Get Your Sex Life Back! What Everyone Gets Wrong About Sex & Libido: Dr. Rena Malik

If you are having sex with a woman for five to six minutes, 90% chance she's not orgasmy. Even if she sounds like she is. I am thrilled today to bring on Dr. Rena Malik. She has a giant following online from being willing to talk about the taboo subjects in a way that is science and data fact. Are we having less sex than ever before?

Absolutely.

Are there studies that show how often women actually fake an orgasm?

40% of women faked an orgasm, but men also fake orgasms.

Whoa. Is the G spot real? Feel? Really?

If you exercise 150 minutes a week, moderate intensity cardiovascular exercise, it's as good as taking a Viagra.

Wow. Women who watch porn and read those like kind of romance fantasy novels, it might increase our sex drive. Hi, I'm Cody Sanchez and this is the Big Deal podcast. I want to talk about a thing we don't talk about enough, which is how to have sex, how to have better sex, how to have sex longer with a partner that you adore. And so this podcast is really, really a special one, I think. And I wouldn't bring just anybody on here to talk to you about this. There's lots of people who talk a lot on the Internet about things like sex. When we come to a subject matter like this, I wanted to bring you the best. She has published 80 peer reviewed publications and been an online content editor for the Journal of Urology. You're gonna want to listen to this episode and I can also promise you you're probably going to want to send it to a few friends. The reason that I wanted to have you on today was not to talk about health broadly, but you know, I talked to our mutual friend and she was like, you have to talk to Dr. Malik about sex. And I was like, excuse me. I'm like, I'm like in my spreadsheets right now. What are you talking about?

You're like, that's not what my audience comes to me for.

And she was like, there is an underpinning of society that obviously we have to procreate and you're happier. There's some studies that show that you might be wealthier if you procreate and get married and have kids. And so I think it's important that we talk about sex. And at the end of this little session, what I'm hoping people listening to today will get is maybe just having better sex, maybe having more sex, maybe not feeling bad, asking the questions that they want to know about good or bad sex, erectile dysfunction, not so at the end, I hope everybody's like, oh, this is amazing. Now I can go have a little bit better sex, a little bit more sex. Because who doesn't want that?

Everybody wants that.

Yeah, except bad sex. Nobody wants more bad sex.

Right? And that's the thing. There's a lot of bad sex. Like there's a lot of bad sex because people are not educated, right? They're like, they see what's on porn or what's in even media, right. Like a guy penetrates a woman, within minutes they're orgasming. She's happy, he's happy. And it's like it's the best thing ever. It's like that's not reality. When you look at first time sex encounters. So let's say a man and a woman, 45% of the time the woman's going to orgasm. Only 45%. If you look at a lesbian first encounter, 95% of the time they orgasm.

That's such incredible advertising for lesbians everywhere. 95% of the time.

Because they know the anatomy. Me, it's so simple. They just know the anatomy.

Of course. It makes all the sense in the world. They're also handy. They got all these extra pockets. I just feel like being a lesbian is. That sounds great. I wish, you know, turns out I'm in a dudes. Yeah, me too. But good on, good on you guys. That's incredible. Yeah, it's not that they're, you know, better, they just are more knowledgeable.

Absolutely.

Like, what are some of the biggest myths that even smart people believe about sex these days?

I think the biggest myth is that the bigger the penis, the better the sex. And like, like, yeah, sure, some women have orgasms from cervical stimulation, but not a lot, right? So 85% of women need clitoral stimulation to climax, which doesn't require a large penis. And so it's like, it's more about. And you know, people joke, oh, it's the motion in the ocean. Whatever, whatever. Like, yeah, it is partially how you move and how you use your other, your other body. Right. Your mouth, your fingers, your whatever, your toys, whatever you bring to the bedroom. Like those things are just as important. And honestly, it's not even just about penetration. Like it's about using like exploring, finding your erogenous zones. Like, like you stimulating other areas and not just being so genital focused. Like it's not all about the orgasm. It's also about the pleasure you feel while you're being intimate and the connection you have with the person. So I think that is the biggest myth is like, that penetration and size are everything.

I can't. That sounds right to me that, like, 85% of need clitoral stimulation. Absolutely is. Are there any studies that show how often women actually fake an orgasm?

Yes, there are studies, and I think it's like, as high as, like, 40% of women faked an orgasm. Like, but men also fake orgasms.

Whoa.

Yes.

Really?

Yeah. So there's, you know, there's some men who have what's called delayed ejaculation. So they will EJ. They will take like, 30 minutes or more to ejaculate. It's like 9%. It's not a small number. But they don't talk, they don't complain about it. Right. Because they're all trained to think this is a good thing. And so then they're just like, I need it to be over, so I'm going to fake it.

That's. That almost, I think, would be worse as a man to fake it.

Right.

Because as a woman, you kind of, like, shake it off.

Yeah.

But as a man, you have, like, a physical manifestation of the fact that you're not done, don't you?

Yes, Yes. I mean, like, I think they do, but they probably, like, I'm guessing, and like, I. I don't think they've gotten into that detail in the research, but they probably, like, roll over, go to the bathroom, like, you know, whatever.

Yeah. I mean, I had a girlfriend who. God, we must have been 30 at the time. And she married and she had a kid already, maybe two, and she had told me she had never had an orgasm. 30 years old, and I was sort of blown away. And it took her a while to. To say that out loud. And then we were in a group, like a small, slightly bigger group of women, and there was another woman. So then I was like, oh, my God, how Common is this?

12% of women have never had an orgasm. That's a lot of women. 12%. And so, like, why is this so. A lot of times it's just because we don't. Women aren't taught. Right. So that one. There's not enough time for arousal. So arousal for women takes longer. It takes about 25 minutes on average. And so if you think about sex, the average duration for sex is about five to six minutes. So for a man to ejaculate, when, in fact, they've actually done a study where they took a stopwatch and timed it like the partner puts on their stopwatch times penetration to climax. And they've done it around the world, and it's around five to six minutes. And so if you think about that, if we're focused only on male pleasure and the. The whole thing is penetration, then within five minutes they will climax and you will barely be aroused. Right. Like, you haven't even gotten there yet. And so if you're not focusing on mutual pleasure, then many women will not orgasm. Right. So that's one. Two is. Yes. There's not enough time. Two is like, yeah, if. If it hurts. So, like, sometimes we just assume you should be well lubricated. Everything should work. But sometimes people have reasons they don't lubricate well. Genetics, they're on certain medications and, and they, and they still have sex with their partner without lubrication because, like, why should I need it? I'm young, I'm healthy. But lubricant is great. It makes things. It makes things more fun. It makes things more pleasurable. So pain is certainly going to prevent you from having an orgasm and then inadequate stimulation. So if you're not stimulating the clitoris, like I said, 85% of women need clitoral stimulation. And if you're just focusing on penetrative sex and you don't have favorable anatomy that's going to let you climax through vaginal penetration, then you're not going to climax.

Wow. So, like, men listening basically need to realize a couple things, which is if you are having sex with a woman for five to six minutes, 90 chance she's not orgasming, even if she sounds like she is.

Yeah.

Just like baseline. Take that for what it is.

Yeah.

And if you're not doing some sort of foreplay and it's not lasting longer than 25 minutes, you're not Casanova who's killing it magically in five to six minutes. You're just, you know, the other person just doesn't want to deal with the fact or come clean about it.

Yeah.

Which is like something that I don't think is said enough to do.

If a woman has an orgasm and she's, like, not sure she didn't have an orgasm.

That's so true. And I think if you have to ask, if you have to ask, she didn't have an orgasm either. Like, that's really fascinating and I think kind of freeing because it's not the size of your penis, so it doesn't really matter if it's huge or not. It's a lot about duration and consistency and touching the clitoris. And, like, this isn't rocket science, dudes. And so you could like, be pretty incredible with your woman with not that much work.

Absolutely. And a lot of it comes from like, just talk to them. But baby, does this feel good? Like, do you like this? What turns you on? What do you like? Like, show me or even watch if someone is open to masturbating, Watch them masturbate. What do they do? But let's masturbate together. I think it's hot. Like, whatever it is, right? And. And you're going to find out what they like because they're going to do it. They're gonna do it.

Well, is it true that women start to desire sex less and that our libido goes down as we get older? And if that is true, can we get a point back and how so?

Low libido is very common. In fact, 40% of women will have low libido in their lifetime. Your sexual desire is based on a variety of different things. So what happens initially? Right? Think about when you're younger and you're dating and you're really excited to see your partner. There's like this atmosphere of desire. You're like, oh, I can't wait to go on a date with you. I'm going to shave my legs. I'm going to look really attractive. I'm going to make sure I shower. Yeah, yeah, totally ready for sex, right? If it comes. Because it may not, right? You're still dating and so you're like, okay, let's be ready. And then you get this, like, you get excited about it and then you get to be with your partner. It's really fun and attractive and you, and you have a great time and everything's wonderful. But then as you're in a longer term relationship, you're like, they're always there. They're always there. And I'm busy and I'm tired and maybe I'm not in the mood today. Maybe you're not in the mood right now. And so it becomes like, you never prioritize sex because you're like, why would I prioritize sex? I've got a job, some kids, like, you know, my parents are aging. All this other stuff is going on and you know, like, that'll happen when it happens. It's supposed to be spontaneous. I'm supposed to see my partner, see them get turned on and jump them. Right? That's how it should be. But the reality of the situation is how often does that really happen? It becomes what's called responsive desire. So you start being with your partner and you're like, you start having foreplay, you start touching, cuddling, Whatever. Oh, oh yeah, I do like that. Oh, I do want sex. But I didn't know it until I actually became a little bit intimate with my partner. I actually started touching them, being with them, like, oh, yeah, I remember. And that's completely normal. And the thing is that people are so fixated on this, like, it needs to be spontaneous that they won't even cuddle or be intimate with their partner because like, oh, then they're gonna want sex and I don't want sex. And so there's also this like back and forth. The issue becomes when you both don't wanna have sex because of low libido. That's okay. I mean, like, you guys are fine as a relationship, but when one person wants a lot and one person doesn't, that's where it becomes a problem. It's not a problem with the person who has low libido or the person who has high libido. It's about matching the relationship together, right? So I don't want ever to point fingers at someone who has low libido. But there, so obviously there are like lifestyle reasons like I talked about. And obviously stress is a huge killer of libido, right? If you're stressed about anything, like you don't want to have sex, you're thinking about that thing. You're not in your mindful moment to have sex, which is what you need to be. You need to be fully present, enjoying the pleasure that comes with being with your partner. And most of us are like thinking about what we got to do after this is all over, right? And so like, we don't take the time and there's no foreplay, right? So like when you're in a long term relationship, you're like, oh, yeah, I see you all the time. I love you, okay? But there's no like sexy tech or like, let me just touch you in the morning and tell you how beautiful I think you are. Or like, hey, I can't wait for later. Like, there's no. And there's no planning. Like, hey, let's, this is going to be our time. This is going to be our time for intimacy. And let's instead of date night where we go out to dinner and just talk, which is still really important. Like, and then we're bloated, we don't want to have sex afterwards. It's like, let's actually say, hey, this is going to be time for intimacy. Like, we are going to shut everything else out, put our phones away, be together, get naked, and if sex happens, it Happens. But let's just like enjoy each other. Let's like put the pressure off, like, oh, I have to have sex. Let's just want to appreciate each other. So those are things that I think you can work on as a relationship. But. But there are reasons, like I said, why libido declines. So in women, we know that libido declines. And one of the reasons is because of testosterone. So testosterone in women, we have more testosterone than we do estrogen in our bodies. So we actually. And that is the hormone of desire. And so we talk about. It's actually having a moment right now, testosterone. But we know that it declines and it doesn't dec like in menopause, like abruptly, but it declines quite significantly. So you'll find that your testosterone starts declining and that can affect your ability to have desire. And so that's one reason. And then so we have, you know, off label ways to improve desire. And we have on label ways in terms of medications, so we have two on label medications for premenopausal women. Now they work for postmenopausal women, they work for men, but they are just studied for that population. And so there's one which is a pill you take every night. It's called addi. You take it every night before bedtime. It slowly increases your desire. So it's not like you're gonna take it and all of a sudden have a desire. But you might like be doing the dishes and a TV show comes on and you're like, oh, that's kind of hot. And you never thought that before, Right? And you're like, okay, I see. I feel myself coming back. I'm getting myself back. I feel like myself again. And then another one is vylisi, which is an injection. You give yourself 45 minutes before sex, before you want to want, basically. And it gives you a very sudden increase in desire. And both of these work on the brain, so they try to increase the hormones of desire. Cause there's like a balance, like a seesaw. So hormones that increase desire and hormones that don't are signals. And so we're increasing some of the signals that do increase desire. And so those are a couple options. And then off label, also you can do testosterone replacement for women.

Interesting.

Yeah.

How big is the population of men that struggle with erectile dysfunction?

So 52% of men over 50. And that goes up every decade. So 60% at 60, 70% at 70. 80%. 80.

So it's really common. Does that mean at like 40 or 30? It's 30 and 40.

It's a little bit less. It's a little bit less. Probably like 25% in your 40s, but.

That'S one out of four.

It's a lot. And so that's why some guy will be like, oh, I'm 40, this shouldn't be happening to me. And the thing about erectile dysfunction is it's like an opportunity to find out what's going on with the patient. And a lot of times they come in and the doctor's like, here's some biography. But it's like a real opportunity. Because of the guys who have ED, 14% of those guys will go on to have a heart attack in seven years. Wow. And because it's a early manifestation of problems with blood flow, and problems with blood flow often lead to heart problems. And so it's like two to three years before you're gonna see a heart issue, you're gonna see erectile dysfunction.

So what do you do to fix it?

So it's the same things. Anything that's good for your heart is good for your genitals, Right? So if it's for blood flow, and that's 70% of the reason that people have ED is from blood flow. I mean, there's obviously psychogenic issues, like it's in your head. But I think every guy who has issues with erectile dysfunction has that. Right? They're like stressed about it, but 70% of guys because of a blood flow issue. And so what you need to do is improve blood flow. So how do you do that? You do that with diet, with exercise, improving your cholesterol, improving your blood pressure and moving your body. Exercise, like cardiovascular exercise, 150 minutes a week, those sorts of things. So the things that are like, not sexy, like nobody wants to do them, but they're so important.

So you could literally, instead of taking Viagra, the research shows that you could solve ED in 70% of cases by working out more and eating healthy.

So there's actually a study that shows that if you exercise 150 minutes a week, moderate intensity cardiovascular exercise, it's as good as taking a Viagra. Hi, this is Deechan Lakhman and I am here to tell you Toyotathon is on.

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That's wild. Because that's what, 25 minutes a day?

Yeah, 30 minutes a day. 30 minutes a day, five days a week.

Oh, yeah, yeah. Fascinating. So then. Then why is Viagra given so much instead of that?

I think because our healthcare system is broken, right? You have 15 minutes to talk to a patient. So you have to get the information, do the exam, and then talk to the patient. So you're like, here's something that can help you. And because a lot of patients, that's what they want. They want a pill that's going to fix their problem.

Yeah. And It's, I think, Dr. Tina, when I had her on the pod, which was a great episode, too, we didn't talk about sex, but she was talking about how, you know, it is. Every doctor has, like, their version of the hammer, which is like, you know, if you're a surgeon, you know, then that's going to be your hammer. And, you know, if. If you're a psychiatrist, then it's going to be pills. And so it's like, whatever is your biggest and hardest weapon is the one that you.

And the one that works most. Right. Because, like, exercise works, but it takes a long time and you have to be consistent. And most people lose consistency. And we know that. Right. For any behavior change, it's very difficult to maintain. And so the thing that's going to be most effective is going to be a medication for most people. Yeah, that's wild.

But I had never thought about. So. So do you see very many men struggle with erectile dysfunction that are super fit?

Yes, I do, actually.

So then what's going on there?

Usually they have high cholesterol or they have high blood pressure. So they may have family history that causes them to have high blood pressure or their diet is affecting their cholesterol. And when you get deposits or atherosclerosis from high cholesterol, that affects blood flow. And so they may not know it. They're, like, really fit. They're like the Specimens of men and their cholesterol's high because of their diet or their genetics, and they then have issues with. With erectile dysfunction.

Because you said something fascinating to me, which is that women who watch porn and read those, like, kind of romance fantasy novels actually might. It might increase our sex drive.

Yeah, I think it. So it depends on how good your sex is in general. So if you are dissatisfied with your partner and you're using these movies or books to escape and, like, get pleasure for yourself, then it's not going to lead to more intimacy because you're already having bad sex with your partner. Right. But whereas, like, you're in a good, healthy relationship, you enjoy your partner and you're just using these as tools, right, to, like, enhance your pleasure so that when you're with your partner, you're, like, really easily getting into the mindset of being able to be pleasured and to be focused and mindful and enjoy. Whereas I think sometimes that's the hardest part for women is that you can't get out of your own head. Right. And we say that, but there's data to it. So, like, when you look at studies of. Lori Brotto is a researcher who did the study. They did 20 minutes of mindfulness for women who were having low libido, 20 minutes of mindfulness outside the bedroom every single day. And they saw that after, I think it was six or eight weeks, they had significant improvements in all the domains of female sexual function. Desire, arousal, libido, everything, and orgasm, everything. And a lot of those women, when they followed up with them a year later, many of them were still doing mindfulness because they had. And without being prompted, they were still doing it because they had so much benefit from it, because being mindful outside of the bedroom helped them be more mindful in the bedroom.

What does a mindfulness practice for sex look like?

It's just, you know, sort of. I mean, there's different ways to do it, but generally think about, like, clearing your head and trying to focus on, you know, your breath and your body and, you know, thoughts will come in, but sort of like saying, okay, let that one go, come back and focus. And sort of just training your brain to be able to focus on your body, what it feels like in space, your breath, those sorts of things.

Oh, so it's not like visualizing sex. It's literally just straight up mindfulness.

Just straight up mindfulness? Yeah.

So almost meditating could help you have a better sex life.

Yeah, absolutely.

Fascinating. I had no idea. But I guess it does make sense. Though for women, because we're always thinking about something else. Yeah.

You could think about it. Right. Even, like doing a podcast. Like, we have long conversations with people, so we're better at listening for long periods of time because we've trained ourselves to do that, whereas someone else may not be able to listen to somebody for two hours. Right.

You know, and we talked a little bit about porn for women, but let's talk about porn for men. I've heard lots of negative things about porn. Is porn bad to watch?

Yeah. So I think that, that there are. I think there's a few. Like, it's a very complex and nuanced discussion. So I think porn has been around for a long, long time. Right. It's not new porn has been around for a long time, but it's never been as accessible as it is today. It's in our pockets. It's everywhere you go. You can literally pull up a porn video for free anytime. And so that's a problem because people will use it as an escape from, like, distressing emotions. So it's like, why are you using porn? There's actually studies that look at, like, what are. Why do people use it? So people use it for pleasure. People use it for learning new skills. People use it to, to, like, escape. People use it to avoid negative feelings. And that's where it becomes a problem. Right? You use it for negative feelings, and then you might. And if you have some, you know, moral incongruence, like you feel shame because of using it because of the way you were raised or because of what society tells you, and then you feel more bad feelings and then you use it again and then you have more bad feelings. And it becomes this vicious cycle. And so that's where it becomes a problem. But there's many, many people. I, I mean, like, I think realistically, 90 plus percent of the population has watched pornography at some point in their lifetime, and most people just use it as a tool to have pleasure, to enjoy, to entertain. Right. And in those cases, people tend to do fine. It's when it becomes this, like, moral incongruence and this shameful spiral where people start really having a problem with it. And then it starts being like, oh, I'd rather watch porn than hang out with people because that gives me distress, or I'd rather watch porn than hang out with you or, or get rejected from my partner because I don't have to, to work at that. Right. And so they start using it as a, not as a tool for pleasure or enjoyment, but as a tool for escaping life.

So are there. Are there studies that show the more porn you watch, the less sex you have?

Not necessarily. So it really. It's not necessarily always correlated with the amount. So if you have, let's say, a moral incongruence, even if you watch porn once a year, you might be very distressed by it. Right. Whereas somebody could watch porn every day and, like, just use it as a tool and they watch it with their partner. And actually, couples who watch it together tend to have more sex and couples who have the same sort of consumption patterns. So say your partner watches it three times a week and you watch it separately three times a week. They show that those couples tend to have more sex because they both have similar, like, thoughts and ideas about. I mean, I'm extrapolating, but, like, probably because they have similar ideas or they're more aroused together, whatever the case is. And whereas when there's this, like, dichotomy where someone's using it a lot and someone's not, that's usually where we see more problems.

If you're married and your partner is using porn instead of having sex with you, which seems to be like, this is something people are talking about. Like, we're not having as much sex as I want, but my husband's watching porn, or vice versa. What do you do in that instance? And is that bad or good?

Yeah. So this is a relationship issue, right? So if they're watching porn and they are, like, rejecting you for sex, that's a problem, right? That's a sign that it's a red flag, right? That's a problem. Whereas if they're watching porn and they initiate with you and you. You, like, don't want to all the time, they're also humans, right? So they're like, you keep rejecting me and I still want to have pleasure, so I'm going to go somewhere else and get that pleasure without cheating on you. Right. Like, I might use a movie. And so I think there's this balance, but I think really it's a relationship issue. It's like, why is this happening? It's not like porn becomes a scapegoat, but why is this happening? Like, why? Like, is there truly just a problem that you have individually with the porn, or is there a relationship issue that we need to uncover?

So I want to break down two things. So one is, let's say that you're not having the amount of sex you ha. You want to have right now in a relationship. What are a couple of things you could do today to Change that. You've given some pill examples, but what else, like practice wise would you say this could work.

So first and foremost, talk to your partner. Like stop thinking about yourself. Like actually sit down and be like, hey, I want to talk to you about sex. It doesn't have to be in that moment. Give them a heads up. Because look, no one knows how to talk about sex. It's very uncomfortable, right? I talk about it all the time. But like I, I know when I talk to people and I like I can feel them getting uncomfort comfortable, right? And so I think it's like you have to give people heads up and realize like your, their response might be like, oh hell no. Like does this mean something's bad? Am I, is something wrong with me? Am I not pleasing you? Or whatever, right? And so I think first give them a heads up. Then like be like, hey, I'd love to just, I just want to talk about our sex life. Like I think we are great and I just want to make it better potentially and start with the good, right? Like, and ideally tell, I tell people like, don't do it looking them face, face to face. Maybe go on a walk, maybe in the car. So like it's the first time you're having a conversation. Just start by finding like what turns you on. And that's a great way to. Even with your, a new partner, what turns you on? Like what, what do you like? You know, and this is what I like. And like oh, that's great. And like do you like this? Like and it could be nonverbal when you're with them. And if it's a new partner, right, like you know, like you hear them responding in a certain way, that means they like it. And that's why I don't like faking, right? Like don't fake like tell like when you like something, you will automatically make the noises they want to hear. Like you need to fake it. But so yeah, I would say that's first and foremost is start the conversation. It is not going to be one conversation. It's going to be an evolving long time. Every, like every so often you're going to have to sit down and talk about it. Like what works, what doesn't. And I think the other thing is like adding novelty, right? So we think about like it's good to have a routine, a comfort, like oh, this always works. We both like enjoy it, we both climax, whatever it is. But like it gets, you know, if you're eating dinner, you don't want to eat, eat Chicken every day, right? So some days you want to have steak or you want to have tofu or like whatever, right? And so it's like you want to change it up. And the same thing goes for sex. So it doesn't even have to be that crazy. Like it might be doing it on a different side of the bed or like in the kitchen instead of the bedroom. Or you could buy stuff. Like you could buy things to just play with and have fun again. Sex is supposed to be play. It shouldn't be that serious. So like, just be open and be playful and enjoy. And I think you will find that just incorporating these small things can make a huge difference. Difference.

Is it ever possible in relationships for it to just stay spontaneous forever? Or is that just something we are telling ourselves that is another way for us to beat ourselves up? That we read these romance novels which are like women's form of porn, I think, these days. And it's like all of a sudden the Hulks picking up the woman every seven seconds. They're having sex everywhere. The sex is glorious. She has to do nothing. You know, it's. It's totally blissful. Um, and then we should have that for the 50 years that we're married. Like, is that reasonable or is it totally unreasonable to think that you won't have to plan sex as you get older?

I would say that it's likely unreasonable to think that. Right? I mean, I can't say there's not people. I mean, there's certainly people who are more sexual and like, say you are reading those books, like that means you're probably going to be more into your partner. So there's data that like, women who watch pornography, and this is not like everybody, but like, women who enjoy those sorts of things are more sexually adventurous, more, you know, they like to have sex with their partner and they actually have more sex if you look at the amount of time they have sex with their partner. So. So there is like, you know, if you are, you know, potentially consuming things together as a couple, or you, but. Or you that's naturally the kind of person you are, then yes, absolutely. If your partner's also that way, it's possible. But I would say most times you have to work at it because life is ever evolving, right? Like, your priorities are not the same at all times in your life. Imagine yourself 10 years ago very different than where you're sitting right now, and it'll be very different 10 years from now. And so, you know, it. It take work. And I think the thing is, people are so afraid to work at sex. Like, why should I have to work at sex? Right, right. It's a natural thing. But guess what? You had to learn everything. You learn how to walk, like, you have to learn how to get good at sex. And it doesn't just happen. You're not just going to be good at it because you're good looking or because you have a large organ or because like, whatever, it's not going to just make you good at sex. Right. And so you have to learn, you have to practice, and you have to learn with your partner if you're in a relationship. Right. Like, what do they like? Like, everyone's not exactly the same. And so, yes, there's things that work for mo many, many people, but it's about finding out what they like and really like identifying that and playing. Sex is supposed to be playful.

Is the G spot real?

Yeah, the G spot is a zone. Actually, it's not a spot. And I think people are like, where is it? What is it? Like, is it a button? Do I have to find it? Like, no, it's just an area, right? So it's like the top of the vagina and it's about 2-3 cm in. That's where it's very densely innervated. There's an area called called the Skene's glands, which also have innervation there. And so that can be very pleasurable. But what I tell people is people like, oh, if I stimulate that area, they're gonna orgasm. But a G spot in a female is the same as the prostate in the male. And so while some guys like prostate play, not everyone does. And not everyone orgasms from prostate play. And so the same thing goes for women. And I think the other thing is, like, there's variations in anatomy. So in the G zone, there's also like the clitoral bodies, which people also don't realize. It's not just the glands. The little head that you see on the outside, it actually goes deep into pelvis. And so. And it curves downward just like the male penis does. And so there's a shaft, basically, but it's internal. And so when you're stimulating the G zone, you're also stimulating the clitoral shaft. And so for some people, where there's maybe some, the, the width of that area or like the, the volume in that area is different, you might get more clitoral stimulation through vaginal penetration. And so those people may orgasm more easily through vaginal penetration, whereas others will not. It's just an anatomic difference. Like, it's not a big deal, but there's other ways to stimulate a partner and to climax. And what does it matter if it's not your penis doing, it's you doing it. That's what matters.

Why did, where did we get this belief that women come every single time from penetration? Like, why is that so pervasive?

Yeah, I, I mean, I, I can't say where it started, but I can tell you that, like, it's like, think about every movie you watch where there's a sex scene. It is literally. There's like, I, I can't remember the first time I saw, like, clitoral stimulation in a mainstream TV show or movie was like, sex scene life. That show on Netflix. Right, Right. I don't think I saw it ever before that. Like, on Sex and City. I don't remember anyone, like, except for talking about vibrators, I don't remember them ever doing anything besides penetrative sex. Right. So it was always depicted as penetrative sex. And that's what gets people off. And so I can imagine that, like, okay, then women are like, hey, I'm having penetrative sex. I'm not orgasming. Maybe I need a bigger penis. Like, maybe that's the answer. Like, I don't know. Right. They don't know because no one taught them. And so they're like, maybe bigger will be better. Maybe girth here will be better. Well, girth here might be a little better because having more pressure on the, on the shaft of the clitoris, but like, yeah, so what, like, what exactly is, you know? So I think it's one, there's no education. Two, it was never shown to us. And three, there's always been this obsession with, like, penile size. Like, my kids are like 9 and 11. Well, my 11 year old will talk about his penis and we talk about everything at home because I'm his mom. But like, you know, like, I'm like, dude, like, you haven't gone through puberty. Like, chill. You know? Hopefully he never listens to this podcast.

Yeah, exactly. Well, or finds your YouTube. YouTube channel. So, like, let's talk about that. Because I think there's also a lot of commentary about what's normal in penis size. What is actually normal.

It's about 5.3 to 5.7 inches erect. So not huge. Not like what we think is average. Right. Everyone's like, oh, you know, 12, I want a 12. Like 12. Do you know how big 12 inches is?

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Or not. Like, no, that's not. And so when you look at the average, people are going to range between like 5 to 5.7 inches fully erect. And so, you know, that is average. And then when you look at like the, the bell curve, like most people fall into that category. And when you start going to like seven and a half to eight inches, that's like the top 5%. And like, they're probably all like, you know, porn stars. But no, not, not exactly. But, you know, a lot of them are. And so, you know, I think it's just like what we see, right? People see like people who are in erotic films and they're. You have very large organs and they're using like camera tricks and all this stuff to make it look bigger. And, and so they're like, oh, that's gotta be what's normal.

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Yeah, so it's hard to study, but I definitely think there is. So what's happening is that this is how young men are learning about sex. They don't learn anything in school. There's only 22 states in the United States that are required to have accurate sexual education in school. So you might have sexual education, it might be accurate, it might not. And usually it's just how to put on a condom, how to get consent. And that's pretty much most of it. Right. You're not going to have a lot of like, this is what happens when you get aroused. This is what happens when you have sex. This is what happens to female body. Body when it gets aroused. Like there's no discussion about that. Right. And so people don't know. And their parents are also just like talking about like being safe Safe sex, it's usually very instructional, right? Like not instructions. Usually very like abstinence or safety based. Now they're like, how do I, how do I, I need instructions. So then I go to porn, right? Because I don't have anywhere else to learn this. I can't ask my parents. How could I ask them, right? And, and they've, that would be so weird. And so like we don't talk and parents are like, well they should learning it at school. And so I always say like you as a parent have to talk to your kid about sex. You have to, it is your job. Like you just have to teach them because that is your job. You are the adult. Get over it. Like talk to them about sex and talk to them about porn because what happens is they're going to come across it. You can put all the blockers you want. The average age of a young person seeing porn is 10.

Woo.

10. Wow. So before 10 you should talk to your kid about porn because what if they come across something on their friend's phone or wherever and they're like, what is this?

And they're stimulated and then they're confused.

They're stimulated, they're confused and then so they, they watch it maybe even a few times, who knows what, right? And then they have sex the first time and they're like, oh, this didn't go like the movie did, right? She didn't respond the way or he didn't respond the way that that happened. So something wrong with me? Am I broken now I'm stressed and the next time I try to have sex that stress is either making it difficult for me as a man to get an erection or as a woman to get aroused because I'm like, what's wrong with me? What's wrong with you? What's wrong with me? I'm thinking like I'm so stress it that I can't function. And now I'm like, I am broken. I'm truly broken. Something is wrong with me. And oh, but I can't go to a doctor because. Or when I do go to the doctor, I get dismissed because unfortunately there's just, oh, it's all in your head, right? And, and so because you know, you see a young person, everything should be fine with you. Your blood flow, everything should be fine. So it's gotta be psychogenic. And so they get dismissed. No one has the conversation like why it might be in your head. And then you're like, okay, now I'm, I'm just broken. And, and porn ruined me. Or whatever ruined me. And yeah, part of it is like, should 10 year olds be watching porn? No. You know, like, I think equivocally, everyone can agree that that should not be the case, that you should not be watching porn until you are an adult and you can separate fantasy from reality.

Yeah, but it's. What would that even look like? Like, do you think parents should teach their kids, like, not just about sex? It's so fast. I've only ever gotten the same safety talk. I got the, you know, here's what happens. Boy meets girl. Don't get pregnant, use a condom. This is what it looks like if you have a baby. Oh, my God, that's so scary. Yeah, but I never got the here's what good sex feels like. Or like, what would that even look like? What do you do with your kids?

Yeah, so I, I don't start with like, let's talk about, like, first. We teach, obviously, like, what are your body parts and how does sex work and what happens during sex? And why is like, so. So you start with, so I have boys. I can tell you for boys what I do. So, okay, they get an erection and they're like, mommy, why is it getting bigger? And most parents are like, oh, my God, it's just panic. It's nothing, right? And so sometimes you do panic. I remember the first time my son asked me about sex and I said, okay, give me a minute. Let me think about how I'm gonna answer you. I'll tell you later, right? Cause I was like, I hadn't thought it through yet. And so even me, who teaches about sex was like, I hadn't thought about how to talk to my son about it. So I said, okay, let me think about it. And so then I came back to him and I said, okay, well, you know, so we'd already talked about erections because they get that they get spontaneous erections all the time, young boys. And so I'm like, okay, this is normal. This is what happens. It's because there's more blood flow there and it's a totally normal thing. And so they're like, okay, it's normal. I'm like, yeah, sometimes it feels tingly or it feels different or it feels, you know, that's normal completely. Nothing bad is happening to you. I reassure them, right? And then, you know, when they ask, what is sex? And I'm like, okay, well, that's what happens. And I obviously preface it with like, you only do it with someone that you're, you know, whatever your personal values are. You bring that into the conversation, and then, you know, you'd be safe about it. But I was like, I tell them the basics. Like, you know. You know how you get an erection? Well, you know when your partner is aroused and they also get lubricated, and then you insert the penis in the vagina, right? And so they're like, okay. And I'm like, look, I know this is a lot, like, ask me questions. And so I let them. Because sometimes you can't think like a kid. You can't, like, think what they're thinking. So then you say, well, what do you want to know about it? Like, even if you don't, to just go into the whole, like, semantics, like, what. What are you curious about? Like, what do you want to know? And. And so just answer the best you can. And even if you're a little awkward or you're uncomfortable, like, they don't really know that. They just know that you're talking to them and you're their parent. Right? I mean, think about when you were a kid. Like, your parents, you thought they were amazing. You were like, they just do everything. Like, I. You never thought that they were insecure or, like, awkward. You were just like, oh, they're just perfect. Like, they're my parents. And I mean, most people have good relationship, but, like, so I think, you know, it's just like, ask and then leave the door open. So, like, talking about porn is really awkward. But what I would say is, like, hey, you might come across some videos where you see people having sex. We've already talked about sex, right? And. And they might be confusing to you. So if you do, just come talk to me. Like, I want you to be able to comfortable, and you build that relationship with them where they can talk to you about it.

Yeah, it's so true. I mean, God, what a difference it would be. And even, like, our generation if we had also learned what it was not supposed to feel. Like is the right word. But, like, I can only imagine if my mom had been like, this is the clitoris. Like, I don't think I knew what that that was until I was, like, 25.

Yeah. I mean, med students don't know what it is, right? Like, I have medical students put in catheters for women. I'm a urologist. And so we would teach them how to put it in. And so many would, like, go towards the clitoris. I'm like, nope, down. The urethra is lower. Right. That's the clitoris. And so, you know, and even in our training there's very little discussion about the clitoris. We're now starting to have this discussion. Like, hey, the clitoris has foreskin. Hey, it can get smegma. It can. There's other issues. You have to look at the clitoris and you have to examine the clitoris because other. What if there's a problem there? What if there's a pathology there? And so it's like, even people who are doing these genital exams, like your gynecologist and your urologist, are not getting really trained on it, right?

And where do you go if people want to get better at sex? So say they actually want to learn how to have. Have sex better, and they want to know themselves better, too. Like, what do you tell them?

Well, I tell people you have to explore, right? So, like, I would say getting better with sex is one with yourself and with the partner. So explore by yourself. Understand, like, what happens when you touch certain areas or what areas do you like to have touched? And, like, sometimes that's very uncomfortable for people. Like, you have to sort of meet people where they are. So if they're not comfortable with that, then there's other ways. But, like, I would say that's one.

Do you give them a book? Do you say, like, I like these books or.

No, not necessarily. I think that innately, people, like, kids, like, you know, kids will, like, touch themselves. Like, they know, you know, inherently what feels you like, right?

Yeah.

And they're not doing it because they, like, want to feel pleasure. They're doing it because they think it soothes them, right? They don't know. They're like, it soothes me, right? And so people generally know. And so it's like, you know, giving them permission. Like, it's okay to explore your own body. It's your body, right? You're allowed to understand what you like and don't like. Like, I think it's very different for boys and girls. Like, boys, they figure it out very easily.

They really do.

And they're going at it, right? And no one ever even questions it. Like, oh, he's probably just jerking off in his room, right? Like, it's like. It's like, okay, and that's fine. No one ever says, like, oh, you shouldn't. I mean, maybe they do say, you shouldn't do that, but, like, people just do it, right? And then they're like, oh, just don't do it in front of people. Right? Don't do that in the living room. Like, but it's like, you know, it is something, though, that we do cloud in shame. So you'll be like, oh, my God, don't do that. Like, that's another way, like, don't react to your kids. Just be like, hey, this is, you know, it's fine to do this, but, like, you should do this in privacy, right? This is something we do privately because that also internalizes the shame around sex very early on. Now for women, it's like, it's never. I mean, it's not as obvious and it's not as intuitive, and there's a lot more like, be a good girl. Don't do this. Don't like. And so there's a lot less, like, openness. So it's a lot also, like, starting at a young age, like, hey, like, this is your body, this is your anatomy. This is, you know, what sex is. This is what pleasure is. Like teaching our girls that. And then, I think, you know, again, meeting people where they are, talk to your partner, explore. So one thing that we do often when people are really in their heads about sex is like, the sex therapist will prescribe something called sensate focus. So what that is is we say you're not allowed to penetrate. You're not even allowed to touch the genitals. You, when you're with your partner, want to explore other areas, find your erogenous zones, touch everywhere, but don't touch the genitals and start really just like, there's no stress about that, right? You don't have to perform. Nothing has to happen, but just touch each other and feel sensual and enjoy each other and figure out what feels good. And once you're in your head and you're like, oh, wow, this is great, I'm enjoying it. Then you start touching genitals, and then you're like, okay, now I'm not stressed about that either. Then we start talking about penetrative sex. And so sort of a way. Way to just work together. And if you're like, I don't know what I like, like, you know, it's hard to admit that. It's hard to admit that. And so to be like. To say to your partner, like, I don't really know, and, like, I'd love for us to figure it out together.

A lot of this stuff about sex seems like it's really about your health overall. Like entire bodily health, not just general health. And then simultaneously relationship or mental. It's like, we keep treating this one area, but it's actually just a symptom of the human.

Yeah, absolutely. I mean, it's. If you like it's such a good biomarker of health, your ability to have sex. So to have desire, to get aroused, to climax and to feel good at the end of it all, all those things should be intact. Right. And when there's a problem with one of them, it tells us, hey, is there a blood flow problem? Is there a hormonal problem? Is there a mental problem? Is there a neurologic problem? Is there something that you're taking that's affecting your sexual function? And so we gotta investigate all those things. Things. And I can't tell you, like, this is one of the greatest ways to find out if something is wrong with you metabolically in your body. Right. Because it's a sign that something is ay. And we need to investigate. And oftentimes it's a metabolic cause for men and women. Right. Like, there's probably. I can tell you that women with diabetes have less arousal and, and often have less. Have more issues with libido.

Yeah. But. And then. So overall, all. Do you think the, the data seems to say, are we having less sex?

Absolutely.

Than ever before.

Absolutely.

So across the country, what's sort of happening?

I mean, there's so many things that I could speculate on. One is, I think that, like, we have phones, right? So, like, in the bed before going to sleep, or like when you're bored, you look at your phone, but before, sometimes you'd be bored and you're like, hey, my partner's next to me. Like, I'll just have sex with them. Like, why not? Right? Or they'd initiate and you wouldn't be like, hey, leave me alone. I gotta, like, look at my sudoku or whatever you're doing, right? And now, like, you have something else that's constantly taking your attention away. So I think that's 1, 2. Is that the stressors are so much higher, right. Like, I think the world has changed, the economic landscape has changed. Like, it's more difficult to financially, like, own a home. There's so many different things, right? So I think that there's more stressors in life, and I think that those. And there's more expectations from people that we're much more individualized. And so, like, when, you know, like in India, for example, it's much more community feel. So, so like, everyone raises the kids, everyone takes care of the kids, everyone helps each other. And so you have, like, more people to help you. Whereas now we just, like, are an island to ourselves.

Yeah, yeah. You know, it's interesting because I, we. We talk a lot about things that could progress society, you know, forward. And at the end of the day, it sort of feels like there's been this kind of continuous attack on the nuclear family. Not saying that in some conspiratorial way. Just like so many things that have been created have sort of tornado torn apart this nuclear family. And so I think it's so important to talk about sex because that's where life comes from, you know, and, and for whatever reason, what did our parents always say? Don't talk about religion, sex and politics and money. Right. And I, for the life of me, I can't understand why you wouldn't talk about money. I can't understand why you wouldn't talk about faith in a positive way. I can't understand why you wouldn't talk about sex in a non shameful, you know, inappropriate way. And so it does feel like there's kind of like this resurgence of people willing to talk about it. So I'm really glad that you. Because yeah, I mean it's, and it's, it's hard to do it in a way that is both entertaining and also super informative.

Yeah. And you know, I think it's just, it's just so important. Like it, it does, it's how we progress in society. Right. That's why there's so much urge for sex. That's why people want to have a lot of sex. That's why sex sells. Because we are hardwired to look for sex. We are hardwired to procreate. And so it is so important. And if we literally stop having sex because of all these external factors, factors, then like what's going to happen to society? Like who's going to take care of our aging population? Like what, what's going to happen? It's a problem.

Let's say that, you know, there's quite a few people here that want to extend their sex span, which I didn't even know that that's a word.

Yeah.

Like how long do humans normally want to still have sex? Like until what age? And how do we increase the amount and duration of our age to want to have, have sex?

So it's interesting. I actually did a study when I was a resident. I don't think I ever published it, but I did a study because I was like, I asked this exact question. I was like, what about older people? Like how old are they when they turns out that 80, 90 year olds still want to have sex? And honestly what I think what happens is that if you, if you continue to cultivate desire, like you still, like, took care of yourself, and you continue to have sex throughout your life. And you. And you. You will still continue to want it, right? Because there's a natural urge to want pleasure and to enjoy people and to have intimacy and connection. But what really happens is sometimes people start getting sexual dysfunction, and so they avoid sex. And then as you stop having sex or you start avoiding it, your desire decreases too. And so that whole thing about use it or lose it is sort of true in the sense that, like, if you don't continue to have sex, your desire will automatically get lower. The other thing is, if you're not getting good blood flow to the genitals, they will start to develop changes in the tissues, which will lead to maybe scarring or what we call fibrosis, which will then make it even more difficult to get blood flow down there because the tissues are no longer healthy. And so that's another thing that happens. So that's why I think sex span is much shorter than lifespan, because you can live without blood flow to your genitals, but you can't necessarily get an erection or get clitoral tumescence and feel arousal because you're not getting good blood flow down there. And then because you're not using it and your desire is going down, you're just not having sex. Right? And so I think that the reason to improve sex span is one, like, we know that people who have more sex live longer. There's actually data to support that when you're having sex once a week, that those people live longer and have less depression than people that don't. Now, I don't think you should, like, have to strive for once a week if that's not in your. But, like, meaning you're continuing to have regular sex with your partner. And I think that's the take home. Because, one, you're getting good. We know that things are functioning well. It's a biomarker of health. You're getting good blood flow, getting your hormones are working. All those things are in good order. You're intimate with another person, you're connecting with another person, which is so vital for feeling human connection. And so I think all those things take into. You're usually happier, and happiness has a good positive predictive value. And so all those things together are gonna expand. This episode is brought to you by Netflix from the creator of Homeland, Claire Danes and Matthew Rhys star in the new Netflix series the Beast. In me as ruthless rivals whose shared darkness will set them on a collision course with fatal consequences. The Beast In Me is a riveting psychological cat and mouse story about guilt, justice, and doubt. You will not want to miss this. The Beast in Me is now playing only on Netflix.

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Learn more@finra.org TradeSmart I'm your lifespan. Let's talk about pelvic floor. So you brought this up before. I had no idea. I. I don't even think I knew this was a thing until I was, like, 35. And one of my girlfriends actually, the other week told me something that I thought was crazy, you probably understand, but she's like. She had some pelvic floor issues, and so she went and she got a pelvic floor massage, which is like. I don't think she called it a massage. I'm gonna call her a massage. But, like, they.

I'm sure I know what she called it.

They go in and they actually. What. What is this? Pelvic floor. How do we fix it? Why are people massaging the insides of my friend's vaginas? What's going on here?

Yeah, so. So, okay, Pelvic floor is a bowl of muscles, right? It sits in our pelvis. Men and women have a pelvic floor. I think people forget this. Like, men also have a pelvic floor. And this pelvic floor is, like, something that's, like, a part of our core musculature. So people think abs, right? But it's abs, back muscles, pelvic floor, it's activated all the time. We're using it with every step. It's helping us remain stable. It's helping hold up our organs. It's helping us when we poop. It's helping women when they're pregnant. Like, it's part of our sex lives. It contracts, like I said, 0.8 seconds. It's part of that whole sexual response. And so it's a very important structure, right? Many structures, a bunch of muscles altogether. And so these muscles usually work fine, and we don't think about it. They're just doing what they need to do. But they can become dysfunctional. So there's a couple different ways they can become dysfunctional. They can become dysfunctional when they're weak. So that's where people, like, do kegels do Kegels. Do Kegels to strengthen the muscles. And that's when women are maybe leaking with coughing, sneezing, jumping on the trampoline. Maybe they're having some prolapse. Like things are falling down. With men, we don't see it as often, but they might notice that they're. They're in very extreme circumstances. They have rectal prolapse. Like their rectum will prolapse out, but sometimes they'll just.

It means that like, like, protrudes at.

Their bottom when they. When they have a poop and not.

Sound fun?

No, it's very rare. And then. But, you know, more often it'll be like, oh, maybe their ejaculate is not going as far as it used to, right? It's just not as forceful as it used to be. And so. But usually you can't tell with men when it's weak. So that's very common. That's what we think about a lot when we think about the pelvic floor, because we, like, do your Kegels, right, To strengthen your pelvic floor, which is just squeezing your vagina, essentially a exercise where you're pulling the pelvic floor muscles, you're contracting them, you're squeezing them up and in, right? And so we describe it. There's many different ways to describe, but, like, it's like as if you're peeing and. And you stop the stream of urine. You don't wanna do it when you're urinating, but that's how you can figure out the moves. For women, we'll say like squeezing up and in. In the vagina, like you're trying to pluck a blueberry up with your vagina. And then for men, I tell them, like, it's like you're. Or you're like holding in a fart. For both genders, you're holding in a fart. Jesus. And then for men, I'll tell them it's like you're lifting up your penis off the ground without touching it. And I just say, but you don't wanna be clenched. It's hard because it's natural to clench your abdomen and your bottom, but you don't wanna clench those. You just wanna focus on those pelvic floor. So it's basically a contraction. Squeeze and relax, just like you would do a bicep contraction, right? And so that's a Kegel. And it's great for strengthening the pelvic floor, but it's not the only thing you need to do. And it's good when you have a weak pelvic floor. But when you have a tight pelvic floor, which is what I think your friend had, it actually can hurt you to do Kegels, because you're strengthening an already tight and tense muscle and you want to relax that muscle first. And so when people have a tight pelvic floor, and this is pretty common, I think underdiagnosed is when people have a lot of tension in that pelvic floor and it's tight and contracted. And why does that happen? Because of trauma, because of stress, because of anxiety, because of other conditions, sometimes can cause, like if you had surgery or other things can tense up those muscles. And just like people get TMJ and they tense their jaw at night and they wake up with headaches and they don't even know they're doing, it's the same thing. It's not like you're controlling your pelvic floor. It's as you're building body's response to that, whatever the cause is. And so I don't want anyone to feel shame if they have high twin pelvic floor. It just happens. It's nothing you can control. And so then when it happens, people usually don't do anything. They just say they might notice, oh, I'm going to the bathroom a little more often. I'm maybe having some constipation. Maybe I'm having back pain, Maybe I'm having pain with sex, Maybe I'm having pain with orgasm. And with men, I might be having a little bit less strong erections. Maybe I'm having pain in the testicles for men. And so you're like, okay, what's going on? Something, something is off. And it could present in any of those ways. So I describe it like if you had your bicep curl and your bicep was stuck like this, obviously your bicep might hurt, but your shoulder might hurt, your elbow might hurt, your wrist might hurt. So you're going to see dysfunction in areas that are connected to the pelvic floor. And so in those cases, we need to learn how to relax those muscles. And so there's different exercises you can do to relax, like yoga poses, like child's pose, Happy Baby Figure 4. Low, deep squats, diaphragmatic breathing, all those things can help. But sometimes people will actually, like, massage the muscles, just like you would massage a muscle that's tense. The same thing is they massage those muscles to help relax the muscles. And so pelvic floor physical therapy, when you go to Physical therapist can include that if you feel comfortable in sort of helping you learn how to relax those muscles.

I just immediately started giving her, which said my. My maturity level with this. I was like, you did what? Where. What happened? But she said it was really helped her. Yeah. And. And she didn't realize basically how much stress and everything she had. But I live in Austin where you are now, so I'm like, I don't know. You know, it might just be like the woo woo people at Austin, but maybe it's not. There seems to be a lot of data that says that, like, drugs and alcohol for sex are bad, but I have a lot of girlfriends, totally qualitatively, that'll use like cannabis, let's say, because it can be a vasodilator, from what I understand, and open up blood flow and actually find that it's incredible for sex when targeted. What is it about drugs and alcohol and sex for women? Should we use them? Should we not?

So marijuana, cbd, thc, whichever form you want to use, has been shown to increase libido in the short term. Right. It's the problem becomes you're using it all the time because it does sort of mellow you out. Right. And it can then over chronic, you sort of just decrease desire. Right. Over long periods. But when you're introducing it in short spurs, it can absolutely increase libido. And in terms of alcohol, alcohol for some people, it does allow them to get uninhibited or be more spontaneous. But again, when you're using it all the time, I mean, generally speaking, alcohol as a whole has been found more and more to be just not healthy. Right. It's more causes concern for cancer, you know, overall health, so many different areas. Right. And so, like, I think for that reason, I just don't recommend it. Right. And then you can also make poor judgment calls if you're too inebriated. Right. And then we talk about alcohol, alcohol for men, causing sometimes arousal issues, like having difficulty with erections. And I suspect that probably the same is for women, although we've never studied it.

Oh, interesting. So, like, if you drink and you're a man, you have an increased likelihood of decreased arousal. You're more likely to not be aroused.

Correct. And that's, you know, interesting. I actually did a deep dive in the day. That's what we tell people, Right. Like, you can get whiskey dick if you get too inebriated. And that's probably true. But like, I think that when you look at the data, it's more when people Were like chronically having a lot of alcohol, alcohol use that are really having these problems. But I think it's, it's also a nice thing to say, like, look, things happen, right? Like for men, like, things happen and sometimes you won't have an erection and like, there might be a reason for it. Like, don't freak out.

Yeah.

And I think that's the real take home. I want people to take. But I think again, for women, it can sometimes cause changes in arousal. It depends on the level of inebriation. And these are hard to study.

Well, I hope that people take this podcast and they share it with people and they follow you on, on the, the social channels. Because I think these are things that are really hard to talk about by yourself to your partner.

Absolutely.

You know, and I think they're hard for you to talk about maybe with your family, but if you can, you know, forward an episode along that talks about it in a way that is not lowbrow, is also really approachable. We don't have to listen to, you know, love, Andrew, but we don't have to listen to, you know, three and a half hours super data heavy podcast on sex. But we also don't have to listen to, you know, call her daddy. You know, hypersexualized. You just like, you know, talk to a doctor who's done this for decades in a way that's really, really approachable. So hopefully if you're listening, you felt the same way and you forward this to somebody that you think would benefit. I think where I want to end is like a couple futuristic things. So, you know, you've been, you've been a clinician, you've been a researcher, you have been on social media with hundreds of millions of people viewing your work, all regarding sex. Do you think in the future we're going to change some of these trajectories? Like, will it be possible for us to have more sex in the future? Do you have positive outlooks on how we could change this? Or are you like, unless we make major changes, fertility is going to be an issue and sexual intimacy is going to be an issue. And you don't like where the future's headed.

We have to make changes. And I think people are starting to see it. Like, I think so in Europe, they're making decisions, they're making some legislation, I forget which country exactly where. They're encouraging, they're giving incentives for people to go on vacation because vacation is stress, but not because they want people to go on vacation and use their money because they Actually want people to go on vacation de stress and have sex and have babies, right? Because they're realizing that their population is declining and who's gonna take care of the aging generation? So I think it is gonna have to come to some degree from legislation also, like women are delaying childbirth because there's no support. Right? Like you're young and you don't have, you don't wanna quit your job, but childcare and like, there's no support and women are not getting motivated or promoted or they're looked at as, you know, not as valuable employees because they're going to go have pregnancy. We have to change that. Right? And so I think there will be changes. I think there have to be changes because otherwise we're headed to a place where we're just not propagating society. Right. And so I'm hopeful that like, I think in general, like, things go in a sine wave, like there's going to be like some pendulum swing one way and then things are going to go back ultimately always sort of goes, ebbs and flows if you look at like the trajectory of history. Right. So I'm hopeful. I mean, I have to be like, otherwise we wouldn't have made it this far in, in society. So.

Yeah, what's a really good point about women today too, with, you know, the, the repercussions of sex, ideally, which are pregnancy. You know, I, I still felt like this. I mean, I have a lot of resources, I'm relatively successful and I'm, I'm 38 now and I can't tell you, probably up until a few years ago, I thought, I don't know how I could do it. Like, I don't know if I could have a baby and work as much as, you know, and grow this business and be relevant and like all of these real fears. And so I think, you know, and then I, and then I employ mothers here who are incredible, you know, and like more efficient, arguably, and more effective in a lot of ways than, than somebody who doesn't.

And yet working together is so important, right? Like, we all bring something unique to the table. And so I think it's just, it's, it's just like we have to value that we, we have to support mothers in having children, but also allow them to succeed in their own right. And I think that there's, you know, there's some people who are better mothers because they work. I know I am. Right. Like, I'm more intentional with my kids. I spend more quality time with them because I go to Work and then I come home and I'm present with them because I now have been stimulated as a human adult. And so I think that. But there's some people who would be better staying at home and that's okay too. Right? But like we just have to promote that, support that.

Do you think we'll have sex with robots in the not too distant future?

I'm sure we will, but I, I hope that like it just won't. Like you don't want someone to yes you to death. Right? You need a little bit of tension. I just worry that the AIs will learn that tension and then we're in trouble. Right? Because you don't want to just be like, yes, yes, yes, I think you're great all the time. Like that gets boring. We need human connection. And so I just, I don't know, I mean, I think that's a little bit scary.

I know I was at this event the other day and it was a, an AI with one of the, I won't say the name of the company, but a well known company in the AI space. And the woman and man who are running the talk, they basically were saying, well, it was kind of a boring talk, honestly. I was listening and it was over my head and I don't really know. And they were saying, yeah, well AI is going to do this and this and AI, you know, we already have friendships with AI and we have, you know, working in relationships with AI. You know, we'll start to have intimacy with AI and then we'll eventually have some sex with AI. And I was like, excuse me, you know, and I just, it sort of like snapped me out and I raised my hand, I was like, I'm sorry, you're gonna have to double click on the last thing about us having sex with AI. And they had said a statement that I thought was so interesting. They were like, well, we have already had sex with magazines, AKA Playboy, etc, We've had sex with computers, obviously porn. We have sex with our phone, you know, porn. And then one guy in the back was like, yeah, sometimes if it's a good looking cloud, you know, and like what was a kid? And I kind of did chuckle while simultaneously being really scared about the future in some ways. Because we humans sometimes do like the path resistance.

Yeah.

And so if we can go down a slippery slope in which the, the robot or AI always says yes and gives us exactly what we want, it already seems like we're choosing less difficulty in, you know, health and relationships and marriage. So I think it's really important, the stuff that you're saying out there, because maybe it's not actually so hard. Maybe having sex with a human is incredibly more fulfilling than porn is in all the ways imaginable. And it's so accessible.

When you look at brain studies, like, yeah, your brain lights up with porn, but it lights up way more with a person, way more. And so, like, if you look at the research, so yeah, you, our bodies want people. It's just becoming more and more difficult and we're becoming more and more distanced because of it. And I think, like I said, I think I'm very hopeful that it's going to come back to like, sort of back to some level of normalcy. And we have a responsibility. Like, I know people want to make money and AI dolls sound like a great idea, but like, we have a responsibility to, to withhold and to take care of society as a whole. Like, we can't just turn us into like, you know, AI loving humans and like, oh, we're filling a gap with AI. Like, no, we need to fix the gap.

Yeah. You do hope that entrepreneurs choose a path that is better for society as opposed to only makes money. We'll have to see what ends up happening there. But I, I think that's, that's very, very true. It's like you get to choose the thing that's. That you work on. But, you know, it's, it's an interesting point. So, like, so, so the brain studies can actually show that you get more pleasure from having sex with a human.

The areas light up, right? So, yes, that they light up more intensely. And it's because, Because I suspect because there's touch receptors of the skin that can only be stimulated by a human hand, not even a gloved hand. It has to be a human touch. And so I think that is the reason that you're getting additional inputs that are much more pleasurable.

That's actually one of the best use cases I've heard against pure robot sex is that it might be more fulfilling scientifically with a human. I think we already all know spiritually that with a human it makes much more sense. And, and also, I mean, anybody who's ever masturbated to porn before, I don't think at the end of masturbating to porn, you're like, oh, bliss universe. This is like, incredible. I just had a spiritual transcendence. You're kind of like, it's a tool.

It's a tool. It is not a person.

You're like, I showered and that happened. It's like.

It felt nice.

Yeah, exactly.

Yeah. It's. It's a prequel to the real thing eventually. Right? Like when you're with a partner.

Yeah.

Well, as it should be.

I love that. Well, thank you so much for being here. This was so interesting. We're going to do the whole thing in the beginning, but where do you. I mean, your YouTube Chann channel is incredible.

Thank you.

Is that where you like to send more people or do you go to Instagram too or.

Yeah, I'm on YouTube. That's my biggest channel. But I also have a podcast and I have an Instagram. All the social. I'm on all the socials, but the biggest one is YouTube.

Yeah.

And Dr. Rena Malik Renamelic, M.D. everywhere.

D. Yes. Important couple letters that you spent a lot of years buying getting those too.

And you have to type the whole thing in on Instagram because I get shadow banned all the time. No way. Because. Type in Rena Malik MD or you won't find me.

Because you're talking about penis size on the red sex. That's why. Well, I guess with all the only.

Fans or something, I, you know, it's interesting to me because they will. There's like women posting like see through dresses and they're fine and it's like people talking about sex from a scientific background and all of us, like sex therapists, doctors, like, who talk about sex. We all get shadow banned.

That's fascinating. You'd think that Facebook by some point would be able to like double click on the fact that you're sitting here in like a button down talking about. About pelvic floor.

I know, I know you think so, but not quite. Not there yet.

One of my favorite videos of yours was actually talking about. We'll link it in the show notes was actually talking about pelvic floor, which is where I learned a lot from it and how important that is for pregnancy and for longevity, which I didn't realize. And I also did think the ones on penis size was pretty clever.

So cute.

Thank you so much for being here.

No problem.

Thank you. At the end, I was going to have Reena sign a postcard and I asked her what she would say to her young self and she said, don't fake orgasm, which make me sort of giggle, but I think is also really true. If you guys liked this podcast, please do me a favor, like, and subscribe. Turns out a bunch of you come every single week. Like 40% of you come every single week. And you listen to the podcast. But you don't actually subscribe, so make sure to follow along. Also, if you're like me right now, you're probably thinking of that one friend or your partner that you know would benefit from listening to this podcast. Do the thing that is the most beautiful gift you can give anybody. Forward this along to somebody else who probably needs to have this conversation and hasn't. I think we've got to normalize talking about sex and you can be the person to do that right now. So send this to a friend.