Sex Expert: What Women Actually Need To Enjoy Sex

Is there a way to enlarge the. >> So, you can put your penis in this. device. They've actually done research. on this. So, 30 minutes twice a day and. it does show improvements in length. about 2 cm. >> Tada. >> And that's not all. So, they actually. did a study on pistachios where guys at. 100 g of pistachios [music] every day. and they saw a decrease in erectile. dysfunction because if you're not having. erections now, you're no longer getting. blood flow to your penis and it will. shrink over time. And the same goes for. women with their clitoris because it's. the same type of tissue. But also, when. you look at people who have sex once a.

week, they live 49% longer than people. who only have sex once a year. >> 49% longer. >> Yeah. And for every 100 orgasms men had, they lived like 13% longer. >> Be right back. [laughter]. >> Dr. Reena Malik has become the world's. most watched urologist. [music]. >> After sharing everything you need to. know about hormones, sexual health, >> and how to [music] have better sex based. on the data. So, how can you have the. best sex possible? So, there's four main. pillars of sexual health. So, pillar one.

is fuel. So, how you nourish your body, and it's a huge part of sexual activity. And then pillar two is strength. When. people think about strength, they always. think about going to the gym and lifting. weights. But it's much more than that. So, when you look at the data, any sort. of cardiovascular exercise is going to. improve sexual function. It's going to. improve blood flow to the penis and to. the clitoris. And then also if you do. 150 minutes a week, it is the same. amount of improvement as you would see. when you take a medication like Viagra. And the other part of it is the pelvic. floor. It's under evaluated, under.

discussed, and we'll get into that. But. pillar three is environment. So things. like stress, [music]. sleep, and endocrine disrupting. chemicals. For example, they looked at. data on men sleeping 5 hours a night. versus 8 hours a night. Guys who sleep 5. hours a night, their testosterone drops. by 15%. Yeah. >> And then the last of the four pillars. that we don't talk about enough is, and. that's still important, >> I want to talk about morning erections, squirting, clitorol stimulation, and. certain positions that are going to. increase the probability that my partner.

has an orgasm. >> Let's talk about all of that. First of. all, >> this is super interesting to me. My team. given me this report to show me how many. of you that watch this show subscribe. And some of you have told us, according. to this, that you are unsubscribed from. the channel randomly. So, favor to ask. all of you. Please could you check right. now if you've hit the subscribe button. if you are a regular viewer of the show. and you like what we do here. We're. approaching quite a significant landmark. on this show in terms of a subscriber. number. So, if there was one simple free. thing that you could do to help us, my.

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[music]. Dr. Reena Malik, if somebody was to come. up to you in the street, having watched. your videos online, and they were a a. follower of the content you've produced. over the last couple of years, if you. had to guess the question they would ask. you, because it's probably the most. frequent, popular question you get. asked, what do you think they would say? >> They would say, "What can I be doing. right now to improve my sex life?". >> Who would be asking you that question? And why do you think they'd be asking.

it? >> I think everyone can agree that sex is. something we enjoy. It's something. that's important that we want to have, right? And there is um a desire to have. good sex or feel like maybe you're. missing out on something that could be. even better. So, how can you have the. best sex possible? Because you hear all. these people talking about amazing sex. in the media. You might see it on. pornography. You might feel like this is. something amazing. Why am I not having. that? I want that. Right. >> So, on that point, you said it's obvious. that it's important. I think it appears.

to be increasingly not obvious that it's. important because when you look at some. of these stats and I'll throw this graph. that I've I found here up on screen and. it shows that people are becoming more. sexless especially young adults between. 18 and 30. This graph is pretty stark. >> Mhm. Think about 50 years ago. There was. no cell phones. There might be some TV. programs but there was ads in between TV. programs and there was only certain TV. shows you could watch at a certain time. that you enjoyed and then there was. nothing to watch. There was no email.

So, you went to work and you came home. and there was really not a lot of. communication between you and your. co-workers or your job. They made dinner. with their family. They hung out and. then maybe they watched a program or two. and then they lied down in bed. They. didn't have a phone to scroll on. They. didn't have anything to keep them up. And so then they were like next to their. partner and maybe they're talking, maybe. they're cuddling. And so there was more. like opportunity and space for sex, right? You it was a thing that you did. for enjoyment, for pleasure, for fun. Now we have all these distractions that. keep our mind away from sex. In order to.

enjoy sex, you need to have space for it. to be able to enjoy your partner and. feel like you want that, right? And now. we're sort of [snorts] there's not as. much room for it. That's one. Two is. younger people, how are they dating, right? How are they meeting each other? They're meeting each other through apps, through um DMs. And so they're not. actually like really having these deep. meaningful connections. there have. there's a big hookup culture. There's a. big like fling culture. And imagine.

first time sex for most people is not. great. You don't know your partner. You. don't know what they like. And you may. not be able to express what you like. You're never taught how to talk about. sex, right? So you don't know how to say. like, "Hey, I like it like this." And. you may be self-conscious cuz it's your. first time. So you have like mediocre. sex or bad sex. And they're like, "Well, I don't really want that." And there's. just no like follow through, right? There's there's not a lot of um. education on what sex should look like. like the only education people are. getting are from often erotic films and. so they're seeing sex that's not real.

that's curated and they're trying to. emulate that and that's not pleasurable. for most people and younger people these. days are um actually having a rise in. more what we call rough sex so choking. has become very very common as common as. like they call choking almost like. vanilla sex so young people if you look. at data like 60% of women and I think. 20% of men have been choked during sex. of that age group, like college age. group. And of those people who get.

choked, 20% have been choked 25 times or. more. Now, I think it's fine if you're. into that, but I can't imagine that that. many people are into choking. And. there's data to support that. So, when. you look at qualitative data, and this. is by uh Debbie Herbick, she's a sex. researcher, and she did qualitative. research, and she asked people like, "What is it like? Do you enjoy being. choked? Tell us about it." Right? Women. were like, "Yeah, it's okay. Sometimes. I'm scared because my partner is big and. strong and I'm, you know, smaller and. they have big hands. Sometimes it's fine. and sometimes I don't really care for.

it, but like it's just a part of sex. It's just as normal as as kissing, for. example. And so if you're having sex and. you're doing things just because you. think that's what your partner wants or. what it should look like and you're not. enjoying it, well, that's not going to. be sex that you want to have. that point. you said about the the lifestyles we. lead and how that might be impacting our. sex lives I thought was really. interesting because we don't talk enough. about this but when you look at some of. the data on this demographic um you know. people 30 and below around that age the.

extreme outliers are spending 8 to 10. hours on their phones on social media. and on the internet and roughly about 15. to 20% of young people describe their. usage as almost constant effectively. scrolling during all waking hours while. they're eating, while they're in the. bathroom, and before they go to sleep. So, and I was wondering from a dopamine. perspective if there's correlation. between these like dopamogenic. activities that are now like hijacking. our lives, whether it's short form. videos on social media, whether it's.

pornography or food, whether it's having. an impact on what then happens in the. bedroom and our performance in the. bedroom. >> If you think about what you need to have. good sex is you need to be sort of in. the mind space for sex. And if you're. constantly like hijacked by all these. other things, you're never like really. getting in the mood, right? You're just. like, "Oh, I'm going to be turned on. when I see my partner and we're going to. have sex and it's going to be over." And. it's just really a mechanical thing at. that point, right? You're not actually. you're just trying to get an orgasm.

You're not actually like spending the. time to enjoy and to experience that. fully because you're just so like you're. just your brain is always doing. something else, right? because people. are constantly scrolling like every 60. seconds there's a new video, there's. something else. And so it's really hard. to focus. And so that can translate to. the bedroom where you're like you're. having sex, but your brain is somewhere. else thinking about something else you. saw or something you have to do or. something you want to see or something. you want to look up, whatever it is, but. you're not really in there in the. moment. You're just going through the.

motions. And so I think that's really. where the challenge is is that people. are becoming increasingly distractable. I find it really hard, I got to be. honest, to have sex if I've had like a. really really busy day or if I'm really. really thinking about something. I. almost have to I have to like. intentionally create quite a lot of. space. >> Exactly. >> In order to be able to be in the mood. >> Yeah. Be aroused, right? It takes like. time and energy. I think I appreciate. you for saying that because a lot of. people think that men are just ready to. go at any moment and that's not fair, right? Because everyone needs time to be.

aroused. It's not just instant for. everybody, especially when you have a. lot of work stress or life stress or. other things going on. It's actually. like you have to make time and space for. it. >> Yeah. Because as a man, you got to get. an erection. And I I always think that. an erection is a consequence usually, especially when it comes to sex. And I'm. not talking about morning glories here, but an erection is a consequence of like. a story. >> You use the word aroused. >> There's like a story in my head which. makes me go, "Oh, that's kind of hot.". >> Yeah. You need something. You need some.

stimuli, right? You need to think about. something, see something, smell. something, feel something, right? You. need to just be together and and sort of. allow yourselves to be intimate before. that sort of desire and arousal come. together. >> And for me as well, it's not just touch. like that doesn't necessarily for me, it. really is quite like a psychological. thing. I was wondering if this is. there's any data around this or I mean. just even anecdotally like people get. aroused in very very different ways, don't they? >> Yeah, absolutely. I mean some people um.

are very like visual so they you know. they see their partner and they get. aroused very quickly. Basically when you. get aroused you need to be in a. parasympathetic nervous system state. So. in order to get an erection you need to. be in the state which is like rest and. digest. So if you're stressed if you're. thinking about other things if you're. essentially on the go you are not. allowing your nervous system to calm. down. And so for some people that's a. whole bunch of different things. Some. people can switch more easily into that. state and some people need more of like. uh you know to feel either mentally.

stimulated or they need to have some. associations like it might be like they. need a certain scent, they need to like. relax their body, they need to like go. take a bath, whatever it is, but some. people need different things and knowing. what that is for your partner is super. important, right? Because then you can. incorporate that. Everything is. scheduled in our lives, right? And then. you're like, "Oh, but now sex is like. the last thing on the schedule, right?". And like I don't even think about it. Like, "Oh, okay. Now, yeah, maybe let's. have sex." But it's like, if you. actually make time to be intimate, allow.

yourself to be in that brain space, be. together, that's when it can actually. happen. Especially when you've been in a. long-term relationship, it doesn't come. as easily like spontaneously, which we. call spontaneous desire. It it comes. more as a response to these other cues. that allow you to feel desire and to. feel aroused. H I also think I was thinking about a. previous relationship I had where on the. days where I'd been like working very. hard and I was like tired or stressed or. I've been traveling and I was jetlagged.

I think there was also because I didn't. see this person often there was also an. expectation that when I did see them we. were going to have sex. >> and um that was that was very hard. because actually the expectation of it. stressed me out more. >> Yeah. And that can happen like if it. becomes the elephant in the room it can. become a little bit heavy which then is. sort of counterproductive to performance. >> and this is you know sort of a variation. on performance anxiety. So when you feel. like you have to perform on demand and.

maybe you're worried it might not happen. it creates this vicious loop right so. you may maybe have trouble with an. erection or maybe it's like I I'm. expected to have sex but I really can't. get there mentally. whatever it is. Now, you're thinking about that, right? And. then you're with your partner. You're. like, "Oh my god, am I going to have. trouble?" You're not enjoying the. pleasurable sensations or the visuals or. like feeling each other. You are. literally thinking in your own head. about how you're going to respond. And. then that anxiety makes it so that you. can't get an erection or you can't be. aroused. And so now you're like anxious. and you're not focused. You're almost.

spectatoring. You're just watching. yourself have sex. You're not actually. like in the moment. So then, you know, you have a negative outcome because when. you're stressed, your sympathetic. nervous system is on, right? You can't. really get an erection or you can't. really get aroused. And so then you're. like, "Oh man, now I've let my partner. down. Now I haven't performed," which I. hate that word, but like performed the. way I should or or I'm expected to. And. now something's wrong with me. And now. that just keeps going in a vicious. cycle. >> Have you spoken to people that have. experienced this?

>> Absolutely. >> It's common. >> Very common. I tell people anytime you. have problems in the bedroom, it stays. with you. >> So, how do you break the cycle? >> Yeah. So, I tell people when you're with. your partner, take the pressure off um. penetration. Just explore each other's. body. Do what's called like sensate. focus. Like explore the rest of your. body. Figure out other arogynous zones, other things that can turn you guys both. on that don't involve erections and. penetration. And then once you realize. you're focused on that, you're really.

like exploring, enjoying, playing, you're having a good time, and you're. not thinking about your erection, now. you'll notice, oh, the erection just. comes, right? And then once you get to. that point, then you can start even. touching genitals, but still hold off on. penetration. And then after you've. realized like the genitals are, you. know, it's always working the way I want. it to. I'm not thinking about it. I'm. not stressed. Then finally, you can then. introduce penetrative sex again. So, it's just sort of like a gradiated sort. of slow advance into um you know, having. sex again, but now kind of focusing on.

being more present and mindful and. enjoying those sensations. >> I think a lot of people will be able to. do that, but there's also a big. contingent of people that just avoid. sex. >> Mhm. >> It's it's a sore subject in their. relationship for whatever reason. Both. partners don't know how to communicate. They haven't got the tools to talk about. these kind of things openly and. honestly. Do you see that a lot as well? >> Absolutely. I mean, what do you hear in. this regard? >> So, I think it's really sad. I see. people come in and they're like, I ask.

every patient like, "Are you are you. having sex? Why not?" Right? Because. sometimes they'll say no. And most. doctors will be okay. But I always say, "Why not?" Right? Why are you not having. sex? Is it because you're having an. issue? Is it because you're having pain? What's going on? Right? And often times. I'll hear from people that my partner is. just not into it and I just sort of gave. up and I'm just we just don't have sex. anymore. You know, for me that's a red. flag because sex is a huge important. part of our lives. It is a way we. connect with another human being. It's.

also telling that things are working. really well. So, when you have good. sexual function, meaning you get an. erection well or you get aroused well. and you have a good orgasm and. everything feels good, that tells me. that, hey, you've got great blood flow. to your genitals, your nerves are. working great, your hormones are sending. signals, like all these things are good, right? But also, sex is more than just. the act of sex. It also helps you live. longer. So, there's been a few studies. looking at sex and longevity. And.

[snorts] when you look at people who. have sex once a week compared to people. who have sex once a year, the difference. in all cause mortality is 49%. They live. 49% longer than people who only have sex. once a year. >> 49% longer. >> Yeah. Yeah. >> Be right back. No, I'm joking. [laughter]. >> So, and but even if you're doing like. less than once a week, but more than. once a year, it still improves your. longevity. There was actually. interesting study in 1997, I think it. was, where they looked at the number of.

orgasms men had, and they found that men. who had for every hundred orgasms men. had, they lived like 13% longer. They. had a 13% increase in life expectancy. And so, it was really interesting to me. just just showing you that like this is. not just an act of pleasure and fun. It. is obviously, but it's much more than. that because people who are having sex. clearly have better health and there. this connection with people. I mean, loneliness is a big issue right now. The.

the WHO made loneliness like an. epidemic. So, they've said that. loneliness is as bad as having like 15. cigarettes. And so, sex is a way to feel. connected to another human being. >> On that data, we're not saying that it's. the sex itself that's causing people to. live longer. We're I guess it's it's. hard to establish causation in terms of. >> Yeah. It's not necessarily sex, but. they've looked at like they try to. control for other things like age and. coorbidities and all these studies and. um it's also like sex is a. cardiovascular workout, right? For many.

people is a cardiovascular workout. You. are getting a phys physical physical. activity with your partner. Um you are. increasing your heart rate. You are. doing these things that are also good. for your body. And the fact that you're. able to have sex, right, tells me a lot. about it, right? You're you're able to. hold a certain position. you're able to. u maintain this level of activity. without getting short of breath, right? Like these are things that having sex, you know, keeps you healthy to some. degree. >> If I want to make sure that I have great. sex, what are some of the foundational. things that I need to be thinking of in.

terms of my lifestyle? >> Yeah. So, there's four main pillars of. sexual health. I like to think of it. like your sexual health is your house. And these pillars are the foundation. And if you don't have the foundation, it. doesn't matter what else you do. Um, you. can try to do everything else to patch. up your house, but it's always going to. break again because the foundation's not. there. So, you've got fuel, and fuel is. how you nourish your body. A lot of the. data I'm going to talk about is about. men because there's just a lot more data. on men and sexual health, but that. doesn't mean that the same things don't.

apply to women. There's just less less. robust data on it. So, when you talk. about fuel, the Mediterranean diet is. the most studied diet. So, including. things like healthy fats like avocados, leafy greens, nuts, and we're going to. talk about nuts in a little more detail. These things are super helpful. And. obviously having lean proteins, having. an abundance of fruits, which we're. going to talk about as well. There's a. study called the Health Professionals. Follow-up Study. They look at 20,000. men, and they saw that men who adhered.

to a Mediterranean diet had a 22% lower. risk of erectile dysfunction. So what. [clears throat] specific things in that. diet, right? People always like, "What. are the superfoods I need to have?". Almonds are great, but pistachios, they. actually did a study on pistachios where. they looked at 100 grams of pistachios. Guys ate 100 grams of pistachios every. day and they saw a decrease in erectile. dysfunction. >> So pistachio nuts will make my penis. harder. >> I mean, so I always say like I don't. love to talk about superfoods because. then people like, "Oh, I just got to eat. pistachios [clears throat] and it's all. good, right?" It's it's part of a whole.

diet, but certainly having nuts because. they have great omega-3s, they have. healthy fats. These are the reasons that. they they really sort of improve diet. >> Fruit um anything that has sort of. flavonoids, so like colorful fruit like. blueberries, citrus fruits, um lycopine, which is red fruits, all of these things. improve antioxidants and also have been. shown to reduce the incidence of. erectile dysfunction. So having stronger. erections. specifically blueberries. actually came out to have I think. something around 20% also improvement in.

erectile function when you're eating. blueberries regularly. So [snorts] lots. of I think things in the diet that can. be helpful. Also fiber is one that we. don't talk about enough. When you eat. fiber in your gut it converts to short-. chain fatty acids. These short- chain. fatty acids then sort of have these. endothelop protective mechanisms. They. protect the blood vessels. They make. them healthier. And so when your blood. vessels are healthier, you get better. metabolic health. So you get less. diabetes, less high blood pressure, less. high cholesterol. And these all of these.

things together improve erectile. function. >> So I think making sure that you meet the. criteria for fiber, which is 38 grams. for men, 25 grams for women, um, is. really really important. And then. obviously managing your calories and a. maintenance, right? because we don't. want to gain weight because excess. atapost tissue or excess fat also puts. you at higher risk for erectile. dysfunction and other sexual. dysfunctions. Next we have uh strength. All right.

So there's strength where we think about. cardiovascular and resistance exercise. but there's also pelvic floor strength. So we'll start with cardiovascular. exercise. The one study that's quoted. very often is 150 minutes of exercise of. cardiovascular exercise moderate. intensity. when you look at the. improvement in erectile function scores, it is the same amount of improvement as. you would see when you take a medication. like Viagra. So, literally, if you do. 150 minutes a week, you are getting the. same improvement as you could get with a.

medication potentially. And so, I tell. people like, look, if you don't want to. take a pill, this is a great way to. improve sexual function. Now, you might. say, okay, well, I, you know, maybe. you're listening and you have heart. issues and you can't really do moderate. intensity exercise. They actually looked. at that too. So there was a group where. they looked at men who had heart disease. and they weren't really able to do. moderate intensity exercise. So they did. like a 5minute warm-up. They did 20. minutes of walking and 5 minutes of a. cool down. And with this supervised. protocol, they still improve erectile.

function by 70%. So it's all relative to. where you're starting. But any sort of. cardiovascular exercise that's above. what you are capable like what you're. doing now is going to improve sexual. function particularly erectile function. cuz it's going to improve blood flow to. the genitals going to improve blood flow. to the penis. It's going to improve. blood flow to the clitoris for women. So. that's where cardiovascular exercise is. so so important in terms of resistance. exercise. I know these little weights. are probably not sufficient for doing. much, especially for men, in terms of.

improving um muscular health, but. obviously we're not going to bring like. really heavy weights to the table here. [laughter] So, one, we know that. resistance training is significantly. correlated with testosterone. So when. you do heavy resistance training of your. large muscle groups, so like your lower. extremities, your glutes, you're doing. like Olympic deadlifts, squats, that. sort of stuff, you actually see. improvements in testosterone. Now, it's. not going to be like you do it once and. you get this sustained improvement, but. continuous sort of regular resistance.

exercise improves testosterone. There's also data that shows that when. men do resistance exercise to maintain. muscle mass. So, we know that muscle. mass decreases about 7% every decade of. life after around 40. When you maintain. it through resistance exercise, they're. three times less likely to have erectile. dysfunction. >> Oh, really? >> Yeah. So, they maintain erectile. function, they maintain sexual desire, they maintain um satisfaction with sex. >> I read a quote yesterday that said. muscle is medicine. And I thought,

that's really true based on everything. I've learned on this podcast around, you. know, like glucose control and and. testosterone. And now you're telling me. about your sex life. >> Yeah, it is. I think people push back. because they think like, why should I. have to go to the gym? But our lives. have changed. We sit at a computer or we. sit at podcasts or we sit all the time. We're not moving. We're not doing manual. labor, which is what a lot of our. historic history is, right? doing manual. labor, farming, doing things outside,

being physical, and we're meant to be. physical. We're meant to lift heavy. things. We're meant to move our bodies, and we're just doing less and less of. it. >> So, I think it's so important. Um, the. other thing is we want to prevent. sarcopenia. So, sarcopenia is muscle. loss. And when you have muscle loss, um, that also increases your risk of having. sexual dysfunction. >> What about the pelvic floor? Like, how. does that come into this story of. >> Oh, yeah. So, we missed that part. So, um, the pelvic floor, here's your. pelvis, right? It's this bony structure.

where all your organs live. This is a. female. So, I'm taking out the, uh, internal structures, which is the. uterus, the rectum, and the bladder. And. so, that's what sits inside the pelvis. And so, you can see this bowl of muscles. here, right? Interesting. I've never. seen. >> And you can see them from the inside, and you could see them from the outside. That's your anus. And in this person, there's a vagina. So, that's the hole. for the vagina. So you can see that your. anus and your vagina run through the. pelvic floor. And in men, your penis. runs through the pelvic floor. And so. this, let me see if I can show you on. this model. In this model, you can see.

they kind of show you the muscles here. on the side. >> Yeah. >> So these are your pelvic floor muscles. that are around the penis and the anus. >> Okay. >> Okay. These structures are very. important for a variety of things. um. they attach to your bony landmarks here, your hips, your sacrum, your pubic. symphysis. They attach to all these and. they sort of just work in the background. for most people. How they affect your. sexual function is when you orgasm,

these muscles contract and release at a. at a rhythmic contraction of8 seconds. And so you may feel that, right? There's. like this pulsing feeling when you. orgasm. And that's these muscles sort of. doing that. And when men ejaculate, the. pelvic floor muscles are contracting to. help shoot the ejaculate out. They. squeeze when you need to keep things in. So they'll keep urine in, they'll keep. um your stool in, and they relax when. you need to pee in, when you need to. defecate. >> So when you're trying to hold a wee, you're like tightening your pelvic.

floor. >> Correct. Correct. But these are also. responsive to stress. So, just like. people get TMJ where they get tense in. their jaw cuz they are stressed and they. like sleep at night and they clench up. their jaw. They don't really know. they're doing it, the same thing can. happen. These muscles can get very tight. or they can get misaligned. So, say you. have a hip injury or say you have a back. injury, the muscles can compensate by. tightening up. And so, a lot of people. unknowingly have tension in these. muscles and it can present in a multiple. different ways. It can present with back.

pain. It can present with constipation. It can present with urgency frequency. because remember your bladder is sitting. right here on top of these muscles. So. when the muscles are tense, your bladder. is feeling like there's something. something activating it. And so it's. like, oh man, I got to pee. That means I. have to pee. This tension is telling my. bladder I have to pee. But it's really. that your bladder is not that full. It's. that these muscles are telling you to do. that. You can also have trouble peeing. because you can see that your urethra. goes through here. And if the muscles.

are really tight, sometimes it can be. difficult to urinate because it clenches. off the pee. And then with sex, it can. cause pain. If they're really tight, it. can prevent blood from getting to the. genital organs. So for men, they can. have erectile dysfunction. For women, they can have difficulty getting orgasms. or difficulty getting arousal because. they're not getting blood flow to the. clitoris. Sometimes they can also cause. premature ejaculation in men. And so. these muscles are so important and all. we hear about is keigull and keigull are.

exercises to strengthen these muscles. But keigull are good when you have a. normal pelvic floor. Meaning like. there's no tension. It's completely. normal. It's acting normal. You're not. having any symptoms at all. But if you. have any of the symptoms I talked about, doing keles might make it worse because. you're now tightening muscles that are. already tight. >> We also talked about pelvic floor. relaxation. Doing exercises to. specifically relax these muscles. So. that can be diaphragmatic breathing. That can be doing like a figure four. stretch. That can be doing happy baby.

pose which are yoga poses or child's. pose. All these things can sort of. stretch and lengthen these muscles so. they can learn to relax again. Now when. it's really bad, you have to go see a. pelvic floor physical therapist who can. really work with you to identify which. of the muscles are maybe more. dysfunctional and maybe work. specifically on those. Um but I think. it's it's so important. that's under. evvaluated, underd discussed when it. comes to sexual function. It's a hugely. important part of sexual function. >> How many people are struggling with.

these issues, specifically the like. erectile dysfunction issues and what age. are they? >> Yeah. So, it starts early. I think. there's always been a sort of a. disconnect where we think young guys. don't have this or if they have it, it's. all in their head. That's not. necessarily true. Many young men do. develop erectile dysfunction because of. biologic factors, but the data is really. robust on older guys. So above the age. of 50, we see 52% of men having erectile. dysfunction, which is. >> 52%.

>> And it goes up 10% every decade. So 60%. of 60-y olds, 70% of 70 year olds. So. erectile dysfunction continues to. worsen. This happens because one, you. know, our blood vessels get older, they. get stiffer, they're not functioning as. well as they should. And we're seeing. also a rise in all these other comorbid. conditions like diabetes, cholesterol, high blood pressure. All these affect. how healthy your blood vessels are. And. so with these, they see the problem in. their penis or in in women's case in.

their clitoris before they see heart. disease or strokes or brain issues or. dementia. And I think this is worth. pausing on which is a erectile. dysfunction problem is a often a symptom. of a cardiovascular issue. Right. >> Yeah. We call it a canary in a coal. mine. So it is like telling you that. something bad is coming. So the data. would support that when you have. erectile dysfunction if it's because of. an organic reason, right? not. psychoggenic but most people I think. have a combination of both that within 3.

to 5 years you will start developing. issues with your heart and so it. precedes those issues and if 7 years. later 14% of those guys will have a. heart attack and so it's really an. opportunity sexual problems are an. opportunity to look inside to figure out. what's going on and to investigate and. to change your life. >> and when you say erectile dysfunction we. should probably define what that means. because there's going to be a lot of. guys sat at home now thinking, "Oh my. god, like my penis is a bit softer than.

usual.". >> Yeah. So, erectile dysfunction is. defined as the inability to maintain an. erection that's sufficient for. intercourse. So, you can get an. erection, but it goes away before you. ejaculate or climax. >> And so, that's typically and I think. it's really important to differentiate. that from something like premature. ejaculation where you climax too soon. So, you ejaculate before you're want to. Uh, but that doesn't mean that you have. a problem maintaining your erection. That's a whole different process. >> I've got a friend, people are gonna.

think I'm talking about myself because I. use that phrase a lot. I've got a. friend. He's um he's almost 40 years old. and I've heard him say on several. occasions that he's lost his erection. during sex. Is that erectile. dysfunction? But what if he can keep his. erection watching porn? >> Well, so that's more multiffactorial, right? So I think if you lose it once or. twice, right? Most guys will have an. issue where they lose an erection at. some point in their life. I think the. important thing is not to catastrophize. It's a problem when it becomes a.

routine. Now, if someone is telling me, "Hey, I can watch porn and maintain my. erection, but I can't with a partner.". There's multiple different reasons for. that that could be at play. One is that. there's no pressure, right? You're by. yourself. You're watching porn. There's. no pressure of performance. There's no. anxiety of performance. So, that may be. part of it. Other thing may be that that. level of arousal that you're getting. from porn. If you're watching like let's. say the same kind of porn every time, you're masturbating the same way every. time, maybe using a firm grip or some. people will masturbate like uh facing.

the bed or um you know against hard. objects. And so that. >> against hot objects. >> Yeah. Like the their fist or something. And so that u can't be replicated by a. person, right? You can't replicate those. behaviors by a vagina or a mouth. If you. become habituated to a certain thing. that turns you on and that's the only. thing that really gets you going and. that's that's something that you can't. really get with your partner, then it. will be difficult to reach the level of.

arousal that you need to get an. erection. >> Okay. So, two questions then. So, >> that doesn't count as erectile. dysfunction. If you can get an erection. watching porn but can't get it with your. partner. >> Yeah, it may or may not be. So, if you. wake up with your morning erection, that's great. That's a sign. That's when. there's nothing else at play, right? You. are just that tells me that your body's. functioning well. You've got good blood. flow, good uh good hormones working, got. a good amount of testosterone, and your. nerves are working well, and you're. getting a good morning erection. Now, morning erections or nighttime erections.

are normal, and they're healthy. So, when you're a young boy, you get. actually like erections three to five. times a night, and they can last up to. 40 minutes long. So you can spend a lot. of your night with an erection. When you. get older, like in your 40s, that drops. to about half the time. So maybe. erections are a little shorter that they. maybe max out at 30 minutes, but. sometimes they're shorter. You should. still be getting three to five erections. at night. You won't know all of these, but typically you wake up with a morning. erection. And so if you're not getting. morning erections, that tells me that, hey, there's something going on that we.

should address. And on your other point. about how you masturbate impacting your. sex life, I imagine that applies to men. and women. >> Absolutely. >> And are you saying that if there's a. particular way you get yourself off in. private. that is very hard for the other person. to replicate, you might become. desensitized to that? >> You might just get habituated. I don't. think desensitized, but habituated is. like you might just your body just might. respond really well to that particular. stimulation. Now, that's not inherently. a bad thing, right? If that's what gets.

you off and you and your partner are. okay with you doing that together, right? You may mutually masturbate. together and that's fun for you and you. guys enjoy it, there's no problem with. it. It's just knowing what's going on, right? And sort of deciding like, okay, if this is a problem, let me try to. diversify what I do during my solo sex. periods or let me take a little break. and kind of uh try something, you know, just not masturbate for a little while. and come back to it later. The fact that. we get an erection in the morning, does. that mean that's we're supposed to have. sex in the morning? From like an.

evolutionary perspective, >> not necessarily. It's just it's the way. your body releases testosterone is one. of the reasons this happens is overnight. your body is making more testosterone. That's when your body sort of has. nocturnal testosterone production. And. so it's highest in the morning, which is. why often you get a morning erection. And you know it just means that some. people will have more desire also in the. morning because testosterone is a. hormone of desire. >> Is it the same for women? >> Yeah. So women um women also have.

nocturnal clitoreral tumescence. Same. sort of pattern and they won't. necessarily know it right because they. can't visualize it. But you know you can. some women may know sort of feel that. pelvic congestion or like feeling that. there's a bunch of like blood flow in. the area. But most will not and that's. okay. But your body protects itself. So. you've heard the term use it or lose it, right? People are like your body's. protecting itself. You don't have to. have sex. If your body is healthy, it. will do this all night to keep your. genitals healthy. It will make sure that. your genitals are getting blood flow.

even if you're not having sex. But if. you stop having those nighttime. erections, now is it becomes more of a. problem because over time, say you stop. having erections or cleral tumes for. months, years, right? And then there's. no blood flow to those areas over time. And actually I can show you here. This. is a a pelvic model. And here this this. purple thing here is called the corpora. And this is like a really nice spongy. tissue that fills with blood. And when.

it fills with blood, it expands and. lengthens. And then um the blood stays. there until you're done with your. stimulation. And then it goes back. And. so if there's no healthy fresh blood. getting to the penis on a regular basis. either through nighttime erections or. through sex with your partner then you. will get fibrosis of these tissues. That. means you get a little scar in the in. the tissues and then over time you might. see some shrinkage of the penis. And so. it is really important to maintain also.

good health of these tissues. And the. same goes for women with their clitoris. because it's the same type of tissue. In. fact, if you look at the clitoris, it is. this is the part that you see. We don't. really We don't have a clitoris. >> That one there. >> This is a uterus. [laughter]. >> You're going to keep that in. >> Okay. I can show you here. There we go. There's [laughter] this like she told. me. >> Is it crazy? >> Okay. Yeah. This is good. This is good. Okay. They [laughter] told me they don't. say glitter.

[laughter]. >> That's a little That's a Yeah. Okay. >> They told me [laughter]. >> you're not going to live that one down. >> You asked the team where the ClariS was. Did you ask the team where the clitoris. was? [laughter]. >> Well, I'm I'm worried about who said. that, too. Um, okay. So, [laughter] so. [snorts] let's talk about the female. anatomy. This is a pelvic model. And. here, um, you can see this is the. vagina. This is the urethra where you. pee from. This is your labia minora. And.

you can't see the labia majora, but they. would be out here, right? So, inner. lips, outer lips. Now, this up here is. your clitorol glands. So, it's the same. as the glands of the penis. And so, this. is all you see, right? It also has a. little covering, which you can't see. here. Just like men have foreskin, women. have a clitoreral hood that covers the. the head of the the clitoris. And so. when you look at the clitoris on the. inside, which we can't see perfectly. here, but I'm going to just take this. out. Um, it actually goes all the way.

back like this. So if you were to feel. from the vagina, from the vaginal side, it would be at the very top of the. vagina going all the way back. These are. the these blue things are the clitoreral. bulbs here. Um, so and these are the. legs of the clitoris here on the side. And so this is essentially the homalogue. of the penis. So if I take the penis and. we don't have a like a full model here. What does homalues mean? >> So homologues means that they're. essentially the same structure. They're.

made from the same cells but they're in. the male and the female. So here you can. see this is if this is your penis. This. is what you see up to here. This is the. bone. This is your fat up here. And then. here it goes deep into the pelvis. And. so here's your testicles, right? And so. below the testicles, this area of the. paranneeium, you also have penal tissue. sort of that you can palpate from this. side um that's coming all the way down. And if you had sort of a 3D model, you'd. see that it forks out just like the. clitoris does.

>> So does clitoral stimulation feel like. stimulating someone's tip of their. penis? >> Exactly. And so you could think if. someone just stimulated the head of the. penis, they uh it would be fine. It. would be nice, but it's probably better. if you stimulate more of the clitoris or. more of the penis. That's why you can. stimulate obviously the external the. clitoris, but you can also stimulate. from the inside. And some people are. more responsive to that than others. What you hear of is like the G-spot or. the Gzone, right? And the G-spot or.

Gzone is if you were to go in the inside. of the vagina at the top side, which I. can't really stick this in here, but it. would be about 2 cm in at the top. And. that's because that's an area where. there's a lot of nerves endings. One, you can palpate the clitoris basically. throughout the entire anterior wall, but. also there's the skins glands, which are. these glands that sit underneath the. urethra, and they're the homalogue of. the male prostate. And so, they're right. there, and then the vagina is there. And. so, that's an area that can be very.

enjoyable to stimulate. It's not. necessarily always going to lead to. orgasm because some people have. different sort of distance between the. clitoreral body and the vagina. So some. people have less distance may feel it. better than some that don't. Uh but. ultimately um that's why that area is so. sensitive for many women. On this point. of um morning erections, I was thinking. much of the reason why I've always been. cautious of having sex in the morning or. even like masturbating in the morning or. anything like that is I'm worried that.

it will cause a dopamine crash which. will make me feel lazy and lethargic. >> Well, so when you think about what. happens during an orgasm is you have. this release of dopamine and then you. your prolactin goes up and sort of like. everything calms down. Now some people. feel a a sense of clarity. They call it. postnut clarity, right? they feel clear, they feel like motivated to do stuff, they feel uh excited to go do something. else and they sort of move on from what. they're doing. There's some people who. feel post-coidal dysphoria. They. actually feel sad or they feel depressed.

after they orgasm. And we don't know. exactly why this happens, but it is. because of this dramatic change in sort. of neurochemical signaling in the brain. And for those people who have it, it can. be days where they sort of like feel. bad. It can be hours where they feel. sad. And so it can be really traumatic. So pillar two, what's pillar two of the. four pillars of men's sexual health? >> We talked about strength. >> Okay, so we did strength, we did fuel. >> What's pillar three? >> Pillar three is environment. So we can. start with the easy stuff and that's.

stress, right? Everyone knows stress is. bad. But I think the thing is people. just think like h I'll just I'll deal. with it. Everyone's stressed. Like. what's it's normal to be stressed? If. you are chronically stressed, that means. your cortisol is raised all the time, which is dampening your testosterone, which is also keeping you in the. sympathetic state, and you just cannot. get in your mind space and in the. nervous system place to actually have. sex. So, that's super important. And I. think, you know, there's lots of.

different ways to alleviate stress. You. got to figure out what works for you. Um, for some people, using a stress. ball, even just at work. And I think. part of it you can actually incorporate. some intimacy. There's some evidence, you know, the Gottmans have been on your. podcast doing a 20 second hug. So. standing with your partner or loved one. and hugging for 20 seconds on your own. like independent gravity. >> actually helps alleviate stress and. break sort of a stress loop. Doing a. six-second kiss with your partner. And.

so it seems like six seconds, no big. deal, but actually if you time it, it's. like hm if I'm just doing a kiss and I'm. not like actually it's a little bit. longer than normal. And so these sort of. small things can help alleviate stress. Any type of movement can be really. beneficial. >> The gym is great as well. >> The other thing is just having like. interactions with people. And so that's. where we're becoming more isolated. But. even just like talking to the barista or. talking to someone at the grocery store, this again tells your brain that you're. in a safe space, like you're talking to. someone. They're having a normal social. interaction.

So, and then being creative. And we've. been trying to work with this work on. this with our kids because there's so. much external stimuli all the time, right? They want to play video games, they want to watch TV, they want to play. sports, but we want them to be bored and. be creative, like come up with creative. ideas to keep themselves. interested and engaged in a different. way. So, I think that's so so important. And outside of stress, sleep. Um, sleep. is there's just so much abundance of. data on how sleep affects hormonal. health. They looked at data on men.

sleeping 5 hours a night versus eight. hours a night. So you take the same guy. and he sleeps eight hours, then you, you. know, do five five hours for a few days. His test for a week, his testosterone. drops by 15%. >> Wow. >> That's like as much testosterone drop as. would happen with 10 years of life. >> And do you know how long they did that. for? How long? >> It was short. It was like a week. So, a. week of sleep deprivation will will tank. your testosterone. >> And sleep apnnea is another one that I. think people one don't realize they have. and two don't realize that fixing it.

could actually improve their hormonal. health. >> Wait, so does this mean that people who. have chronically bad sleep probably have. low testosterone? >> Probably. Yeah. >> And what is the symptoms of low. testosterone? >> So, low testosterone, they're sometimes. very vague. So it can be fatigue, it can. feel brain fog, it can be depression, it. can be low desire, it can be erectile. dysfunction. That's what people always. think. It's just erectile dysfunction, but it's this whole constellation of. symptoms. It can also be increased fat. mass, decreased muscle mass. So all of. these things can happen because we have.

testosterone receptors all over our. body. We have them in our brain. We have. them in our muscle. We have them in our. bone. And these can all have really. serious consequences when it's low. when. you have sleep apnnea. And how you know. you have sleep apnea is uh your partner. might tell you that you're like waking. up in the middle of like gasping for. air. If you have one really easy way to. check is take a a measuring tape and. measure your neck circumference. If it's. more than 17 in for a guy or 16 inches. for a female, it means it's very likely. that you may have sleep apnea. And.

that's because when you have excess mass. basically here, it's compressing your. airway and can make it difficult to get. air into your um into your body. When. you improve sleep apnea, we've seen. improvements in testosterone as high as. 200 nanogs per deciliter. So huge jumps. in testosterone after fixing sleep. apnea. And the same goes for other sleep. disorders, although the data is not as. abundant. Uh but sleep is so important. Then we talk about what's in your. environment. So let's grab this. Okay.

So, you get a bottle of water. So many. of my patients actually they only buy. like cases of plastic bottled water. Once in a while a plastic bottle of. water like don't stress yourself out. This goes back to stress. People get. really stressed like what's in my. environment? What am I drinking? What am. I eating? Like do what you can control. So plastic water bottles have things. like phalates and BPAs which can affect. hormonal health. They can mimic. estrogen. They can reduce the production.

of testosterone based on these. mechanisms. Also things like plastics in. the environment, PAS, so the things like. non-stick cookware, all those things can. affect hormone health. Now, how do you. sort of protect yourself, right? I tell. people again, don't stress. There's only. so much you can control. So, like I love. that we're not drinking out of plastic. If you have to drink out of plastic. because you're at an event or whatever, try to make sure it's not a um a warm. bottle. So, it hasn't been like sitting. in the sun for hours and hours and hours.

because as it gets warm, it releases. more microlastics and more chemicals. into the water. When you're eating food, if you are eating out of say you get. takeout, put it on a plate and warm it. up. Don't ever warm up that plastic. And. when you store food in the fridge, put. it in a glass container or a metal. container, but don't ever leave the food. in the plastic and put it in the fridge. These are simple things you can control. You could also limit sort of your. exposure to dust because dust has. microplastics. You can try to wear more. cotton fabrics, less synthetic fabrics.

because they shed less microplastics. But again, I think do what you can do, but don't let the stress of these. chemicals like derail you because stress. is not helping either. And how much of a. difference does you know microplastics. make on my hormonal health? Is it really. a big big deal? >> Well, I think it depends. It's all dose. dependent, right? So, we're all exposed. Like, if you look at the data, like. people are, you know, consuming quite a. bit of microplastics and we're seeing. them actually even in testicles, in.

penis tissue samples, like they're in. our bodies. And so, I think that it's. definitely playing a role. How much? We. don't know yet. We just know there are. mechanisms and we know that they do. affect hormonal health and so do the. best you can. >> Do you and your family drink out of. plastic bottles? >> No, we drink we we have like metal water. bottles for the kids and myself. And. >> what about non-stick pans? >> We buy ceramic. We we do our best to. like avoid those as much as possible. So. the other thing is the company you keep. I think we don't talk about this enough.

and we talk about it in terms of. business like you want to keep people. who are successful around you. You want. to keep people who can help you. But it. also plays a role in your sexual. environment, right? So my husband is in. these groups with a bunch of other male. physicians. And there's a lot of. discussion about how they never have sex. anymore. And they're all just like, "Oh. yeah, this is just like normal. Like. we're getting older. Our partners don't. want to have sex. It's so frustrating.". And there's a lot of discussion about. this and and it's it's almost like, "Oh, that's okay." Like that's just normal, right? They're normalizing this. experience where that sex has not become.

a priority because life is so stressful, things are so crazy. Maybe you're having. relationship discord. So, it absolutely. plays a role. And there's actually some. evidence that it may help you make. better choices. So, there's one study. where they looked at I think it was like. 50,000 people and they um did an. intervention where they tried to. encourage these people to surround. themselves with positive influences that. were like have safe sex and avoid. negative influences. And they saw that. for that these people had an increase in.

like sexual positive behavior. So like. safe sex practices by 46%. So just by changing who they spent their. time with, they saw this major. difference in how they approached their. sex lives. >> Okay. So if your friends are very. pessimistic about sex and they're not. having and they're complaining about it, that's going to become sort of. contagious. >> Yeah. And I think it it extrapolates to. everything. what kind of relationships. you you're in. How do they view their. relationship with their partner? Is it a. priority? Do they make it a priority?

Right? Or are they just busy doing their. own thing and they're just like living. in parallel lives? They're doing their. own thing. You're doing your own thing. You never really spend time with your. partner and then when you go hang out. with your friends, you're like, "Oh god, I'm so glad to get away." And you're not. like talking about how much you enjoy. your partner. People tend to talk. negatively, right? They want to like. sort of like vent. And so when you have. people who don't make that a part of. their lives, it also affects you. They. value their partner and they talk about. them in a positive way, that's a a great. thing to say like, okay, this is the. right kind of person I want because I.

want to value my partner too and I don't. want that to rub off on me because it. absolutely does. >> And the other thing you said in this. category of environmental stuff is. things like pornography consumption. Is. it possible to consume too much porn? >> So it's not the amount of porn that you. watch, it is the sort of the way you. feel about it. Many [snorts] people. watch porn for a variety of different. reasons. Most often it's for pleasure. and enjoyment. But there's some people. who watch porn because they want to get. away from negative feelings, right? This. is giving them dopamine and they're. using it as a way to just feel better in.

the moment. And so that become that can. become a compulsion where they're. watching porn and it's like giving them. these positive feelings and they feel. negative in life and they're going back. to porn to sort of again have that. compulsion to watch porn again. But. that's a small subset of people. The. other thing is that there's a lot of. negative discussion around porn, right? People like porn is bad, it's dangerous, it's evil. And I think, you know, it's. more nuanced than that. But if you feel. that porn is bad, every time you watch. porn, you feel negative, you feel bad.

about yourself. That's where we see. people having the most dysfunction. associated with it because they feel. guilty. They could watch it once a year. and they could feel super guilty about. it and it could affect their sexual. function. They could see themselves as a. bad person. and they could see. themselves as wrong or immoral. And. that's really when it becomes an issue. If you are finding yourself either. compulsively watching pornography and. using it as a scapegoat, maybe time to. reevaluate, say, why am I doing this? How can I switch this out for something. else that makes me feel better that.

might be healthy, like exercise or going. for walks or whatever that may be? And. then if it's something that's really. making you feel like bad or guilty. because maybe that's how you were. raised, maybe that's what you feel about. morality, then yeah, maybe like you. either need to work through that because. porn is maybe something that you still. want to watch at times or you need to. abstain. But usually those are it's very. difficult to abstain for most people to. abstain for prolonged periods of time. So I think it's it's something you have. to work through if you find yourself. having these sort of feelings about. pornography or you're compulsively.

watching it. But for most people, it's. adults. For most adults, it is fantasy. It's a place where you can experience uh. see things that you may never do in real. life that may be enjoyable, that are fun. to watch, that have allow you to feel. arousal. We see that when couples watch. porn together, they are more likely to. be more satisfied in their relationship. And when there's a discord, like one. person really doesn't like it or doesn't. use it, and the other one uses it a lot, that's where we see the problem. Is porn.

consumption going to impact my intimacy. with my partner? [snorts]. >> So, it depends. I think a lot of people. watch it without an issue, right? They. watch. >> if I masturbate and I ejaculate, I'm not. going to then be able to ejaculate very. quickly necessarily with my partner. >> Yeah. So, that obviously that is, you. know, there's a refractory period after. you ejaculate. Now, when you're younger, that refractory period could be minutes. And when you're older, that can be a day. and a half. And so we see that some. people may struggle, especially if. they're watching a lot of porn every.

single day and their refractory period. is maybe a day. Then they may actually. really have trouble ejaculating with. their partner because they've not given. themselves that time. >> This has had probably the single biggest. impact on my office. Of all the products. that I've tried that have given me. productivity gains or cognitive boosts, I would say that exogenous ketones are. in the top three most pivotal things. that have given me a massive. productivity gain. It's some Stanford. graduates that have been able to.

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agile without compromising on quality. So, if you need these kind of skills in. your business, head to pro.fr.com to. find pioneering talent to fill your. business's gaps. That's pro.fr.com. And the last one, the last of the four. pillars, >> the last of the four pillars we talked a. little bit about, it's called. confidence. And confidence is not like. stringing around like a peacock like I. know what I'm doing. It's confidence in. knowledge and curiosity. So, knowledge. [snorts] we talked about a little bit, understanding female anatomy, like how. do female bodies get aroused, right?

what makes them aroused, where is the. clitoris, knowing some anatomy, and two, actually talking to your partner or. paying attention to their cues. We that, for some reason with sex, it's the only. time that we just expect people to be. mind readers. We just want you to know. what I like and just go for it, right? And and then when it's not good, you're. like, well, you just don't know what. you're doing. And it's like, it's it's. wild to me that we actually never got. taught how to talk about sex, how to. bring it up with a partner, how to, you. know, just explore and have fun with.

sex. maybe add a toy to the bedroom. So, there's lots of different types of toys. This is a uh vulva stimulator. So, you. put this on the outside. So, you can see. that it would in theory, if this was. smaller, would stimulate the um the. clitoris on the outside. It also can. change in shape. It'll vibrate, right? It'll have different stimulations that. you can play around with and decide what. you enjoy. >> So, this one's run out of battery. Um. [laughter]. so, >> they're brand new. They have not been. used.

>> I didn't say they had been very. defensive though. Um, so if my pinky. finger, if my finger here is the. clitoris, >> Yeah. >> I put it on like that. >> Yeah. >> And then it vibrates. >> Correct. >> And then the penis goes through the. hole. >> And there's another version of that. This is basically. [laughter]. >> this is basically like the hole goes. around the penis. >> and that goes in. >> and that can go in and stimulate and vi. vibrate. So, you both feel the vibration. and you both feel the stimulation. >> I remember I was with um had a partner.

and she she felt that sex toys were for. older people. Old people specifically. what she said and she she was kind of. against the use of them. I've always. been down. >> I think it adds novelty and it's. exciting and it just adds something new. >> But she felt like it was almost like. giving up. >> Well, I mean, look, I think I wonder. why. I would I would if I she was here, I'd ask her, why do you think that? What. belief system do you have [laughter]. that's making you think that this is. like not a good thing to use? Right? We. use technology in so many places in our.

lives, right? So why not introduce it in. our sex lives? >> Are you going to become reliant on it. though? Because it doesn't make it. easier to get off with a sex toy. >> So they've actually looked at vibration. and can you get desensitized to it? And. the way they've looked at is actually. like construction workers where they're. using those like vibration tools, right, to and and seeing if like their hands. get desensitized. And what they've seen. is yes, for a short period of time they. do lose a little bit of sensation at. their fingertips, but then it restores. back to normal. And so it's not that. you're going to become desensitized. forever, right? I think you brought up a.

great point, which is adding novelty. Now, I think when I say novelty, people. are like, "Oh my god, I need to role. play in a different way or bring like. some sort of BDSM or whatever into my. sex life." And that's not exactly true. So when you think about sex, right, it's. just like eating your favorite ice. cream. Maybe you have vanilla ice cream, you know, three times a week and you. enjoy it. But if you start having. vanilla ice cream every single day, you're kind of bored with it, right? And. the same goes for sex. Now having. routine in sex, knowing what you like,

um knowing what your partner likes, it. can be very helpful, but it also is nice. to add novelty. So if you think about. you can extrapolate from the flow state. So when you are in a flow state for. work, right, things feel really almost. effortless and you're just like in a. zone, you can also get into a sexual. flow state. When you look at the flow. state, yeah, you need things to be. slightly challenging to get into the. flow state. They can't be easy and they. can't be so hard that you're going to. get frustrated, right? And so you need. to add a slight challenge to your sexual.

encounter to get into that flow state. And that's when you start having really. great sex cuz you're like in you're so. totally immersed. you're feeling great. and it's it's super fun, right? So, I. think that's another part of being. confident is being able to and confident. to try new things and explore new. things. And it can be as simple as like. doing it in a different room or maybe. getting a pillow or switching where your. head position is. Like, it can be so. small, but it can just add a little bit. of uniqueness and novelty and challenge.

>> Are there certain positions that are. going to increase the probability that. my partner has an orgasm? >> Yeah. So, uh, typically when the female. partner is on top, she has more control. over where she's getting stimulation, um, to the clitoris because, right, she. can angle her body in such a way. So, often time that shows uh, that has, uh, higher orgasm rates. There's actually. like this uh this technique called the. cooidal alignment technique where you.

sort of move in a rocking uh a sort of a. rocking motion so that um your pubic. symphysis. So this bone right here um is. sort of like rubbing against their. clitoris like this area the skin here is. rubbing against the clitoris while. you're penetrating and that has been. shown to increase orgasm rate and. pleasure in sex. But really it's about. figuring out and trying different things. and realizing like that for example that. coil alignment technique is sort of. difficult like it's not that easy and. intuitive and so you have to sort of. play around with it and figure out like.

what is going to work uh best and yeah. realizing it might not work. You might. be like super awkward and like okay like. that's okay like it's not the end of the. world if sex is not perfect every time. because we're learning and we're playing. and we're having fun. And so I think. that's really the key is like not. letting yourself get so frustrated if. something doesn't go exactly the way you. envision it in your head. >> I used to think that a woman orgasming. was when this was when I was younger. Um. was when she squirted. >> Mhm. >> So like that's what I thought it thought. an orgasm was squirting. >> Yeah. Well, you're probably not the only.

one to think that. And so squirting, not. every woman squirts. So about 40% of. women squirt. Squirting is the emission. of fluid at the time of orgasm. Um. usually it's clear, colorless, and it. can be quite voluminous. um it's coming. from the urethra which is the pee hole. essentially and remember I talked about. those skins glands those skins glands. are the homalogue of the male prostate. and they have a little bit of fluid in. them too typically when you have. stimulation um and squirting they will.

release fluid from the bladder as well. as the skins glands that combines. together and and it's emitted through. through that. >> so it's not pee. >> the way they describe it and there's. been a lot of research on this so. there's people who say it's pee. There's. people who say it's not. There's a. couple studies. So, one is they put dye. into the bladder and they took women who. said they were squirters and they had. them orgasm and they saw is there dye in. the uh in the fluid and yeah, there was. dy in fluid. So, it's coming, it has to. come from the bladder. The skins glands.

only hold a small amount, but it's. chemically different. It's usually. clear, odorless. It doesn't smell like. pee. And so, there's some theories as to. why that might be. It may be that um. when you're having sex, there's. different hormonal signals that change. the concentration of what's filtering. through your kidneys so that it is a. little bit different in composition. There's some theories that when there's. more estrogen around that it may change. There may be some like um fluid filling. in the actual interstissia of the. organs. Again, it's hard to say, but.

it's absolutely coming from the urethra. which is connected to the bladder as. well as the steam glands. But I think. like this this whole discussion about. what it is, it doesn't matter. Like is. it pleasurable? Are you enjoying it? Great. If you squirt and you enjoy it, great. If you don't, that doesn't mean. that there's something wrong and that. your partner hasn't orgasmed. The way to. figure out if your partner orgasm is you. ask her, right? Either she tells you or. you ask her. And sometimes it's obvious. and sometimes it's not, but you know, you you sort of figure it out. >> There's three theories that emerged in.

my research about why women squirt from. an evolutionary perspective. The first. was that, and these are just theories, they're not proven. Um, of course, the. first is that squirting contains PSA and. zinc, which are naturally antibacterial, and ejaculating these fluids during or. after sex may have evolved to flush the. urethra and prevent UTI. Um, the logic. being in a pre antibiotic world, a woman. who could flush bacteria out of her. system after mating was more likely to. stay healthy and reproduce. That's one. theory. The other reason, >> well, before you I want to talk about. that really quickly. So, that's a really.

interesting theory. So one the reason. they emit PSA is because schemes glands. are the homalologue of the prostate. So. the prostate makes PSA which is prostate. specific antigen. >> So this point this word homalogue again. >> Yeah it's a so basically the prostate in. the male the same tissue when they're an. embryo becomes the prostate in the male. and becomes a skins glands in the. female. So that's why it's emitting PSA. That is an interesting theory because. there are a subset of women who get UTI. after sex. Not everybody but some do. And it's it's not because of the.

ejaculate or because of the male. harboring some bacteria. It's because of. the actual thrusting of the penis. It's. taking bacteria from the outside and. making it more easy for it to go through. the urethra into the bladder. And women. have a short urethra. And so I want just. to debunk that myth that it's like. you're getting it from your partner or. there's something wrong with you. It is. literally just anatomy. And so some. women do get more UTI after sex. >> And so that is an interesting theory. because maybe that's true. I don't know. The second theory was in ancient.

ancestors, the hormonal surge during. orgasm and ejaculation actually. triggered the release of an egg. Humans. evolved to ovulate on a cycle now, but. we kept the plumbing and the neuro. hormonal reflex. It's a happy accident, a biological vestage that no longer. serves its original reproductive. purpose, but remains because it isn't. harmful for survival. >> Interesting. I mean there is some. thought that maybe orgasming. um spasms orgasm help with fertility but. it's not really uh robust. >> And the last one kind of matches what.

you just said there which is the mate. selection theory. The intense pleasure. and psychological response of squirting. or or orgasm act as a reward system. It. incentivizes women to seek out specific. partners who provide high levels of. stimulation, potentially signaling a. better genetic compatibility or a more. attentive male, which would help with. the survival of of offspring. Maybe. >> that makes sense. >> 40% of women squirt. >> Yeah. So, the other thing is obviously a. lot of sex is focused on genitals, but. there's a whole body of arogynous zones,

right? Almost almost your entire body. can be an erogynous zone. We talked a. little bit about it when we talked about. sensate focus, right? You can explore, you can find areas that people find uh. erogynous. So when you looked at data, necks, nipples, lips, buttocks, inner. thighs, all these areas are considered. arogynous by most most people regardless. of their um sexual orientation, regardless of their cultural upbringing. It seems to be pretty universal. There's. actually a famous paper about.

non-genital orgasms and like how people. orgasm without any genital stimulation. So lip orgasms, anal sex orgasms. >> Is that possible? >> Yeah, it's been documented. Absolutely. And and so it's um nipple orgasms. There's a whole variety of ways even. like women have had orgasms during. childirth. Like there's there have been. these documented ways to orgasm and it's. because these areas can be very. erogynous and sometimes stimulating. multiple areas can like add more. erogynous interest and that's why you.

see people like maybe in the BDSM. community they'll they'll be using um. nipple clamps while they're doing other. things right so there's there's a whole. bunch of areas that are erogynous and. most of the times people are not really. spending much time on foreplay or. stimulating these erogynous zones as. much as they should Right? You you have. a whole body to play with. And how do. you stimulate them? There's actually. evidence behind that. So on your skin, we have these special fibers called C. tactile eference. When you stimulate. these fibers, they help you feel.

pleasure, enjoyment, those sorts of. things. And so there was a study where. they took 19 couples, a small study, it. was out of London, and they basically. told them to stimulate an arogynous zone. and a non-erogynous zone. The. non-erogynous zone being the forehead. And so they had the couples stimulated. And they told them stimulated at levels. of 18 cm/s. uh in terms of how fast you're caressing. the arm or or or body part and at 3 cm. per second. And what they found was. those who stimulated at 3 cm per second.

had more sexual arousal had more. pleasant stimulation compared to those. who were stimulating at 18 cm per. second. Now this makes sense because. those C tactile aphrant fibers respond. very well to that slow gentle caress. The other interesting thing is that. these fibers are only responsive to. human touch. So if I take a glove and I. put it on my hand and I touch you, it. still doesn't work. >> Interesting. That's so interesting. because in Los Angeles where we are now, we were viewing an office and we were.

walking down the street to see what the. neighborhood was like and we walked past. one place and it is a robot massage. parlor. M. >> and I always thought great like well. part of me thought maybe my prefrontal. cortex thought oh great idea because you. know you can get massages whenever you. want it's going to be cheap maybe you. can have one in your home but then the. other part of me as I saw it thought. actually I don't actually think that's. like why I get massages. >> I think there's something about human. touch which makes a big difference. >> absolutely there is um and so I think. that's uh we're evolutionary.

evolutionarily built to seek out human. touch and human behavior. >> I wonder if I would want a robot to. massage me. >> It wouldn't be as good. No. >> I mean, think about sitting in a massage. chair. Is it ever as good? >> It's never as good, >> right? And so, I don't think a robot's. going to be that different from a maybe. a little better than a massage chair, but like. >> massage chairs are never good. >> No, they're just like they're okay. They're mediocre. M Reena, I want to. talk about um testosterone, how that.

links to sexual function, but also just. overall health because I was reading. that there's been a 300% increase in the. United States in the last 10 years of. testosterone prescriptions. And my. friends are increasingly having. conversation about testosterone, which. we weren't having. >> even 5 years ago. It wasn't a. conversation. And now the conversation. I'm having amongst my friends is like, is our testosterone high enough? Do we. need to go get supplements to increase. our testosterone? >> Testosterone is declining. So when you. look at testosterone levels from the. 1990s, like late 1990s, the average. level was around 600 and if you look at.

data around two 2015, it was 450. So. there's been like a 25% decline in. testosterone. Now you're going to ask me. why. One, we talked about some of the. endocrine disrupting chemicals. That's. part of it certainly. Two, there's a. significant rise in obesity. Testosterone has aromatase. And. testosterone converts to estrogen using. this enzyme called aromatase. And so. when you have more fat mass, you have. more aromatase. And more testosterone is. being converted to estrogen. And so now.

you have less testosterone. >> Sorry. How do we how do you have less. testosterone? >> So because there's more fat mass, there's more aromatase. So that. aromatase sees all this testosterone and. it converts it to estrogen. >> Okay. This is where they say they talk. about man boobs. >> Yeah. So when you have a lot of. estradiol around you can get man boobs, >> you can get gynecomastia. [clears throat]. So a term for it. So that's one. Two is. we see a rise in diabetes and insulin. resistance which also causes a decrease. in testosterone. [snorts] We're seeing a.

rise in ultrarocessed food intake and. that doesn't have the optimal nutrition. that you need to optimize testosterone. So we're getting you know a high highly. caloric which then leads to obesity. We're getting um lack of healthy fats. We're you know all these things are. super important for testosterone. The. Mediterranean diet is what has been the. most studied and basically. anti-inflammatory diet is what they. found for testosterone. So trying to. just eat like whole foods, unprocessed.

foods as much as possible and minimizing. the inflammatory foods. >> Does testo having high testosterone make. me more fertile? No, not necessarily. So, I think people inherently think that. the higher your testosterone level is. when you check your blood work, that. that's better. And that's not. necessarily true. Now, everyone is. different. And what I can't tell you is. what your receptors look like, what your. testosterone or androgen [clears throat]. receptors look like, how sensitive are. they to testosterone. And everyone's a.

little bit different. But when you look. at the same guy or you look at two. different guys, their variability can be. so much that a guy who's 900 can be. normal and a guy who's 500 can be normal. because everyone has individual genetic. variations. It's how their cells how. sensitive their cells are, how many. cells they have, you know, how many. latig they have in their testicles. Um. the CAG repeats, which are these DNA. repeats on the receptor themselves. People who have more are less sensitive. to the testosterone that's around. So. they need more testosterone to get the. same result. Whereas people who have.

less repeats have more sensitivity so. they they don't need as much. testosterone. And so everyone is. individual. And so that's why it's. really important to understand how are. you feeling, right? It's not about. chasing a number. And so absolutely we. know that when your testosterone is low. below 214 nanogs per deciliter that your. risk of mortality goes up by two. So you. are going to double your risk of dying. if you have low testosterone. But when. you go super high, super physiologic, meaning like 1,800 or higher, now you're.

putting yourself at risk for other. things. You can have blood thickening, which is a known side effect of. testosterone replacement, and that puts. you at risk for stroke, heart attack, heart disease. Over long periods of. time, it can affect your heart because. it can um there's also heart muscle. cells that get exposed to this high. level of testosterone. And when that. happens, these they sort of change over. time and they become more collagen. deposition. They get more fibrosis and. this makes them stiffer and so that.

you're not pumping blood as effectively. as you would otherwise. And so there are. real consequences to going too high. There's also the side effects of having. acne, of changes in mood in terms of. aggression and things when you get. really high. So really, it's about. finding what you feel good at. More is. not necessarily better. Once your. testosterone receptors are saturated, meaning they're all bound to. testosterone more doesn't help you. It. might help you get more muscles, which. is why people abuse anabolic steroids. and testosterone because it will.

continue to help you get bigger muscles, but that's it. It's not going to help. you with your brain health, your bone. health, your sexual health, your any of. that. >> Is there a way to. visually spot a person with low. testosterone? Are there visual clues? Usually it's someone who feels very. fatigued like they can't get out of bed. They feel just like so drained. Usually. they are a little bit more overweight. >> Skinny fat. >> visceral adop I mean you can't always.

tell if they're skinny. So it could be. because they could have visceral adopy. which is meaning that the fat is around. the the organs right and so you don't. see like a big pot belly necessarily. Um. they may have really low sexual desire. They may have decrease in mood. >> What about skin and bones? Does it. impact skin and bones? >> Yeah. So, if you get high testosterone, you can get acne because it affects the. sebum in the skin. Um, bone health. So, testosterone converts to estradiol and. [snorts] estradiol is really important. for bone metabolism. And so, when you.

have low testosterone, you can also have. low estrogen. And when your estrogen. gets very low, you get a higher risk for. fractures, higher risk for osteoporosis. And so that's where your bone health um. can be in danger. And so that's why. testosterone can help protect your bones. because of its conversion to estradile. >> If you do have low testosterone, should. you be considering taking anabolic. steroids? Like. and who is testosterone replacement. therapy good for? >> So I'm going to ask you a question. Why.

why are you saying anabolic steroids? >> I don't know. Cuz I hear that people big. bodybuilders take anabolic steroids. The. reason I asked you that is because. people think anabolic steroids and. testosterone replacement therapy are the. same thing and they're not. And so. testosterone replacement therapy is what. is given to guys who have low. testosterone. If you have truly low. testosterone, there's a few things you. can obviously improve testosterone. naturally by going back to those pillars. of health that we talked about. Improve. your sleep, do resistance training, avoid endocrine disrupting chemicals. But if you are still low despite doing.

all those things or you're like so. fatigued that you can't move your body. and like you really need to do it, then. I think testosterone replacement is is. very valuable. And so testosterone. replacement is getting you to a level of. testosterone that is within normal. We're not trying to get you super high. We're not trying to get you to become a. bodybuilder. We're trying to get you to. normal, what you should be. And so. anabolic steroids are different. And. anabol steroids are like all these. different um oral pills and injectables. and things that work on muscle as well.

as work on your uh androgen receptors. And so those are typically things that. people are taking on their own. They're. kind of self-directing their care and. they're not really monitoring their. testosterone or they don't really care. how high they go. They just want the end. product of looking muscular. And so they. are getting really high testosterones. and that has its own host of concerns in. addition to the ones we talked about. like blood clots and and heart attack. But there's a 15 times higher risk of.

having premature heart failure and a 122. times more risk of cardiac death when. you're taking anabolic steroids for the. purposes of increasing muscle mass and. not and get getting really high in your. testosterone. So, it is a real serious. issue when you take anabolic steroids. because it can have real serious health. consequences. >> I've always imagined that once I have. kids, so I'm I think I'm scared that if. I have testosterone replacement therapy. at this age at 33, it might impact my.

fertility. >> It absolutely will. >> Okay, good. So, I'm not going to do that. until I've had all four of the kids. >> Yeah. >> As many as I can. >> And then I figured when I hit like 45, then I'll go on testosterone replacement. therapy. Is this a good strategy? >> Well, first of all, I would want to know. why you want to be on testosterone. Is. your testosterone low? >> I have no idea. >> Right? Are you having any symptoms? >> I mean, you live a very highpowered, busy life. And so, I can guarantee your. stress is probably not under control.

Like, probably you're not sleeping. great. And not to say that those are. things that, you know, you can't do in. addition to taking testosterone if your. testosterone is indeed low. But I think. the important thing is realizing like. it's only going to help you if your. testosterone receptors are not fully. saturated and giving you more. testosterone is going to saturate them. >> Doesn't it just drop anyway with age? >> It does. So it drops about uh 1% a year. on average. Some people drop less, some. people drop more. So if you look at. someone who is healthy and they have a.

normal testosterone, they usually won't. become what we call hypogonatal or have. low testosterone even as they age. because the drop is so low. it's only 1%. a year. But if you add on these comorbid. conditions, if you add on a high stress. life, if you add on poor sleep, if you. add on um exposure to endocrine. disrupting chemicals, you're going to. see um that number come down much. higher. >> It's actually I was just I pulled up a. graph here um that shows testosterone. decline with age. And it's actually not.

that steep. >> It's not It is going to decline, but it. may not decline to the point where you. need testosterone. So, not everyone. needs it. Depending on the data you look. at, 20 to 40% of guys have low. testosterone. Um, and when you look at. the number that get treated, it's like. 2%. >> And it starts declining from about 20. years old. >> Yeah. Depends on the person. 20 to 40. years old that start, it's probably more. around 30 to 40. And the reason we came. up with these numbers, right, these. guidelines to to guide us on what's.

normal and what's not is because you. look at population-based data and you. look at when these symptoms arise and. there are like clear numbers like you. may start having bone loss uh around. 300. You might start having uh you know. decreased sexual frequency of thoughts. at 215. You might start having feeling. less physical vigor uh around 290. Right? And so there are numbers that we. know based on population-based data that. we're seeing these numbers decline. Now. the other thing to think about when.

you're looking at testosterone is free. testosterone. So testosterone comes in. different forms in the body. It comes. bound and unbound. So 45% of. testosterone is bound to SHBG which is a. molecule of protein that is really. tightly binds to testosterone. Doesn't. let it go for your body to use. Then. there's some that's bound to albumin. which is sort of loosely bound and then. there's 2% that's free 1 to 2% that's. free and that's what we say is like the. most available to your body for use and.

there's actually you know good data that. looks at free testosterone and the. levels of free testosterone are. correlated with these symptoms as well. and so you do have to look at the big. picture so I always check a total. testosterone as well as an SHBG because. some people can have elevated SHBG. thyroid dysfunction due to aging, just. genetic variability, right? In women, SHBG goes up when you take oral. contraceptives and it stays up for life. if you take oral contraceptives. So, it. can affect their free testosterone. The.

other thing to think about testosterone. is it's for life. Once you take it, your. body stops making its own testosterone. Many people over years will notice that. their testo their testicles get smaller. um because their body stops making its. own testosterone. So, it's not something. to take lightly. Now if you want say you. were low right now and you wanted to. conceive there are ways where you can. take other um other pharmaceuticals that. will naturally boost your own production. like hcg or clomid or enclomophene. These work basically uh in different.

ways to either tell your brain that hey. we need more testosterone or they send. they mimic the signals that tell your. testicles to make more testosterone. And. so there are ways to do it and you. definitely need someone who's, you know, well-versed in managing hormone. management. Uh, but there are things. that you can do if you're low. But. again, I don't think it's once you once. you start these things, you can't go I. mean, you can get off of it, but it's. sort of a process and it's not something. that everyone will do because you're. going to feel good on testosterone if. you're taking it. And then when you get. off it, because your body is like no.

longer making its own, you're going to. feel horrible. So, do you think most 50. plus year old men should be taking. testosterone. replacement therapies? >> Only if they're symptomatic and they're. low, right? So, >> would it make them the average man, the. average 50-year-old man, if this is the. average, feel better on a daily basis? >> Not necessarily. Because if they are. normal, like I said, if their. testosterone receptors are already fully. saturated, it's not going to change, right? It's not going to change their. it, like I said, it may make their. muscles look bigger, but it's not going. to change their their cognition. It's.

not going to change their mood. It's not. going to change their sex drive. It's. not going to change their erections when. their testosterone receptors are fully. saturated. >> And you know, in this graph, what is. showing the decline here? Has that got. anything to do with whether their. testosterone levels are fully saturated? Because. >> no, you can't tell from that. >> You can't tell from that. So, you could. have low testosterone but still be. fully. >> That's why we talk about symptoms, right? Because that's how I can tell. I. think, you know, that's part of what. being a doctor is, right? Talking to. your patients and figuring out what's. going on with them and what their. symptoms are and making sure it's.

nothing else, right? You can have low. thyroid and that can mimic what what uh. what low testosterone feels like. You. can have a high prolactin because you. might have a benign tumor in your brain. that's secretreting prolactin and that. can reduce your testosterone. So that's. the the reason to get a full evaluation. to make sure there's nothing else that. we're missing that's causing you to have. these symptoms if your other levels are. normal. >> Uh okay, that makes sense. So just. because my testosterone levels would be. low doesn't mean I necessar if I don't. if I'm not symptomatic doesn't mean that.

I should necessarily just assume that I. need testosterone replacement therapy. >> Exactly. >> Okay. Yeah. I think I think most of my. male friends are just assuming that once. we hit 50 we're all on the testosterone. >> I mean look I think when if you need it. it's a great drug. It's a great option. to improve your quality of life. It's. obviously preventing uh bone loss. It's. improving your longevity. it's uh. preventing hopefully having some benefit. in terms of cardioabolic health and so. yeah absolutely if you need it but it's.

not something that like everyone should. just take cuz why not right like it's a. when you play with hormones it's serious. business you know. >> I guess a lot of men are self-conscious. in a way that they don't often admit and. they want to have big muscles. >> and they want to feel strong. >> and this is the the problem I'm seeing. with younger guys right now is that. there's a lot of young kids taking. anabolics because there's so much. pressure to look a certain way, right? Because nowadays when how do you meet. people on social media through like. swiping and and all you see is what they.

look like. And so there's this pressure. and like I'll see it at the gym like I'm. like at the gym and there's these young. kids who I'm like there is no way you. are naturally that built at that age, right? Like unless you've been lifting. since you were like seven years old. And. so and of course there are some. But it. is serious because one, it causes. infertility, right? When you're on. testosterone replacement after about 18. 18 months, 70% of people on testosterone. replacement will be infertile. >> 17. >> 70 70%.

>> 70. >> And even as soon as like 10 weeks, we. see some people having drops in their. sperm count. So, it's variable with how. quickly you're going to see impacts on. your fertility, but it absolutely. happens. And it can it can come back for. the large majority of people, but how. long it takes depends on your age and. how long you were on testosterone. replacement therapy. And in some cases, it can take as long as 2 years to come. back. >> I really need to get my testosterone. levels checked. >> Yeah, you should. [laughter]. But also, you should get your semen.

analysis checked. And I've done that. >> Good. Good. Because that's also a. biomarker of health. We've seen that. people who have poor semen parameters. they have higher rates of mortality and. they actually live when you look at age. like what age people die they die. younger compared to people and it's dose. dependent. So if you're have like normal. uh the concentration of sperm and then. it keeps going down and down and down. If you look at the age it's like they. live to 78 77 76 like you can actually. see it come down except for people who.

have no sperm because those are usually. genetic disorders. Those are live a. little longer because it's not. necessarily due to cardioabolic issues. Um, but it's basically a reflection of. your overall health. >> Steve, what are you doing? >> Uh, just making myself a delicious. coffee. >> from the freezer. >> From the freezer. Have you not heard. about Contier? >> No. >> Oh my gosh. This is going to change your. life. A couple of months ago, the. founder of this business called Matt. sent a big shipment of this coffee to.

our office in London. What most people. don't know is that the processing of. coffee takes out a lot of the taste. So. what they do is they flash freeze it at. the optimal moment when it's most tasty. and they send you in the post the coffee. in these little frozen ice cubes. Now. Matt sent a big shipment to my office. I. moved it to the kitchen. I said to the. team, "Knock yourselves out." And then I. saw so many messages in our Slack. channel of people going, "Oh my god, what the hell is that? It's so. delicious." All I have to do is pop it. out in the morning using the little. button on the back of this thing. I pour.

my hot water in and I mix it and that is. done. You can get $30 off your first. order of Cometier coffee if you go to. cometier.com/stephven. Try it and please Instagram DM me, LinkedIn me and let me know if you love. it as much as I do. Make sure you keep. what I'm about to say to yourself. I'm. inviting 10,000 of you to come even. deeper into the diary of a CEO. Welcome. to my inner circle. This is a brand new. private community that I'm launching to. the world. We have so many incredible.

things that happen that you are never. shown. We have the briefs that are on my. iPad when I'm recording the. conversation. We have clips we've never. released. We have behind the scenes. conversations with the guests and also. the episodes that we've never ever. released. And so much more. In the. circle, you'll have direct access to me. You can tell us what you want this show. to be, who you want us to interview, and. the types of conversations you would. love us to have. But remember, for now, we're only inviting the first 10,000. people that join before it closes. So,

if you want to join our private closed. community, head to the link in the. description below or go to. daccircle.com. I will speak to you then. One of the things I was quite surprised. by, I'll be honest, is when I went on. your YouTube channel. >> Mhm. >> one of your very high performing videos, I think it had 31 million views, was. about enlarging your penis. >> Yes. >> I didn't know that so many men were.

interested in ways to enlarge their. penis. Well, it's interesting because. when you look at the data, more men want. to so I let's say most guys would love. to be taller, right? If you're an. average height man, most guys would love. to be taller, right? >> Yeah. True. >> Um more men want to have a longer penis. than they want to be taller. >> Really? >> Mhm. >> Wow. Wow. Why is this? >> Well, I think you know a lot of people.

um it starts at a young age. I have. sons, right? And so I see it like they. talk about their penis in such a way. like very early in life like oh my god. my penis is so big or it should be so. big or whatever and and there and it's. like this it becomes this like this. society thing about who's got a bigger. penis like it's very interesting but. there's a lot of pressure to feel like. and and a lot of discussion around. bigger is better right it's it's talked. about in media it's subtly joked about. it is um everywhere you look people are.

talking about like being wellendowed as. being better. But interestingly, on my. podcast, we interviewed the the guy who. has the largest medically verified. penis. It's I think it's like 13 or 14. inches in length. And um he actually has. a lot of trouble because it's so large. that people don't want to have sex with. him and it's uncomfortable for them. And. so, like, it's not all roses and. sunshine on the other side. But the. reality is that many people feel what's. called small penis anxiety. and they.

they even if they have a normalsized. penis, they feel consumed with how the. size of their penis is. And so that's. why this video did so well. I naively. had no idea how many people it would. resonate with because I'm not a guy, right? And I see patients all the time, but at that time in my career, people. weren't coming to me to talk about it. And so I um I realized like there's so. many people quietly feeling insecure. And we talk a lot about women having. body image issues. Men do too, right? They feel insecure about the size of.

their penis because also they're seeing. guys on pornography who have very. well-endowed fallaces and you know they. chose to be porn actors for a reason, right? Because they are naturally. wellendowed. And so you're comparing. yourself to the outliers and the average. penis is about 5.3 to 5.5 in erect. But. when you look at like what do women. want, they will say on average they want. a 6 in penis. But when you look at like. the kind of sex toys they buy and they. did this study because they were looking. at people who they were trying to decide.

what kind of when they were developing. fallaces for trans people like they they. reconstruct fallacuses for they wanted. to they were making them too girthy and. they like well we need to figure out. what girth women want and so they looked. at like what women buy on online like. what is the most purchased sex toy and. it's actually pretty close to average. >> Do you say 5.2 in. >> 5.2 two to 5.5 depending on the study. you're looking at. Yeah. >> Correct. >> Mhm. >> H. And what size do men think the.

average is? >> Oh, they think it's like six or seven. in. >> Oh, okay. So, they think the average is. bigger. And also, how does age come into. this? Because I'm presuming that when I. get older, my penis is going to shrink. or something. >> If you have good blood flow to your. penis, it shouldn't shrink. So, like I. said earlier, if you stop having. nighttime erections or you're not having. erections, now you're no longer getting. blood flow to your penis and it will. shrink over time. Also, if you're. gaining weight, it will appear that it's. shrinking because you're getting more. fat over here. So, if you think about.

your penis here, this is the fat right. above this bone. And as this fat gets. more and more, you're seeing less and. less of the penis. >> And is there a way to enlarge the penis? So there are many ways that have been uh. tried, discussed, um attempted. So. there's definitely surgeries that you. can get, but they there's not a lot of. surgeons who do a lot of penile. lengthening surgeries and they have lots. of complications, like very high rates. of complications because the penis is a. very vascular organ. And the thing is.

that when you have the tiniest. difference on your penis, you notice it, right? Like I have guys come to like the. tiniest little thing on their penis and. they're like, "Is this okay?" Like this. is new. And like luckily it's nothing, right? But I'm like they notice it. You. notice it when something's wrong. So. imagine you have a surgery and now. something changes, right? So it is it is. really difficult to sort of replicate. exactly a normal penis when you're. lengthening it through surgery. So I. don't recommend surgery for lengthening. penis. There is a safer way and that has.

been shown to help and that's using a. traction device. So a traction device, we have one here. This is one brand. You. can get many of these online. And you. can put your penis in this device. >> It really I like I feel like um I get. like shivers when I watch you do this to. this penis. >> So you would wrap it. It would be more. comfortable than just putting this like. directly on your penis. >> For you guys that can't see, she's. clamping the end of the penis into this. >> into this device. And then you sort of.

lengthen it uh extend it with this 30. minutes twice a day for this particular. device. They've actually done some. research on this one. 30 minutes twice a. day and you there's like a whole. protocol on their website and it does. show improvements in length about two. centimeters but it is a commitment to. increasing length and to doing this. process. >> So just on those numbers 2 cm increase. over what period of time and does that. >> or about 3 to 6 months depending yeah. >> and is it permanent? >> So that's all we don't know. I mean most. of the studies stop at you know once.

they get their results and we don't know. that if you stop will it just revert. back to normal? I don't know. And so the. other thing about this particular. traction device that's night is if you. have a curvature in the penis like you. develop something called Peron's. disease, this device can actually curve. a little bit away from if you like let's. say you have um indentation on the top. of the penis, it can actually bend away. from that and it can help straighten out. the penis. So, that's actually a a a. really nice utilization for it because. um for some people that can be really.

traumatic and devastating to have a. change in the way your penis appears. because it starts curving all of a. sudden. And this is safe and effective. and you can have bruising. It can be. slightly uncomfortable, but it's you're. not going to really hurt yourself uh too. much by doing something like this. >> I thought a curved penis would hit the. G-spot better. Yeah, sometimes a slight. curve can be beneficial for some people, but again, I think like when you notice. like there's a a dramatic change. You do. that more. Come [laughter].

rip the end off. >> It's okay. Um, >> I'm just trying to figure out how this. works. So, I get the penis. I put it. >> through. Yeah. >> Clamp it down. >> And you want to put it at your normal. And then you'll just slightly advance. the [clears throat] the length. You're. not going to pull crazy. easier. It's. going to do a little bit of traction so. it's not uncomfort. It's slight like. just a slight tension. It shouldn't be. like like that. It should be much. [laughter] less tension, but it is I. mean they can vary in price from $100 to. $500. So it's a onetime cost. It is not,

like I said, not dangerous. What is. dangerous is when people try to do. something that became popular on TikTok. called jelking. And jelking is where you. use your your hands and you make like an. okay sign with your fingers and you're. like stretching the penis with your. hands. And this can be dangerous because. you can create micro tears in the penis. And we in the urology community have. seen plenty of patients who have now. developed erectile dysfunction after. doing jelking because they've now.

created damage to their penis. And so I. I really caution people because this. there is so much despair around sexual. function, around penal health that. people are willing to try things and. they might really hurt themselves. No. joke, I had a patient the other day ask. me if he should drink hydrogen peroxide. because he saw some ad that said. hydrogen peroxide will fix your. erections and I said please don't. um. this is you know but he really was like.

seriously earnestly asking me this. question and I you know I didn't want to. shame him by any means and I was like no. you know this is actually not safe and. it's not going to help you and there's. no pill there's no drink there's no. anything that's going to give you a. longer penis. >> what are the cases that you see that. break your heart. >> you know I I've seen so there I've seen. patients who've had surgery to lengthen. their penis and they are above average. when they at baseline and they have. these surgeries to lengthen their penis. and then they have a bad outcome and now.

their penis is disfigured forever. And. that's what really um you never forget. that because that person knowing the. risks and benefits perhaps made a choice. and that choice didn't go the way they. wanted and now they have to live with. that for the rest of their life and. that's really sad. >> Gosh, imagine that. Christ. >> Yeah. >> Well, and it just it doesn't work. anymore. Well, like the one patient I'm. thinking of, um, he, uh, had a like it.

it basically developed a scar all at the. top of the penis. So, it was like. disfigured essentially. Um, and so it. was it was really sad. >> Before I hit puberty, I definitely had a. penis anxiety because I was the youngest. in my year at school and I I was the I. was short, very very short, very small. I remember what it felt like to like. hide my hide my dick. >> when I was around like guys in the. changing room and stuff like that. Um, you know, after puberty things I.

changed. >> And what I want people to understand, I. think more than anything is that you. don't need a long penis to pleasure a. partner. We just talked about how the. clitoris is the is the most reliable. route to orgasm, right? And so you don't. need a penis to stimulate the clitoris. You can use your mouth, your fingers, you can use a toy. There's so many ways. to help your partner achieve pleasure. And and yes, of course, there are a. small subset of women who really. appreciate a large fallus. But the large.

majority of women, if you look at survey. data, are very happy with the size of. their partner, are very content with. average or slightly above average or. slightly below average as long as they. are feeling intimate and they're feeling. pleasure. And so I think that there's a. misnomer that that people think if I. have a longer penis I'm going to be able. to pleasure my partner more. >> as it relates to women. Is there. different size vaginas? >> Yeah. So the a so just like there's. averages there's averages in females. And so average vag vaginal length is.

about 3 and 1/2 in. So when women get. aroused it expands and widens and. lengthens to about double. So the. average woman can easily accommodate the. average penis. maybe slightly larger. than average. And so I think generally. speaking, knowing that like you will be. able to fit in the average woman and you. will be able to please her with the size. of your fallus. And like I said, penetration is is not as important. In. fact, only about 85% of women orgasm.

through penetration alone. They need. clitoreral stimulation to achieve. climax. And so again, penetration feels. good. I I tell guys, it's like somebody. rubbing your testicles or your. paranneeium. feels good, but it's not. going to make you orgasm. And so. penetrating, yeah, if you're getting a. lot of clitoreral stimulation because. maybe she has a thinner, you know, her. clitoreral shaft is closer to the. vaginal canal, maybe, you know, the size. of the penis matters more. But for a lot. of women, it's not going to be.

sufficient and they're going to need. some directed clitoreral stimulation. Why do different vaginas feel different. to and I guess the the inverse is also. the case where like different penises. will feel remarkably different even if. they're the same size roughly and you. can have sex with somebody and go it. feels really good. >> I mean I think again it's how you it's. like the emotion in the ocean right like. how you use your so let's let's talk. about the vaginas first. So, when a. vagina is um has more pelvic floor. strength, they may be able to like tense.

around the penis better, like they may. be able to sort of grab the penis with. their pelvic floor a little stronger. versus someone who doesn't. And that's. where I think some people get worried. when I say, "Oh, you need to relax your. pelvic floor." They're like, "Oh, I. don't want to be looser." Right? And. that's not going to happen if you have a. normally functioning pelvic floor. If. you're. >> So, the penis is going in here, right? >> Correct. So, if I if you're a woman and. you do pelvic floor exercises, then. you're going to feel tighter. >> Well, you're you're able to contract and.

squeeze those muscles during sex better. around the penis. >> Yes. But we don't want you to be. tighter. We want you to be able to. squeeze the muscles and relax the. muscles. Use them like a normal muscle. like your bicep. You squeeze and relax. Squeeze and relax. We don't want it to. be constantly squeezed. >> But to the man, it will feel tighter. >> You will perceive it as tighter, but it. will not be that she's actually tighter. it just means that maybe her pelvic. floor muscles are doing a better job. So. that's for the female. For the male, it's it's generally like how the penis. moves and how the positioning is and.

where it's uh it may be girth that's. different. It may be the way that you're. moving in the vaginal canal and that may. be why it feels different. >> They often say that if you've got big. feet or big hands, you know, like people. think you have a big penis. >> Not necessarily true. So there's um. there's actually no evidence that big. hands, big feet correlate to female. size. There's one study in Japan where. they looked at nose length. And so the. longer your nose is from the the bridge. down to the tip, that is potent, at.

least the Japanese population that they. studied was correlated with the length. of the penis. >> People also think tall people have big. penises. Not necessarily. [clears throat]. >> But nose length, there's some. correlation in a study in Japan. >> Yes. >> Okay. I was just checking if my nose. [laughter]. >> Okay. Um the last thing I want to talk. to you about is. >> and how this relates to everything we've. talked about today, desire, attraction, sex. Is there any early data emerging.

that shows any correlations? >> Yeah. So ompic there's sort of benefits. and there's potential downsides. So the. benefits are that when you're on Osmpic, we see improvements in metabolic. diseases. They have improvements in. diabetes, improvements in heart disease, improvements in overall health, right? And so that is going to mean that your. blood vessels are healthier. You're more. able to get blood flow to your genitals. You're going to have stronger sexual. function and arousal, right? So that's. great. The other thing is that you are.

losing weight. So you feel better. you. feel more like your body image is is. feeling good about yourself. Also, for. men, remember I talked about this fat. pad right above your penis. >> That's getting smaller. And so now you. can see more of your penis. So you may. have heard of ompic penis where people. are saying, "Oh, my penis is getting. longer." It's not actually that your. penis is getting longer. It's that this. fat is going down. So now you're seeing. more of your penis, >> which makes it look longer. >> Yes. Exactly. Reality. Yes. Exactly. [laughter]. Well, it is reality to the person.

looking. Right. Um so those are all. great things and I think that's. wonderful. Now the other part of it is. ompic works on the brain and it works on. the reward pathway. So you now see food. and you don't feel like it's that much. of a reward. So you don't chase after. you have less desire for food. There's. emerging data that we're seeing people. on these medications, these GLP1s, have. less desire for, let's say, gambling, let's say shopping, let's say, you know, alcohol, smoking, whatever it is, right? And so there's a theoretical because it.

works on the same pathways that it could. also decrease desire for sex. And I. think the thing that, you know, there's. so many people on these medications, there's so many metabolic benefits that. I worry that people may not even realize. that their sexual desire is changing, right? They might just be like, "Oh, you. know, I'm I'm eating less. I look great. Everything's wonderful." But like slowly. in the background, they're like, "Oh, maybe my desire is less." And maybe it's. creating discord in the relationship. Hard to say because we don't have data. yet. So yeah, I think it's just. something that you should be aware of.

that if you start feeling like you have. less desire for sex or maybe you're. like, "Man, I just really don't feel. into anything." Talk to your doctor cuz. maybe your dose is just too high and. maybe it just needs to come down a. little bit. And again, we don't know. yet. But I do worry about this because I. feel like we're we're gonna start seeing. it. >> Is it possible to do studies on this. type of thing? [snorts]. >> Absolutely. So you can take people. starting Ozmpi and you can say, "Hey, here is or or any GLP1." You know, there's questionnaires. So like for.

women there's the female sexual function. index. For men there's Adam, which is a. questionnaire about testosterone. But. you could there's sexual desire. questionnaires that you can use. Um, and. you can take it at the beginning and. then you can take it as they increase. their dose and see if there's a change, right, in terms of their sexual desire. >> You said at the start about knowing how. to talk to your partner. I think like. intimacy desire, maybe the conversations. like with your partner, how to have that. conversation when there's a problem. >> Yeah. I I wish I could say there was. like a script that you can follow and. it's going to work. But everyone's so. different. But I think the important.

thing is like not giving up because what. happens is because we don't ever talk. about sex, when you bring it up, it's. immediately like, "Oh my god, is. something wrong? Did I do something. wrong? Um, do you not like me? Am I not. attractive?" Right? You're automatically. going down the rabbit hole of worry and. concern. And instead of dealing with it, you're supposed to shut it down. No, I. don't want to talk about it. Right? Um. especially if like maybe you haven't. connected intimately in a while and like. you just don't want to deal with that or. you're you have other stressors in life. Maybe you're not feeling like very good. about yourself and so you're like,

"Well, I don't really feel sexy, so I. don't want to have sex." And so, I think. really understanding that whatever. reaction you get from your partner when. you do talk to them, it's not about you. It's just usually about how they're. feeling. And so, don't stress about. that. And two, like it's anything that. is worth having requires work. So having. a good sex life, having intimacy over. the long haul with someone, if you are. committed to that relationship, it is. worth working for. It is worth dealing. with a little bit of discord to get.

there. And so I tell people when you. want to talk about sex, first of all, don't do it in the bedroom. Don't do it. right before or after sex. Do it at a. time where you are both calm, relaxed. Maybe you're out for a walk, maybe. you're in the car, so you're not like. looking directly at each other. You're. kind of parallel. And always start with. a positive thing. like I you know I. really enjoy this about our relationship. and I would love if we could talk about. this and and maybe they're going to be. like uh I'm not ready for that and you. say maybe we could come up with a time. where we can talk about this that works. for you right let them feel like they're.

coming to the conversation with like. they're not being ambushed or like. talking about something and then be. curious. I think the big thing is like. being curious like what's going on with. you like I want to I want to I want to. be there for you. I love you. you know, I miss what we used to have or I miss. this about us. And I think that there's. always these misconceptions. I hear it. all the time, right? It'll be like this. partner only wants sex and this partner. never wants sex and you know, and that's. it. Like that's the end of the. conversation. But the reality is that. there it's it's somewhere in between. So.

typically women tend to view sex as like. added stress sometimes when they're. already stressed. Like they're like, "Oh, it's just one more thing to do.". Whereas men look at it as a stress. relief. So, one, you're coming at it. from two different angles. The other. thing is men aren't really taught how to. be intimate. And so, for a lot of men, sex is their version of intimacy. Like, that's how they connect. That's how they. feel connected with a partner. And so, often times when they're doing these. initiations or attempts at sex, it feels.

like they're being greedy or it feels. like they're they just want sex. And I. think we have to reframe how we look at. that. Like, sex is not just sex. It is. intimacy. It is being together. connecting with another human being. So. how do we do that right? And like how do. we make that sex worth having? We get. into this frame where we have sex as. like in a hurried quick like just got to. get this done way. I just need to get an. orgasm. I just need to get a release. But sex is supposed to be something we. look forward to. It's supposed to be. something that we're excited about. And.

so we have to build that in. We have to. sort of like build the environment where. sex can can happen. So, it may mean. like, "Hey, we are affectionate during. the day. Maybe we send a lovey text. message. Maybe um you know, I give you a. hug. I caress your back. I um tell you. you look beautiful. I I'm I'm showing. you gratitude for how much I care about. you in other ways." I think just really. taking the time to understand why your. partner feels the way they do. >> I'm curious about on that communication. point about how different genders.

in heterosexual couples have different. sort of taboos and things that are just. a bit sensitive. Um, and I was looking. at the the variance between men and. women, and the the top one for men was. around performance anxiety. So, like. admitting to things like erectile. dysfunction because it feels like it's. so intrinsically connected to. masculinity. >> and you feel like a failure as a man if. you can't get a erection and pleasure. your partner, right? >> And then for women, it was talking about. um prioritizing pleasure and asking for. more foreplay or um, you know, specific.

specific stimul stimulation around the. clitoris or something like that. um. because they don't want to be labeled as. highmaintenance or too much hard work, etc. >> And it's interesting that on that walk. with your partner, there are different. things that will trigger each of you. >> Mhm. >> Um other ones for women were pain and. discomfort, bringing that up. Um body. image and the mental load, explaining. why you aren't in the mood. And other. ones for men are expressing nonsexual. needs because it might be seen as. unmanly, unmanly, boundaries and. rejection, communicating when they don't.

want sex. And lastly, the script, which. is discussing fantasies that deviate. from the norm. >> So, I want to talk about fantasy, but. before that, I would just say that, you. know, it because of social media, we're. in a place and I get text messages from. my husband 24 hours a day with like not. 24 hours a day, but like all waking. hours with reals and videos. Oh, I think. you'd like this. I think you'd like. this. You should check this out. And. it's like his way of like connecting and. like, hey, let's talk about this later. Like, this is fun. And so I I tell my. patients like send your partner a a. video that you saw on social media that.

might help them understand like why this. is important to you. Maybe send them a. video send them this podcast, right? Say. like, "Hey, I watched this. It was. great." Good idea. You know, um and I I. learned so much. And honestly, so many. patients bring their partners to me. Whether it's women bringing male. partners or men bringing female. partners, they come to me and they say, "Look, like I want you to meet this. doctor and I want you to talk to them.". And like it's beautiful to see that. Like I love it because it's it's so. deeply caring that they like brought. their partner and they want them to feel.

good and they just want to figure out. what's going on and like I think it's so. lovely to to to find someone who's so. invested in making sure that sex is good. for you, right? >> As men though, we're just not good at. talking about this stuff, >> right? But you know, I think you can't. use that as a crutch. >> Yeah. >> Do you know what I mean? Like. >> Yeah, I do. Yeah. We're just not good at. it though. We just. >> But no one's good at it. It's not men. Women are not good at it either. >> I think men are worse at it. I think in. general no one is good at talking about. sex. Like I, you know, I think it's. interesting because I talk about it all. the time, but I have seen very good.

communicators struggle with talking. about sex. And so I think it's just um. it's just it's uncomfortable and and. it's like if you and I can have this. conversation and we can talk about sex. openly, like there's no reason that you. can't learn how to talk about sex and it. it's it's a learning process and it's. worth it's worth investing in. Do people. bring you their fantasies? >> Yeah, I've had I've had well more not. not as many fantasies as like real sort. of diverse interests in sex.

>> What do you mean by So I had a patient. who came to me and said uh you know. after sometimes this was not like our. first visit like we built a rapport and. he told me you know the I I really. struggle with arousal and the only time. I get aroused is I have a a medical kink. and so I go to this person who will put. a fully catheter in me and that's what. turns me on. And I was like that's. really interesting. And I was like, "Okay, like that's that's great, but. like it took a long time for us to get. there for him to feel comfortable." But. it also then was like, "Well, if that's. what turns you on, you know, then you.

got to sort of explore other ways to. incorporate that with a partner. Maybe. not." So like a a catheter is is um is a. tube that you put in the bladder for to. drain urine. >> What hole does that go in? >> The urethra. >> It goes in the penis. >> Correct. And so there's actually a lot. of people who enjoy urethral play. So. they will take sounds, they're called. sounds, like little um uh rods with a. frail flared base and they will insert. them in the urethra. But people do find that pleasurable. And.

so because there is some, you know, there there are some nerve endings there. that can be pleasurable. And so again, it is totally fine to have interests. that are, you know, outside what we call. conventional. Um, but of course I think. you need to uh if that's something that. you're really into, you have to sort of. bring your partner into the into the. fold if that's what really gets you. turned on. Now, in terms of fantasies, almost everyone fantasizes, right? Almost everyone does. And the. interesting thing when you look at. fantasies is there's a lot of fantasies.

that you would think are not common but. are. So, for example, um being sexually. submissive is very common. So women. fantasize about it like around 60%, men. are like 20%, having this desire of sex, this fantasy of sexual submission. It. may not mean that they want to be. submissive in real life, but that's the. fantasy they're having. Um, men often. have voyerism fantasy. So like watching. sex. Um, they also have uh sex with. multiple partners. Um, women tend to.

have a lot of like sexual um dominance. but also romance in their fantasies. So. like in exotic places or um that or with. and a lot of times like 90% of the time. people fantasize about strangers or it. could be someone they know but outside. of their relationship and so that's. completely normal and nothing to be. worried about. It doesn't mean that like. you want that person. It's just a. fantasy. It's a safe place in your head. to think about fantasy. And I think one. realizing if someone fantasizes about. something it means nothing about how. they feel about you. It's just where.

their brain goes to explore. I tell my. patients sometimes write down your. fantasies for yourself. Just like write. them down. Don't share that with anybody. and have your partner do the same. And. then if you guys decide you feel. comfortable at some point to each share. one fantasy and you can start talk and. maybe one that you would want to try and. like it allows you to sort of explore. and think about different things. It. could be a negative outcome like you. could just be like oh no this what. didn't do it for me but it could also be. very positive. And so just like again I. think the big thing is understanding. like it doesn't need to be that serious. like we can experiment, we can play, we.

can have fun. And if you bring that back. into your life, you are going to be. happier, less lonely, live longer. Like. everyone should just be having more sex. >> It's um Yeah, it's interesting that. we're getting more and more sexless. because I think the world is stealing. our attention and that's causing a big. loss in connection. But then everyone's. lives are more stressful than ever. before. if a bomb goes off 10,000 miles. that way, I I see it when I open my. phone. >> Um, so it's an interesting time to sort.

of almost try and reclaim sex and. >> to work on one's sexual health, the. overall the full picture of one's sexual. health. Um, you're working on a book. which is, I guess, endeavoring to do. much of that, which is coming out in. September. >> called The Hard Truth: Everything Men. Need to Know About Good Health, Great. Sex, and Long Life. So, if you're. watching this after the 1st of September. 2026 or around that time, then the book. is probably available for pre-order or. already out. It's not available for. pre-order yet, is it?

>> Uh, it will be soon, but not yet. >> Okay. When the book is out, I'm going to. link it below in the comments section. Um, when it's available for pre-order, The Hard Truth: Everything Men Need to. Know About Good Health, Great Sex, and. Long Life. So, if the subjects we talked. about today have piqu your interest, the. book, I imagine, is going to go into. greater detail on all of these subjects. >> Absolutely. I think it's a book that. really I I wish was a part of sexual. education. I think all men need to know. this. You know, as women, we end up. taking care of our male partners. I make. all the doctor's appointments. I, you.

know, I organize all of that. I make. sure that my kids get all their. vaccines, all that sort of stuff. And. and you know, it becomes on us to take. care of our fathers, too. And so, as. women, we hold that role. And I think it. is so valuable to understand what men go. through and also to be able to support. them along the way. And I think it's a. great gift for, you know, men in your. life or for, you know, older sons even. to like help people understand their. bodies. And honestly, it's a huge. motivator. I tell people like for.

nothing else, people care about sex. And. I have seen patients turn around their. lives because they want to have better. sex. They'll literally improve their. blood sugars. They'll improve their. blood pressure because they just want to. protect their sexual health. >> Reena, thank you. We have a um closing. tradition on this podcast where the last. guest leaves a question for the next. guest not knowing who they're leaving it. for. >> Mhm. >> This is the first time in Dario history. where the guest has actually stamped it. with a stamp that says certified 100%. human.

>> Okay. >> So, you can see there's a little stamp. >> So, when is that AI? >> So, it's not AI and it actually says. that in the middle. It says Gen AI free. sign of things to come. But their. question I guess is somewhat linked to. that. They the question they've asked. for you is so much of the world feels. hopeless about this moment. What would. you tell someone to help them. [clears throat]. reclaim their agency? I think that.

we as humans are meant to be with other. humans. We are meant to connect and I. think making that a priority will allow. people to feel. um to feel a part of something again. You know, I think um I think there is. like an emergence of people starting to. look back at religious constructs and. and go to community and be a part of. things and enjoy live events again like.

we weren't doing before. I think if we. prioritize that, there is still hope. that we can come together as a society. And I think, you know, the pendulum. always swings right in every way, like. it's going to go far right or far left. and people are going to hate each other. and then they're going to love each. other and they're going to come back. And I think if you just look at history. time and time again, it repeats itself. And we will find unity and we will find. togetherness. We are obviously feeling. pain from a variety of different sources.

and we may feel pain right like in terms. of other things to come but ultimately I. I'm an optimist and I think that we'll. come together and and we will find um. happiness and joy in human connection. >> and I hope you're right and I think. we're seeing the early signs of that now. for anyone that's listening that wants. to learn more from Reena um I highly. recommend they go to your YouTube. channel I will collab if we can um and. if we do collab on YouTube you'll a. little smiling Reena um next to the Dar.

of Seio logo where you can click through. to her YouTube channel. She's got almost. 3 million subscribers and she goes. through all of the questions which no. one has ever answered for us. And I was. looking at some of the questions that. you answer for people. Everything from. >> why you dribble after you pee and how to. stop it. porn director reveals what what. scenes are faked in almost every scene. of movies, but then also a lot of the. stuff we've talked about today around um. penal health, erectile dysfunction, um. sex positions, and so much more. So,

it's a wonderful repository of. information that is constantly being. updated. That is a great place to. subscribe. So, I highly recommend you. do. Dr. Reena, thank you so much for. your time. >> You're so welcome. YouTube have this new. crazy algorithm where they know exactly. what video you would like to watch next. based on AI and all of your viewing. behavior. And the algorithm says that. this video is the perfect video for you. It's different for everybody looking. right now. Check this video out and I. bet you you might love.