The Better-Sex Doctor: The Link Between Masturbating & Prostate Cancer! Dr Rena Malik

Men who ejaculate 21 or more times a month are less likely to develop

prostate

cancer

. OMG, why is it because Dr. Reena Malik is a board-certified urologist who is an expert in sexual health and a rock star at educating the public about the facts and myths of sex? Reena I Want to Start with this idea that other couples have significantly more sex than we do, a big myth, people have sex about once a week. Will my eyes get smaller as I get older? So in terms of how we maintain our punishment, what you need is to have.

There is a disparity between how long we think sex should last and how long it actually takes. Yes, we all think it lasts longer. Women want it to be 18 to 25 minutes. Men's are a little shorter, maybe 12 minutes, is there an average? time 5.1 to 5.7 minutes, then too much masturbation will have an adverse effect for men and women. Masturbation is generally safe as long as you don't do it, that's when it becomes a problem. Reena, do we understand our bodies in relation to our sexual health? not at all, for example, with the pelvic floor, it is related to orgasm, it is related to sexual function, but nobody really talks about it, in fact, men will be surprised.

Oh, I have a pelvic floor too and there are a lot of problems that can arise from having a pelvic floor. weak pelvic floor, including erectile dysfunction, so how can I strengthen my pelvic floor? Pelvic floor exercises are going to increase your orgasm, make your semen propel more, and ultimately it would be something as simple as it is absolutely crazy to me for it to be that way. Many of you have decided to watch our show and many of you have decided to subscribe to our show. We now have five million subscribers on YouTube, which is a number I simply cannot fathom and is a dream I could never fathom.

If we had started Dio a little over three years ago and by my wildest expectations we would have already had 100,000 subscribers, so you can imagine how surprised I am that so many of you have chosen to tune into these conversations every week, um, and spend. some time with us, so thank you and I made a deal with you. I made a deal that if you sign up for this program we will continue to raise the bar and in 2024 we will raise the bar like never before. I have been working for the last 9 months on a surprise for all of you who have subscribed to the show and I am very excited to be able to deliver it to you, the production is going to change, we are going to go even further with our guests and us.

We're going to tell even more global stories, so as always, if you appreciate what we're doing here, your simple and free favorite question is to hit the Subscribe button, let's continue with the episode Dr. Reena Malik with all your work, what is ? what you're trying to do, so what I'm trying to do is get people to understand that sexual health is health. I think we have a lot of misunderstandings about what good sexual health is, how do you know why good sex is important? It's good to have good sexual health and that creates a lot of despair and devastation and people don't talk about it, so they reflect on what they feel bad about themselves and it's pervasive throughout their entire life, so I think ultimately Ultimately, my goal is to make education freely accessible. and understandable so that people can know what is happening with their bodies what is normal what is not and what is available to help them how sexual health is defined so sexual health is an individual thing, but most people would say that you can having sex you are able to have an orgasm you are able to have pleasure and achieve the benefits of that we understand our bodies in relation to our sexual health no, not at all, I will tell you, so I talk, for example, about how it is normal to have erections at night or even nocturnal emissions, so have a wet dream, how is it a normal physiological function and a lot of people will message me and ask me how can I stop having what they call Nightfall or how can I stop waking up with an erection because they think. for some reason it's embarrassing or it's a bad thing and when it's realistic it's just normal and some of it is correct in the media, so when you watch TV you see a man getting an erection very quickly, he immediately starts penetrating a woman and she immediately has an orgasm and the whole act is really hot and heavy and that's not really what sex is like, so if you're not seeing what normal sex is like, what normal foreplay is like, what's the fact that Sometimes it is normal to have difficulty getting an erection, that is normal sometimes. not having an orgasm for a woman or it may take longer to turn a woman on and require more foreplay that you're essentially watching a script that's not real and then you're like, What's wrong with me?

I'm broken? Know? There is something wrong with my body that doesn't work the way I see it on television, in the media or in erotic movies. Where does your experience on this topic come from? I'm a urologist and I trained a board certified urologist, so we're the genital urinary tract

doctor

s and surgeons, so we're essentially the plumbers, so when you have a problem with your kidneys, the tubes that drain the kidneys, the bladder, or your genitals , we are the ones who are going to fix them if so. We are a surgical topic and we also deal with the medical aspects of some of those things and that was my training, but when I started my social media, my channel I wanted to offer education to people and when I started doing this education, I realized how how much people wanted to know about sexual health, how much they didn't know and how they really wanted to empower themselves with this information and people aren't asked about sexual function, even when you go to see your GP, when It was the last time? "The time they asked you about anything, they might ask you about erections, but that's probably where it ends, even if they ask about that, they definitely don't ask women if you're having orgasms.

They definitely don't ask anyone if sex is pleasant. We don't ask them if they feel satisfied with the way things are going and if they enjoy the desire, do they feel normal? So I realized that there was a disconnect here with what people wanted to know and what was available? for them, etc. I really started doing sexual health content and spending more time researching in that area, treating patients in that area and it totally became an all-encompassing field for me You're an expert in it too. pelvic floor. MH, what was your type of training with the pelvic floor, so when you do a fellowship in what we call female pelvic medicine, a lot of what we do is related to pelvic floor strength or weakness, so that, to begin with, the pelvic floor is a bowl of muscles that sits in the pelvis, so the organs, the bladder, the rectum, for women, the vagina, the uterus, the urethra, pass through the pelvic floor , it attaches to the bones of the pelvis and is extremely important for a variety of functions, it offers stability, so when you're standing sitting it offers stability it offers the ability to defecate and urinate normally it offers uh when women are pregnant the flower pelvic floor becomes very important it is involved in orgasm it is involved in sexual function but no one really talks about it, no one really knows men will be surprised oh, I have a pelvic floor too because we talk about it a lot with women, right, we talk about it in terms of oh, I might leak a little after having babies when I cough, sneeze, or jump on a trampoline. but the pelvic floor is much more complex than that and very often we will see people who have pelvic floor weakness.

Yes, we will see urine leakage, but sometimes your pelvic floor may be uncoordinated or may be too tight. or you have a high tone and what that means is you can develop a lot of abnormalities and that might be you have constipation, you might have trouble emptying your bladder, you might feel like you have to go to the bladder, go to the bathroom a lot. , so you may urinate frequently, you may feel the need to go frequently, sometimes it may cause pain, so it may cause pain when urinating, you may feel like you have a urinary tract infection, it may cause pain with erection or ejaculation in men, so there are a lot of problems that can arise from having pelvic floor abnormalities and even if you have had lower back or hip injuries, they can affect pelvic floor coordination because everything is interconnected , so I will see patients like you.

I know I've had a lot of hip problems because I played sports when I was younger and now I have problems with sexual function, so it's all interconnected and I don't think we spend enough time talking about how important it is. and how valuable it is to people when they have problems. I want to dig deeper into the pelvic floor and really figure out how I can improve it and what I'm doing to damage it or injure it, but you said something. There

doctor

s don't ask about sexual health they don't ask if to have orgasms they don't ask if to ejaculate those types of things why should they be asking about that because I think of a doctor as I don't know how to fix Other parts of my body I don't consider as if They were examining my sex life, so if you have a normal sex life and are satisfied with it, it won't even bother you, right?

Think about it, but people who are struggling may be walking around feeling ashamed, they may be walking around wondering what's wrong with them, this can be pervasive because they may have relationship problems and they may have problems in their life with the relationship they have. then it makes them less productive at work, less happy, less satisfied with life, they feel more depressed, more anxious, and so it all comes together and, in fact, the other really important thing, at least for men, We know that when they develop problems with a person, you say so. You have erectile dysfunction and today you are diagnosed with erectile dysfunction 7 years later, approximately 15% of those men will have a heart attack and the reason is that if it is a blood flow problem, the arteries that go to the penis are approximately 1 to 2 The arteries that go to the heart are approximately 3 to 4 millimeters and when you have approximately 50% occlusion of a blood vessel due to high blood pressure, high cholesterol, heart disease, that organ will start to have problems and, Therefore, you will start to see erectile dysfunction.

In men who have vascular problems before they start having chest pain or other signs of heart disease, the same thing happens and probably similarly in women, although the data is not as we do not have data for women that maybe if they are suddenly developing. problems with arousal, maybe that's an indicator, but again, that's more complex and we don't have the data for that, but certainly for men we have a clear indication that a problem with erections could precede really serious cardiac consequences and When you look at people who have had a heart attack, around 50% of men will have had erectile dysfunction before that. 50% mhm is a pelvic floor dysfunction in men and it is also related to erectile dysfunction because I heard in some of your work that sitting every day in the way I do it here, sometimes I sit here for 10 hours a day, which could be creating erectile dysfunction, so sitting every day can cause the pelvic floor to not stretch properly, as if you were not moving your body regularly.

If your body gets tense from sitting all day, then your pelvic floor doesn't relax and contract normally, so some people will develop some tension in the pelvic floor and there are a lot of arteries and nerves running through it that They then go to the penis to provide blood flow, so if the pelvic floor is too tight, it can cause problems getting blood flow and then problems getting erections, so while that's no different than having vascular problems, it is more of a muscle problem. that that can be a problem in terms of causing erectile dysfunction in some men because I heard during Co that there was an increase in pelvic floor dysfunction as people were sitting all day yeah I mean I definitely saw that I don't know if en It's actually been studied, but I definitely saw it in my own clinical setting and a lot of my colleagues came in and started having more erectile dysfunction, they might have more urinary urgency, which means they had to go.

They had to go to the bathroom or went more often, which wasn't a big deal because the bathroom was close to them, but sometimes they noticed it was a change and sometimes some people even dealt with the pain. like they had more pain in that area or women would think they were having urinary tract infections when in reality they were just experiencing discomfort from the pelvic floor being tight. One of the things you're particularly good at is taking on some of the big myths. in whatrefers to sexual health and I want to start with one of the big myths around sexual health, which is the idea that we all think that other people and other couples have significantly more sex than we do, yeah, so it's interesting I think it's a big myth and when you look at people they want to know what is normal, how much sex they should be having correctly and there is no ideal number, but when you look at the right studies, I have analyzed a large number of people who are in relationships. couples have sex approximately once a week on average if they have it, if they feel like they know it, in couple relationships where sex is always available, but it is very variable from person to person and what I really like to say The quantity of sex that matters is the quality of the sex, so if you have good sex once a month, that may be enough for you.

Instead of having mediocre or bad sex four times a month or 10 times per month, even so, ultimately, there's no right number, it's really the right thing for you and I think focusing on something like baseline sexual right is really harmful because now you're like, well, I need to have sex that many times. What is the purpose of sex? The purpose of sex is pleasure and sometimes people get many benefits from orgasm. We know that orgasm has physiological benefits in terms of stress. Reduce more Potentially focus on

better

sleep and maybe even lower blood pressure, things like that, so if people benefit from orgasms and intimacy with their partner and the pleasure they get from sex, that's what matters, not the number of times you are having it. sex, another big myth around sex that I thought I understood is about pain during sex.

It's one of the most popular questions that I often think I get whenever I talk to someone who is a sexual health expert. Sex is supposed to hurt because it hurts a lot of people. No, it's not supposed to hurt, so if it hurts, you want to evaluate it. Normally it is the female partner who feels the pain. So you're not lubricated enough? that you haven't had enough foreplay because the body prepares for intercourse, particularly in women, then what happens is that you go through arousal, your body self-lubricates and the vagina actually lengthens and widens almost twice in size to accommodate the phus or whatever you have.

Whether you are using a toy, a finger or anything else, if you don't have enough time to allow those things to happen, it will be painful and sometimes lubrication can vary from person to person, so some people may have large amounts. of lubricant. lubrication and some people may have less and it could be based on genetics it could be based on what age they are at, what stage of their hormonal status it could be based on what medication they take that could decrease lubrication. I think there is another big myth is that lube is not for everyone and I maintain that lube is for everyone because it makes things more fun it makes things more slippery it makes things more pleasurable and it certainly makes pain less of a problem. for a lot of people now there may be other issues that cause pain, so if you've tried all of these things, you know you're completely aroused, you know you're lubricated, you know you're still in pain, then it's very important to get evaluated to understand what's going on. causing exactly. the pain could be hormonal changes in the vestibule, which is a part of the vagina that is very sensitive hormonally, it could be painful, it could be pelvic flower dysfunction, it could be things like endometriosis or other factors that may be happening that need be really advanced.

It helps, but most of the time many people can feel and enjoy sex more easily if they simply increase the amount of foreplay and increase the amount of lubrication. You said the vagina expands during sex, so how much does it expand and for how long? Is that necessary because I think men don't really understand this process? A lot of men just like to rush it, you know, yeah, so it usually expands about twice as long and twice as wide, so it will expand and basically the cervix moves up and out of the way, the vagina expands to accommodate the duration of the phus and we think it takes on average 18 to 20 minutes so that's the amount of time and some people faster and some people longer but ultimately you know it's like understand that, but also, lubrication is another big part of this, so I think both things together, you know you need, you need some time and some people, like I said, it may not take 18 minutes.

They can take a couple of minutes, so it's very reasonable to go in there if that's what your partner wants, but again I think the biggest problem is that we're not communicating about sex, no one taught us how to talk about sex, right? TRUE? I didn't grow up talking about sex with my family, a lot of my friends and colleagues didn't grow up unless they were in a very progressive family talking about sex or even learning about sex from their parents, and you don't learn much in school. learn how to put on a condom, learn how to ask for consent, learn about STDs and that, if you're lucky, in the US, 13 states don't have to have accurate sex education, as if it's not a requirement for education sexual is accurate. in 13 US states where we are learning sex, so the vast majority of young people.

I mean, this data shows that at least one in four teens are learning sex through porn and it's probably more than that, so I think a lot of people are learning sex. learning from their friends porn a small subset is learning from their parents there are still people who learn about sex from their parents but ultimately it's not enough so if people learn about sex through porn, porn It's entertainment, it's manipulated, it's not. real and I think people then take that and say why my sexual encounter wasn't like that why I didn't have that much volume of semen why my partner didn't have an orgasm as fast and it can be on both sides where women can be Why Why didn't I react like that?

Why didn't I get so excited right away? And I think there's a real problem in terms of if people only learn about sex through porn, then they're already set up to be disappointed. when they have their first sexual encounter and at that point of communication we don't talk about it as a society, but even within our own relationship, you know, we don't talk about the things that we're struggling with with our own partners and the insecurities that we have and I think that that can cause a spiral of misunderstanding and I've seen that historically in my own sex life where maybe there was something that I was feeling insecure about or there was something that I was thinking about and instead of communicating it I might have just done it. you just acted strangely and then that gets misinterpreted and then the other person gets a little insecure or whatever and then there's some sort of downward spiral of misunderstanding that leads to absolutely no sex; you are simply avoiding the situation because no one wants to talk about it and this is the problem as you know people ask me like what is this what is the key what is the key what is the secret the secret is that you have to know what you like , you have to know what you want and you have to communicate with your partner how then this is the issue it is not easy it is not easy because no one taught us to have these conversations and they are loaded with a lot of emotion right you feel insecure you feel inadequate or you feel resentful because you're not getting what you want out of the relationship, so it has to come from a place of understanding that this conversation is not one, there is no such thing as a conversation, there are multiple conversations over multiple periods of time and the first time you you have the conversation, it could be a total disaster, but you know, if you were in a relationship where someone really also has the same goals as you of having a great relationship with a good sex life, ideally, that wouldn't continue and you would move on. having conversations.

What I tell people is don't have conversations in the bedroom right before or right after sex you want to wait until you leave the bedroom not during or during definitely not during that happened before it was yeah yeah that's pretty bad that it is enough. bad, so you know, one and then two have it in a place like someone's not looking at the person properly, you can be sitting in a car, you can go for a walk because it's very uncomfortable to look at someone in the face and be like You know what I felt, this wasn't really great, you know? and then be like it's okay, like you know, talk again using the same kind of communication techniques you use for other things, talk about eye statements, not Being that you did this, you didn't do this anymore about how I feel, what really turns me on, what I would really like in the relationship and then realizing that they might not react well, they might say, "Oh my gosh, I can." If you don't think we're talking about this, you have your own stereotypes and prejudices that you're also bringing into that conversation or your shame or whatever you grew up with in society, whatever you think about sex can be very loaded, so It's kind of There's a lot of work to get over that, but realizing it might take time and sometimes getting help, so seeing a sex therapist or someone with experience in psychology and sex to talk, learn how to talk about sex with them and overcome difficulties. but it's worth the investment, right, it's not easy, but nothing in life that's good or worth getting is easy, right, okay, so there's a couple listening right now, there's probably a member of the couple listening right now and they've heard everything you've said, but they've reached the point of no return in their relationship as far as they're concerned, they haven't had a functional, healthy sex life for maybe a year, maybe 6 months, maybe 5 years and it has simply become the new normal for MH.

What is the case that you would tell that person to take steps to try to rectify the situation? I would first ask them how important sex is to them, if not that important, and the other things in their relationship, and that's fine, right? Some people find that it's okay, everything else in the relationship is great. I love this person. We still have intimacy. We still love each other. We still hug each other. We still have a lot of great things in our relationship and the sex right now isn't working out. true or not, it's not working for us, so I'm okay with that, okay, you don't have to feel bad about it, but I think if it's a problem, then I think it's worth working on, like if you have a relationship that you value and that person you're with values ​​their relationship, then it's worth keeping trying.

Try to have a conversation. Try to include them in the conversation. How much have you tried well? Have you really had enough tries? a conversation, a real conversation where you didn't get too frustrated, like when you were, okay, I understand that you have this is a difficult conversation that we're going to have and I understand that you may have feelings about it, but I love you. And I really want to try to have this conversation and keep it going and I realize that's not easy, right, it's not easy. I'm not saying it is, but I'm saying that when you're in a relationship, it's worth having.

Ideally, at some point the other partner will see how much this matters to you and want to work with you on it. If he loves you, if he is with you, he wants the best for your relationship, he doesn't want to hide. They're not burying their heads in the sand and saying, Oh, I'm like they realize they just don't want to talk about it. They are not stupid. They just don't want to talk. about it because they are ashamed, they feel that they are the ones who have something wrong, maybe or maybe they have a problem that they have not mentioned, maybe they are feeling a lot of pain with sex or maybe they are going through hormonal changes and their tissues They're very dry or whatever, there's a lot of things that could be going on that they don't feel comfortable talking to you about, so I think it's valuable to say if there's something I'm not doing like telling me how you feel about the sex like leaving it open to really find out what's going on with them because it's usually not like they're like I just don't want to have sex and that's it, there's usually a lot more to it.

It's very difficult for us to know, isn't it, when it comes to sex what the root cause of the problems is? And I think some Rel ships are like a frog in a frying pan, the frog in the frying pan analogy for anyone who I don't know, is that old story about a frog that jumps into a frying pan and then, because the water gets hot gradually, he ends up dying, but if the water was warm from the moment the Dr. jumped in, the idea would have directly occurred to him that it is a gradual death for the Frog and in relationships it is a kind of slow decline, day by day. day, month after month, in privacy and you end up finding yourself like a dead frog in a frying pan, you end upfinding yourself in a sexless relationship and you think how the hell did we get here?

Mhm um and it feels like a long way back from that point. It's going to be okay because you let it go down and you didn't talk about it and it's going to take. work and I think that's the key, if you want to fight for that in your relationship, it's going to take work and it's going to require acceptance from both sides, right, you have to work for anything in your relationship, relationships are not easy, TRUE? you want to have kids, that takes work, you want to decide to put a house together, that takes work, deciding and figuring out what kind of house you want, how much money you want to spend, there are all kinds of things that take work and this is one that people just he doesn't know how to talk and that's why they just ignore him because it's harder to bring up the topic for both parties, right?

What is the one who maybe doesn't want sex or is it the one who says no and the one who always wants sex and then feels rejected because he doesn't get it. Is there some kind of difference between the sexual desire of men and women as we age? Know? Because I think there is a myth that says that men always want to have sex and women maybe. not so much that it's a real myth um in terms of something you hear, but it's also true so let's talk about desire, desire comes in two flavors, so there's spontaneous desire where you see someone you like, oh man, They are so attractive that I can't wait to sleep with them.

I get turned on immediately I want to have sex right now you didn't have to do anything you just saw them and it happened and then there is a response desire where you are with them you may be touching them you may not actually be . thinking about sex but like you're touching them you're with them you're like oh this feels good I like this like oh now I'm turned on after we started being a little romantic with they're a little more intimate with each other and both desires are normal and they're both Desires are okay to have now in the literature you'll find that men tend to more often have spontaneous desires and women tend to more often have receptive desires, especially when you're in long-term relationships, so there's this disconnect, right, the women say: why don't I see you and want to jump on you?

True, I used to feel that way, but I don't anymore, what's wrong with me? I am broke? so they don't realize it's okay, maybe we just like being together and seeing what happens and they don't even want to start because they're worried what if I don't want to have sex and we have Now I started this like touching hugs where, oh, that person He's getting really excited, what if I don't get excited and what if I just name them? So there are a lot of charged emotions there, but I realize that this is normal, common and receptive. desire isn't wrong it's just different and people just don't know it exists because again the media attention is like you see someone attack them you're immediately horny you have sex and that's not what It happens all the time and that's okay and then you know you can be with your partner, look I have no expectations of you, I just want to be with you physically and see if it turns into sex, so often we give people homework, like put it on the calendar.

Put it on the calendar that you're going to be intimate together right now and I know it sounds weird, like you're looking at me like I'm crazy, but we put it on the calendar when we want to work out, we put it. the calendar when we want to have lunch with our friends we put it on the calendar when it's right and when we were younger when we used to go on dates with people we said okay let's go on a date on Friday night We know that sex is on the table with our partner on Friday night, so we would get very excited.

We like. Okay, I'm going to shave. I will look very pretty. I'm going to smell good. do all the things that make me desirable and feel confident and ready to have sex properly, then you would be very excited and then you would have all this anticipation about how fun it will be, but the anticipation can cause chaos content can, can, so The opposite is true, but that's because if you expect it, that's why I say intimacy and not sex, so if you say you're going to have sex, it can be like, Oh my God, what if I don't?

What happens if I don't do it right? What if I don't want sex? What if it hurts a lot? So you too can have that kind of brooding and spiraling, but if you're like that, look, all we're going to do is be together and be intimate, we're not just going to go to dinner and talk, we're going to literally like be together, not having our phones with us, maybe touching us, maybe undressing us, maybe you just know how to feel what it feels like and that's it. there's no expectation of sex on either side, we're going to go in knowing that and then slowly work towards something like, you know, maybe sex will happen and maybe it won't, and over time as you keep putting it in the calendar.

If you prioritize your intimacy with your partner, eventually you'll get to a point where, oh, you'll remember that connection you used to have and then you'll be able to find that joy again in connecting sexually, that's the kind of aspect of desire that is I guess it's a little more psychological, but there is also a kind of physiological element to desire as it relates to hormonal levels, so if someone has a low libido, it may be a hormonal dysfunction, which is why testosterone is the most notorious for desire. both men and women and I think this is a big mistake: we don't talk about testosterone in women, but testosterone in women is more predominant than estrogen, we have more testosterone in our bodies than estrogen and testosterone is very important for desire in both men and women, but anything that interacts with testosterone is also important, so thyroid hormone can cause problems with testosterone.

Prolactin, which is another hormone produced by the brain, can also interact with testosterone, so essentially testing those things and making sure your levels are normal or appropriate for your age can be helpful, that's probably the number one thing. , but the other thing outside of physiology is that stress, although stress is kind of an abstract thing, stress affects our physiology, so when you have a lot of stress in life, whether it's a work relationship, stress, stress in children, whatever is right, it increases the cortisol level and when the cortisol level is high you can't produce testosterone, it goes down, so if you are chronically stressed, many of us are right, you spend Like in society In today's modern day, chronic stress is like a real problem, so that will really affect your libido, so yes, your hormones may suffer because of that, but if you don't fix the stress, you won't fix the root cause. problem, can I just inject myself with a bunch of testosterone?

However, to get my libido back, it won't work for everyone, so if it's not really low testosterone, meaning you have normal testosterone levels, chances are your testosterone receptors are completely saturated, plus testosterone isn't. I'm going to solve the problem, so it depends on your individual level of hormones, but at some point, more is not

better

, in fact, more can be dangerous, so it really depends on your individual level, so, giving yourself as if give it to a boy who has something completely normal. Testosterone levels, both free and total testosterone, are completely normal and I give him testosterone.

Probably nothing will change because your testosterone receptors are already completely saturated with testosterone, so nothing else will do anything. What are the other ways I can increase my testosterone if I go and get tested and it says I have low testosterone and I don't want to just inject myself with testosterone. Are there natural ways to absolutely increase it? So number one is sleep, so sleep is actually very important for testosterone. Know that when you reduce the amount of sleep you get, for example, if you sleep less than six, five, six hours, you will have at least a 10 to 15% reduction in testosterone, and that is because our body follows a rhythm circular and so when your highest level of testosterone is in the morning and it starts to decrease over the course of the day, there is a little increase again and then it goes back down in the evening, it is low and your body, when it sleeps , replenishes that testosterone, and if you're getting fewer hours of sleep or poor quality sleep, meaning you know you don't feel very rusty when you wake up, that's a sign of poor quality sleep.

Both of these things can dramatically affect your testosterone. The other thing. What you can do is exercise and specifically resistance exercise so doing tall is the largest muscle group so the lower extremities and their use have generally been shown to increase testosterone more significantly than any other type of exercise, in fact, when you do high-intensity cardiovascular exercises. resistance training, so let's say you're doing Ultram Man marathons all the time, long bike rides, long swims, you know, swimming for long periods of time can increase your cortisol, your stress because your body is having a response to the stress and that can actually lower your testosterone, so it's important to do cardiovascular exercise, aerobic exercise, but in moderation, because we see some people who are great athletes that you know they run, they run miles and miles and miles, but their testosterone is low because they have been doing this. long-duration chronic resistance exercise, so a hit-and-run type of training is fine, but it's when you start doing these big thousand-M Iron Man races that cortisol demands.

I'm so healthy I'm the healthiest I could be and I have low testosterone, why is that? And what about food and testosterone? So, the food, you know, there are a lot of facts about food, but most of the facts are about the Mediterranean. diet and that's because it's the best studied in medicine, but essentially eating vegetables, fruits, low amounts of processed foods, good healthy fats, nuts and seeds, so a lot of people don't realize, but you need fat good for having testosterone. Testosterone is a pre is a production in the cholesterol pathways and therefore it comes from those pathways so you need to have a certain level of fat if you have a diet that is too low in fat that will also affect your testosterone so ideally What I tell people is While there is a lot of data about different types of diets, the important thing to know is that you should avoid processed foods, avoid a lot of sugar, and have good, healthy fats in your diet.

And know? I've heard a few times that testosterone levels have been declining over the past two decades in men. MH, is it true? Yes, that's right, so not only are we seeing a decrease in testosterone levels, but we're also seeing a decrease in sperm quality and sperm quantity, so sperm concentration. and over the course of the last 50 years, and there are many reasons for this, one is that society has become more sedentary, we are seeing less active people suffering from more and more metabolic conditions such as diabetes, high blood pressure, these conditions then cause endocrinological diseases. abnormalities, they cause problems with blood flow and all of these things can affect the quality of your sperm as well as the quality of your testosterone production, and we also think that in the environments there are more microplastics and more endocrine disrupting chemicals. the environment, so it's probably a role now that we don't have exact quantitative data on that, but we think it's probably playing a role and reducing exposure to these endocrine disrupting chemicals, so we tell people to try to Do not drink from plastic water bottles try to heat food and glass and avoid plastic.

I mean, these are easy things you can do, but if you want to care about the amount of plastics in the environment, there's not much you can do on an individual level. I tell people to do the things that you can control and the other things that we know we have to work on as a society, that's really interesting because I don't think I think much about this other than eliminating chemicals from my life in terms from it that is. kind of thing that I'm holding the metal cup in front of me and then the plastic bottles that I'm drinking from could be having an impact on my testosterone and my sperm count, I could say not everyone is right, think about how many people drink from plastic water bottles, but if you can lower your exposure properly, it's probably additive, so the more exposure you have, the more likely it is to affect your body, how do you know this?

How does anyone know that chemicals are having an impact on our sperm? and testosterone, so you know there's basic science research where they look at the impact of these things on rats and other animals and then they also look at the amount of exposure to things likephalates and laboratories and see how that you know we can't, everything is because everything is correlation, we can't say it's causal because no, we're not going to do a randomized study in which you drink from water bottles for 10 years and drink from bottles of glass water. for 10 years and let's see what happens, that hasn't been done, but they can say okay, the higher your exposure based on whatever biomarkers we can test for, then maybe urinary phalates or other things, we can say okay, these people who have more exposure to According to the data, they are more likely to have lower levels of testosterone and then you look at the mechanisms of how they interact with testosterone production and I'm not an expert in those areas, but there certainly has been sort of of plot.

Mechanisms of how these things work. How sperm count has been decreasing over the years. If you look at the last 50 years you will see that the average sperm count has decreased by almost 50% and fortunately the average sperm count is still high enough for fertility. Based on the rates, the average sperm count is probably around 50 million fathers fathering children, so it's still above that, but it's certainly significantly lower than it was 50 years ago and that's where we think, it's probably plus a The global environmental factor that is contributing to that, in addition to this increase in comorbidities and poor health over time, I mean the direction of travel there is deeply concerning because if something decreases by 50% in the last 50 years, what did you say?

So if we go ahead, another 50 years and assume the same rate of decline, which means we will be at 25% of where we were 100 years ago, yes, and then what happens if you can no longer father children and if you don't can you have?offspring that will then propagate the species correctly, so there are certainly concerns about that and I think we know that as a society we have to do better in terms of the things that we can, so that we can control the diet, we can control the exercise, we can control those things. certain things we can't, but we can try to control what our people are exposed to and that can be at a government level, like having some kind of laws in place so that we know that in the US there are less restrictions while in other countries there is more. restrictions on things like dyes and food dyes that can go back in.

I don't know the details, but I'm sure you know that there are certainly more restrictions in other countries than in the US for some reason, so maybe there needs to be more critical evaluation of where we can actually implement some things that would actually have broader changes when we think about sperm count, we often think about fertility um and you know, I don't know if this is just because society has changed. and we're trying to have kids later, but it seems like people are struggling more and more with fertility. I mean, even in my own circle of friends, you know, there are a couple of people who have reported that they have problems with fertility or that you.

I know you are spending 12 months or 24 months trying to have children. Do you think this is also related to this? I could be. I mean, when we look at fertility, we know that about half of the fertility is due to half of the fertility of women. it's due to men and then a combination of the two so definitely as women get older fertility declines and we know that women wait longer to have children so that's a big part of why society has changed, women work and prioritize their careers. It's not a bad thing, but it will certainly affect fertility and then, yes, there may be these issues that affect male sperm count that are also causing problems, but I don't know if there's been any updated data in terms of what the causes are or the consequences. numbers in terms of fertility rates, fertility aside, is there any correlation between our health outcomes and our sperm volume, not volume but concentration, so volume is the amount of right, so sperm concentration in semen is more of a predictor in terms of um?

Sperm volume not sailor volume let's be clear sperm volume and sperm concentration are sort of biomarkers and we would say yes there is a correlation with overall health in terms of sperm concentration and sperm volume but I think I don't want to. make people worry that if they really have male fat factor, infertility, then now their overall health is an issue, but it's certainly important to have them evaluated and checked regularly by their doctor and at that point, regarding to sailor volume, is there a way to increase that and is it similar to what you said about increasing testosterone or is there another set of practices that we can do to increase our sailor volume, yes sailor volume is variable depending on which be the biggest, it's how long it's been since the last ejaculation is correct, so the longer you take between one ejaculation and the next, the more sailor volume you'll get, that's probably the most predictive.

You know hydration can play a role if you hydrate more, you're bound to see more seam in volume, um, sometimes it's a low seam in volume because you actually have less ejaculation force. Interestingly, when you are young, the force of ejaculation can be very, very strong, it can be up to 30 to 60 cm away, like when you ejaculate, that's how forceful it can be. As you age, after age 50, it may decrease to 15 to 30 cm in distance and you may feel that it has less volume because it is less forceful and in those cases that is due to the pelvic floor muscles that are around the urethra .

There are muscles that help drive ejaculation, so you can strengthen those muscles with pelvic floor exercises like Keigle exercises. I warn people because people always like oh, they're going to do these Keele exercises, they're great, they're going to increase orgasm. They're going to make my semen push more and I think it's okay if you don't have pain, you don't have discomfort and you're doing them correctly because sometimes what we see is that it can actually cause damage to your pelvic floor. it's tense like we talked about before or it can cause pain and dysfunction if you're tense, tense, tense and not relaxed, so if you don't know how to do it correctly, then you could hurt yourself, but yes, they can improve stitching. and volume by the parameter of increasing the strength of a jackulate and obtaining more catechism that can be left if you do not have such a strong muscle contraction.

Does masturbation improve my pelvic floor? Does it strengthen my pelvic floor? So that's good. Question that orgasm is what improves your pelvic floor, so if you masturbate in your orgasm, when you have an orgasm, your pelvic floor contracts involuntarily, you can't do anything about it at a rate of about every 08 seconds, so that contracts and that is kind of like a pelvic floor muscle exercise, but it does it involuntarily, it contracts for an average of 5 to 60 seconds, usually, that way you are increasing the strength of the pelvic floor, so In fact, it has been observed that in women, in particular, the orgasm is just as good. how to do pelvic floor exercises and they've seen you know you can see a pretty measurable improvement in pelvic floor strength if you orgasm regularly, is it?

And you may know how to do ke gos just as well depending on how often you do it. So yes, the orgasm itself can be very beneficial in strengthening the pelvic floor. One of the big myths I've always had and have yet to answer is the impact our technology is having on our genitals. You know, there's kind of a widespread myth that if you put your phone next to your testicles, your sperm count will go down like when I'm in the car, um, and I don't know, I'm sitting there or I'm sitting at home somewhere and I take my phone and put it near my genitals, my girlfriend attacks me and likes to take it out or tell me to take it out because I think she's worried that we won't have kids if she's down there.

Yes, yes, there is some data in terms of you know that when you have these devices, like on your lap or near your genitals, they will increase the temperature and therefore when the testicles are in the scrotum for a while. The reason is correct, it is because they need this perfect environment with this specific temperature to create sperm and anything that alters that temperature can cause differences and cause abnormalities in sperm production, for example when you have a fever because you have the flu or you have a cold. . they'll check your sperm, your seminal analysis and they'll see that your sperm count is zero because the temperature, the fever has temporarily stopped your sperm production and so you can see that people are also talking like, oh, what's up with boxers or briefs? and all of these things can increase the temperature around the scrotum, which can then cause changes in sperm production, so I tell patients, especially if they're trying to have babies, to put their phone in their back pocket, in the breast pocket, don't put it. your computer or your laptop right on your lap, I mean, it's pretty easy to do and it raises the temperature, so absolutely yes, these things can't be for everyone, there are people, so we say people like you shouldn't smoke a lot marijuana when I'm trying to get pregnant because marijuana can cause problems with sperm production, but you'll see people who smoke every day and still have babies or you'll see people who do all these things right, they wear boxers, they put their phone on. in their pocket, they put their laptop on their lap and they still have babies, so it's not an allomer, but they are certainly things that you can easily avoid putting near your genitals if I'm in the sauna every day or if I'm in a room of steam every day, isn't that going to have an impact on my sperm count?

Yes, it does and it's interesting because I think we'll see more of this as we see earnings increase. saunas, certainly, but as we're seeing an increase in people actually using saunas all the time, there may be, so we tell people that when they're trying to have them, if they have fertility problems, they don't do it in the jacuzzis. going to saunas because it could affect sperm production, so those are the conservative things we tell people to do, interesting and this point about the phone next to the genitals is not because Wi-Fi and the Bluetooth are going to like zap my babies, no, I mean, there are some questions about that, but we don't know, I don't think we know, but we know that there is a temperature increase because phones get hot, we talked briefly about masturbation, um, one of the big questions.

What people often ask me when I talk to someone who has experience in sexual health is about masturbation and if it lowers testosterone levels then it doesn't. There is a study and it was done on 10 men who abstained from masturbation for 21 days and these are healthy young men so this is where I think everyone is getting their data from is from this study and they took their testosterone before taking their testosterone after and what they found was that there was an increase of about 50 50 nanog per deil 0.5 um was 50 nanograms per D, which is not a huge amount at 21 days, but we know that testosterone changes all the time and two, there are a lot of anticipatory signals when you've been waiting to masturbate for 21.

Days where your brain is really excited, there's all this, okay, I'm finally going to release and that in itself can increase testosterone. So, generally speaking, there is no empirical evidence that is compelling, high-quality level evidence that

masturbating

or abstaining from masturbation. it will increase testosterone so you know people report other benefits so I tell people if you are getting other benefits from abstaining then by all means go ahead but don't do it because I don't like White Knuckle , to get something theoretical. increase in testosterone that one wasn't even that big and two probably won't be tested in a larger sample, what about the opposite?

So too much masturbation will have an adverse effect on us for men and women, yes, so I think it is like that. I know what I tell people is that masturbation is generally safe as long as you don't masturbate to the point where you now choose to masturbate instead of doing anything else, so you choose to masturbate instead of having sex with the couple you are choosing. masturbate before going to work or you're going to be a little late for work because I want to finish

masturbating

or you literally can't sleep without masturbating every day like that, you become dependent on this particular activity for the enjoyment it provides, that's when it becomes becomes a problem, but if you are using it in terms of masturbation to get the orgasm and the benefits of the orgasm that I get from that because maybe my partner doesn'twants to have sex or maybe I have more sexual desire than my partner or I don't have a partner, let's face it, if you don't have a partner, you'll have to have one, if you want to have an orgasm, you'll probably have to have one. masturbate, then I think the problem also arises when people only masturbate in the same way every time they only watch a certain type of erotic movie or they do the same thing every time and their body gets used to that and then they find it difficult to reach the climax. with a partner because they can't replicate what they're doing, whether it's what they're seeing or how they're doing it with a partner, are we teaching ourselves something?

Are we teaching ourselves how we get aroused and how we orgasm? Yes your brain is very powerful, so when you do the same thing every time your body says oh, this is what turns me on, this is what makes me have an orgasm and then when you are your partner you say, oh, I'm not getting the same type of stimulation, so it doesn't happen to a lot of people, but I would say I certainly see people where this happens, so you know you have to take a break and come back to... evaluate and try different things and get your body used to different things, which takes a little work, but keeping it varied can be helpful.

Another big myth, masturbation will make me blind, yes, no, I literally don't know where. that came from there it's like Harry Pals blindness like I don't know where I think this is kind of from the religious rhetoric that says you know you shouldn't masturbate um and you know where that came from you know it as something completely different . story I think what do you think of this idea of ​​no crazy November, yeah, so I guess I'm not a fan, the reason is because I think it makes people feel like it's something they have to do and if you want to like it, he said that if you find benefit in abstaining from ejaculation for 30 days or 28 days or whatever, then of course, go ahead, if you want to try something, there's no harm in it, but I think what a lot of people do is they feel that it's something that will take them to a higher level and they will become a great person because they can conquer this goal, but they are literally miserable, so they are clenching their fists. their pelvic floor all the time because they are stressed from not ejaculating, they can ejaculate at night and they will have a nocturnal emission and then they will feel very bad because they have failed it is nothing that you can control nocturnal emissions are physiological they are totally normal and 86% of men have had a wet dream at some point in their life as if it is very common and more likely the longer you are to ejaculate so your body will take care of ejaculation whether you ejaculate or not then you will reabsorb the semen or ejaculate through the night, so if you want to do it because you feel good, I have a challenge.

I want to conquer it, I want to see if I can do this and you feel better because you're not able to not focus on sexual thoughts or you're actually able to find some other level of spirituality or something like that. Of course, go ahead, I don't have a problem with that, what I do have is making people feel bad because they can't do it or don't want to do it and making people feel forced or feel like I need to do it to prove something to someone else. , yeah, because I mean, the way they explained it to me is that it's something about semen retention that gives you some mental clarity or something, because a lot of athletes before they have their big fights or, you know, their most important Olympic competitions, they will refrain from masturbating.

I often hear in the UFC, for example, mixed martial arts fighting championship, that athletes haven't had sex or ejaculated for two weeks before a fight or four weeks before a fight, yeah, so there's a lot of rhetoric there, I think that comes from something historical, so even in Greek times they told people to avoid having sex or masturbating before big fights or whatever sports they were. play and it's also true in the data, so if you look at studies that have looked at people doing athletic feats, whether it's like biking or running or whatever, they haven't found that abstaining from ejaculation in reality changes its performance capacity, etc.

In those cases, I say, well, there's no real scientific evidence that we have that it's going to get better, and in fact, if you're someone who, for example, has sex every morning or masturbates every morning for whatever reason, that's part of your routine, disrupting the routine can actually be detrimental to performance and sometimes the only thing that can be said in terms of performance disruption is that after masturbating you see a small increase in heart rate, it has a bounce, so it decreases and then it has an increase in bounce. in heart rate which may slightly affect your ability to recover from performance.

But ultimately, I think if you find benefit because people report feeling more aggressive about abstaining, then of course if you find it helpful, I think that's fine, but is it mandatory? I don't believe it based on the evidence we have now because I heard that rumor many years ago and I think I assumed it was correct. I heard the rumor and this was an evolutionary story that was attached to the rumor that once upon a time. when we were dating, I don't know, we were looking for a sexual partner, we would have to be more articulate and more persuasive and more, I don't know, attractive, basically, so we were optimally attractive before ejaculating and then after ejaculating like that. of energy comes out of us and it recharges and rebuilds itself again, so when I heard that I thought okay, so if I'm speaking on stage or I'm doing a podcast, I want to make sure that you know my mouth and my brain is wired.

I am articulate. I'm persuasive in everything I need to be, so don't ejaculate or masturbate at any time before doing anything where I need to use my brain in my mouth. Well, you know, some people describe the post unclearly, so really, it feels like an alternative and there's no good data on this, the data we have is on people in the very small subset of people who have post-coid dysphoria. nutty, not postcoid, so they actually feel bad, but in terms of clarity, you know, some. People like it when you try. You're motivated to get a suitable partner, you're like trying to woo them, you're really focused on that singular effort which, once you've gotten it, is very similar.

The singular focus disappears and other parts of your brain can now be activated and then used. Some people will describe being more productive, more able to get work done after masturbation, it's very individualized or ejaculation, whatever, after that, Clarity, I've never done it. I've heard someone talk about this before and I've also been told over the years that it's something only men predominantly experience and for anyone who doesn't post nuts. Clarity is the definition that I understand and have experienced. To be honest, after ejaculation your desire for the other person is significantly reduced and there is a stereotype here that women do not experience this post-nut Clarity in the same way now if I ask all my male friends if I told them?

Has there ever been a time in your life where maybe you were texting someone that you were attracted to or that you knew you had some kind of sexual attraction to and then you masturbated? Did your desire decrease after masturbating for that person you just texted? I think about 90% of my male friends would say yes, yes and they describe it as someone taking off a pair of sunglasses as a pretty extreme sudden change and I've always wondered if this is just for men if it's just women. Why does this happen? When you look at brain studies of people who have an orgasm, what happens is when you have an orgasm, your whole brain lights up because your heart rate goes up, your blood pressure goes up, and your pupils go down, so all of these things are different.

Parts of your body are working, so your whole brain lights up and then after orgasm it becomes very quiet, so we see that in women it can take a little bit longer to become really quiet; In men, it happens very quickly and this can be associated with some sort of hormonal changes that occur after orgasm, so we know that prolactin increases after orgasm, dopamine decreases and there are some evolutionary theories about why this happens, so which one is after ejaculating, if you are having ejaculation with a woman, then I don't want to have sex again and the same thing with the refractory period, right, there is a period of time when you don't want to have sex again or not you will be able to have sex even if you want to and this is because evolutionarily, if you deposit your ejaculate in a woman, if you then have sex again, you could actually dislodge the semen and then you would have less ability to properly fertilize the egg and then the other thought is that you don't want to become too exhausted, so if you had the unlimited ability to have sex over and over again, that exhaustion might be a real thing and then you're kind of a protective mechanism, um, and those are kind of theories. of why This is and there is an absolutely refractory time where you don't want sex at all and then there is a relatively refractory time where if you had a really novel or strong stimulus for sexual activity, you could do it in terms of clarity because we know that there are some differences in the brain.

It may not be as obvious in women in terms of it taking a little longer for them to get that down after orgasm due to brain activity, but there's probably something there. We just haven't studied it enough and I always say this that when we look at the studies on women's sexual health and men's sexual health they are so unbalanced that if you type penis as a search engine for Google or for PubMed, which is where you search for research articles you will find 50,000 articles, if you search for clitoris you will get 2,000 articles, so it is very unbalanced in terms of what we study for sexual function and sexual itself.

Many people do not consider this function mandatory or important for health, so funds are less available for sexual health, which is why we have so little data in some areas, closing the point again on masturbation, is there a

link

between I'm masturbation and

prostate

cancer

because I've heard a lot of different things about it. Some people think that excessive masturbation is causing prostate cancer and others say the opposite, yeah, so there's actually a really good study that was done looking. on ejaculation frequency and prostate cancer and it was very well done, they tried to control for many other factors and what they found was that men who ejaculated 21 times or more a month were less likely to develop prostate cancer, this is just a Statistical Number, it is not a number that means anything, but we are seeing that it is okay, so more masturbation can help, why is it correct?

So there may be a prostate stagnation hypothesis that the fluids you know are part of your ejaculate fluids come from the prostate and therefore when you are urinating frequently, you are more likely to get rid of that. liquid and replenish it or clean the pipes, so to speak, which can now be beneficial in terms of prostate cancer prevention. Do you have to masturbate or ejaculate or have sex 21 times a month? No, but you know there could be a benefit, yes, and living a healthy life, it could be that those people who had sex more often or Jacine more often were just healthier.

In other ways, they were able to have sex more often or masturbate more often because they were, you know, healthy enough to do so, and while they were trying to control those things, there are always uncontrollable variables that come into that kind of thing. of studies, yes, that's what I was wondering: is there another glaringly obvious factor that those people had more relationships, therefore their mental health was better, therefore X, Y and Z tried to control for comorbidities, But again, they are, aren't I? I think they controlled, I mean, they control the marriage, I think, um, but I'm not sure if they controlled for like in a relationship versus not, and how healthy that relationship is, that certainly wasn't assessed.

I'll

link

to the study below so everyone can read for themselves about the controls in that study and how it was carried out the link to this is the topic of um it was interesting because I was doing a lot of research on the topic that sounds like a Little strange. There is a lot of research on the topic of pornography and conversations on the topic and one of the pretty surprising things is that a lot of people are trying to figure out how to stop watching pornography. Many people wonder about mechanisms to do so. installing things on your computer that prevent porn time and, um, looking for solutions around porn addiction and a lot of peopleI was looking for if pornography is a sin and I think there is something broader here about the idea of ​​shame that is linked to pornography, what is it? your take on this is that porn is a bad thing, yeah, so I don't think porn is a bad thing.

I'll start with that, is it a sin? It's more of a moral question, right? And I think that's something that you individually have to decide for yourself if you feel like it's morally inappropriate but it's entertainment, it's just a different form of entertainment and I think the problems with porn, because I wouldn't say it's 100% great, I think there are definitely problems with her. One of the big ones that I've talked a lot about is children watching pornography, so now we know that the average age of a child who watches pornography is 13 years old and that is the average meaning that between 8 and 10 children are exposed to pornography. um, which wasn't the case when, for example, we were growing up, right, you had to do it.

I always say this, you had to find a tape, maybe find a VC, you were in a room that no one was going to enter or you had to find a magazine and hide it somewhere and go get it, so it wasn't available , you had to work to be able to watch it and now watching pornography is very easy to get and, therefore, very often children watch it, even if you, as a parent, do not want to. It asks them if you've locked their phones and devices, they may have access to it through a friend or they can see it somewhere else and, um, and your brain is not fully developed to understand one of what you're seeing and two of Understand that this is not real unless your parents have talked to you about it.

You know this is kind of a movie that's not real life and that's not really what sex is like, so I think that has implications for them in terms of how they view sex. and how then they try to have sex with their partners and you also know that because your brain is not fully developed, you're getting a huge dopamine rush from seeing something like that and that's not something that we traditionally have at that age, so It can become very addictive now as an adult. I think it's different because you have a fully formed brain.

You understand that the concept of this is not real for most people. So it can be just a way to have pleasure and even watch it with your partner. It's a pleasure, but yes, we are seeing some people who have a problematic use of pornography in literature, they say it's 4%. I suspect maybe it's a little higher now or people are finding that watching porn is easier than going out and trying to find a partner. you don't have to face rejection you don't have to face the difficulties and discomfort of having a first sexual encounter with someone that happens often and therefore can become a way because it releases dopamine like anything else releases dopamine. so it can become kind of a way to feel better about anything, like you just feel depressed, like I want to watch porn because it makes me feel better.

It might not just be that you like sex a lot, it's just that you really want that rush dopamine hit, um and then there's obviously this shame that comes with oh my god why am I using porn just because I feel bad ? and then you say, oh, but I feel bad and that's why I'm I'm going to use porn again and it becomes a kind of negative vicious cycle that can happen, but I think when it's used for entertainment and pleasure, I think it's okay and a lot People use it for entertainment and pleasure without any problem.

The other day I bought the Apple Vision Pro, that new headset and I tell you what, my goodness, it's an incredible piece of technology. This feature they have is called space video and I don't know if you've tried it yet but you put it on and yes I've taken a space video which you can now take on the new iPhone and also on the Vision Pro. It basically feels like a 3D video and it's like nothing I've ever experienced before. One of our team members commented that you know they lost. a family member and they wish they had this because it's like the person is in front of you again, it's not like a photo or a video anymore, but then the little monster in my mind says, "There will be other applications of this technology." relates to the graph and we let them know that if we assume some rate of improvement with this technology, I just know that 5% a year we will eventually get so close to being indistinguishable from a human being that the incentive structure of going out and getting one day and you know, with the goal of having sex or whatever instead of just putting headphones on, which is going to get cheaper and cheaper and cheaper and better and better and better um it gets really unbalanced.

It's very clear to me that if I just fast forward 10 years and we're on the air of Apple Vision Pro 17, there will be so many people who will use it as a way to masturbate and watch porn, and that will reduce the number of people who are. seeking real intimate relationships in real life in the real world, yes, it's a real concern I would say, but we know from some data that people will find physical contact in particular, particularly in hairy areas, very important in terms of intimacy with a partner, so um Intimacy in general, so I can only hope that that continues, that you want physical contact because no matter what you can see with your eyes, um, he's not touching you, it's not like it's still you who touch, there's no element of surprise or excitement or buildup in terms of there being someone else in the room with you, so I can only hope that's the case, but that remains to be seen, however I will show that there are some interesting applications of this in terms of fear, so if you're really afraid of something, you can desensitize yourself by wearing these virtual reality headsets and they can actually be very powerful.

I was talking to researcher Lori BR about how they are using them in their lab for women who are afraid of penetration because they have had trauma or have other conditions that make it painful and so you can work with them to use these headphones to simulate a sexual experience and then they can use a DI like you use a tool or a dilator or something to then penetrate into a safe space, not like you're with a partner and you're trying to have sex and you know you don't feel very safe allowing that. . It's very preliminary research, but I think ultimately there are some positive things that maybe come from using these types of VR headsets and I can only hope that that predominates and we can continue and that people inherently want other people are right.

We're programmed to be around people and be intimate with people that's how our brain works, so I'm hopeful that that will continue to be the case, but I can't, I can't predict it. You don't seem convinced, well, you know, I mean, I think it's me. I'm worried, you know, I think phones have changed lives too, like now, our kids, our younger generation, they don't communicate as well because when they hang out together. all sitting together looking at their phones properly, so we have to actively work to prevent, like I do, my kids from having full conversations with people.

I tell them that they have to come and hang out with adults and have conversations and talk to people and we have to train them on how to talk to people, because I'm worried that people like it too much, even when they go out with their friends, The easy dopamine rushes that these devices give us are right, so we actually have to actively work on it and people are inherently going to take the route of easier, so as a society we have to work together to achieve it. preventing these easy wins, easy things, easy dopamines from taking over something that you mentioned there, although it was the idea of ​​trauma and I'm quite interested in the role that our trauma plays in our sexual health and sexual dysfunction, which is important to know over there. and trauma plays some role in the patients that you care for absolutely 100%, so your body, when you go through trauma, remembers it even if you don't do it right, so these people, many people who have pelvic floor . dysfunction, meaning their pelvic floors are too tight or too tense, they've had some kind of trauma, not all, some of it is just stress and anxiety, but sometimes they've had some kind of trauma years ago and it's been with I remember having had like a 70-year-old woman who had such terrible pelvic flower dysfunction for God knows how many years that it ultimately caused really negative consequences for her bladder function and, um, absolutely when you have trauma that's not resolved in any way. shape.

It will affect you either your mental health or your physiological health. I mean our brains are so powerful that you know when it's in a bad place it can affect you negatively when it's in a positive place it can affect you more positively the only thing I will say If you have trauma, getting therapy and getting help to resolve that trauma is very important. I talk to all my patients and I tell them that yes, you may have an organic problem, meaning a physiological body problem that is causing your sexual dysfunction, but everyone who has sexual dysfunction has a psychological component because it is devastating, it is stressful. , it's horrible to feel like you're not normal, your body isn't functioning normally, especially in an intimate space like sex, so I think ideally everyone should see a sex therapist if they were one. available to everyone, but it's not right, how can we allow people to have access to the things they need because we don't teach these things in school?

I mean, this is my big complaint: How can we improve education for kids like us? We need better sex education We need better education on how to resolve trauma or how to deal with it or how to get help How to do digital health, for example, how do you navigate the world with all this misinformation? How do you find good quality information? Assess it like there are so many things, including how to properly balance your books, they don't learn that in school, so ultimately there are so many things that I think if we were really putting a critical eye on how we teach our young people, we could improve and part of that would be including people so they know and realize when they need help through any trauma they've suffered or stress or anxiety they're suffering from and how that can spread throughout life and create real problems. .

I have to ask. This question because people mention this quite frequently. Can you have sex while pregnant? Absolutely, why not? I'm asking it because it was one of the most searched questions on Google, online, actually, yes, one of the highest search volumes I've ever seen on a The search term was: can you have sex during pregnancy? Actually, I didn't say it. I mean. I've heard a lot of things and I think people feel like I've heard that men think they're going to hurt the baby. They're going to um, they're going to cause a problem, but no, absolutely, you can have sex, you're not going to create premature labor, you're not going to harm the fetus, like nothing bad is going to happen from having it.

Sex during pregnancy is okay, so let's talk about orgasms and the clitoris. So you mentioned before that, um, there's disproportionately less research done on the clitoris as a man, what do I need to know about the CU clitoris? I'll be honest, I know this very well. Little do I know where it is, that's an advantage, well, not everyone knows, yes, I didn't always know where it was. I had a couple of misunderstandings but I found out that I finally found it and I think I know how to stimulate it but I really don't know what's going on there or how it works so what I tell everyone and what men may think is that the clitoris It's like the penis, so when you're a fetus, there's something called the genital tunic before it's assigned to you. sex that genital tunic when you're a man that genital tunic becomes the penis and the shaft and the glands and in a woman it becomes the clitoris and the clitoris actually then goes deep into the pelvis um just like the penis that has a shaft in the pelvis and then surrounds the vaginal canal, so the clitoris is as sensitive as a man's penis, so if you stimulate the clitoris like your penis is stimulated, then it will lead to orgasm and is probably the most reliable route for orgasm for women, so 85% of women need some type of climax stimulation to climax and many women have difficulty climaxing through vaginal penetration alone, that's not that they are broken or something happening to them, it's just that they don't and because the clitoral stimulation is so strong that it leads to a very reliable route to orgasm, now the way you stimulate it is very individual, specific but typically oral stimulation , vibratory stimulation, uh, manual stimulation, all those things can work, but that's where the communication comes. where, as the partner, ideally you would know what you like andI could tell you um or you could check if this feels good, this feels good, you like this is this, you know it or you know it, and that's again a challenge.

Because of the communication thing, we've talked about this throughout this whole talk, but that's really what's important now, the clitoris, like I said, goes deep above the vagina and around it so that people can still get stimulation from the clitoris through penetration, depending on how. Now you stimulate the other areas that are important for orgasm are the Gerogenous Zone, it's not really a place, it's a Zone and that's where essentially, if you look at the vagina on the anterior wall, which is the top of the vagina underneath from the urethra where the PE comes out about 2 to 3 centimeters and is called the gynecological zone, named after the person who identified it.

I think it's green house or something, but essentially that area is full of certain nerve endings, as well as the female prostate. or the skin glands, so those are areas that are quite sensitive and they use a different nerve, so the clitoris is invated by the pudendal nerve, the erogenous zone is invated by the hypogastric nerve, so a different nerve and then the cervix is ​​the last area where Sometimes women feel a lot of stimulation and that is stimulated by the vagus nerve, so all of these different areas can bring women to orgasm and they can be additive, so if you are By stimulating all three, you may have a stronger orgasm and the orgasm may feel a little different now people like to call it like oh, you're having a clitoral orgasm or a vaginal orgasm, it's all an orgasm, it's just a question of what stimulation is causing the orgasm and so I think ultimately it's really important for the easiest.

The reliable route to orgasm is cital stimulation, which is not traditionally stimulated properly through penile and vaginal sex, so it requires a little extra thought about how you are going to stimulate it and how you are going to please your partner and to get it. reaching orgasm and a lot of times, if you think about the time it takes to reach orgasm, in a man, the average duration if you look at the studies that have looked at stopwatches is like the female partner actually starting a stopwatch at the beginning of sex. and stopping it at the end when the man climaxes, is approximately 5.1 to 5.7 minutes.

In fact, UK men tend to last a little longer, which is an interesting concept, but what sex is men, men, men, from penetration to climax? of men, so when they do it, they basically measured not including foreplay, but if they measured, they measured like 15,000 people in many different countries and they asked the woman to take a stopwatch and start clicking when they penetrate him and they turn off when they climax and they have measured the time and it has passed between 5.1 and 5.7 minutes, that is the time it now takes for a woman when you look at the average time to orgasm for a woman, it is approximately 14 minutes and So you can imagine that if the entire sexual encounter takes place around the male climax and the man has this, as we've already talked about, in this post, Clarity like: I don't want refractory time, they won't want to do it. be more intimate if you don't prioritize the woman's climax or stimulate her before you start penetrating, then she probably won't orgasm, um and so on, and what's interesting is when you look at sexual encounters and you look at men and women having sex.

For the first time, the woman will have an orgasm 45% of the time, the man will have an orgasm 95% of the time, when you look at women having sex with women in a first encounter they both have orgasms 95% of the time, so clearly there is an educational disconnect. Women know what they like and what stimulates them and men don't understand the note. I feel totally attacked, not attacked, letting you know. facts I know it makes sense because yeah I think men are still struggling to understand again because of what you said we don't really get sex education so we learn this stuff from porn and obviously in porn they don't show it yeah.

I mean, there are usually not many women who have orgasms in porn, as it happens with men who have orgasms in porn, what is an orgasm and what kind of function does it serve, why do we have an orgasm and also when I say what is an Orgasm is a Orgasm is like a switch or it's like a spectrum, so it's a kind of spectrum. I guess I mean, let's talk about what exactly it is, so an orgasm is a moment in time that is combined with peak tension and then. a release and during that time you are completely unable to think about anything else, it is a very powerful pleasurable sensation and it usually happens, like I said, for 5 to 60 seconds, it can last and it depends on how you get it.

It is usually the culmination of stimulation over a period of time, even with a certain type of rhythm that is required to reach climax and that is different from person to person, so I can't give you the script on how quickly you need to penetrate or this. it's like what stimulation do you need to use, okay, that's the end of the conversation, okay, we're done here, so, yeah, because no one wants to talk about it, they literally want me to say like this, this is what you do with a instructor b c d, so, um, but Yeah, ultimately all of those things create this tension, so in the course of sexual stimulation you're reaching an ex-arousal phase where your body is changing, so In women, for example, you will see that the lips become a little redder. um, they expand in size like I said, the vagina gets longer and longer, um, from 3 to 6 inches.

I heard you say yes, about twice as much, yes, and it is different from the person, that is the average, so there is something like this thought. That's okay, if it's really really big, it's always going to be better and that's actually not always the case because not all vaginas can accommodate a really big phus um, but when you're having an orgasm, essentially your pelvic floor muscles tighten up. They're getting really tense and you're reaching this, you're basically reaching the top of the hill, you're getting a lot of climax and then your body is like climbing, climbing and climbing and up you're reaching like increasing dopamine and you're increasing. , so when you think about what's happening in the brain, your hormones are going up more and more and there's also an inhibitory pathway, there's a stimulatory pathway and an inhibitory pathway and then the stimulation pathway goes up, the inhibitory stimulation, you're basically trying to run to the top of this mountain and once the stimulation reaches the top then you have the orgasm and you release all this tension and during this time your heart rate is speeding up, your pupils are dilating, there are all these physiological changes, and then when you have an orgasm your muscles contract like I mentioned before and every 8 seconds they have a contraction, sometimes you will have involuntary phonation so people will know. moaning or screaming and sometimes it's not under your control like there's actually an involuntary component and then it kind of goes down and it's not necessarily a switch, it's kind of a climb up a mountain is the way I would describe it to times. it feels like blowing up a balloon with a small hole and what I say with a small hole I mean because if you stop it feels like some air is coming out of the balloon mhmh that's why I said the kind of things to do. be a rhythm, it must continue at a certain pace to achieve that climax because if it doesn't, then you can do it again, that's a very good description, you will lose that little bit of air in the balloon, okay, to increase female pleasure, okay, we need to understand the person we're dealing with of course, but the clitoris is a great way to orgasm, you're PR, lubes, MH, a lot of people feel like that's not natural, so in a way avoid it, but you're Pro lubes and you're Pro, so you schedule sex or you're Pro SCH time for intimacy scheduling time for intimacy, so because sex ads, like we talked about, add a kind of stress level in terms of how I'm going to say if I want to have sex, will I be able to get an erection?

Am I going to enjoy sex whatever it is? Are they going to reject me like all those things because you're still a human being and you might actually like being one? You stressed that day that you put on the calendar and said, "I can't, I can't find the right headspace to have sex, so if you're constantly ruminating or stressing about other things, you're not going to be able to have a good day." sexual encounter, in fact, they have looked at mindfulness in terms of how it improves sexual function, especially in women, but we have seen very clear data that having a mindfulness practice leads to better sexual function in terms of desire and other factors like arousal and lubrication and orgasm, but the biggest thing is desire and that's because if you can focus on what's happening during the sexual encounter, you can focus on what it feels like, how you're enjoying that sensation instead of thinking about it. yes I'm coming. you go to Climax and it's going to happen or whatever you're thinking about during sex because you're worried about how the other partner might react, then you're more likely to enjoy the experience, feel it, and then have a good experience. and subsequently have more desire for additional experiences.

We talked earlier at the beginning of the conversation about comparisons and how that can really destroy sex. Is there a disparity between how long we think sex should take and how long it actually takes? Yes, we all think so. lasts longer and when you ask people what the average time is and this is a difficult question because people think of sex as a complete encounter and when we do it scientifically we look at sex from penetration to the end of penetration and the Sex is more diverse, correct sex. It can include oral sex, anal sex and manual sex, any type of sexual stimulation, so when you think about the whole encounter, it can be very variable, some people want a quickie, others want to have this long, luxurious love-making scenario and It really depends on what's going on in your life, you might not have that luxury so I don't think about it again, it's not about hitting a certain benchmark or a certain number, it's really about quality. of sex, so if you have great sex and it takes 3 minutes, that's great, fine, but as long as it's great for both of you, right, if you're both like that, that's awesome.

I'm having great sex and it takes three minutes, okay, but how long do people think about sex? lasts on average versus how long it actually lasts on average yeah so I think most people definitely think it lasts longer so women tend to not know how long they think it lasts but what they want it to be is 18 to 25 minutes. the men's are a little bit shorter, maybe 12 minutes, but generally we all want it to last about that long, but you kind of lose track of time, so there's really no one there with the stopwatch knowing exactly how long it lasts.

In fact, I've had friends say to me like oh, I watched your video and now when my partner wants sex, I'm like, oh, it'll only take five minutes as I can. I can have sex with them like I used to in My head I used to think it would take a lot longer and I realized it takes less time and I don't have that stress of oh my God I'm going to have to waste like half an hour and I'm so tired like it's gone out the window because I know it's really not going to take that long, it's just that they've ever put people in a lab or whatever and I guess this goes back to what you said before, is there a average time? people spend having sex was that the 5 minutes you talked about 5.7 minutes 5.1 to 5.7 minutes depending on which study you look at and they looked at all of the Trade, so it's actually different in different countries, so when you look at like turkey it was like four minutes and if you look at the UK it was like 10 minutes so it's actually thank you so it's actually variable and that may be a cultural thing but ultimately the average is around five, which is interesting, so we want sex, women want sex to last between 18 and 25 minutes, ideally men want it to last ideally about 16 minutes, including the first one, but it actually lasts five five minutes, yes, that's good to know.

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This is a big step forward and there is nothing more. that is available even close to it in the market so to getlearn more and start your Zoe Journey visit zoe.com stepen you can use my exclusive code ceo1 to get 10% off don't tell anyone ok just for Guys we talked about sizes of things a second ago and we said we'd come back to this, so there are two types of sizes that people usually think about: vagina size and penis size. There is a myth in society that the more sex a woman has, the bigger her vagina becomes, that myth is true or false.

Fake, so the way women's vaginas get, if you want to say loose, is the term people use or they have a weak pelvic floor and that's from having babies. having maybe neurological conditions that affect pelvic floor strength having collagen disorders having um just from having a job where you're on your feet all day and you're like your entire body weight is on your pelvic floor, those muscles They can weaken over time. Over the course of your life, you may feel a little looser because those muscles may not be clenched as tightly, but it's not related to how much sex you have because, as we mentioned earlier, when you have an orgasm, you're actually strengthening your pelvis. floor a little bit like you're contracting those muscles so actually probably the more sex a woman has, her pelvic floor is probably stronger unless she's not, you know, but you know you add in having babies and stuff. , It is variable. but probably the more orgasms a woman has, the stronger her pelvic floor will be, but things like childbirth can cause the pelvic floor to loosen, weaken, yes, yes, so when it weakens, that's the cause of things like stress incontinence, so when a woman, um lifts something heavy or exercises or jumps or coughs or sneezes.

She may have a few drops of urine or a lot of urine due to a weak pelvic floor. It can also cause something like a prolapse, which is like a hernia. in the vagina, where the pelvic floor is so weak that now the vaginal skin and the organ behind it are kind of bulging and can cause discomfort and a kind of feeling maybe some dysfunction in the organ, but really mainly discomfort and so they are signs of weak pelvic floor, you don't know, not having a loose vagina during sex and we can do something to strengthen our pelvic floor, which is what Keegle exercises are, yes, it's more than Keel, I mean, Keel is he who has the most is the best.

PR of any type of thing that I have seen in medicine, but yes, it is a pelvic floor exercise, the keel is a pelvic floor exercise that serves to strengthen the pelvic floor and there are others, what is it? Basically, men never know it isn't. It's your fault that women know it, but they don't even know it, so what happens is there are those same muscles that we talked about before, and you're basically doing one rep, you're squeezing, contracting, and relaxing, just go to the gym. . You tighten and relax in a very similar way, you're squeezing those muscles and relaxing those muscles.

I can do this sitting now, yeah, basically, for men, what I tell people is that it's like the feeling when you're peeing and you stop the stream of urine, that's it. you're using those same muscles, so that's one way, another way to think about it is if you were trying to lift your penis off the ground without touching it, oh, okay, yeah, okay, and the third is you're trying to hold on. a fart, so all those different ways you get those muscles, the only thing I tell people is that they make a mistake when they do it, they don't relax enough, so it's like when you go to the gym. not doing rep after rep after rep, you're actually taking a break and you're letting your muscles relax before you do another rep, same thing, you have to squeeze for 5 seconds, relax for 5 seconds, right, you actually have to relax and just like.

With any exercise you don't want to overdo it, so I tell people to start lying down so that the only thing you have to focus on from a muscular standpoint is those muscles, as you master them lying down, then do them sitting up. and then as you learn to do them sitting down, you can do them standing up or do them anywhere but like. You're not going to be like there, you know, I remember the scene in Sex in the City where, as the character Samantha, she was like, "I'm doing my Keel right now", like yeah, you've probably been doing Keel for a long time and now you're so good at them that you can do them while brushing your teeth, but it's not like one day you'll wake up and be perfect at them like anyone else. another exercise, so that's an exercise, there are certainly other things you can do to strengthen. your pelvic floor traditionally things like yoga and pilates have some core work that also helps with the pelvic floor, but I really recommend that if you have problems you see a CU pelvic floor physical therapist, they are like when you go to You can do it just in the gym or you can go with the personal trainer.

They are like personal trainers for your pelvic floor. How do I know if I have pelvic floor problems? What are the symptoms? Like I said, the obvious ones. for women, leaks are, um, having prolapse due to weakness, in men, we often don't see as much, but like I said, you may notice that your semen isn't as forceful when it comes out, um, that's usually the sign most common secondary of a weak pelvis. pelvic floor there aren't that many for men, but in terms of a too high tone pelvic floor, what concerns us is that there are a lot of symptoms, it could be as simple as having lower back pain, it could be that you have pain in the hip could be that you are having pain with sex you are having pain with erections pain with ejaculation you go to the bathroom often you have to go you have to go you feel like you have difficulty emptying your bladder or you are um, very often, of suddenly, so it can be a vague variety of these symptoms and generally it's important to get evaluated to see if your pelvic floor is examined by a professional, whether it's a urologist or gynecologist, pelvic floor physical therapist, someone who can evaluate your pelvic floor if you have these problems because it could be pelvic floor, it may not be good, how do you evaluate it if I go to a urologist and say, listen, check my pelvic floor? on a man it would be a rectal exam and essentially that's what the pelvic floor muscles feel like so what I say to the young people that come in I said look I can examine you but I bet based on your story that you're a young man. , you've had these new stressors in your life, um, and you haven't and you're otherwise healthy, it's unlikely that you have a developing vascular condition and other things like that, it's probably likely, so if you want to avoid the exam . because it can be uncomfortable or I'll tell you that if you have pelvic floor dysfunction and someone does an exam on you, it's going to be uncomfortable, it's going to be potentially painful because they're putting pressure on those muscles that are already tight and it can be painful, that's how I tell people. like tomorrow you can hate me because she'll hurt you and you'll say what did she do during that exam and I'll tell them preemptively because she just gently pushes like she's pushing the pad on my finger, but that's enough. for a kind of C a strain of the pelvic floor muscle and cause pain wherever you want in the muscles of the pelvic floor muscles, so you can do it if you put your finger in the rectum if you push down on a man.

You're feeling the prostate and if you push on the sides at a variety of different angles, you'll feel different pelvic floor muscles, like the levator ani and the transoperative muscles, those muscles are the ones that are part of the pelvic floor. We can't feel all of them, but we can feel some of them, so that's where we feel in terms of the pelvic floor muscles, okay, because I was thinking that if we go to the rectum, I guess you have the glutes there too, which are on both sides, so your pelvic floor is actually a part of your core, but your glutes are further back, they won't be felt from there, but anyway, if you think about your pelvic floor you actually know that people think about your core like in your abs, but we know that in some way it encompasses your back, your front and even your pelvic floor is a kind of part of your core muscles, I understood you well, interesting, very interesting in um on the subject of sizes, so one of the most important things for men is penis size M and one of the big questions that men often ask is are there ways to increase my penis size.

In fact, there's a whole industry around penis enlargement pumps and all kinds of different things. It is possible to increase penis size, yes, so in terms of looking at the evidence, the safest and most reliable way is to use a traction device and these are devices that are essentially made to lengthen the penis, but they are also made to men who have something called paronis disease where they can develop plaque in their penis and a curvature, so there is a device that is actually made that pulls away from the plaque to help break down that plaque, so it has two uses, but Basically these devices are like stretching tissue over time, so the original traction devices that were studied would have to be worn 6-8 hours a day for several months to see a 2cm increase in length, now that may be enough. for some people they said yes I definitely want that and some people like you know what it may or may mean, 2cm is the average, some are going to be less correct so do you have time to do that? you want to do that, but there are newer devices now where they've studied them and they use them twice a day for 30 minutes and they've seen an increase in the duration of the penalty.

In general, they are quite safe. It's more about um, you. You may have some bruising just from putting the traction device on, and as long as you follow the instructions, you probably won't hurt yourself. The thing is that the penis pump does not have pumps, so pumps have not been proven to increase the penis. What is a bomb? It has a cylinder that you put your penis in and it uses a kind of vacuum technology to suck blood into the tissues and then you put, if you have problems with erectile function, then you would put a ring at the base of the penis to keep the erection uh, these don't help with length, they have looked at them in those cases, they have also looked at surgeries and different types of things to increase penis length and ultimately many of them already know this. a very high complication rate, um or risks that I would say are probably not advisable for most people, you know, I think in terms of penal lengthening, people always wonder why you would want to do that, why a lot of people poop poop from people who want to change the appearance of their penis and I've evolved in my way of thinking and saying, well, you know what this is a big part of, you know the identity of a man and how he feels about himself and I wish he would. we would have done. something that was safe and easy for men to do, like we had breast implants, but we're not there yet, so I just want people to be safe in terms of realizing what our limitations are right now and Things can change, you know.

As people become more interested in this area, the role it plays in our perception of what a normalized penis is, do you know any data on what size people think a penis should be versus actual penis size? Yes, yes, the majority. people think it should be around 6 inches, so like we said, the average is around 5.1 to 5.3 inches, so when you look at the data in terms of what people think, men They think it should be around 6 inches in terms of women, where we found that the data on what they prefer is quite interesting, so now that we're having more surgeries for trans men, one of the surgeries we do is a neo phallus.

We created a new phus and one of the types of surgeries that we do is to use a forearm flap, so it can be very, very long and very, very thick and in fact, they were doing these surgeries and they realized that some people actually couldn't have sex with it because it was too thick so I then wanted to see how we determine the correct size, length and girth of this neop fallis so we know that they can then have sex with it so What they did was look at the top, you know, the top. Five to ten sex aids or toys that women buy online and you know you can imagine that when you think about a dildo, they can go from one that you know to liking the biggest thing you've ever seen and the giri.

What you've ever seen is that you like a normal size, so when you have the option to choose as many as you want, what do you choose? So what they found was that women tend to choose the length of about 6 inches, but as you know you're not putting the whole device on, there has to be a handle or something, so it's probably about the sizenormal and the girth was also about the average male penis girth, so in general, women tend to want what is. average or around average, and um, interestingly, there is a product that is available called no, no, no, no, I'm not sponsored by them or anything, but essentially you, you, for women who have pain with penetration with men that are too good. endowed men actually use it so that all the phus doesn't come in during sex to make it more comfortable for the couple so we know that sometimes it can be really uncomfortable if it's too well endowed and I think ultimately um, while I understand that porn has made people feel very self-conscious about the length of their penis and I'm very sad about that because I think that, as we've talked about before, clal stimulation is the easiest way for women climax and no penetration is needed for that, so to have pleasure and give pleasure you don't need a big penis and in fact some women don't even care about the size of your penis, it's more of a social issue of the one we talked about, a joke of correct women. about it women talk about it I mean, you can't go, you know, even I accidentally made comments where I said oh, that's great, that like I have a big penis, I said, well, I can't believe it.

I just said that, I'm going to say it and say, oh my God, I can't believe that came out of my mouth of all people and I think it's so ingrained in our brain to say oh, I'd like to really celebrate. well endowed organs when it is actually not necessary and sometimes even painful, my penis will get smaller as I get older, so no, if you are healthy, in terms of how we maintain our penal health, your body does a very good job at try to maintain criminal health because over the course of a night men will have five to six erections over the course of the night and that will happen whether you have a sexual dream or not, whether you sleep certain way or not, it's because your body provides blood flow to the area periodically throughout the night, whether you're having sex or not, you're now getting a good flow of oxygenated blood to the penis if you develop other conditions where you can't get blood it flows into the penis like if you have high blood pressure, you have diabetes, you have heart disease and those arteries start to narrow and then you stop having nighttime erections and you start having difficulty getting erections.

Over time, the tissues can change and they can become what we call fibrotic and they can become a little less spongy and less elastic, so in those cases you can see a little bit of shortening. Now people will also see a shortening because they gain weight throughout their lives and as they gain weight, the penis is penalized. It is not shrinking, but the fat in the MS or the area just above the penis is enlarging and darkening the length of the penis. There is one of my penis sizes around that you know if I have big hands because I know these are not small hands, if I have big hands then I have a big penis or if I have big feet then I have a big penis Is there data to support this idea that the length of any part of my body is correlated with my penis YES, yes there is a study, it's a Japanese study where they looked at only Japanese men, so there are some limitations, but essentially they measured all of these body parts and penis length, and what they found was that nose length was correlated with penis length. length, not hand length or foot length, so how can I increase my nose length?

Yeah, but I thought it was really interesting again. Nothing you can control. These things are genetically determined to some extent and in fact you know we talked about some trends. and while we have seen semen rates a change in sperm quality over the last 50 years, we have also seen a change in average penal length over many recent years. I don't know the exact number, but 50 years and in fact they have seen that the penal length is increasing and they think that this is because the onset of puberty is changing and children are exposed to factors that make them go through puberty earlier and therefore they are more exposed to testosterone and are developing longer penises, I mean, something like that.

Interesting theoretical thing, I don't know if that's true or not, but more or less what the theory is. Yes, I actually read about that study that says that one study shows that the average penis size of men has increased over the last 29 years from 4.8 to 6 in mhm, that's pretty dramatic, that's huge, yeah, wait others 29 years old, you could be a Jesus Christ, but I don't think women's vaginal length is changing, so I don't know what that means, oh yeah, ah, yeah, it's interesting because you when we talk about vaginal length increasing as that someone gets excited.

You mentioned that it goes from about 3 inches on average to about 6 inches. The size of the flaccid penis correlates with the size of the erect penis, going from about 3.6 in flaccid to about 5.1 to 5.2 in erect, so what you can see that these two things are actually made for each other, yeah, they are, I mean. I think in general as if we are all, I mean, we are designed correctly, the most important thing we should do as a species is have children, that is, the goal of life is to propagate. our species and therefore it would make sense that we were designed to be able to do that easily.

Many people are undergoing this new procedure called plasia tag. Did I pronounce labiaplasty correctly? What is this? Why labiaplasty is essentially taking the labia uh manora and making them a little bit shorter or smaller depending on what your preference is and the labia come in all kinds of shapes and sizes, they are the inner lips of the vagina, so which sometimes come in all kinds of shapes and sizes. They will be crooked so one will be longer than the other, some will be longer, some will be smaller and we often see in porn manur lip really small so people will tend to feel like maybe they should look not like that now.

Everyone, some people really have discomfort, their lips are so long that they cause friction, pain or discomfort, in those cases it is absolutely reasonable, but just like people have insecurities about their genitals when they are men, women can also have insecurities about her lips. Women, so plas lips essentially make them smaller and more cosmetically attractive when women want that, but I think the important thing to take home is that they are so diverse that they are so diverse. Like your fingerprint, your lips are unique to you and there's no script for what it should look like, so I usually tell people that if that's something you want, that's absolutely fine, but again, this isn't It's not a pathology or something bad, it's something that you know is more cosmetic and there has been an 80% increase in labiaplasty surgery from 2015 to 2019, which is very misunderstood as you know as a man who doesn't.

I don't have a vagina. I've seen squirting in porn I've seen. I watch porn. I think it's important to say it. I think a lot of people watch porn. And in the porn I've seen, the woman spews this liquid. she comes out and says Seaman ejaculates or is it something else, what is it? And we should also try to make our partner cum. Yeah, let's talk about it, so this is important and really interesting. I just had a conversation with a researcher about this because it is very misunderstood and we still don't know, there have only been three or four studies looking at female ejaculation throughout our history, there are different types of fluids that the vagina produces, obviously there is a lubrication that is different and that can be very copious for some very not so copious for others uh that is a type of liquid the other type of liquid is female ejaculation now female ejaculation is similar to male ejaculation it comes from the skin glands that same female prostate is a small amount like a kind of sticky white liquid that women ejaculate and then they release that liquid and it's not like this big amount of liquid that you see in pornography.

The next type of fluid is squirts and squirts, it has been described as a clear, colorless, odorless liquid that is emitted from the urethra. When they looked at their tests, they discovered that there is what we call PSA or prostate-specific antigen now that we traditionally think of as men, but women's skin glands also produce it now. People say: is it true? That's the big question, and the one where they looked at the analysis they found that there was dilute urine and then another study thought it was fine, they scanned people before they squirted and after, and they scanned. their bladders to see if the amount of urine changed and they said yes and now it's urine but what we really don't know and what is the limitation that women never know when they squirt like they know.

It's not urine, so if you talk to enough women who are dripping, they'll tell you that you know it's not urine. I'm sure it's not urine, but where does that liquid come from? That's where the question arises and, for example, if it is not urine. It comes from the urethra like it doesn't make sense, so this is Dr. Barry Korak, who has done a lot of research on the orgasm. He said you know it can be water imbibition, so when you think about a liquid that fills the walls of the uterus. and the vagina during or during the arousal process and that can be during climax when you actually have contractions of that fluid from those organs that occur during climax and that can actually release this fluid.

I don't know, I think jewelry remains out. I don't think we have a conclusive answer because the studies are not perfectly designed. We have a closing tradition on this podcast where the last guest leaves a question for the next guest without knowing who they will leave it for. And the question that remains for you, if there was a message that you would want your life's work to communicate to the world, what would it be and why is my message that sexual health is health and that we must prioritize our sexual health and educate. our young people about sex and why because I think the impacts of having negative sexual health or negative sexual encounters can be so dramatic in terms of physiological outcomes, interpersonal outcomes, work productivity, I mean, it can be far reaching and if we are capable of educating. and Empower people, we can change the world Dr.

Reena Malik, thank you so much for your time today and thank you so much for shining a light on a lot of topics about sexual health that I have never understood or been able to discuss before and I think these conversations are incredibly important because As you say, sex permeates every facet of our lives and I think sometimes people wonder why I spend so much time on the show talking about sex when this is called Diary of a CEO, but it is. because it's the same reason I spend a lot of time talking about health and the brain and neuroscience and relationships and all that because I've learned that even though I'm a CEO I'm a business person all these things like you I said it feeds my ability to be a CEO and what a CEO is.

A CEO is a human being. A CEO is simply someone who has a kind of high-initiation career. We all have high intensity races and we are these. multifaceted objects, but some parts of these multifaceted objects are still in the shadows because there's stigma and shame and there's not a lot of education around them and if I think about my career as a whole, um, sex and my relationships have been that huge. um. A big part of this is that once I focused more energy and started investing in all the other parts of my career, I improved all the other parts of my life, I improved my health, I improved my performance at work, I improved my anxiety levels, they dissipated and that's why I think these conversations are incredibly important and the work that you've done both in your kind of clinical practice and what you're doing on YouTube, which I'll link below so everyone can go and seeing it, allows this information to be accessible to everyone, even those who don't have the money to go drive, like you said, go see a therapist.

I think it's incredibly important work and I'm glad you're a world champion and a force behind it. So thank you very much on behalf of me, my team, but also everyone who has consumed your work and derived value from it. Thank you. I would just say that I always tell people this because I mentor a lot of young medical students and I always tell young women that The number one most important decision you are going to make is who you choose as your partner and that is because That person, whether emotionally but also sexually correct, and how they support you in your life, will determine whether you are capable of success. or not and I was talking to another woman and you know she was like my husband was wonderful.

I said, "I'm not surprised. I said you can't be a woman."successful and a happy, well-adjusted and successful woman unless you either know that you are very happy being alone or you have an excellent partner who supports you because if you have a toxic partner at home it is not going to work amen thank you oh