
friend. He's um he's almost 40 years old
00:31:06
and I've heard him say on several
00:31:09
occasions that he's lost his erection
00:31:11
during sex. Is that erectile
00:31:13
dysfunction? But what if he can keep his
00:31:16
erection watching porn?
00:31:18
>> Well, so that's more multiffactorial,
00:31:20
right? So I think if you lose it once or
00:31:22
twice, right? Most guys will have an
00:31:24
issue where they lose an erection at
00:31:25
some point in their life. I think the
00:31:26
important thing is not to catastrophize.
00:31:28
It's a problem when it becomes a
00:31:30
routine. Now, if someone is telling me,
00:31:32
"Hey, I can watch porn and maintain my
00:31:34
erection, but I can't with a partner."
00:31:36
There's multiple different reasons for
00:31:38
that that could be at play. One is that
00:31:40
there's no pressure, right? You're by
00:31:41
yourself. You're watching porn. There's
00:31:43
no pressure of performance. There's no
00:31:45
anxiety of performance. So, that may be
00:31:46
part of it. Other thing may be that that
00:31:49
level of arousal that you're getting
00:31:51
from porn. If you're watching like let's
00:31:52
say the same kind of porn every time,
00:31:54
you're masturbating the same way every
00:31:56
time, maybe using a firm grip or some
00:31:58
people will masturbate like uh facing
00:32:00
the bed or um you know against hard
00:32:03
objects. And so that
00:32:05
>> against hot objects.
00:32:07
>> Yeah. Like the their fist or something.
00:32:09
And so that u can't be replicated by a
00:32:12
person, right? You can't replicate those
00:32:14
behaviors by a vagina or a mouth. If you
00:32:18
become habituated to a certain thing
00:32:20
that turns you on and that's the only
00:32:23
thing that really gets you going and
00:32:25
that's that's something that you can't
00:32:26
really get with your partner, then it
00:32:28
will be difficult to reach the level of
00:32:30
arousal that you need to get an
00:32:32
erection.
00:32:32
>> Okay. So, two questions then. So,
00:32:34
>> that doesn't count as erectile
00:32:36
dysfunction. If you can get an erection
00:32:38
watching porn but can't get it with your
00:32:39
partner.
00:32:40
>> Yeah, it may or may not be. So, if you
00:32:42
wake up with your morning erection,
00:32:44
that's great. That's a sign. That's when
00:32:45
there's nothing else at play, right? You
00:32:47
are just that tells me that your body's
00:32:49
functioning well. You've got good blood
00:32:50
flow, good uh good hormones working, got
00:32:52
a good amount of testosterone, and your
00:32:54
nerves are working well, and you're
00:32:56
getting a good morning erection. Now,
00:32:58
morning erections or nighttime erections
00:33:00
are normal, and they're healthy. So,
00:33:02
when you're a young boy, you get
00:33:04
actually like erections three to five
00:33:06
times a night, and they can last up to
00:33:07
40 minutes long. So you can spend a lot
00:33:10
of your night with an erection. When you
00:33:12
get older, like in your 40s, that drops
00:33:14
to about half the time. So maybe
00:33:16
erections are a little shorter that they
00:33:18
maybe max out at 30 minutes, but
00:33:19
sometimes they're shorter. You should
00:33:21
still be getting three to five erections
00:33:22
at night. You won't know all of these,
00:33:24
but typically you wake up with a morning
00:33:25
erection. And so if you're not getting
00:33:27
morning erections, that tells me that,
00:33:29
hey, there's something going on that we
00:33:31
should address. And on your other point
00:33:33
about how you masturbate impacting your
00:33:35
sex life, I imagine that applies to men
00:33:38
and women.
00:33:39
>> Absolutely.
00:33:39
>> And are you saying that if there's a
00:33:41
particular way you get yourself off in
00:33:43
private
00:33:44
that is very hard for the other person
00:33:46
to replicate, you might become
00:33:47
desensitized to that?
00:33:49
>> You might just get habituated. I don't
00:33:50
think desensitized, but habituated is
00:33:53
like you might just your body just might
00:33:54
respond really well to that particular
00:33:57
stimulation. Now, that's not inherently
00:33:58
a bad thing, right? If that's what gets
00:34:01
you off and you and your partner are
00:34:02
okay with you doing that together,
00:34:04
right? You may mutually masturbate
00:34:06
together and that's fun for you and you
00:34:07
guys enjoy it, there's no problem with
00:34:09
it. It's just knowing what's going on,
00:34:11
right? And sort of deciding like, okay,
00:34:13
if this is a problem, let me try to
00:34:15
diversify what I do during my solo sex
00:34:18
periods or let me take a little break
00:34:20
and kind of uh try something, you know,
00:34:22
just not masturbate for a little while
00:34:24
and come back to it later. The fact that
00:34:25
we get an erection in the morning, does
00:34:27
that mean that's we're supposed to have
00:34:29
sex in the morning? From like an
00:34:30
evolutionary perspective,
00:34:31
>> not necessarily. It's just it's the way
00:34:33
your body releases testosterone is one
00:34:35
of the reasons this happens is overnight
00:34:37
your body is making more testosterone.
00:34:39
That's when your body sort of has
00:34:41
nocturnal testosterone production. And
00:34:43
so it's highest in the morning, which is
00:34:45
why often you get a morning erection.
00:34:47
And you know it just means that some
00:34:50
people will have more desire also in the
00:34:52
morning because testosterone is a
00:34:53
hormone of desire.
00:34:55
>> Is it the same for women?
00:34:56
>> Yeah. So women um women also have
00:35:00
nocturnal clitoreral tumescence. Same
00:35:02
sort of pattern and they won't
00:35:04
necessarily know it right because they
00:35:06
can't visualize it. But you know you can
00:35:08
some women may know sort of feel that
00:35:10
pelvic congestion or like feeling that
00:35:12
there's a bunch of like blood flow in
00:35:13
the area. But most will not and that's
00:35:16
okay. But your body protects itself. So
00:35:18
you've heard the term use it or lose it,
00:35:19
right? People are like your body's
00:35:21
protecting itself. You don't have to
00:35:23
have sex. If your body is healthy, it
00:35:25
will do this all night to keep your
00:35:27
genitals healthy. It will make sure that
00:35:29
your genitals are getting blood flow
00:35:30
even if you're not having sex. But if
00:35:33
you stop having those nighttime
00:35:35
erections, now is it becomes more of a
00:35:37
problem because over time, say you stop
00:35:40
having erections or cleral tumes for
00:35:42
months, years, right? And then there's
00:35:46
no blood flow to those areas over time.
00:35:48
And actually I can show you here. This
00:35:50
is a a pelvic model. And here this this
00:35:54
purple thing here is called the corpora.
00:35:57
And this is like a really nice spongy
00:35:59
tissue that fills with blood. And when
00:36:02
it fills with blood, it expands and
00:36:03
lengthens. And then um the blood stays
00:36:06
there until you're done with your
00:36:08
stimulation. And then it goes back. And
00:36:10
so if there's no healthy fresh blood
00:36:12
getting to the penis on a regular basis
00:36:15
either through nighttime erections or
00:36:16
through sex with your partner then you
00:36:18
will get fibrosis of these tissues. That
00:36:21
means you get a little scar in the in
00:36:23
the tissues and then over time you might
00:36:25
see some shrinkage of the penis. And so
00:36:27
it is really important to maintain also
00:36:30
good health of these tissues. And the
00:36:31
same goes for women with their clitoris
00:36:34
because it's the same type of tissue. In
00:36:35
fact, if you look at the clitoris, it is
00:36:38
this is the part that you see. We don't
00:36:39
really We don't have a clitoris.
00:36:41
>> That one there.
00:36:42
>> This is a uterus.
00:36:49
>> You're going to keep that in.
00:36:51
>> Okay. I can show you here. There we go.
00:36:53
There's this like she told me.
00:36:54
>> Is it crazy?
00:36:56
>> Okay. Yeah. This is good. This is good.
00:36:58
Okay. They told me they don't say
00:36:59
glitter.
00:37:04
>> That's a little That's a Yeah. Okay.
00:37:08
>> They told me
00:37:10
>> you're not going to live that one down.
00:37:11
>> You asked the team where the ClariS was.
00:37:13
Did you ask the team where the clitoris
00:37:15
was?
00:37:16
>> Well, I'm I'm worried about who said
00:37:18
that, too. Um, okay. So,
00:37:21
so let's talk about the female anatomy.
00:37:23
This is a pelvic model. And here, um,
00:37:25
you can see this is the vagina. This is
00:37:28
the urethra where you pee from. This is
00:37:30
your labia minora. And you can't see the
00:37:32
labia majora, but they would be out
00:37:34
here, right? So, inner lips, outer lips.
00:37:36
Now, this up here is your clitorol
00:37:39
glands. So, it's the same as the glands
00:37:41
of the penis. And so, this is all you
00:37:43
see, right? It also has a little
00:37:45
covering, which you can't see here. Just
00:37:46
like men have foreskin, women have a
00:37:48
clitoreral hood that covers the the head
00:37:50
of the the clitoris. And so when you
00:37:53
look at the clitoris on the inside,
00:37:55
which we can't see perfectly here, but
00:37:56
I'm going to just take this out. Um, it
00:37:59
actually goes all the way back like
00:38:02
this. So if you were to feel from the
00:38:04
vagina, from the vaginal side, it would
00:38:05
be at the very top of the vagina going
00:38:08
all the way back. These are the these
00:38:10
blue things are the clitoreral bulbs
00:38:12
here. Um, so and these are the legs of
00:38:16
the clitoris here on the side. And so
00:38:18
this is essentially the homalogue of the
00:38:21
penis. So if I take the penis and we
00:38:23
don't have a like a full model here.
00:38:26
What does homalues mean?
00:38:27
>> So homologues means that they're
00:38:28
essentially the same structure. They're
00:38:30
made from the same cells but they're in
00:38:32
the male and the female. So here you can
00:38:35
see this is if this is your penis. This
00:38:38
is what you see up to here. This is the
00:38:39
bone. This is your fat up here. And then
00:38:42
here it goes deep into the pelvis. And
00:38:45
so here's your testicles, right? And so
00:38:47
below the testicles, this area of the
00:38:49
paranneeium, you also have penal tissue
00:38:52
sort of that you can palpate from this
00:38:54
side um that's coming all the way down.
00:38:56
And if you had sort of a 3D model, you'd
00:38:58
see that it forks out just like the
00:38:59
clitoris does.
00:39:00
>> So does clitoral stimulation feel like
00:39:04
stimulating someone's tip of their
00:39:06
penis?
00:39:07
>> Exactly. And so you could think if
00:39:08
someone just stimulated the head of the
00:39:10
penis, they uh it would be fine. It
00:39:14
would be nice, but it's probably better
00:39:15
if you stimulate more of the clitoris or
00:39:17
more of the penis. That's why you can
00:39:19
stimulate obviously the external the
00:39:21
clitoris, but you can also stimulate
00:39:23
from the inside. And some people are
00:39:25
more responsive to that than others.
00:39:27
What you hear of is like the G-spot or
00:39:29
the Gzone, right? And the G-spot or
00:39:31
Gzone is if you were to go in the inside
00:39:34
of the vagina at the top side, which I
00:39:36
can't really stick this in here, but it
00:39:38
would be about 2 cm in at the top. And
00:39:40
that's because that's an area where
00:39:42
there's a lot of nerves endings. One,
00:39:44
you can palpate the clitoris basically
00:39:46
throughout the entire anterior wall, but
00:39:48
also there's the skins glands, which are
00:39:50
these glands that sit underneath the
00:39:52
urethra, and they're the homalogue of
00:39:53
the male prostate. And so, they're right
00:39:57
there, and then the vagina is there. And
00:39:58
so, that's an area that can be very
00:40:00
enjoyable to stimulate. It's not
00:40:02
necessarily always going to lead to
00:40:04
orgasm because some people have
00:40:06
different sort of distance between the
00:40:08
clitoreral body and the vagina. So some
00:40:11
people have less distance may feel it
00:40:14
better than some that don't. Uh but
00:40:16
ultimately um that's why that area is so
00:40:18
sensitive for many women. On this point
00:40:20
of um morning erections, I was thinking
00:40:23
much of the reason why I've always been
00:40:25
cautious of having sex in the morning or
00:40:27
even like masturbating in the morning or
00:40:28
anything like that is I'm worried that
00:40:30
it will cause a dopamine crash which
00:40:32
will make me feel lazy and lethargic.
00:40:34
>> Well, so when you think about what
00:40:36
happens during an orgasm is you have
00:40:38
this release of dopamine and then you
00:40:40
your prolactin goes up and sort of like
00:40:43
everything calms down. Now some people
00:40:46
feel a a sense of clarity. They call it
00:40:48
postnut clarity, right? they feel clear,
00:40:50
they feel like motivated to do stuff,
00:40:51
they feel uh excited to go do something
00:40:54
else and they sort of move on from what
00:40:55
they're doing. There's some people who
00:40:56
feel post-coidal dysphoria. They
00:40:58
actually feel sad or they feel depressed
00:41:00
after they orgasm. And we don't know
00:41:03
exactly why this happens, but it is
00:41:05
because of this dramatic change in sort
00:41:08
of neurochemical signaling in the brain.
00:41:10
And for those people who have it, it can
00:41:12
be days where they sort of like feel
00:41:14
bad. It can be hours where they feel
00:41:16
sad. And so it can be really traumatic.
00:41:18
So pillar two, what's pillar two of the
00:41:21
four pillars of men's sexual health?
00:41:23
>> We talked about strength.
00:41:24
>> Okay, so we did strength, we did fuel.
00:41:27
>> What's pillar three?
00:41:28
>> Pillar three is environment. So we can
00:41:29
start with the easy stuff and that's
00:41:31
stress, right? Everyone knows stress is
00:41:33
bad. But I think the thing is people
00:41:35
just think like h I'll just I'll deal
00:41:37
with it. Everyone's stressed. Like
00:41:38
what's it's normal to be stressed? If
00:41:40
you are chronically stressed, that means
00:41:43
your cortisol is raised all the time,
00:41:45
which is dampening your testosterone,
00:41:47
which is also keeping you in the
00:41:49
sympathetic state, and you just cannot
00:41:51
get in your mind space and in the
00:41:54
nervous system place to actually have
00:41:56
sex. So, that's super important. And I
00:41:59
think, you know, there's lots of
00:42:00
different ways to alleviate stress. You
00:42:03
got to figure out what works for you.
00:42:04
Um, for some people, using a stress
00:42:06
ball, even just at work. And I think
00:42:08
part of it you can actually incorporate
00:42:10
some intimacy. There's some evidence,
00:42:11
you know, the Gottmans have been on your
00:42:13
podcast doing a 20 second hug. So
00:42:16
standing with your partner or loved one
00:42:18
and hugging for 20 seconds on your own
00:42:21
like independent gravity
00:42:23
>> actually helps alleviate stress and
00:42:25
break sort of a stress loop. Doing a
00:42:27
six-second kiss with your partner. And
00:42:30
so it seems like six seconds, no big
00:42:32
deal, but actually if you time it, it's
00:42:33
like hm if I'm just doing a kiss and I'm
00:42:34
not like actually it's a little bit
00:42:36
longer than normal. And so these sort of
00:42:38
small things can help alleviate stress.
00:42:41
Any type of movement can be really
00:42:42
beneficial.
00:42:43
>> The gym is great as well.
00:42:45
>> The other thing is just having like
00:42:47
interactions with people. And so that's
00:42:48
where we're becoming more isolated. But
00:42:50
even just like talking to the barista or
00:42:52
talking to someone at the grocery store,
00:42:54
this again tells your brain that you're
00:42:56
in a safe space, like you're talking to
00:42:58
someone. They're having a normal social
00:42:59
interaction.
00:43:01
So, and then being creative. And we've
00:43:03
been trying to work with this work on
00:43:04
this with our kids because there's so
00:43:06
much external stimuli all the time,
00:43:07
right? They want to play video games,
00:43:09
they want to watch TV, they want to play
00:43:10
sports, but we want them to be bored and
00:43:13
be creative, like come up with creative
00:43:14
ideas to keep themselves
00:43:17
interested and engaged in a different
00:43:18
way. So, I think that's so so important.
00:43:21
And outside of stress, sleep. Um, sleep
00:43:24
is there's just so much abundance of
00:43:26
data on how sleep affects hormonal
00:43:28
health. They looked at data on men
00:43:30
sleeping 5 hours a night versus eight
00:43:32
hours a night. So you take the same guy
00:43:34
and he sleeps eight hours, then you, you
00:43:35
know, do five five hours for a few days.
00:43:38
His test for a week, his testosterone
00:43:39
drops by 15%.
00:43:41
>> Wow.
00:43:42
>> That's like as much testosterone drop as
00:43:44
would happen with 10 years of life.
00:43:46
>> And do you know how long they did that
00:43:47
for? How long?
00:43:48
>> It was short. It was like a week. So, a
00:43:50
week of sleep deprivation will will tank
00:43:52
your testosterone.
00:43:54
>> And sleep apnnea is another one that I
00:43:56
think people one don't realize they have
00:43:58
and two don't realize that fixing it
00:44:00
could actually improve their hormonal
00:44:01
health.
00:44:02
>> Wait, so does this mean that people who
00:44:03
have chronically bad sleep probably have
00:44:05
low testosterone?
00:44:07
>> Probably. Yeah.
00:44:07
>> And what is the symptoms of low
00:44:09
testosterone?
00:44:10
>> So, low testosterone, they're sometimes
00:44:12
very vague. So it can be fatigue, it can
00:44:15
feel brain fog, it can be depression, it
00:44:18
can be low desire, it can be erectile
00:44:21
dysfunction. That's what people always
00:44:22
think. It's just erectile dysfunction,
00:44:23
but it's this whole constellation of
00:44:25
symptoms. It can also be increased fat
00:44:27
mass, decreased muscle mass. So all of
00:44:29
these things can happen because we have
00:44:31
testosterone receptors all over our
00:44:33
body. We have them in our brain. We have
00:44:34
them in our muscle. We have them in our
00:44:36
bone. And these can all have really
00:44:38
serious consequences when it's low. when
00:44:41
you have sleep apnnea. And how you know
00:44:42
you have sleep apnea is uh your partner
00:44:44
might tell you that you're like waking
00:44:45
up in the middle of like gasping for
00:44:47
air. If you have one really easy way to
00:44:50
check is take a a measuring tape and
00:44:52
measure your neck circumference. If it's
00:44:54
more than 17 in for a guy or 16 inches
00:44:57
for a female, it means it's very likely
00:44:59
that you may have sleep apnea. And
00:45:02
that's because when you have excess mass
00:45:04
basically here, it's compressing your
00:45:05
airway and can make it difficult to get
00:45:08
air into your um into your body. When
00:45:11
you improve sleep apnea, we've seen
00:45:12
improvements in testosterone as high as
00:45:14
200 nanogs per deciliter. So huge jumps
00:45:17
in testosterone after fixing sleep
00:45:19
apnea. And the same goes for other sleep
00:45:22
disorders, although the data is not as
00:45:24
abundant. Uh but sleep is so important.
00:45:27
Then we talk about what's in your
00:45:28
environment. So let's grab this. Okay.
00:45:32
So, you get a bottle of water. So many
00:45:35
of my patients actually they only buy
00:45:37
like cases of plastic bottled water.
00:45:39
Once in a while a plastic bottle of
00:45:41
water like don't stress yourself out.
00:45:42
This goes back to stress. People get
00:45:44
really stressed like what's in my
00:45:45
environment? What am I drinking? What am
00:45:47
I eating? Like do what you can control.
00:45:50
So plastic water bottles have things
00:45:52
like phalates and BPAs which can affect
00:45:55
hormonal health. They can mimic
00:45:57
estrogen. They can reduce the production
00:46:00
of testosterone based on these
00:46:02
mechanisms. Also things like plastics in
00:46:05
the environment, PAS, so the things like
00:46:08
non-stick cookware, all those things can
00:46:09
affect hormone health. Now, how do you
00:46:12
sort of protect yourself, right? I tell
00:46:14
people again, don't stress. There's only
00:46:16
so much you can control. So, like I love
00:46:18
that we're not drinking out of plastic.
00:46:20
If you have to drink out of plastic
00:46:22
because you're at an event or whatever,
00:46:24
try to make sure it's not a um a warm
00:46:28
bottle. So, it hasn't been like sitting
00:46:29
in the sun for hours and hours and hours
00:46:31
because as it gets warm, it releases
00:46:33
more microlastics and more chemicals
00:46:35
into the water. When you're eating food,
00:46:37
if you are eating out of say you get
00:46:39
takeout, put it on a plate and warm it
00:46:41
up. Don't ever warm up that plastic. And
00:46:43
when you store food in the fridge, put
00:46:45
it in a glass container or a metal
00:46:48
container, but don't ever leave the food
00:46:49
in the plastic and put it in the fridge.
00:46:51
These are simple things you can control.
00:46:53
You could also limit sort of your
00:46:54
exposure to dust because dust has
00:46:56
microplastics. You can try to wear more
00:46:59
cotton fabrics, less synthetic fabrics
00:47:01
because they shed less microplastics.
00:47:04
But again, I think do what you can do,
00:47:06
but don't let the stress of these
00:47:08
chemicals like derail you because stress
00:47:11
is not helping either. And how much of a
00:47:13
difference does you know microplastics
00:47:16
make on my hormonal health? Is it really
00:47:18
a big big deal?
00:47:19
>> Well, I think it depends. It's all dose
00:47:20
dependent, right? So, we're all exposed.
00:47:22
Like, if you look at the data, like
00:47:24
people are, you know, consuming quite a
00:47:26
bit of microplastics and we're seeing
00:47:27
them actually even in testicles, in
00:47:30
penis tissue samples, like they're in
00:47:32
our bodies. And so, I think that it's
00:47:35
definitely playing a role. How much? We
00:47:37
don't know yet. We just know there are
00:47:39
mechanisms and we know that they do
00:47:40
affect hormonal health and so do the
00:47:43
best you can.
00:47:44
>> Do you and your family drink out of
00:47:45
plastic bottles?
00:47:46
>> No, we drink we we have like metal water
00:47:49
bottles for the kids and myself. And
00:47:50
>> what about non-stick pans?
00:47:52
>> We buy ceramic. We we do our best to
00:47:54
like avoid those as much as possible. So
00:47:57
the other thing is the company you keep.
00:47:59
I think we don't talk about this enough
00:48:00
and we talk about it in terms of
00:48:02
business like you want to keep people
00:48:03
who are successful around you. You want
00:48:05
to keep people who can help you. But it
00:48:06
also plays a role in your sexual
00:48:08
environment, right? So my husband is in
00:48:10
these groups with a bunch of other male
00:48:12
physicians. And there's a lot of
00:48:13
discussion about how they never have sex
00:48:15
anymore. And they're all just like, "Oh
00:48:17
yeah, this is just like normal. Like
00:48:18
we're getting older. Our partners don't
00:48:20
want to have sex. It's so frustrating."
00:48:21
And there's a lot of discussion about
00:48:22
this and and it's it's almost like, "Oh,
00:48:26
that's okay." Like that's just normal,
00:48:27
right? They're normalizing this
00:48:29
experience where that sex has not become
00:48:31
a priority because life is so stressful,
00:48:33
things are so crazy. Maybe you're having
00:48:34
relationship discord. So, it absolutely
00:48:37
plays a role. And there's actually some
00:48:39
evidence that it may help you make
00:48:41
better choices. So, there's one study
00:48:42
where they looked at I think it was like
00:48:44
50,000 people and they um did an
00:48:48
intervention where they tried to
00:48:49
encourage these people to surround
00:48:52
themselves with positive influences that
00:48:53
were like have safe sex and avoid
00:48:55
negative influences. And they saw that
00:48:57
for that these people had an increase in
00:49:00
like sexual positive behavior. So like
00:49:02
safe sex practices by 46%.
00:49:05
So just by changing who they spent their
00:49:08
time with, they saw this major
00:49:10
difference in how they approached their
00:49:12
sex lives.
00:49:12
>> Okay. So if your friends are very
00:49:14
pessimistic about sex and they're not
00:49:15
having and they're complaining about it,
00:49:17
that's going to become sort of
00:49:19
contagious.
00:49:20
>> Yeah. And I think it it extrapolates to
00:49:22
everything. what kind of relationships
00:49:24
you you're in. How do they view their
00:49:26
relationship with their partner? Is it a
00:49:28
priority? Do they make it a priority?
00:49:30
Right? Or are they just busy doing their
00:49:31
own thing and they're just like living
00:49:33
in parallel lives? They're doing their
00:49:35
own thing. You're doing your own thing.
00:49:36
You never really spend time with your
00:49:37
partner and then when you go hang out
00:49:39
with your friends, you're like, "Oh god,
00:49:41
I'm so glad to get away." And you're not
00:49:42
like talking about how much you enjoy
00:49:44
your partner. People tend to talk
00:49:47
negatively, right? They want to like
00:49:48
sort of like vent. And so when you have
00:49:50
people who don't make that a part of
00:49:52
their lives, it also affects you. They
00:49:53
value their partner and they talk about
00:49:55
them in a positive way, that's a a great
00:49:58
thing to say like, okay, this is the
00:49:59
right kind of person I want because I
00:50:01
want to value my partner too and I don't
00:50:03
want that to rub off on me because it
00:50:05
absolutely does.
00:50:06
>> And the other thing you said in this
00:50:07
category of environmental stuff is
00:50:09
things like pornography consumption. Is
00:50:10
it possible to consume too much porn?
00:50:12
>> So it's not the amount of porn that you
00:50:14
watch, it is the sort of the way you
00:50:17
feel about it. Many people watch porn
00:50:19
for a variety of different reasons. Most
00:50:21
often it's for pleasure and enjoyment.
00:50:23
But there's some people who watch porn
00:50:24
because they want to get away from
00:50:26
negative feelings, right? This is giving
00:50:28
them dopamine and they're using it as a
00:50:30
way to just feel better in the moment.
00:50:32
And so that become that can become a
00:50:35
compulsion where they're watching porn
00:50:36
and it's like giving them these positive
00:50:38
feelings and they feel negative in life
00:50:39
and they're going back to porn to sort
00:50:41
of again have that compulsion to watch
00:50:43
porn again. But that's a small subset of
00:50:45
people. The other thing is that there's
00:50:47
a lot of negative discussion around
00:50:49
porn, right? People like porn is bad,
00:50:51
it's dangerous, it's evil. And I think,
00:50:53
you know, it's more nuanced than that.
00:50:55
But if you feel that porn is bad, every
00:50:58
time you watch porn, you feel negative,
00:51:00
you feel bad about yourself. That's
00:51:02
where we see people having the most
00:51:04
dysfunction associated with it because
00:51:05
they feel guilty. They could watch it
00:51:07
once a year and they could feel super
00:51:09
guilty about it and it could affect
00:51:10
their sexual function. They could see
00:51:12
themselves as a bad person. and they
00:51:13
could see themselves as wrong or
00:51:15
immoral. And that's really when it
00:51:17
becomes an issue. If you are finding
00:51:19
yourself either compulsively watching
00:51:21
pornography and using it as a scapegoat,
00:51:24
maybe time to reevaluate, say, why am I
00:51:26
doing this? How can I switch this out
00:51:28
for something else that makes me feel
00:51:29
better that might be healthy, like
00:51:31
exercise or going for walks or whatever
00:51:33
that may be? And then if it's something
00:51:35
that's really making you feel like bad
00:51:38
or guilty because maybe that's how you
00:51:40
were raised, maybe that's what you feel
00:51:41
about morality, then yeah, maybe like
00:51:43
you either need to work through that
00:51:45
because porn is maybe something that you
00:51:47
still want to watch at times or you need
00:51:49
to abstain. But usually those are it's
00:51:51
very difficult to abstain for most
00:51:53
people to abstain for prolonged periods
00:51:55
of time. So I think it's it's something
00:51:56
you have to work through if you find
00:51:58
yourself having these sort of feelings
00:51:59
about pornography or you're compulsively
00:52:01
watching it. But for most people, it's
00:52:04
adults. For most adults, it is fantasy.
00:52:07
It's a place where you can experience uh
00:52:11
see things that you may never do in real
00:52:12
life that may be enjoyable, that are fun
00:52:15
to watch, that have allow you to feel
00:52:16
arousal. We see that when couples watch
00:52:19
porn together, they are more likely to
00:52:21
be more satisfied in their relationship.
00:52:22
And when there's a discord, like one
00:52:24
person really doesn't like it or doesn't
00:52:26
use it, and the other one uses it a lot,
00:52:27
that's where we see the problem. Is porn
00:52:30
consumption going to impact my intimacy
00:52:33
with my partner?
00:52:35
>> So, it depends. I think a lot of people
00:52:37
watch it without an issue, right? They
00:52:39
watch
00:52:39
>> if I masturbate and I ejaculate, I'm not
00:52:42
going to then be able to ejaculate very
00:52:43
quickly necessarily with my partner.
00:52:45
>> Yeah. So, that obviously that is, you
00:52:47
know, there's a refractory period after
00:52:49
you ejaculate. Now, when you're younger,
00:52:50
that refractory period could be minutes.
00:52:53
And when you're older, that can be a day
00:52:55
and a half. And so we see that some
00:52:58
people may struggle, especially if
00:52:59
they're watching a lot of porn every
00:53:01
single day and their refractory period
00:53:03
is maybe a day. Then they may actually
00:53:05
really have trouble ejaculating with
00:53:07
their partner because they've not given
00:53:09
themselves that time.
00:53:11
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And the last one, the last of the four
00:55:13
pillars,
00:55:14
>> the last of the four pillars we talked a
00:55:15
little bit about, it's called
00:55:17
confidence. And confidence is not like
00:55:19
stringing around like a peacock like I
00:55:21
know what I'm doing. It's confidence in
00:55:22
knowledge and curiosity. So, knowledge
00:55:25
we talked about a little bit,
00:55:26
understanding female anatomy, like how
00:55:28
do female bodies get aroused, right?
00:55:31
what makes them aroused, where is the
00:55:32
clitoris, knowing some anatomy, and two,
00:55:35
actually talking to your partner or
00:55:37
paying attention to their cues. We that,
00:55:39
for some reason with sex, it's the only
00:55:41
time that we just expect people to be
00:55:43
mind readers. We just want you to know
00:55:44
what I like and just go for it, right?
00:55:46
And and then when it's not good, you're
00:55:48
like, well, you just don't know what
00:55:49
you're doing. And it's like, it's it's
00:55:51
wild to me that we actually never got
00:55:54
taught how to talk about sex, how to
00:55:55
bring it up with a partner, how to, you
00:55:58
know, just explore and have fun with
00:56:00
sex. maybe add a toy to the bedroom. So,
00:56:02
there's lots of different types of toys.
00:56:04
This is a uh vulva stimulator. So, you
00:56:07
put this on the outside. So, you can see
00:56:08
that it would in theory, if this was
00:56:11
smaller, would stimulate the um the
00:56:14
clitoris on the outside. It also can
00:56:16
change in shape. It'll vibrate, right?
00:56:19
It'll have different stimulations that
00:56:21
you can play around with and decide what
00:56:22
you enjoy.
00:56:23
>> So, this one's run out of battery. Um
00:56:27
so,
00:56:28
>> they're brand new. They have not been
00:56:29
used.
00:56:30
>> I didn't say they had been very
00:56:32
defensive though. Um, so if my pinky
00:56:34
finger, if my finger here is the
00:56:35
clitoris,
00:56:36
>> Yeah.
00:56:36
>> I put it on like that.
00:56:39
>> Yeah.
00:56:39
>> And then it vibrates.
00:56:40
>> Correct.
00:56:41
>> And then the penis goes through the
00:56:43
hole.
00:56:44
>> And there's another version of that.
00:56:45
This is basically
00:56:48
>> this is basically like the hole goes
00:56:50
around the penis
00:56:51
>> and that goes in
00:56:52
>> and that can go in and stimulate and vi
00:56:54
vibrate. So, you both feel the vibration
00:56:56
and you both feel the stimulation.
00:56:58
>> I remember I was with um had a partner
00:57:00
and she she felt that sex toys were for
00:57:02
older people. Old people specifically
00:57:04
what she said and she she was kind of
00:57:07
against the use of them. I've always
00:57:08
been down.
00:57:09
>> I think it adds novelty and it's
00:57:11
exciting and it just adds something new.
00:57:13
>> But she felt like it was almost like
00:57:16
giving up.
00:57:17
>> Well, I mean, look, I think I wonder
00:57:19
why. I would I would if I she was here,
00:57:20
I'd ask her, why do you think that? What
00:57:22
belief system do you have that's making
00:57:24
you think that this is like not a good
00:57:26
thing to use? Right? We use technology
00:57:28
in so many places in our lives, right?
00:57:31
So why not introduce it in our sex
00:57:33
lives?
00:57:33
>> Are you going to become reliant on it
00:57:34
though? Because it doesn't make it
00:57:35
easier to get off with a sex toy.
00:57:37
>> So they've actually looked at vibration
00:57:40
and can you get desensitized to it? And
00:57:42
the way they've looked at is actually
00:57:43
like construction workers where they're
00:57:44
using those like vibration tools, right,
00:57:46
to and and seeing if like their hands
00:57:48
get desensitized. And what they've seen
00:57:50
is yes, for a short period of time they
00:57:52
do lose a little bit of sensation at
00:57:54
their fingertips, but then it restores
00:57:56
back to normal. And so it's not that
00:57:58
you're going to become desensitized
00:57:59
forever, right? I think you brought up a
00:58:02
great point, which is adding novelty.
00:58:03
Now, I think when I say novelty, people
00:58:05
are like, "Oh my god, I need to role
00:58:08
play in a different way or bring like
00:58:10
some sort of BDSM or whatever into my
00:58:13
sex life." And that's not exactly true.
00:58:15
So when you think about sex, right, it's
00:58:17
just like eating your favorite ice
00:58:19
cream. Maybe you have vanilla ice cream,
00:58:21
you know, three times a week and you
00:58:22
enjoy it. But if you start having
00:58:23
vanilla ice cream every single day,
00:58:25
you're kind of bored with it, right? And
00:58:27
the same goes for sex. Now having
00:58:29
routine in sex, knowing what you like,
00:58:32
um knowing what your partner likes, it
00:58:33
can be very helpful, but it also is nice
00:58:37
to add novelty. So if you think about
00:58:39
you can extrapolate from the flow state.
00:58:41
So when you are in a flow state for
00:58:43
work, right, things feel really almost
00:58:45
effortless and you're just like in a
00:58:46
zone, you can also get into a sexual
00:58:49
flow state. When you look at the flow
00:58:50
state, yeah, you need things to be
00:58:52
slightly challenging to get into the
00:58:53
flow state. They can't be easy and they
00:58:56
can't be so hard that you're going to
00:58:57
get frustrated, right? And so you need
00:58:59
to add a slight challenge to your sexual
00:59:03
encounter to get into that flow state.
00:59:05
And that's when you start having really
00:59:07
great sex cuz you're like in you're so
00:59:09
totally immersed. you're feeling great
00:59:11
and it's it's super fun, right? So, I
00:59:13
think that's another part of being
00:59:15
confident is being able to and confident
00:59:17
to try new things and explore new
00:59:18
things. And it can be as simple as like
00:59:21
doing it in a different room or maybe
00:59:22
getting a pillow or switching where your
00:59:25
head position is. Like, it can be so
00:59:27
small, but it can just add a little bit
00:59:29
of uniqueness and novelty and challenge.
00:59:32
>> Are there certain positions that are
00:59:35
going to increase the probability that
00:59:37
my partner has an orgasm?
00:59:38
>> Yeah. So, uh, typically when the female
00:59:41
partner is on top, she has more control
00:59:43
over where she's getting stimulation,
00:59:46
um, to the clitoris because, right, she
00:59:48
can angle her body in such a way. So,
00:59:50
often time that shows uh, that has, uh,
00:59:53
higher orgasm rates. There's actually
00:59:55
like this uh this technique called the
00:59:57
cooidal alignment technique where you
01:00:00
sort of move in a rocking uh a sort of a
01:00:03
rocking motion so that um your pubic
01:00:06
symphysis. So this bone right here um is
01:00:09
sort of like rubbing against their
01:00:11
clitoris like this area the skin here is
01:00:13
rubbing against the clitoris while
01:00:14
you're penetrating and that has been
01:00:16
shown to increase orgasm rate and
01:00:19
pleasure in sex. But really it's about
01:00:21
figuring out and trying different things
01:00:23
and realizing like that for example that
01:00:24
coil alignment technique is sort of
01:00:26
difficult like it's not that easy and
01:00:27
intuitive and so you have to sort of
01:00:29
play around with it and figure out like
01:00:31
what is going to work uh best and yeah
01:00:33
realizing it might not work. You might
01:00:35
be like super awkward and like okay like
01:00:37
that's okay like it's not the end of the
01:00:38
world if sex is not perfect every time
01:00:41
because we're learning and we're playing
01:00:42
and we're having fun. And so I think
01:00:44
that's really the key is like not
01:00:45
letting yourself get so frustrated if
01:00:47
something doesn't go exactly the way you
01:00:49
envision it in your head.
01:00:50
>> I used to think that a woman orgasming
01:00:52
was when this was when I was younger. Um
01:00:54
was when she squirted.
01:00:56
>> Mhm.
01:00:56
>> So like that's what I thought it thought
01:00:58
an orgasm was squirting.
01:00:59
>> Yeah. Well, you're probably not the only
01:01:01
one to think that. And so squirting, not
01:01:03
every woman squirts. So about 40% of
01:01:05
women squirt. Squirting is the emission
01:01:07
of fluid at the time of orgasm. Um
01:01:10
usually it's clear, colorless, and it
01:01:11
can be quite voluminous. um it's coming
01:01:14
from the urethra which is the pee hole
01:01:16
essentially and remember I talked about
01:01:18
those skins glands those skins glands
01:01:21
are the homalogue of the male prostate
01:01:23
and they have a little bit of fluid in
01:01:24
them too typically when you have
01:01:28
stimulation um and squirting they will
01:01:30
release fluid from the bladder as well
01:01:33
as the skins glands that combines
01:01:34
together and and it's emitted through
01:01:37
through that
01:01:37
>> so it's not pee
01:01:39
>> the way they describe it and there's
01:01:40
been a lot of research on this so
01:01:41
there's people who say it's pee. There's
01:01:43
people who say it's not. There's a
01:01:44
couple studies. So, one is they put dye
01:01:47
into the bladder and they took women who
01:01:50
said they were squirters and they had
01:01:51
them orgasm and they saw is there dye in
01:01:54
the uh in the fluid and yeah, there was
01:01:57
dy in fluid. So, it's coming, it has to
01:01:59
come from the bladder. The skins glands
01:02:00
only hold a small amount, but it's
01:02:02
chemically different. It's usually
01:02:04
clear, odorless. It doesn't smell like
01:02:06
pee. And so, there's some theories as to
01:02:08
why that might be. It may be that um
01:02:11
when you're having sex, there's
01:02:13
different hormonal signals that change
01:02:14
the concentration of what's filtering
01:02:16
through your kidneys so that it is a
01:02:18
little bit different in composition.
01:02:20
There's some theories that when there's
01:02:21
more estrogen around that it may change.
01:02:23
There may be some like um fluid filling
01:02:26
in the actual interstissia of the
01:02:28
organs. Again, it's hard to say, but
01:02:30
it's absolutely coming from the urethra
01:02:32
which is connected to the bladder as
01:02:34
well as the steam glands. But I think
01:02:35
like this this whole discussion about
01:02:37
what it is, it doesn't matter. Like is
01:02:39
it pleasurable? Are you enjoying it?
01:02:41
Great. If you squirt and you enjoy it,
01:02:43
great. If you don't, that doesn't mean
01:02:45
that there's something wrong and that
01:02:46
your partner hasn't orgasmed. The way to
01:02:48
figure out if your partner orgasm is you
01:02:50
ask her, right? Either she tells you or
01:02:52
you ask her. And sometimes it's obvious
01:02:54
and sometimes it's not, but you know,
01:02:55
you you sort of figure it out.
01:02:58
>> There's three theories that emerged in
01:03:00
my research about why women squirt from
01:03:02
an evolutionary perspective. The first
01:03:04
was that, and these are just theories,
01:03:06
they're not proven. Um, of course, the
01:03:08
first is that squirting contains PSA and
01:03:10
zinc, which are naturally antibacterial,
01:03:13
and ejaculating these fluids during or
01:03:14
after sex may have evolved to flush the
01:03:17
urethra and prevent UTI. Um, the logic
01:03:19
being in a pre antibiotic world, a woman
01:03:22
who could flush bacteria out of her
01:03:24
system after mating was more likely to
01:03:25
stay healthy and reproduce. That's one
01:03:26
theory. The other reason,
01:03:27
>> well, before you I want to talk about
01:03:28
that really quickly. So, that's a really
01:03:30
interesting theory. So one the reason
01:03:32
they emit PSA is because schemes glands
01:03:35
are the homalologue of the prostate. So
01:03:38
the prostate makes PSA which is prostate
01:03:40
specific antigen.
01:03:41
>> So this point this word homalogue again.
01:03:42
>> Yeah it's a so basically the prostate in
01:03:44
the male the same tissue when they're an
01:03:47
embryo becomes the prostate in the male
01:03:48
and becomes a skins glands in the
01:03:50
female. So that's why it's emitting PSA.
01:03:53
That is an interesting theory because
01:03:54
there are a subset of women who get UTI
01:03:56
after sex. Not everybody but some do.
01:03:59
And it's it's not because of the
01:04:01
ejaculate or because of the male
01:04:04
harboring some bacteria. It's because of
01:04:05
the actual thrusting of the penis. It's
01:04:08
taking bacteria from the outside and
01:04:09
making it more easy for it to go through
01:04:11
the urethra into the bladder. And women
01:04:13
have a short urethra. And so I want just
01:04:15
to debunk that myth that it's like
01:04:17
you're getting it from your partner or
01:04:19
there's something wrong with you. It is
01:04:20
literally just anatomy. And so some
01:04:22
women do get more UTI after sex.
01:04:25
>> And so that is an interesting theory
01:04:26
because maybe that's true. I don't know.
01:04:28
The second theory was in ancient
01:04:30
ancestors, the hormonal surge during
01:04:32
orgasm and ejaculation actually
01:04:33
triggered the release of an egg. Humans
01:04:36
evolved to ovulate on a cycle now, but
01:04:38
we kept the plumbing and the neuro
01:04:40
hormonal reflex. It's a happy accident,
01:04:42
a biological vestage that no longer
01:04:43
serves its original reproductive
01:04:45
purpose, but remains because it isn't
01:04:47
harmful for survival.
01:04:49
>> Interesting. I mean there is some
01:04:50
thought that maybe orgasming
01:04:53
um spasms orgasm help with fertility but
01:04:56
it's not really uh robust.
01:04:59
>> And the last one kind of matches what
01:05:00
you just said there which is the mate
01:05:02
selection theory. The intense pleasure
01:05:03
and psychological response of squirting
01:05:05
or or orgasm act as a reward system. It
01:05:08
incentivizes women to seek out specific
01:05:10
partners who provide high levels of
01:05:12
stimulation, potentially signaling a
01:05:13
better genetic compatibility or a more
01:05:16
attentive male, which would help with
01:05:18
the survival of of offspring. Maybe
01:05:21
>> that makes sense.
01:05:23
>> 40% of women squirt.
01:05:25
>> Yeah. So, the other thing is obviously a
01:05:27
lot of sex is focused on genitals, but
01:05:29
there's a whole body of arogynous zones,
01:05:31
right? Almost almost your entire body
01:05:34
can be an erogynous zone. We talked a
01:05:36
little bit about it when we talked about
01:05:37
sensate focus, right? You can explore,
01:05:39
you can find areas that people find uh
01:05:42
erogynous. So when you looked at data,
01:05:44
necks, nipples, lips, buttocks, inner
01:05:48
thighs, all these areas are considered
01:05:50
arogynous by most most people regardless
01:05:53
of their um sexual orientation,
01:05:55
regardless of their cultural upbringing.
01:05:57
It seems to be pretty universal. There's
01:05:59
actually a famous paper about
01:06:00
non-genital orgasms and like how people
01:06:03
orgasm without any genital stimulation.
01:06:06
So lip orgasms, anal sex orgasms.
01:06:09
>> Is that possible?
01:06:10
>> Yeah, it's been documented. Absolutely.
01:06:13
And and so it's um nipple orgasms.
01:06:15
There's a whole variety of ways even
01:06:17
like women have had orgasms during
01:06:18
childirth. Like there's there have been
01:06:20
these documented ways to orgasm and it's
01:06:23
because these areas can be very
01:06:24
erogynous and sometimes stimulating
01:06:26
multiple areas can like add more
01:06:29
erogynous interest and that's why you
01:06:31
see people like maybe in the BDSM
01:06:33
community they'll they'll be using um
01:06:35
nipple clamps while they're doing other
01:06:37
things right so there's there's a whole
01:06:38
bunch of areas that are erogynous and
01:06:41
most of the times people are not really
01:06:43
spending much time on foreplay or
01:06:46
stimulating these erogynous zones as
01:06:48
much as they should Right? You you have
01:06:50
a whole body to play with. And how do
01:06:51
you stimulate them? There's actually
01:06:53
evidence behind that. So on your skin,
01:06:55
we have these special fibers called C
01:06:57
tactile eference. When you stimulate
01:06:59
these fibers, they help you feel
01:07:01
pleasure, enjoyment, those sorts of
01:07:03
things. And so there was a study where
01:07:06
they took 19 couples, a small study, it
01:07:07
was out of London, and they basically
01:07:10
told them to stimulate an arogynous zone
01:07:12
and a non-erogynous zone. The
01:07:13
non-erogynous zone being the forehead.
01:07:15
And so they had the couples stimulated.
01:07:16
And they told them stimulated at levels
01:07:18
of 18 cm/s
01:07:21
uh in terms of how fast you're caressing
01:07:23
the arm or or or body part and at 3 cm
01:07:27
per second. And what they found was
01:07:28
those who stimulated at 3 cm per second
01:07:31
had more sexual arousal had more
01:07:33
pleasant stimulation compared to those
01:07:35
who were stimulating at 18 cm per
01:07:37
second. Now this makes sense because
01:07:39
those C tactile aphrant fibers respond
01:07:42
very well to that slow gentle caress.
01:07:46
The other interesting thing is that
01:07:47
these fibers are only responsive to
01:07:50
human touch. So if I take a glove and I
01:07:52
put it on my hand and I touch you, it
01:07:54
still doesn't work.
01:07:55
>> Interesting. That's so interesting
01:07:57
because in Los Angeles where we are now,
01:07:59
we were viewing an office and we were
01:08:00
walking down the street to see what the
01:08:02
neighborhood was like and we walked past
01:08:04
one place and it is a robot massage
01:08:07
parlor. M
01:08:09
>> and I always thought great like well
01:08:11
part of me thought maybe my prefrontal
01:08:13
cortex thought oh great idea because you
01:08:15
know you can get massages whenever you
01:08:16
want it's going to be cheap maybe you
01:08:18
can have one in your home but then the
01:08:19
other part of me as I saw it thought
01:08:21
actually I don't actually think that's
01:08:22
like why I get massages
01:08:24
>> I think there's something about human
01:08:25
touch which makes a big difference
01:08:27
>> absolutely there is um and so I think
01:08:29
that's uh we're evolutionary
01:08:32
evolutionarily built to seek out human
01:08:35
touch and human behavior
01:08:37
>> I wonder if I would want a robot to
01:08:38
massage me.
01:08:41
>> It wouldn't be as good. No.
01:08:42
>> I mean, think about sitting in a massage
01:08:44
chair. Is it ever as good?
01:08:45
>> It's never as good,
01:08:46
>> right? And so, I don't think a robot's
01:08:47
going to be that different from a maybe
01:08:49
a little better than a massage chair,
01:08:51
but like
01:08:52
>> massage chairs are never good.
01:08:53
>> No, they're just like they're okay.
01:08:55
They're mediocre. M Reena, I want to
01:08:57
talk about um testosterone, how that
01:09:00
links to sexual function, but also just
01:09:02
overall health because I was reading
01:09:04
that there's been a 300% increase in the
01:09:06
United States in the last 10 years of
01:09:08
testosterone prescriptions. And my
01:09:10
friends are increasingly having
01:09:11
conversation about testosterone, which
01:09:12
we weren't having
01:09:14
>> even 5 years ago. It wasn't a
01:09:15
conversation. And now the conversation
01:09:17
I'm having amongst my friends is like,
01:09:18
is our testosterone high enough? Do we
01:09:19
need to go get supplements to increase
01:09:21
our testosterone?
01:09:22
>> Testosterone is declining. So when you
01:09:24
look at testosterone levels from the
01:09:26
1990s, like late 1990s, the average
01:09:29
level was around 600 and if you look at
01:09:32
data around two 2015, it was 450. So
01:09:35
there's been like a 25% decline in
01:09:38
testosterone. Now you're going to ask me
01:09:39
why. One, we talked about some of the
01:09:41
endocrine disrupting chemicals. That's
01:09:43
part of it certainly. Two, there's a
01:09:45
significant rise in obesity.
01:09:47
Testosterone has aromatase. And
01:09:49
testosterone converts to estrogen using
01:09:51
this enzyme called aromatase. And so
01:09:54
when you have more fat mass, you have
01:09:55
more aromatase. And more testosterone is
01:09:57
being converted to estrogen. And so now
01:10:00
you have less testosterone.
01:10:01
>> Sorry. How do we how do you have less
01:10:02
testosterone?
01:10:03
>> So because there's more fat mass,
01:10:05
there's more aromatase. So that
01:10:07
aromatase sees all this testosterone and
01:10:09
it converts it to estrogen.
01:10:11
>> Okay. This is where they say they talk
01:10:13
about man boobs.
01:10:14
>> Yeah. So when you have a lot of
01:10:15
estradiol around you can get man boobs,
01:10:19
>> you can get gynecomastia. So a term for
01:10:20
it. So that's one. Two is we see a rise
01:10:23
in diabetes and insulin resistance which
01:10:26
also causes a decrease in testosterone.
01:10:30
We're seeing a rise in ultrarocessed
01:10:32
food intake and that doesn't have the
01:10:36
optimal nutrition that you need to
01:10:38
optimize testosterone. So we're getting
01:10:41
you know a high highly caloric which
01:10:43
then leads to obesity. We're getting um
01:10:46
lack of healthy fats. We're you know all
01:10:48
these things are super important for
01:10:50
testosterone. The Mediterranean diet is
01:10:52
what has been the most studied and
01:10:54
basically anti-inflammatory diet is what
01:10:56
they found for testosterone. So trying
01:10:58
to just eat like whole foods,
01:11:00
unprocessed foods as much as possible
01:11:03
and minimizing the inflammatory foods.
01:11:05
>> Does testo having high testosterone make
01:11:07
me more fertile? No, not necessarily.
01:11:10
So, I think people inherently think that
01:11:12
the higher your testosterone level is
01:11:14
when you check your blood work, that
01:11:16
that's better. And that's not
01:11:17
necessarily true. Now, everyone is
01:11:20
different. And what I can't tell you is
01:11:22
what your receptors look like, what your
01:11:25
testosterone or androgen receptors look
01:11:27
like, how sensitive are they to
01:11:29
testosterone. And everyone's a little
01:11:31
bit different. But when you look at the
01:11:32
same guy or you look at two different
01:11:34
guys, their variability can be so much
01:11:36
that a guy who's 900 can be normal and a
01:11:38
guy who's 500 can be normal because
01:11:40
everyone has individual genetic
01:11:41
variations. It's how their cells how
01:11:44
sensitive their cells are, how many
01:11:46
cells they have, you know, how many
01:11:47
latig they have in their testicles. Um
01:11:50
the CAG repeats, which are these DNA
01:11:52
repeats on the receptor themselves.
01:11:54
People who have more are less sensitive
01:11:56
to the testosterone that's around. So
01:11:58
they need more testosterone to get the
01:11:59
same result. Whereas people who have
01:12:01
less repeats have more sensitivity so
01:12:03
they they don't need as much
01:12:05
testosterone. And so everyone is
01:12:06
individual. And so that's why it's
01:12:08
really important to understand how are
01:12:09
you feeling, right? It's not about
01:12:11
chasing a number. And so absolutely we
01:12:14
know that when your testosterone is low
01:12:16
below 214 nanogs per deciliter that your
01:12:20
risk of mortality goes up by two. So you
01:12:22
are going to double your risk of dying
01:12:24
if you have low testosterone. But when
01:12:26
you go super high, super physiologic,
01:12:29
meaning like 1,800 or higher, now you're
01:12:31
putting yourself at risk for other
01:12:33
things. You can have blood thickening,
01:12:35
which is a known side effect of
01:12:36
testosterone replacement, and that puts
01:12:38
you at risk for stroke, heart attack,
01:12:40
heart disease. Over long periods of
01:12:43
time, it can affect your heart because
01:12:45
it can um there's also heart muscle
01:12:48
cells that get exposed to this high
01:12:50
level of testosterone. And when that
01:12:52
happens, these they sort of change over
01:12:54
time and they become more collagen
01:12:56
deposition. They get more fibrosis and
01:12:59
this makes them stiffer and so that
01:13:00
you're not pumping blood as effectively
01:13:02
as you would otherwise. And so there are
01:13:05
real consequences to going too high.
01:13:08
There's also the side effects of having
01:13:09
acne, of changes in mood in terms of
01:13:12
aggression and things when you get
01:13:13
really high. So really, it's about
01:13:15
finding what you feel good at. More is
01:13:18
not necessarily better. Once your
01:13:20
testosterone receptors are saturated,
01:13:22
meaning they're all bound to
01:13:23
testosterone more doesn't help you. It
01:13:25
might help you get more muscles, which
01:13:27
is why people abuse anabolic steroids
01:13:29
and testosterone because it will
01:13:30
continue to help you get bigger muscles,
01:13:32
but that's it. It's not going to help
01:13:34
you with your brain health, your bone
01:13:36
health, your sexual health, your any of
01:13:38
that.
01:13:39
>> Is there a way to
01:13:41
visually spot a person with low
01:13:43
testosterone? Are there visual clues?
01:13:46
Usually it's someone who feels very
01:13:48
fatigued like they can't get out of bed.
01:13:51
They feel just like so drained. Usually
01:13:53
they are a little bit more overweight.
01:13:56
>> Skinny fat
01:13:58
>> visceral adop I mean you can't always
01:14:00
tell if they're skinny. So it could be
01:14:01
because they could have visceral adopy
01:14:02
which is meaning that the fat is around
01:14:04
the the organs right and so you don't
01:14:06
see like a big pot belly necessarily. Um
01:14:09
they may have really low sexual desire.
01:14:12
They may have decrease in mood.
01:14:13
>> What about skin and bones? Does it
01:14:15
impact skin and bones?
01:14:16
>> Yeah. So, if you get high testosterone,
01:14:18
you can get acne because it affects the
01:14:19
sebum in the skin. Um, bone health. So,
01:14:22
testosterone converts to estradiol and
01:14:26
estradiol is really important for bone
01:14:28
metabolism. And so, when you have low
01:14:31
testosterone, you can also have low
01:14:33
estrogen. And when your estrogen gets
01:14:35
very low, you get a higher risk for
01:14:38
fractures, higher risk for osteoporosis.
01:14:41
And so that's where your bone health um
01:14:43
can be in danger. And so that's why
01:14:45
testosterone can help protect your bones
01:14:47
because of its conversion to estradile.
01:14:50
>> If you do have low testosterone, should
01:14:51
you be considering taking anabolic
01:14:53
steroids? Like
01:14:55
and who is testosterone replacement
01:14:57
therapy good for?
01:14:59
>> So I'm going to ask you a question. Why
01:15:00
why are you saying anabolic steroids?
01:15:02
>> I don't know. Cuz I hear that people big
01:15:03
bodybuilders take anabolic steroids. The
01:15:05
reason I asked you that is because
01:15:06
people think anabolic steroids and
01:15:08
testosterone replacement therapy are the
01:15:09
same thing and they're not. And so
01:15:11
testosterone replacement therapy is what
01:15:14
is given to guys who have low
01:15:16
testosterone. If you have truly low
01:15:18
testosterone, there's a few things you
01:15:20
can obviously improve testosterone
01:15:21
naturally by going back to those pillars
01:15:23
of health that we talked about. Improve
01:15:24
your sleep, do resistance training,
01:15:26
avoid endocrine disrupting chemicals.
01:15:28
But if you are still low despite doing
01:15:30
all those things or you're like so
01:15:32
fatigued that you can't move your body
01:15:33
and like you really need to do it, then
01:15:35
I think testosterone replacement is is
01:15:37
very valuable. And so testosterone
01:15:39
replacement is getting you to a level of
01:15:42
testosterone that is within normal.
01:15:45
We're not trying to get you super high.
01:15:47
We're not trying to get you to become a
01:15:48
bodybuilder. We're trying to get you to
01:15:50
normal, what you should be. And so
01:15:53
anabolic steroids are different. And
01:15:55
anabol steroids are like all these
01:15:56
different um oral pills and injectables
01:15:58
and things that work on muscle as well
01:16:00
as work on your uh androgen receptors.
01:16:03
And so those are typically things that
01:16:05
people are taking on their own. They're
01:16:08
kind of self-directing their care and
01:16:10
they're not really monitoring their
01:16:12
testosterone or they don't really care
01:16:14
how high they go. They just want the end
01:16:16
product of looking muscular. And so they
01:16:20
are getting really high testosterones
01:16:22
and that has its own host of concerns in
01:16:26
addition to the ones we talked about
01:16:27
like blood clots and and heart attack.
01:16:29
But there's a 15 times higher risk of
01:16:32
having premature heart failure and a 122
01:16:36
times more risk of cardiac death when
01:16:39
you're taking anabolic steroids for the
01:16:41
purposes of increasing muscle mass and
01:16:43
not and get getting really high in your
01:16:45
testosterone. So, it is a real serious
01:16:48
issue when you take anabolic steroids
01:16:50
because it can have real serious health
01:16:52
consequences.
01:16:53
>> I've always imagined that once I have
01:16:55
kids, so I'm I think I'm scared that if
01:16:57
I have testosterone replacement therapy
01:16:59
at this age at 33, it might impact my
01:17:01
fertility.
01:17:02
>> It absolutely will.
01:17:03
>> Okay, good. So, I'm not going to do that
01:17:06
until I've had all four of the kids.
01:17:08
>> Yeah.
01:17:08
>> As many as I can.
01:17:10
>> And then I figured when I hit like 45,
01:17:13
then I'll go on testosterone replacement
01:17:15
therapy. Is this a good strategy?
01:17:17
>> Well, first of all, I would want to know
01:17:19
why you want to be on testosterone. Is
01:17:20
your testosterone low?
01:17:21
>> I have no idea.
01:17:22
>> Right? Are you having any symptoms?
01:17:24
>> I mean, you live a very highpowered,
01:17:26
busy life. And so, I can guarantee your
01:17:29
stress is probably not under control.
01:17:31
Like, probably you're not sleeping
01:17:33
great. And not to say that those are
01:17:35
things that, you know, you can't do in
01:17:36
addition to taking testosterone if your
01:17:38
testosterone is indeed low. But I think
01:17:41
the important thing is realizing like
01:17:43
it's only going to help you if your
01:17:45
testosterone receptors are not fully
01:17:47
saturated and giving you more
01:17:48
testosterone is going to saturate them.
01:17:50
>> Doesn't it just drop anyway with age?
01:17:52
>> It does. So it drops about uh 1% a year
01:17:56
on average. Some people drop less, some
01:17:58
people drop more. So if you look at
01:17:59
someone who is healthy and they have a
01:18:02
normal testosterone, they usually won't
01:18:04
become what we call hypogonatal or have
01:18:06
low testosterone even as they age
01:18:09
because the drop is so low. it's only 1%
01:18:11
a year. But if you add on these comorbid
01:18:14
conditions, if you add on a high stress
01:18:15
life, if you add on poor sleep, if you
01:18:18
add on um exposure to endocrine
01:18:20
disrupting chemicals, you're going to
01:18:21
see um that number come down much
01:18:24
higher.
01:18:24
>> It's actually I was just I pulled up a
01:18:26
graph here um that shows testosterone
01:18:29
decline with age. And it's actually not
01:18:32
that steep.
01:18:33
>> It's not It is going to decline, but it
01:18:36
may not decline to the point where you
01:18:38
need testosterone. So, not everyone
01:18:40
needs it. Depending on the data you look
01:18:41
at, 20 to 40% of guys have low
01:18:44
testosterone. Um, and when you look at
01:18:47
the number that get treated, it's like
01:18:48
2%.
01:18:49
>> And it starts declining from about 20
01:18:51
years old.
01:18:52
>> Yeah. Depends on the person. 20 to 40
01:18:54
years old that start, it's probably more
01:18:55
around 30 to 40. And the reason we came
01:18:57
up with these numbers, right, these
01:18:59
guidelines to to guide us on what's
01:19:00
normal and what's not is because you
01:19:02
look at population-based data and you
01:19:04
look at when these symptoms arise and
01:19:06
there are like clear numbers like you
01:19:08
may start having bone loss uh around
01:19:10
300. You might start having uh you know
01:19:14
decreased sexual frequency of thoughts
01:19:16
at 215. You might start having feeling
01:19:19
less physical vigor uh around 290.
01:19:22
Right? And so there are numbers that we
01:19:24
know based on population-based data that
01:19:26
we're seeing these numbers decline. Now
01:19:28
the other thing to think about when
01:19:30
you're looking at testosterone is free
01:19:31
testosterone. So testosterone comes in
01:19:34
different forms in the body. It comes
01:19:36
bound and unbound. So 45% of
01:19:39
testosterone is bound to SHBG which is a
01:19:43
molecule of protein that is really
01:19:45
tightly binds to testosterone. Doesn't
01:19:47
let it go for your body to use. Then
01:19:49
there's some that's bound to albumin
01:19:51
which is sort of loosely bound and then
01:19:53
there's 2% that's free 1 to 2% that's
01:19:56
free and that's what we say is like the
01:19:57
most available to your body for use and
01:20:01
there's actually you know good data that
01:20:02
looks at free testosterone and the
01:20:04
levels of free testosterone are
01:20:06
correlated with these symptoms as well
01:20:08
and so you do have to look at the big
01:20:10
picture so I always check a total
01:20:12
testosterone as well as an SHBG because
01:20:14
some people can have elevated SHBG
01:20:17
thyroid dysfunction due to aging, just
01:20:20
genetic variability, right? In women,
01:20:22
SHBG goes up when you take oral
01:20:24
contraceptives and it stays up for life
01:20:27
if you take oral contraceptives. So, it
01:20:28
can affect their free testosterone. The
01:20:30
other thing to think about testosterone
01:20:31
is it's for life. Once you take it, your
01:20:33
body stops making its own testosterone.
01:20:36
Many people over years will notice that
01:20:37
their testo their testicles get smaller
01:20:40
um because their body stops making its
01:20:42
own testosterone. So, it's not something
01:20:44
to take lightly. Now if you want say you
01:20:46
were low right now and you wanted to
01:20:48
conceive there are ways where you can
01:20:50
take other um other pharmaceuticals that
01:20:53
will naturally boost your own production
01:20:55
like hcg or clomid or enclomophene.
01:20:58
These work basically uh in different
01:21:00
ways to either tell your brain that hey
01:21:02
we need more testosterone or they send
01:21:04
they mimic the signals that tell your
01:21:06
testicles to make more testosterone. And
01:21:09
so there are ways to do it and you
01:21:10
definitely need someone who's, you know,
01:21:12
well-versed in managing hormone
01:21:14
management. Uh, but there are things
01:21:16
that you can do if you're low. But
01:21:18
again, I don't think it's once you once
01:21:20
you start these things, you can't go I
01:21:21
mean, you can get off of it, but it's
01:21:23
sort of a process and it's not something
01:21:24
that everyone will do because you're
01:21:26
going to feel good on testosterone if
01:21:28
you're taking it. And then when you get
01:21:29
off it, because your body is like no
01:21:31
longer making its own, you're going to
01:21:32
feel horrible. So, do you think most 50
01:21:34
plus year old men should be taking
01:21:37
testosterone
01:21:39
replacement therapies?
01:21:40
>> Only if they're symptomatic and they're
01:21:42
low, right? So,
01:21:42
>> would it make them the average man, the
01:21:44
average 50-year-old man, if this is the
01:21:45
average, feel better on a daily basis?
01:21:48
>> Not necessarily. Because if they are
01:21:50
normal, like I said, if their
01:21:51
testosterone receptors are already fully
01:21:53
saturated, it's not going to change,
01:21:54
right? It's not going to change their
01:21:56
it, like I said, it may make their
01:21:58
muscles look bigger, but it's not going
01:21:59
to change their their cognition. It's
01:22:01
not going to change their mood. It's not
01:22:03
going to change their sex drive. It's
01:22:04
not going to change their erections when
01:22:06
their testosterone receptors are fully
01:22:08
saturated.
01:22:09
>> And you know, in this graph, what is
01:22:10
showing the decline here? Has that got
01:22:12
anything to do with whether their
01:22:14
testosterone levels are fully saturated?
01:22:15
Because
01:22:16
>> no, you can't tell from that.
01:22:17
>> You can't tell from that. So, you could
01:22:18
have low testosterone but still be
01:22:19
fully.
01:22:20
>> That's why we talk about symptoms,
01:22:21
right? Because that's how I can tell. I
01:22:23
think, you know, that's part of what
01:22:25
being a doctor is, right? Talking to
01:22:26
your patients and figuring out what's
01:22:28
going on with them and what their
01:22:29
symptoms are and making sure it's
01:22:30
nothing else, right? You can have low
01:22:32
thyroid and that can mimic what what uh
01:22:35
what low testosterone feels like. You
01:22:37
can have a high prolactin because you
01:22:38
might have a benign tumor in your brain
01:22:41
that's secretreting prolactin and that
01:22:43
can reduce your testosterone. So that's
01:22:44
the the reason to get a full evaluation
01:22:46
to make sure there's nothing else that
01:22:48
we're missing that's causing you to have
01:22:50
these symptoms if your other levels are
01:22:52
normal.
01:22:53
>> Uh okay, that makes sense. So just
01:22:54
because my testosterone levels would be
01:22:56
low doesn't mean I necessar if I don't
01:22:59
if I'm not symptomatic doesn't mean that
01:23:01
I should necessarily just assume that I
01:23:03
need testosterone replacement therapy.
01:23:05
>> Exactly.
01:23:05
>> Okay. Yeah. I think I think most of my
01:23:08
male friends are just assuming that once
01:23:09
we hit 50 we're all on the testosterone.
01:23:11
>> I mean look I think when if you need it
01:23:14
it's a great drug. It's a great option
01:23:16
to improve your quality of life. It's
01:23:19
obviously preventing uh bone loss. It's
01:23:22
improving your longevity. it's uh
01:23:24
preventing hopefully having some benefit
01:23:26
in terms of cardioabolic health and so
01:23:28
yeah absolutely if you need it but it's
01:23:31
not something that like everyone should
01:23:32
just take cuz why not right like it's a
01:23:35
when you play with hormones it's serious
01:23:36
business you know
01:23:38
>> I guess a lot of men are self-conscious
01:23:39
in a way that they don't often admit and
01:23:41
they want to have big muscles
01:23:43
>> and they want to feel strong
01:23:44
>> and this is the the problem I'm seeing
01:23:45
with younger guys right now is that
01:23:48
there's a lot of young kids taking
01:23:50
anabolics because there's so much
01:23:52
pressure to look a certain way, right?
01:23:54
Because nowadays when how do you meet
01:23:56
people on social media through like
01:23:58
swiping and and all you see is what they
01:24:00
look like. And so there's this pressure
01:24:02
and like I'll see it at the gym like I'm
01:24:03
like at the gym and there's these young
01:24:05
kids who I'm like there is no way you
01:24:06
are naturally that built at that age,
01:24:09
right? Like unless you've been lifting
01:24:11
since you were like seven years old. And
01:24:13
so and of course there are some. But it
01:24:16
is serious because one, it causes
01:24:18
infertility, right? When you're on
01:24:19
testosterone replacement after about 18
01:24:23
18 months, 70% of people on testosterone
01:24:25
replacement will be infertile.
01:24:27
>> 17
01:24:28
>> 70 70%.
01:24:30
>> 70.
01:24:31
>> And even as soon as like 10 weeks, we
01:24:33
see some people having drops in their
01:24:36
sperm count. So, it's variable with how
01:24:38
quickly you're going to see impacts on
01:24:40
your fertility, but it absolutely
01:24:42
happens. And it can it can come back for
01:24:45
the large majority of people, but how
01:24:47
long it takes depends on your age and
01:24:49
how long you were on testosterone
01:24:50
replacement therapy. And in some cases,
01:24:52
it can take as long as 2 years to come
01:24:54
back.
01:24:54
>> I really need to get my testosterone
01:24:56
levels checked.
01:24:57
>> Yeah, you should. But also, you should
01:25:00
get your semen analysis checked. And
01:25:01
I've done that.
01:25:02
>> Good. Good. Because that's also a
01:25:03
biomarker of health. We've seen that
01:25:05
people who have poor semen parameters
01:25:08
they have higher rates of mortality and
01:25:10
they actually live when you look at age
01:25:12
like what age people die they die
01:25:14
younger compared to people and it's dose
01:25:16
dependent. So if you're have like normal
01:25:20
uh the concentration of sperm and then
01:25:22
it keeps going down and down and down.
01:25:23
If you look at the age it's like they
01:25:25
live to 78 77 76 like you can actually
01:25:28
see it come down except for people who
01:25:30
have no sperm because those are usually
01:25:31
genetic disorders. Those are live a
01:25:33
little longer because it's not
01:25:34
necessarily due to cardioabolic issues.
01:25:37
Um, but it's basically a reflection of
01:25:39
your overall health.
01:25:43
>> Steve, what are you doing?
01:25:44
>> Uh, just making myself a delicious
01:25:46
coffee
01:25:47
>> from the freezer.
01:25:49
>> From the freezer. Have you not heard
01:25:50
about Contier?
01:25:50
>> No.
01:25:51
>> Oh my gosh. This is going to change your
01:25:53
life. A couple of months ago, the
01:25:55
founder of this business called Matt
01:25:56
sent a big shipment of this coffee to
01:26:00
our office in London. What most people
01:26:01
don't know is that the processing of
01:26:02
coffee takes out a lot of the taste. So
01:26:04
what they do is they flash freeze it at
01:26:07
the optimal moment when it's most tasty
01:26:10
and they send you in the post the coffee
01:26:12
in these little frozen ice cubes. Now
01:26:14
Matt sent a big shipment to my office. I
01:26:16
moved it to the kitchen. I said to the
01:26:17
team, "Knock yourselves out." And then I
01:26:19
saw so many messages in our Slack
01:26:20
channel of people going, "Oh my god,
01:26:23
what the hell is that? It's so
01:26:24
delicious." All I have to do is pop it
01:26:26
out in the morning using the little
01:26:27
button on the back of this thing. I pour
01:26:30
my hot water in and I mix it and that is
01:26:34
done. You can get $30 off your first
01:26:36
order of Cometier coffee if you go to
01:26:39
cometier.com/stephven.
01:26:41
Try it and please Instagram DM me,
01:26:44
LinkedIn me and let me know if you love
01:26:46
it as much as I do. Make sure you keep
01:26:48
what I'm about to say to yourself. I'm
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inviting 10,000 of you to come even
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01:27:01
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01:27:06
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01:27:38
I will speak to you then.
01:27:43
One of the things I was quite surprised
01:27:44
by, I'll be honest, is when I went on
01:27:47
your YouTube channel
01:27:48
>> Mhm.
01:27:48
>> one of your very high performing videos,
01:27:51
I think it had 31 million views, was
01:27:55
about enlarging your penis.
01:27:56
>> Yes.
01:27:59
>> I didn't know that so many men were
01:28:02
interested in ways to enlarge their
01:28:04
penis. Well, it's interesting because
01:28:06
when you look at the data, more men want
01:28:08
to so I let's say most guys would love
01:28:12
to be taller, right? If you're an
01:28:13
average height man, most guys would love
01:28:14
to be taller, right?
01:28:16
>> Yeah. True.
01:28:16
>> Um more men want to have a longer penis
01:28:18
than they want to be taller.
01:28:20
>> Really?
01:28:20
>> Mhm.
01:28:23
>> Wow. Wow.
01:28:26
Why is this?
01:28:28
>> Well, I think you know a lot of people
01:28:31
um it starts at a young age. I have
01:28:33
sons, right? And so I see it like they
01:28:35
talk about their penis in such a way
01:28:37
like very early in life like oh my god
01:28:39
my penis is so big or it should be so
01:28:41
big or whatever and and there and it's
01:28:44
like this it becomes this like this
01:28:46
society thing about who's got a bigger
01:28:48
penis like it's very interesting but
01:28:50
there's a lot of pressure to feel like
01:28:53
and and a lot of discussion around
01:28:54
bigger is better right it's it's talked
01:28:57
about in media it's subtly joked about
01:28:59
it is um everywhere you look people are
01:29:02
talking about like being wellendowed as
01:29:04
being better. But interestingly, on my
01:29:06
podcast, we interviewed the the guy who
01:29:09
has the largest medically verified
01:29:10
penis. It's I think it's like 13 or 14
01:29:13
inches in length. And um he actually has
01:29:16
a lot of trouble because it's so large
01:29:18
that people don't want to have sex with
01:29:20
him and it's uncomfortable for them. And
01:29:22
so, like, it's not all roses and
01:29:24
sunshine on the other side. But the
01:29:27
reality is that many people feel what's
01:29:29
called small penis anxiety. and they
01:29:31
they even if they have a normalsized
01:29:33
penis, they feel consumed with how the
01:29:36
size of their penis is. And so that's
01:29:38
why this video did so well. I naively
01:29:40
had no idea how many people it would
01:29:42
resonate with because I'm not a guy,
01:29:43
right? And I see patients all the time,
01:29:45
but at that time in my career, people
01:29:47
weren't coming to me to talk about it.
01:29:48
And so I um I realized like there's so
01:29:52
many people quietly feeling insecure.
01:29:54
And we talk a lot about women having
01:29:55
body image issues. Men do too, right?
01:29:58
They feel insecure about the size of
01:30:00
their penis because also they're seeing
01:30:02
guys on pornography who have very
01:30:05
well-endowed fallaces and you know they
01:30:07
chose to be porn actors for a reason,
01:30:09
right? Because they are naturally
01:30:11
wellendowed. And so you're comparing
01:30:13
yourself to the outliers and the average
01:30:15
penis is about 5.3 to 5.5 in erect. But
01:30:19
when you look at like what do women
01:30:21
want, they will say on average they want
01:30:23
a 6 in penis. But when you look at like
01:30:26
the kind of sex toys they buy and they
01:30:28
did this study because they were looking
01:30:29
at people who they were trying to decide
01:30:32
what kind of when they were developing
01:30:34
fallaces for trans people like they they
01:30:37
reconstruct fallacuses for they wanted
01:30:39
to they were making them too girthy and
01:30:40
they like well we need to figure out
01:30:41
what girth women want and so they looked
01:30:44
at like what women buy on online like
01:30:47
what is the most purchased sex toy and
01:30:49
it's actually pretty close to average.
01:30:52
>> Do you say 5.2 in
01:30:53
>> 5.2 two to 5.5 depending on the study
01:30:55
you're looking at. Yeah.
01:30:56
>> Correct.
01:30:57
>> Mhm.
01:30:58
>> H. And what size do men think the
01:31:02
average is?
01:31:03
>> Oh, they think it's like six or seven
01:31:04
in.
01:31:05
>> Oh, okay. So, they think the average is
01:31:06
bigger. And also, how does age come into
01:31:08
this? Because I'm presuming that when I
01:31:10
get older, my penis is going to shrink
01:31:11
or something.
01:31:11
>> If you have good blood flow to your
01:31:13
penis, it shouldn't shrink. So, like I
01:31:15
said earlier, if you stop having
01:31:18
nighttime erections or you're not having
01:31:19
erections, now you're no longer getting
01:31:21
blood flow to your penis and it will
01:31:22
shrink over time. Also, if you're
01:31:24
gaining weight, it will appear that it's
01:31:26
shrinking because you're getting more
01:31:28
fat over here. So, if you think about
01:31:31
your penis here, this is the fat right
01:31:33
above this bone. And as this fat gets
01:31:35
more and more, you're seeing less and
01:31:37
less of the penis.
01:31:38
>> And is there a way to enlarge the penis?
01:31:40
So there are many ways that have been uh
01:31:43
tried, discussed, um attempted. So
01:31:46
there's definitely surgeries that you
01:31:48
can get, but they there's not a lot of
01:31:50
surgeons who do a lot of penile
01:31:52
lengthening surgeries and they have lots
01:31:54
of complications, like very high rates
01:31:56
of complications because the penis is a
01:31:58
very vascular organ. And the thing is
01:32:00
that when you have the tiniest
01:32:03
difference on your penis, you notice it,
01:32:05
right? Like I have guys come to like the
01:32:06
tiniest little thing on their penis and
01:32:08
they're like, "Is this okay?" Like this
01:32:09
is new. And like luckily it's nothing,
01:32:12
right? But I'm like they notice it. You
01:32:14
notice it when something's wrong. So
01:32:15
imagine you have a surgery and now
01:32:17
something changes, right? So it is it is
01:32:19
really difficult to sort of replicate
01:32:22
exactly a normal penis when you're
01:32:24
lengthening it through surgery. So I
01:32:27
don't recommend surgery for lengthening
01:32:29
penis. There is a safer way and that has
01:32:32
been shown to help and that's using a
01:32:34
traction device. So a traction device,
01:32:38
we have one here. This is one brand. You
01:32:40
can get many of these online. And you
01:32:42
can put your penis in this device.
01:32:45
>> It really I like I feel like um I get
01:32:48
like shivers when I watch you do this to
01:32:49
this penis.
01:32:50
>> So you would wrap it. It would be more
01:32:52
comfortable than just putting this like
01:32:54
directly on your penis.
01:32:55
>> For you guys that can't see, she's
01:32:56
clamping the end of the penis into this
01:32:58
>> into this device. And then you sort of
01:33:01
lengthen it uh extend it with this 30
01:33:04
minutes twice a day for this particular
01:33:05
device. They've actually done some
01:33:07
research on this one. 30 minutes twice a
01:33:09
day and you there's like a whole
01:33:11
protocol on their website and it does
01:33:13
show improvements in length about two
01:33:14
centimeters but it is a commitment to
01:33:17
increasing length and to doing this
01:33:19
process.
01:33:20
>> So just on those numbers 2 cm increase
01:33:22
over what period of time and does that
01:33:24
>> or about 3 to 6 months depending yeah
01:33:26
>> and is it permanent?
01:33:27
>> So that's all we don't know. I mean most
01:33:29
of the studies stop at you know once
01:33:31
they get their results and we don't know
01:33:32
that if you stop will it just revert
01:33:35
back to normal? I don't know. And so the
01:33:37
other thing about this particular
01:33:38
traction device that's night is if you
01:33:40
have a curvature in the penis like you
01:33:41
develop something called Peron's
01:33:43
disease, this device can actually curve
01:33:46
a little bit away from if you like let's
01:33:48
say you have um indentation on the top
01:33:50
of the penis, it can actually bend away
01:33:52
from that and it can help straighten out
01:33:54
the penis. So, that's actually a a a
01:33:57
really nice utilization for it because
01:33:59
um for some people that can be really
01:34:01
traumatic and devastating to have a
01:34:03
change in the way your penis appears
01:34:05
because it starts curving all of a
01:34:06
sudden. And this is safe and effective
01:34:08
and you can have bruising. It can be
01:34:10
slightly uncomfortable, but it's you're
01:34:12
not going to really hurt yourself uh too
01:34:15
much by doing something like this.
01:34:16
>> I thought a curved penis would hit the
01:34:18
G-spot better. Yeah, sometimes a slight
01:34:20
curve can be beneficial for some people,
01:34:23
but again, I think like when you notice
01:34:25
like there's a a dramatic change. You do
01:34:28
that more. Come
01:34:30
rip the end off.
01:34:31
>> It's okay. Um,
01:34:34
>> I'm just trying to figure out how this
01:34:35
works. So, I get the penis. I put it
01:34:38
>> through. Yeah.
01:34:40
>> Clamp it down.
01:34:41
>> And you want to put it at your normal.
01:34:42
And then you'll just slightly advance
01:34:44
the the length. You're not going to pull
01:34:45
crazy. easier. It's going to do a little
01:34:47
bit of traction so it's not uncomfort.
01:34:49
It's slight like just a slight tension.
01:34:51
It shouldn't be like like that. It
01:34:52
should be much less tension, but it is I
01:34:55
mean they can vary in price from $100 to
01:34:58
$500. So it's a onetime cost. It is not,
01:35:02
like I said, not dangerous. What is
01:35:04
dangerous is when people try to do
01:35:06
something that became popular on TikTok
01:35:08
called jelking. And jelking is where you
01:35:10
use your your hands and you make like an
01:35:13
okay sign with your fingers and you're
01:35:15
like stretching the penis with your
01:35:18
hands. And this can be dangerous because
01:35:21
you can create micro tears in the penis.
01:35:23
And we in the urology community have
01:35:24
seen plenty of patients who have now
01:35:27
developed erectile dysfunction after
01:35:29
doing jelking because they've now
01:35:30
created damage to their penis. And so I
01:35:34
I really caution people because this
01:35:36
there is so much despair around sexual
01:35:39
function, around penal health that
01:35:42
people are willing to try things and
01:35:44
they might really hurt themselves. No
01:35:46
joke, I had a patient the other day ask
01:35:48
me if he should drink hydrogen peroxide
01:35:50
because he saw some ad that said
01:35:52
hydrogen peroxide will fix your
01:35:54
erections and I said please don't. um
01:35:57
this is you know but he really was like
01:36:00
seriously earnestly asking me this
01:36:02
question and I you know I didn't want to
01:36:04
shame him by any means and I was like no
01:36:05
you know this is actually not safe and
01:36:07
it's not going to help you and there's
01:36:09
no pill there's no drink there's no
01:36:11
anything that's going to give you a
01:36:13
longer penis
01:36:15
>> what are the cases that you see that
01:36:16
break your heart
01:36:18
>> you know I I've seen so there I've seen
01:36:20
patients who've had surgery to lengthen
01:36:22
their penis and they are above average
01:36:25
when they at baseline and they have
01:36:27
these surgeries to lengthen their penis
01:36:28
and then they have a bad outcome and now
01:36:31
their penis is disfigured forever. And
01:36:33
that's what really um you never forget
01:36:36
that because that person knowing the
01:36:38
risks and benefits perhaps made a choice
01:36:40
and that choice didn't go the way they
01:36:42
wanted and now they have to live with
01:36:43
that for the rest of their life and
01:36:45
that's really sad.
01:36:46
>> Gosh,
01:36:48
imagine that. Christ
01:36:50
>> Yeah.
01:36:51
>> Well, and it just it doesn't work
01:36:53
anymore. Well, like the one patient I'm
01:36:56
thinking of, um, he, uh, had a like it
01:37:00
it basically developed a scar all at the
01:37:02
top of the penis. So, it was like
01:37:04
disfigured essentially. Um, and so it
01:37:08
was it was really sad.
01:37:10
>> Before I hit puberty, I definitely had a
01:37:12
penis anxiety because I was the youngest
01:37:14
in my year at school and I I was the I
01:37:18
was short, very very short, very small.
01:37:20
I remember what it felt like to like
01:37:22
hide my hide my dick
01:37:24
>> when I was around like guys in the
01:37:26
changing room and stuff like that. Um,
01:37:29
you know, after puberty things I
01:37:32
changed.
01:37:32
>> And what I want people to understand, I
01:37:34
think more than anything is that you
01:37:36
don't need a long penis to pleasure a
01:37:38
partner. We just talked about how the
01:37:40
clitoris is the is the most reliable
01:37:42
route to orgasm, right? And so you don't
01:37:45
need a penis to stimulate the clitoris.
01:37:48
You can use your mouth, your fingers,
01:37:50
you can use a toy. There's so many ways
01:37:52
to help your partner achieve pleasure.
01:37:56
And and yes, of course, there are a
01:37:58
small subset of women who really
01:37:59
appreciate a large fallus. But the large
01:38:02
majority of women, if you look at survey
01:38:04
data, are very happy with the size of
01:38:06
their partner, are very content with
01:38:09
average or slightly above average or
01:38:10
slightly below average as long as they
01:38:12
are feeling intimate and they're feeling
01:38:14
pleasure. And so I think that there's a
01:38:16
misnomer that that people think if I
01:38:18
have a longer penis I'm going to be able
01:38:20
to pleasure my partner more
01:38:22
>> as it relates to women. Is there
01:38:24
different size vaginas?
01:38:26
>> Yeah. So the a so just like there's
01:38:27
averages there's averages in females.
01:38:29
And so average vag vaginal length is
01:38:31
about 3 and 1/2 in. So when women get
01:38:34
aroused it expands and widens and
01:38:37
lengthens to about double. So the
01:38:40
average woman can easily accommodate the
01:38:42
average penis. maybe slightly larger
01:38:45
than average. And so I think generally
01:38:47
speaking, knowing that like you will be
01:38:49
able to fit in the average woman and you
01:38:52
will be able to please her with the size
01:38:54
of your fallus. And like I said,
01:38:56
penetration is is not as important. In
01:38:58
fact, only about 85% of women orgasm
01:39:01
through penetration alone. They need
01:39:03
clitoreral stimulation to achieve
01:39:04
climax. And so again, penetration feels
01:39:07
good. I I tell guys, it's like somebody
01:39:10
rubbing your testicles or your
01:39:12
paranneeium. feels good, but it's not
01:39:14
going to make you orgasm. And so
01:39:16
penetrating, yeah, if you're getting a
01:39:18
lot of clitoreral stimulation because
01:39:20
maybe she has a thinner, you know, her
01:39:22
clitoreral shaft is closer to the
01:39:24
vaginal canal, maybe, you know, the size
01:39:26
of the penis matters more. But for a lot
01:39:28
of women, it's not going to be
01:39:30
sufficient and they're going to need
01:39:31
some directed clitoreral stimulation.
01:39:33
Why do different vaginas feel different
01:39:35
to and I guess the the inverse is also
01:39:38
the case where like different penises
01:39:40
will feel remarkably different even if
01:39:42
they're the same size roughly and you
01:39:44
can have sex with somebody and go it
01:39:46
feels really good.
01:39:48
>> I mean I think again it's how you it's
01:39:50
like the emotion in the ocean right like
01:39:52
how you use your so let's let's talk
01:39:54
about the vaginas first. So, when a
01:39:56
vagina is um has more pelvic floor
01:39:59
strength, they may be able to like tense
01:40:02
around the penis better, like they may
01:40:04
be able to sort of grab the penis with
01:40:06
their pelvic floor a little stronger
01:40:08
versus someone who doesn't. And that's
01:40:09
where I think some people get worried
01:40:11
when I say, "Oh, you need to relax your
01:40:12
pelvic floor." They're like, "Oh, I
01:40:13
don't want to be looser." Right? And
01:40:16
that's not going to happen if you have a
01:40:17
normally functioning pelvic floor. If
01:40:19
you're
01:40:19
>> So, the penis is going in here, right?
01:40:21
>> Correct. So, if I if you're a woman and
01:40:23
you do pelvic floor exercises, then
01:40:25
you're going to feel tighter.
01:40:27
>> Well, you're you're able to contract and
01:40:30
squeeze those muscles during sex better
01:40:32
around the penis.
01:40:33
>> Yes. But we don't want you to be
01:40:34
tighter. We want you to be able to
01:40:36
squeeze the muscles and relax the
01:40:38
muscles. Use them like a normal muscle
01:40:39
like your bicep. You squeeze and relax.
01:40:41
Squeeze and relax. We don't want it to
01:40:42
be constantly squeezed.
01:40:44
>> But to the man, it will feel tighter.
01:40:46
>> You will perceive it as tighter, but it
01:40:47
will not be that she's actually tighter.
01:40:49
it just means that maybe her pelvic
01:40:50
floor muscles are doing a better job. So
01:40:53
that's for the female. For the male,
01:40:55
it's it's generally like how the penis
01:40:58
moves and how the positioning is and
01:41:00
where it's uh it may be girth that's
01:41:03
different. It may be the way that you're
01:41:05
moving in the vaginal canal and that may
01:41:08
be why it feels different.
01:41:09
>> They often say that if you've got big
01:41:11
feet or big hands, you know, like people
01:41:14
think you have a big penis.
01:41:15
>> Not necessarily true. So there's um
01:41:18
there's actually no evidence that big
01:41:19
hands, big feet correlate to female
01:41:21
size. There's one study in Japan where
01:41:23
they looked at nose length. And so the
01:41:26
longer your nose is from the the bridge
01:41:29
down to the tip, that is potent, at
01:41:32
least the Japanese population that they
01:41:34
studied was correlated with the length
01:41:35
of the penis.
01:41:39
>> People also think tall people have big
01:41:41
penises. Not necessarily.
01:41:45
>> But nose length, there's some
01:41:47
correlation in a study in Japan.
01:41:48
>> Yes.
01:41:49
>> Okay. I was just checking if my nose.
01:41:52
>> Okay. Um the last thing I want to talk
01:41:54
to you about is
01:41:56
>> and how this relates to everything we've
01:41:58
talked about today, desire, attraction,
01:41:59
sex. Is there any early data emerging
01:42:01
that shows any correlations?
01:42:03
>> Yeah. So ompic there's sort of benefits
01:42:06
and there's potential downsides. So the
01:42:08
benefits are that when you're on Osmpic,
01:42:10
we see improvements in metabolic
01:42:12
diseases. They have improvements in
01:42:14
diabetes, improvements in heart disease,
01:42:16
improvements in overall health, right?
01:42:18
And so that is going to mean that your
01:42:20
blood vessels are healthier. You're more
01:42:22
able to get blood flow to your genitals.
01:42:24
You're going to have stronger sexual
01:42:26
function and arousal, right? So that's
01:42:29
great. The other thing is that you are
01:42:31
losing weight. So you feel better. you
01:42:33
feel more like your body image is is
01:42:36
feeling good about yourself. Also, for
01:42:38
men, remember I talked about this fat
01:42:40
pad right above your penis.
01:42:42
>> That's getting smaller. And so now you
01:42:44
can see more of your penis. So you may
01:42:46
have heard of ompic penis where people
01:42:47
are saying, "Oh, my penis is getting
01:42:48
longer." It's not actually that your
01:42:50
penis is getting longer. It's that this
01:42:51
fat is going down. So now you're seeing
01:42:53
more of your penis,
01:42:54
>> which makes it look longer.
01:42:56
>> Yes. Exactly. Reality. Yes. Exactly.
01:42:59
Well, it is reality to the person
01:43:00
looking. Right. Um so those are all
01:43:03
great things and I think that's
01:43:05
wonderful. Now the other part of it is
01:43:07
ompic works on the brain and it works on
01:43:09
the reward pathway. So you now see food
01:43:12
and you don't feel like it's that much
01:43:13
of a reward. So you don't chase after
01:43:15
you have less desire for food. There's
01:43:17
emerging data that we're seeing people
01:43:18
on these medications, these GLP1s, have
01:43:21
less desire for, let's say, gambling,
01:43:23
let's say shopping, let's say, you know,
01:43:25
alcohol, smoking, whatever it is, right?
01:43:28
And so there's a theoretical because it
01:43:30
works on the same pathways that it could
01:43:32
also decrease desire for sex. And I
01:43:35
think the thing that, you know, there's
01:43:36
so many people on these medications,
01:43:38
there's so many metabolic benefits that
01:43:40
I worry that people may not even realize
01:43:42
that their sexual desire is changing,
01:43:45
right? They might just be like, "Oh, you
01:43:47
know, I'm I'm eating less. I look great.
01:43:49
Everything's wonderful." But like slowly
01:43:50
in the background, they're like, "Oh,
01:43:52
maybe my desire is less." And maybe it's
01:43:54
creating discord in the relationship.
01:43:56
Hard to say because we don't have data
01:43:57
yet. So yeah, I think it's just
01:43:59
something that you should be aware of
01:44:00
that if you start feeling like you have
01:44:03
less desire for sex or maybe you're
01:44:05
like, "Man, I just really don't feel
01:44:06
into anything." Talk to your doctor cuz
01:44:09
maybe your dose is just too high and
01:44:11
maybe it just needs to come down a
01:44:12
little bit. And again, we don't know
01:44:14
yet. But I do worry about this because I
01:44:16
feel like we're we're gonna start seeing
01:44:18
it.
01:44:19
>> Is it possible to do studies on this
01:44:20
type of thing?
01:44:22
>> Absolutely. So you can take people
01:44:24
starting Ozmpi and you can say, "Hey,
01:44:26
here is or or any GLP1." You know,
01:44:29
there's questionnaires. So like for
01:44:30
women there's the female sexual function
01:44:32
index. For men there's Adam, which is a
01:44:33
questionnaire about testosterone. But
01:44:35
you could there's sexual desire
01:44:36
questionnaires that you can use. Um, and
01:44:38
you can take it at the beginning and
01:44:39
then you can take it as they increase
01:44:41
their dose and see if there's a change,
01:44:43
right, in terms of their sexual desire.
01:44:45
>> You said at the start about knowing how
01:44:48
to talk to your partner. I think like
01:44:50
intimacy desire, maybe the conversations
01:44:51
like with your partner, how to have that
01:44:53
conversation when there's a problem.
01:44:54
>> Yeah. I I wish I could say there was
01:44:56
like a script that you can follow and
01:44:57
it's going to work. But everyone's so
01:44:59
different. But I think the important
01:45:00
thing is like not giving up because what
01:45:03
happens is because we don't ever talk
01:45:05
about sex, when you bring it up, it's
01:45:07
immediately like, "Oh my god, is
01:45:08
something wrong? Did I do something
01:45:09
wrong? Um, do you not like me? Am I not
01:45:11
attractive?" Right? You're automatically
01:45:13
going down the rabbit hole of worry and
01:45:15
concern. And instead of dealing with it,
01:45:17
you're supposed to shut it down. No, I
01:45:18
don't want to talk about it. Right? Um
01:45:19
especially if like maybe you haven't
01:45:21
connected intimately in a while and like
01:45:23
you just don't want to deal with that or
01:45:24
you're you have other stressors in life.
01:45:27
Maybe you're not feeling like very good
01:45:29
about yourself and so you're like,
01:45:30
"Well, I don't really feel sexy, so I
01:45:32
don't want to have sex." And so, I think
01:45:34
really understanding that whatever
01:45:36
reaction you get from your partner when
01:45:37
you do talk to them, it's not about you.
01:45:39
It's just usually about how they're
01:45:40
feeling. And so, don't stress about
01:45:42
that. And two, like it's anything that
01:45:45
is worth having requires work. So having
01:45:48
a good sex life, having intimacy over
01:45:51
the long haul with someone, if you are
01:45:54
committed to that relationship, it is
01:45:56
worth working for. It is worth dealing
01:45:58
with a little bit of discord to get
01:46:00
there. And so I tell people when you
01:46:02
want to talk about sex, first of all,
01:46:03
don't do it in the bedroom. Don't do it
01:46:05
right before or after sex. Do it at a
01:46:07
time where you are both calm, relaxed.
01:46:09
Maybe you're out for a walk, maybe
01:46:10
you're in the car, so you're not like
01:46:12
looking directly at each other. You're
01:46:13
kind of parallel. And always start with
01:46:15
a positive thing. like I you know I
01:46:17
really enjoy this about our relationship
01:46:19
and I would love if we could talk about
01:46:21
this and and maybe they're going to be
01:46:23
like uh I'm not ready for that and you
01:46:25
say maybe we could come up with a time
01:46:27
where we can talk about this that works
01:46:28
for you right let them feel like they're
01:46:30
coming to the conversation with like
01:46:32
they're not being ambushed or like
01:46:34
talking about something and then be
01:46:35
curious. I think the big thing is like
01:46:37
being curious like what's going on with
01:46:39
you like I want to I want to I want to
01:46:41
be there for you. I love you. you know,
01:46:43
I miss what we used to have or I miss
01:46:45
this about us. And I think that there's
01:46:47
always these misconceptions. I hear it
01:46:49
all the time, right? It'll be like this
01:46:51
partner only wants sex and this partner
01:46:53
never wants sex and you know, and that's
01:46:56
it. Like that's the end of the
01:46:57
conversation. But the reality is that
01:46:59
there it's it's somewhere in between. So
01:47:01
typically women tend to view sex as like
01:47:05
added stress sometimes when they're
01:47:06
already stressed. Like they're like,
01:47:07
"Oh, it's just one more thing to do."
01:47:10
Whereas men look at it as a stress
01:47:11
relief. So, one, you're coming at it
01:47:13
from two different angles. The other
01:47:15
thing is men aren't really taught how to
01:47:17
be intimate. And so, for a lot of men,
01:47:20
sex is their version of intimacy. Like,
01:47:22
that's how they connect. That's how they
01:47:24
feel connected with a partner. And so,
01:47:27
often times when they're doing these
01:47:29
initiations or attempts at sex, it feels
01:47:31
like they're being greedy or it feels
01:47:32
like they're they just want sex. And I
01:47:34
think we have to reframe how we look at
01:47:36
that. Like, sex is not just sex. It is
01:47:38
intimacy. It is being together
01:47:40
connecting with another human being. So
01:47:42
how do we do that right? And like how do
01:47:45
we make that sex worth having? We get
01:47:48
into this frame where we have sex as
01:47:50
like in a hurried quick like just got to
01:47:53
get this done way. I just need to get an
01:47:54
orgasm. I just need to get a release.
01:47:56
But sex is supposed to be something we
01:47:58
look forward to. It's supposed to be
01:47:59
something that we're excited about. And
01:48:01
so we have to build that in. We have to
01:48:02
sort of like build the environment where
01:48:05
sex can can happen. So, it may mean
01:48:08
like, "Hey, we are affectionate during
01:48:10
the day. Maybe we send a lovey text
01:48:12
message. Maybe um you know, I give you a
01:48:14
hug. I caress your back. I um tell you
01:48:17
you look beautiful. I I'm I'm showing
01:48:18
you gratitude for how much I care about
01:48:20
you in other ways." I think just really
01:48:23
taking the time to understand why your
01:48:25
partner feels the way they do.
01:48:26
>> I'm curious about on that communication
01:48:28
point about how different genders
01:48:31
in heterosexual couples have different
01:48:33
sort of taboos and things that are just
01:48:35
a bit sensitive. Um, and I was looking
01:48:37
at the the variance between men and
01:48:39
women, and the the top one for men was
01:48:41
around performance anxiety. So, like
01:48:43
admitting to things like erectile
01:48:44
dysfunction because it feels like it's
01:48:46
so intrinsically connected to
01:48:47
masculinity
01:48:49
>> and you feel like a failure as a man if
01:48:50
you can't get a erection and pleasure
01:48:52
your partner, right?
01:48:53
>> And then for women, it was talking about
01:48:54
um prioritizing pleasure and asking for
01:48:57
more foreplay or um, you know, specific
01:49:01
specific stimul stimulation around the
01:49:03
clitoris or something like that. um
01:49:05
because they don't want to be labeled as
01:49:06
highmaintenance or too much hard work,
01:49:09
etc.
01:49:10
>> And it's interesting that on that walk
01:49:11
with your partner, there are different
01:49:13
things that will trigger each of you.
01:49:15
>> Mhm.
01:49:16
>> Um other ones for women were pain and
01:49:18
discomfort, bringing that up. Um body
01:49:20
image and the mental load, explaining
01:49:22
why you aren't in the mood. And other
01:49:24
ones for men are expressing nonsexual
01:49:26
needs because it might be seen as
01:49:26
unmanly, unmanly, boundaries and
01:49:29
rejection, communicating when they don't
01:49:30
want sex. And lastly, the script, which
01:49:32
is discussing fantasies that deviate
01:49:33
from the norm.
01:49:35
>> So, I want to talk about fantasy, but
01:49:36
before that, I would just say that, you
01:49:38
know, it because of social media, we're
01:49:40
in a place and I get text messages from
01:49:43
my husband 24 hours a day with like not
01:49:44
24 hours a day, but like all waking
01:49:46
hours with reals and videos. Oh, I think
01:49:49
you'd like this. I think you'd like
01:49:50
this. You should check this out. And
01:49:52
it's like his way of like connecting and
01:49:54
like, hey, let's talk about this later.
01:49:55
Like, this is fun. And so I I tell my
01:49:57
patients like send your partner a a
01:49:59
video that you saw on social media that
01:50:01
might help them understand like why this
01:50:03
is important to you. Maybe send them a
01:50:05
video send them this podcast, right? Say
01:50:07
like, "Hey, I watched this. It was
01:50:08
great." Good idea. You know, um and I I
01:50:10
learned so much. And honestly, so many
01:50:12
patients bring their partners to me.
01:50:14
Whether it's women bringing male
01:50:15
partners or men bringing female
01:50:17
partners, they come to me and they say,
01:50:19
"Look, like I want you to meet this
01:50:20
doctor and I want you to talk to them."
01:50:21
And like it's beautiful to see that.
01:50:24
Like I love it because it's it's so
01:50:26
deeply caring that they like brought
01:50:28
their partner and they want them to feel
01:50:30
good and they just want to figure out
01:50:31
what's going on and like I think it's so
01:50:33
lovely to to to find someone who's so
01:50:35
invested in making sure that sex is good
01:50:37
for you, right?
01:50:38
>> As men though, we're just not good at
01:50:39
talking about this stuff,
01:50:41
>> right? But you know, I think you can't
01:50:42
use that as a crutch.
01:50:44
>> Yeah.
01:50:44
>> Do you know what I mean? Like
01:50:45
>> Yeah, I do. Yeah. We're just not good at
01:50:47
it though. We just
01:50:48
>> But no one's good at it. It's not men.
01:50:49
Women are not good at it either.
01:50:51
>> I think men are worse at it. I think in
01:50:53
general no one is good at talking about
01:50:54
sex. Like I, you know, I think it's
01:50:57
interesting because I talk about it all
01:50:58
the time, but I have seen very good
01:51:01
communicators struggle with talking
01:51:03
about sex. And so I think it's just um
01:51:06
it's just it's uncomfortable and and
01:51:08
it's like if you and I can have this
01:51:10
conversation and we can talk about sex
01:51:12
openly, like there's no reason that you
01:51:14
can't learn how to talk about sex and it
01:51:16
it's it's a learning process and it's
01:51:18
worth it's worth investing in. Do people
01:51:20
bring you their fantasies?
01:51:22
>> Yeah, I've had I've had well more not
01:51:24
not as many fantasies as like real sort
01:51:27
of diverse interests in sex.
01:51:30
>> What do you mean by So I had a patient
01:51:32
who came to me and said uh you know
01:51:34
after sometimes this was not like our
01:51:36
first visit like we built a rapport and
01:51:38
he told me you know the I I really
01:51:40
struggle with arousal and the only time
01:51:42
I get aroused is I have a a medical kink
01:51:45
and so I go to this person who will put
01:51:47
a fully catheter in me and that's what
01:51:50
turns me on. And I was like that's
01:51:52
really interesting. And I was like,
01:51:53
"Okay, like that's that's great, but
01:51:55
like it took a long time for us to get
01:51:56
there for him to feel comfortable." But
01:51:58
it also then was like, "Well, if that's
01:51:59
what turns you on, you know, then you
01:52:02
got to sort of explore other ways to
01:52:03
incorporate that with a partner. Maybe
01:52:05
not." So like a a catheter is is um is a
01:52:09
tube that you put in the bladder for to
01:52:11
drain urine.
01:52:13
>> What hole does that go in?
01:52:14
>> The urethra.
01:52:15
>> It goes in the penis.
01:52:16
>> Correct. And so there's actually a lot
01:52:18
of people who enjoy urethral play. So
01:52:20
they will take sounds, they're called
01:52:22
sounds, like little um uh rods with a
01:52:25
frail flared base and they will insert
01:52:27
them in the urethra.
01:52:29
But people do find that pleasurable. And
01:52:31
so because there is some, you know,
01:52:33
there there are some nerve endings there
01:52:34
that can be pleasurable. And so again,
01:52:37
it is totally fine to have interests
01:52:39
that are, you know, outside what we call
01:52:41
conventional. Um, but of course I think
01:52:43
you need to uh if that's something that
01:52:45
you're really into, you have to sort of
01:52:46
bring your partner into the into the
01:52:48
fold if that's what really gets you
01:52:50
turned on. Now, in terms of fantasies,
01:52:52
almost everyone fantasizes, right?
01:52:54
Almost everyone does. And the
01:52:56
interesting thing when you look at
01:52:57
fantasies is there's a lot of fantasies
01:53:00
that you would think are not common but
01:53:02
are. So, for example, um being sexually
01:53:05
submissive is very common. So women
01:53:08
fantasize about it like around 60%, men
01:53:11
are like 20%, having this desire of sex,
01:53:15
this fantasy of sexual submission. It
01:53:16
may not mean that they want to be
01:53:18
submissive in real life, but that's the
01:53:19
fantasy they're having. Um, men often
01:53:22
have voyerism fantasy. So like watching
01:53:26
sex. Um, they also have uh sex with
01:53:29
multiple partners. Um, women tend to
01:53:32
have a lot of like sexual um dominance
01:53:34
but also romance in their fantasies. So
01:53:36
like in exotic places or um that or with
01:53:39
and a lot of times like 90% of the time
01:53:42
people fantasize about strangers or it
01:53:44
could be someone they know but outside
01:53:45
of their relationship and so that's
01:53:46
completely normal and nothing to be
01:53:48
worried about. It doesn't mean that like
01:53:49
you want that person. It's just a
01:53:50
fantasy. It's a safe place in your head
01:53:52
to think about fantasy. And I think one
01:53:55
realizing if someone fantasizes about
01:53:57
something it means nothing about how
01:53:58
they feel about you. It's just where
01:54:00
their brain goes to explore. I tell my
01:54:02
patients sometimes write down your
01:54:03
fantasies for yourself. Just like write
01:54:05
them down. Don't share that with anybody
01:54:06
and have your partner do the same. And
01:54:08
then if you guys decide you feel
01:54:09
comfortable at some point to each share
01:54:11
one fantasy and you can start talk and
01:54:13
maybe one that you would want to try and
01:54:15
like it allows you to sort of explore
01:54:17
and think about different things. It
01:54:19
could be a negative outcome like you
01:54:20
could just be like oh no this what
01:54:21
didn't do it for me but it could also be
01:54:23
very positive. And so just like again I
01:54:25
think the big thing is understanding
01:54:26
like it doesn't need to be that serious.
01:54:28
like we can experiment, we can play, we
01:54:30
can have fun. And if you bring that back
01:54:33
into your life, you are going to be
01:54:34
happier, less lonely, live longer. Like
01:54:38
everyone should just be having more sex.
01:54:42
>> It's um Yeah, it's interesting that
01:54:44
we're getting more and more sexless
01:54:46
because I think the world is stealing
01:54:49
our attention and that's causing a big
01:54:51
loss in connection. But then everyone's
01:54:52
lives are more stressful than ever
01:54:54
before. if a bomb goes off 10,000 miles
01:54:57
that way, I I see it when I open my
01:54:59
phone.
01:54:59
>> Um, so it's an interesting time to sort
01:55:01
of almost try and reclaim sex and
01:55:05
>> to work on one's sexual health, the
01:55:08
overall the full picture of one's sexual
01:55:10
health. Um, you're working on a book
01:55:12
which is, I guess, endeavoring to do
01:55:14
much of that, which is coming out in
01:55:15
September
01:55:16
>> called The Hard Truth: Everything Men
01:55:18
Need to Know About Good Health, Great
01:55:20
Sex, and Long Life. So, if you're
01:55:21
watching this after the 1st of September
01:55:24
2026 or around that time, then the book
01:55:26
is probably available for pre-order or
01:55:28
already out. It's not available for
01:55:29
pre-order yet, is it?
01:55:30
>> Uh, it will be soon, but not yet.
01:55:32
>> Okay. When the book is out, I'm going to
01:55:34
link it below in the comments section.
01:55:35
Um, when it's available for pre-order,
01:55:37
The Hard Truth: Everything Men Need to
01:55:38
Know About Good Health, Great Sex, and
01:55:40
Long Life. So, if the subjects we talked
01:55:42
about today have piqu your interest, the
01:55:45
book, I imagine, is going to go into
01:55:46
greater detail on all of these subjects.
01:55:48
>> Absolutely. I think it's a book that
01:55:50
really I I wish was a part of sexual
01:55:52
education. I think all men need to know
01:55:54
this. You know, as women, we end up
01:55:57
taking care of our male partners. I make
01:55:59
all the doctor's appointments. I, you
01:56:01
know, I organize all of that. I make
01:56:03
sure that my kids get all their
01:56:04
vaccines, all that sort of stuff. And
01:56:06
and you know, it becomes on us to take
01:56:08
care of our fathers, too. And so, as
01:56:09
women, we hold that role. And I think it
01:56:12
is so valuable to understand what men go
01:56:16
through and also to be able to support
01:56:17
them along the way. And I think it's a
01:56:20
great gift for, you know, men in your
01:56:22
life or for, you know, older sons even
01:56:25
to like help people understand their
01:56:27
bodies. And honestly, it's a huge
01:56:28
motivator. I tell people like for
01:56:30
nothing else, people care about sex. And
01:56:33
I have seen patients turn around their
01:56:35
lives because they want to have better
01:56:37
sex. They'll literally improve their
01:56:38
blood sugars. They'll improve their
01:56:41
blood pressure because they just want to
01:56:42
protect their sexual health.
01:56:44
>> Reena, thank you. We have a um closing
01:56:46
tradition on this podcast where the last
01:56:48
guest leaves a question for the next
01:56:49
guest not knowing who they're leaving it
01:56:50
for.
01:56:50
>> Mhm.
01:56:50
>> This is the first time in Dario history
01:56:53
where the guest has actually stamped it
01:56:56
with a stamp that says certified 100%
01:56:59
human.
01:57:00
>> Okay.
01:57:00
>> So, you can see there's a little stamp.
01:57:02
>> So, when is that AI?
01:57:03
>> So, it's not AI and it actually says
01:57:04
that in the middle. It says Gen AI free
01:57:08
sign of things to come. But their
01:57:10
question I guess is somewhat linked to
01:57:11
that. They the question they've asked
01:57:12
for you is so much of the world feels
01:57:15
hopeless about this moment. What would
01:57:18
you tell someone to help them reclaim
01:57:21
their agency?
01:57:29
I think that
01:57:33
we as humans are meant to be with other
01:57:36
humans. We are meant to connect and I
01:57:40
think making that a priority will allow
01:57:43
people to feel
01:57:46
um to feel a part of something again.
01:57:49
You know, I think um I think there is
01:57:51
like an emergence of people starting to
01:57:53
look back at religious constructs and
01:57:56
and go to community and be a part of
01:57:58
things and enjoy live events again like
01:58:01
we weren't doing before. I think if we
01:58:03
prioritize that, there is still hope
01:58:05
that we can come together as a society.
01:58:08
And I think, you know, the pendulum
01:58:10
always swings right in every way, like
01:58:12
it's going to go far right or far left
01:58:14
and people are going to hate each other
01:58:16
and then they're going to love each
01:58:17
other and they're going to come back.
01:58:18
And I think if you just look at history
01:58:20
time and time again, it repeats itself.
01:58:22
And we will find unity and we will find
01:58:26
togetherness. We are obviously feeling
01:58:28
pain from a variety of different sources
01:58:31
and we may feel pain right like in terms
01:58:33
of other things to come but ultimately I
01:58:36
I'm an optimist and I think that we'll
01:58:38
come together and and we will find um
01:58:41
happiness and joy in human connection
01:58:44
>> and I hope you're right and I think
01:58:46
we're seeing the early signs of that now
01:58:48
for anyone that's listening that wants
01:58:49
to learn more from Reena um I highly
01:58:51
recommend they go to your YouTube
01:58:52
channel I will collab if we can um and
01:58:55
if we do collab on YouTube you'll a
01:58:57
little smiling Reena um next to the Dar
01:59:00
of Seio logo where you can click through
01:59:01
to her YouTube channel. She's got almost
01:59:03
3 million subscribers and she goes
01:59:05
through all of the questions which no
01:59:08
one has ever answered for us. And I was
01:59:09
looking at some of the questions that
01:59:11
you answer for people. Everything from
01:59:13
>> why you dribble after you pee and how to
01:59:16
stop it. porn director reveals what what
01:59:19
scenes are faked in almost every scene
01:59:21
of movies, but then also a lot of the
01:59:23
stuff we've talked about today around um
01:59:25
penal health, erectile dysfunction, um
01:59:28
sex positions, and so much more. So,
01:59:30
it's a wonderful repository of
01:59:32
information that is constantly being
01:59:34
updated. That is a great place to
01:59:35
subscribe. So, I highly recommend you
01:59:36
do. Dr. Reena, thank you so much for
01:59:38
your time.
01:59:39
>> You're so welcome. YouTube have this new
01:59:40
crazy algorithm where they know exactly
01:59:42
what video you would like to watch next
01:59:44
based on AI and all of your viewing
01:59:46
behavior. And the algorithm says that
01:59:49
this video is the perfect video for you.
01:59:52
It's different for everybody looking
01:59:53
right now. Check this video out and I
01:59:55
bet you you might love
