Penis Problems, Solved

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What we found out is that these same guys were coming back about five years later and telling us they had their first heart attack. And it wasn't that the Viagra was causing the heart attack. It's that we weren't recognizing back then that these guys are really are suffering from cardiovascular disease. And we were treating it as though, like if a guy came in and said, hey doc, my, my chest hurts when I exercise. And I say, okay, here's a Viagra pill. That's not the right thing to do. You should go get checked out. Get a cardiologist to check your blood vessels to see if there's anything wrong with them.

You're listening to Sex with Emily. I'm Dr. Emily, and I'm here to help you prioritize your pleasure and liberate the conversation around sex. Whether it's erectile dysfunction, premature ejaculation, or a slight penis curve, It. It's common to have penis questions, especially when they're affecting your sex life. But where do you go for answers? Well, you come right here to this informative convo between me and urologist Dr. Edward Kurtman, as well as Jeff Abraham of Promescent on this best of show. We're talking to you all about what to do when you could get erect, but you aren't climaxing. What to do when you take ED meds but aren't getting hard and much more. Plus, I take your intimacy questions like how do you get out of your head during sex? How to reduce anxiety in the run up to intercourse, and how to effectively work with your penis as you get older. Intentions with Emily Join me in setting an intention for the show. I do it. I encourage you to do the same. It'll help you ground in this material and think of like what do you want to get out of this episode? Well, my intention is to help demystify your penis health. Whatever you or the penis owner in your life is currently experiencing, I can assure you it's common. And on today's show, Dr. Cartman and I provide solutions for all your pressing penis issues. Please, please rate and review Sex with Emily. Where you ever listen to the show, do it Now. Totally helps us do more episodes and more quality shows. I appreciate you. My new article, missionary Sex position new and Improved is up on sex with emily.com and check out my YouTube channel for more sex tips and advice. And also follow me on TikTok. It's sex with Emily and it's all going to be happening there soon. If you want to ask me questions, leave me your questions or Message me at sex with emily.com Ask Emily or call my hotline 559-talk-EX or 559-825-5739. Always include your name, your age, where you live and how you listen to the show. And I'm totally cool if you want to change your name to remain anonymous. All right, everyone enjoyed this episode.

Doctor Edward Cartman is a board certified urologist with a background in male reproductive medicine and surgery, microsurgery and male sexual dysfunction. He's currently the medical director of the Men's Health center at El Camino Hospital, Los Gatos and the California Vasectomy and Reversal center and has appeared on npr, NBC News and more talking about male fertility and penis health. Learn more about Dr. Cartman@healthy-mail.com or on Instagram cartmanmd. You're amazing. Welcome to the show, Dr. Cartman. Now we've established, you know, all things penis penis challenges I feel have been on the rise lately. What's going on? Like, I know that it affects 50% of men over the age of 40. Some kind of penis challenge. But why do you think it's becoming more of a problem now or is it just that we talk about it more?

I think it's a little bit of both. I always tell people that in 1999 when Viagra came Out. It was a sexual revolution, a renaissance for us. And we finally had a drug that could effectively treat erectile dysfunction. And we started talking about it. Remember, there were commercials for Viagra. Famous senators like Bob Dole were going on TV saying that I'm using this.

Yeah.

And it became socially acceptable in our puritanical society to talk about sex. And I think it's only been 20 years since Viagra came out. And we've seen this evolution, and we're seeing new products come to market, things to treat crooked penises, more hormone replacement products, and we're seeing a lot more attention to it. So that's one of the things. I think we're just bringing more attention to the issue of sexual dysfunction. Our society is not getting healthier, so we're getting more problems at the same time.

Let's just talk about erectile dysfunction real quickly, because I think people sometimes get confused with what it might mean. So what is it? And how. Like, how would you define it? And how does it affect a person psychologically?

Well, affects a person psychologically tremendously. Okay, let's just get that out of the way. But erectile dysfunction is defined as the inability to obtain and very importantly, maintain an erection adequate to complete sexual intercourse. So many guys think that, oh, if I could get it up for. For a minute, 100%, I don't have a problem. But even though it goes down before I can reach climax or satisfy my partner, I don't have a problem. That's a problem.

That's a problem for everyone.

Yes.

Involved.

And in fact, that's a form of erectile dysfunction is called a venous leak, where guys can get a good erection, but they just can't maintain that erection. And this is a very devastating form of erectile dysfunction because it affects young men.

And how does it affect young men? What is it? Is it something that's genetic? Is it something.

Yeah.

Well, it's just it might be something that they acquired from, say, some trauma or some injury or some. Something like that. But a lot of guys, it's a genetic problem, and it's the inability of them to just hold that blood in their penis. And the analogy that I always give my patients is that imagine you had a faucet and you had a bucket, and someone said, hey, you got to carry a bucket of water from the faucet over to that point B. Faucet works great. Water flows in great, but someone drilled a hole in that bucket. So by the time you get over to point B, half the water's leaked. Out already. So obviously, you're not gonna have much water in that bucket. So that's the kind of ed that younger men get and a lot of older men get as well.

Okay, so that's one kind of. But essentially, we're just talking about. I always say, like, it's this umbrella of penis challenges. Like, it's just.

You can't get hard, or you get hard, you can't stay hard, and it's a problem. And then sometimes there's pain involved.

It's a form of pain. I mean, it's painful. It's a painful relationship.

Well, it's painful. So let's talk about it. How much of these PE challenges are mental and not necessarily physical?

Small percentage. We're talking about 10% of erectile dysfunction is due to some psychological causes. And there's things like, you know, stress, anxiety. Those will contribute to erectile dysfunction. Expectations being inappropriate, you know, those will contribute to erectile dysfunction, but it's really a small percentage. About 10% is due to what we call psychogenic erectile dysfunction. The vast majority is truly an organic problem, that there's something wrong with the guy, and we can usually identify it and fix it.

Just to make the distinction here that people with premature ejaculation, which is you come too quickly, you're hard, and then you're not hard very long. That could be more mental in many ways.

It can be. A perfect example is a guy who has a venous leak realizes he only has about a minute or two of hardness before it goes soft. So just like Pavlov's salivating dog, he trains himself to come quickly in order to reach climax. Because orgasm is why we have sex, right, Emily?

No, not the only reason.

Well, that's the.

It's a drive. It's the carrot, I guess. But there's other things that happen.

You're right. I don't want to minimize the whole process. Foreplays and poor in the process.

Foreplay starts after last orgasm.

Exactly.

I saw you noticed my sign when you came in.

Love it.

So, yeah.

So I think that we strive for orgasm because if we don't achieve orgasm, then we feel like we didn't complete our sexual act. And so these men who have these momentary erections then almost train themselves to have premature ejaculation, and they develop another problem because they don't address their underlying problem.

Okay, so this venous leak thing is a new. New information for me. Are you telling me then that there's a lot of younger men that could have this venous Leak and not know it at all. Because not many doctors know about this. As Western, you go into your regular urologist, he might not know about the Venus leak.

Well, no urologist will know about it. But a lot of people, regular doctor.

Doctor. Your general physician.

Yeah.

You go into your doctor and if you're 20 or 30 years old and you say you have a problem with your erections, they automatically assume it's in your head and they neglect you. They say you're having stress, you don't need to see anybody. And then the patient becomes embarrassed because they're like, oh, yeah, maybe I'm just crazy. Maybe it's all in my head. And they don't want to go anywhere else because they don't want to be embarrassed a second, third, fourth time by another doctor telling them the same thing. So they just leave it at that. But it is a big problem in our society and it's under addressed. I've seen some devastating life experiences in patients who didn't know they had venous leak when they were young. But then when they turned 40, 50, and they already went through a ruined marriage and they're having depression, all these problems, they finally come to somebody who can address that issue and explain it to them and treat it effectively.

Well, is there any way. What are the symptoms of. I know you explained to me with the bucket and there's a leak, but how could you, Is there any way you could know? Like, when I do my call show, people call in. Is there any way I could say, like, that sounds like a venous leak, or do they actually have to go see you?

No, I mean, essentially, if a guy could get 100% erection, like hard firmness.

Right.

Let's knock on the table. What does hard sound like? And then. But it doesn't last. So you're having sex with your partner, you're into it, it's hot and sweaty and you want to be there. You don't want to be anywhere else. And then out of nowhere, this thing just started going soft. You're like, what's going on? I'm not thinking about anything else. I'm thinking, you're naked in front of me, you're beautiful, I'm turned on. But why is he getting soft?

Right?

So that is a physiologic organic problem that out of the control of the guy. It has nothing to do with his head.

Okay?

He's into it, he's in the game. He wants to have sex with that woman or man.

But that describes this sounds like most erectile Dysfunction then is that you get. You get hard and then you don't.

Well, so the traditional garden variety. Garden variety eating is an arterial problem where a guy can't get a full erection.

So because of blood flow and.

Yeah, you don't need a full. You don't need 100% rigid erection to have sex, to have penetration.

Right.

You could have penetration with about 50% rigidity. So. And it doesn't go from 100 to 50% overnight. It goes from 100 to 95 to 90 to 85. So there's.

But the venous link is like hard and then soft.

Hard and then soft. It goes soft. So they'll get. They'll get up to 100 and I'll be there for a minute, and then it starts getting soft in the midst of it.

Okay, got it. The penis calls are lining up for you, Dr. Cartman. We're gonna go to Amy. She wants a question for you. Amy, 40 in Orange county, you have a question. Hi, thanks for calling. I'm here with Dr. Cartman. So what's going on with your boyfriend? We want to help you. Tell me everything.

So he has trouble reaching orgasm when we have sex. Sometimes it just takes a really long time and sometimes he just gives up and we can't at all. We just stop. And then sometimes he can. We stop and then he'll just, like, finish himself up masturbating and then he can. Okay, so I just wanted to know what you can do causing it and if I could do anything.

Okay, great question. So it's just a delayed ejaculation is what it sounds to me. What do you say about delayed ejaculation? When typically a man lasts longer than what, 30, 45 minutes?

So some guys with premature ejaculation, which is the most common problem, are saying, why are you complaining?

Right.

But it is a problem. And my first question to you, Amy, is your boyfriend on any medications for depression?

No, he's not.

Okay.

He doesn't take any medications.

None at all.

Okay. Because the reason is that a lot of people take antidepressants like Prozac, Paxil, Lexapro, all these medications, and they have a known side effect of delaying ejaculation. We actually use them off label to treat men who have premature ejaculation, which is the most common sexual problem that men have. But if that's not the case for your boyfriend, and he doesn't do any drugs.

Okay.

No, he drinks alcohol. But this happens if he's drinks or if he doesn't.

Right. And he's probably has. He said this has been a thing that's always been an issue or a challenge for him.

I haven't really gone there to probe that. I don't know how long it's been going on. But he. We're both divorced, and he told me the reason he thinks that happens is because with his ex wife, the whole time, their whole relationship, they never used birth control, and so he always had to pull out. And he thinks that he just, like, developed like, a nervous thing from that. And that's hard for him to get there because of that. So I don't know if that's the case or not, but that's what he attributes it to.

Huh. I mean, could be. Could be watching porn too. Like, if he has, like, a tight grip around his penis when he's watching porn, that could be it too.

Well, that's. That was gonna be my next question. Does he watch porn? Do you guys watch porn together or does he watch porn alone?

We don't watch it together. And not that I know of that he does, but. But from what you're saying of the tight grip, like, when I. When he does do it, he seems to, like, have a really loose grip when he does it. So I don't think that's it.

There's a lot of things when we think of any kind of ejaculatory problems like that, we're always thinking, what's going on in the brain? And so one of the things, and I would explore this a little bit more with him, is how much porn he does watch. Because there's this thing called porn induced ed, but there's also a desensitization that happens with watching too much porn. So you can imagine if you're a guy and you watch porn and you watch your favorite genre, you could pick any genre, but it's like.

Three women with big breasts and taking turns on you. And so that becomes your new threshold for reach and climax. And then you come back to your relationship where it's kind of normal sex. I'm sure you guys experiment, but it's nothing like that. What you see in the movies.

Yeah. So, Amy, I would just have more. I think we just gave you a few ideas of what it could be. But I think in talking to him and kind of getting more history and saying, hey, like, I'm just curious, has this always happened? Can you tell me the history of this? I mean, if it is a learned response from his marriage, that's also possible. But what Dr. Cartman was also saying about this ability to think your way to orgasm and to kind of like learn to orgasm without ejaculation. Is that weird? Which is a practice.

Yes, and it's true. It could be also a form of depression that's manifesting as delayed ejaculation, which is very possible. So depression and the treatment for depression both can cause delayed ejaculation. But then it goes back to the point that I was making. It's in the brain.

Yeah.

Okay, Amy, I would just get clearer with him and start to talk to him. And there is some more information. We have information on our site about learning how to orgasm without ejaculation. We can get into that, but let's get some more history from this and then call me back. Call me back with him. Okay? Okay. Thanks, Amy. Let me how it goes. Okay, let's talk to Ken, 55 in New York. Hi, Ken. What's going on? How can we help you?

How you doing? Having trouble maintaining and getting an erection. And even after taking Cialis.

Okay, 55 in New York. All right, Ken. What? Okay, so even after taking Cialis, how long were you taking Cialis for?

As needed. I mean, just.

It doesn't seem to work.

Did it ever work?

Not really, no.

Well, how are you taking it, first of all, until. Well, no. Are you taking it 20 minutes before sex and then you sit there watching SportsCenter until something happens, or do you take it on an empty stomach an hour and a half before intercourse and then you go stimulate yourself?

How do you take it, you know, like an hour before? You know, I haven't tracked exactly what I've done, waiting, but I'm not seeing results.

So Cialis is the one different one out of all the drugs that we use, like Viagra, Levitra, Stendra, those are all quick acting 30 minutes after you take it? If you take it on an empty stomach, they kick in. They only last for four hours, though. Cialis, or the generic name is Tadalafil, works a little differently. And it's been dubbed the Weekender because a guy could take a pill on Friday and potentially it can work all through, like, you know, Friday night, Saturday morning, Saturday night, and even maybe into Sunday morning because it has a 24 hour, 24 to 36 hour duration of action. But you have to take that one an hour and a half before intercourse. And if you take it with food in your stomach, it'll take longer to absorb. So the most common, you know, consultation I get for failed, you know, the Viagra, I'll just use Viagra. As a name, but any one of these drugs, they don't work on me anymore. The most common reason, I find is that people just aren't using them correctly and they're prescribed by their primary care doctor. Nowadays, you could even get them online without even a real consultation from a doctor explains how to use them. And people just take them the wrong way. And so the first thing to do is make sure you're taking it the right way, you rechallenge yourself, and then you're in the right situation. So with Cialis, it's an hour and a half before sex, empty stomach, sexual stimulation after an hour and a half.

All right, Ken, you want to try it that way?

Yeah, I tried crushing it too. Would that help?

It can, but it won't make that big of an effect again. If you have a steak sitting in your stomach from dinner, and no matter whether you crush it, you take it whole, it's not going to get absorbed adequately.

Okay.

What could be the problem physically if I was taking it correctly?

Okay, so let's talk about that. So first of all, real quickly, do you have any medical conditions like high blood pressure, diabetes, heart disease?

No.

Okay, so you're otherwise completely healthy?

Yeah, for the most part, yeah.

Okay. And is it more of a problem getting it up or is it more of a problem keeping it up?

I'd say getting it.

Getting it up. Okay, so when guys say getting it up is a problem, to me that sounds more of like an arterial problem. Means you can't get enough blood flow into your penis. Okay.

Could be due to. The most common reasons would be disease in your blood vessels. That things like heart disease and erectile dysfunction is really now considered like a form of a manifestation of cardiovascular disease. And so I would recommend if you haven't get checked out by a cardiologist. In fact, I'll tell you an interesting anecdotal story. When Viagra came out in the late 90s, we started giving it out like candy as urologists, and we were rock stars. We had the first FDA approved oral medication that actually worked. And people loved us. And we were giving it out, and guys were having great sex finally with a pill. And what we found out is that these same guys were coming back about five years later and telling us they had their first heart attack. And it wasn't that the Viagra was causing the heart attack. It's that we weren't recognizing back then that these guys are really are suffering from cardiovascular disease. And we were treating it as though, like if a guy came in and said, hey, doc, my chest hurts when I exercise. And I say, okay, here's a Viagra pill. That's not the right thing to do. You should go get checked out. Get a cardiologist to check your blood vessels to see if there's anything wrong with them. And the ultimate thing to do is to get a penile ultrasound by somebody who knows how to do those and interpret them.

All right, Ken.

Okay.

Thanks for calling, Ken. Have a good night.

The guidelines have changed now that we're almost obligated to ask these guys these questions about their heart when they come in and say, hey, doc, I just have Ed just write me a prescription for the pill. I'll be out of your office in no time. I'll let you go see the next patient. And I say, sure, I'll write you the prescription, but you got to do this for me. You got to go get your heart checked out. And so I work very closely with a lot of cardiologists because it's very important if you're dealing with sex, especially if you're dealing with erectile dysfunction, is to understand this relationship and make sure that these guys aren't coming in and you're just giving them a pill or a treatment and not recognizing the underlying problem that's going on.

Yeah, that sounds like such a. That makes so much more sense, holistic approach, not just giving a pill to solve it. Okay, we've got Rick, 46, in Ohio. Hey, Rick, you're on with Emily and Dr. Cartman. How can we help you? Hi, Emily. Hi.

I have a question about. I got a vasectomy about almost 10 years ago now.

Okay.

And ever since I got that vasectomy, my ejaculation is so different. I mean, it feels the same, but, you know, I used to be able to spray everywhere. Now it's just a little bit, drizzles out. I was wondering why is that? And is there anything I could do to get that back?

Love it, Rick. Thanks for the question. Okay, hold please. We got. Okay, what do you think, Dr. Cartman?

How long was the time from when you had your vasectomy? How long of time went by after you had your vasectomy before you noticed this problem that you're. We'll call it the money shot.

Right away. Right, Right away.

Right away. Okay, so this requires a little physiology, so bear with me here. Okay, so your ejaculation, most of it actually comes from your. No pun intended, but it comes from your prostate and your seminal vesicles, which are way downstream from where we do a vasectomy and the only thing that the testes contribute to your money shot is the sperm. And that makes up about by volume, only about by 5%. So most guys don't notice a change in their volume of ejaculate after they get a vasectomy. Nor do they praise me when I reverse their vasectomy and say, oh my God, I got this huge load now that's coming out. We just don't hear that now. Whenever you have a procedure done on your body, okay. You become more in tune to what's going on. And so sometimes it's just a question of like observation and being alerted to it. And I've had guys come in and tell me that in my office after I've done a vasectomy and they said, well, barely anything comes out. And I said, well, let's check it out. And I have them do a semen analysis right there in my office and I show them like the volume is really unchanged. You can't really perceive a change. So the vasectomy doesn't, like I said, doesn't take away More than 5% of your ejaculate volume if you get one done. So if you do notice a decrease in your ejaculate volume, you should be looking downstream at the prostate or the seminal vesicles. Could be a hormonal problem. Maybe your testosterone's low and you're just not producing as much fluid anymore because your testosterone's low and that's what drives your prostate and your seminal vesicles.

Yeah, I wasn't. That makes sense. It makes sense. I was in my mid-30s when I did that. So I guess that'd be the time when, you know, you might start losing testosterone. I guess you start losing it. Yeah, in that time frame. And then I had one more follow up question, if I may.

I have a younger wife who's about, you know, 15 years younger than me, likes to have sex a lot. And I find, and I find that I have to take, I usually take about a half of Viagra, like 80 milligrams, just so it's nice and erect. And I don't have any issues because when I don't take that.

I can get an erection. It just isn't as firm and hard and it doesn't stay and last as long. I mean, I exercise, you know, I'm not, I would probably say I'm a little overweight, but I'm certainly not, you know, I mean, it's not out of control or anything. And so I was just wondering.

Yeah, Rick, good question. What do you think? Dr. Cartman?

I tell guys, as you get older, you're gonna have some decrease in your rigidity. Now, it's not anywhere close to classified as say, Ed, that you can't complete the sexual act and satisfy yourself and your partner, but you notice a little change as you get older. This is part of the aging process. You know, I tell guys like, these drugs are like performance enhancing drugs and it's kind of like, you know, the steroids that people use. Like, Barry Bonds was a great baseball player before he took steroids, and he became an exceptional baseball player when he started taking them. So it's kind of like the way these drugs work. And yes, in a guy who's old, getting older. You're not old. Okay, I'm older. Way older than you. Okay. But it can happen. You can start noticing some decrease in function. And so these. These drugs do help perk you up a little bit.

And we also don't know, Rick, if she's. She might be fine with your penis where. However it is. But you're thinking, like, it's got to be harder, it's got to be bigger. It's got to be all these things. And I'm gonna bet that your wife is pretty satisfied as it is right now.

That's. That's true. That's true. That's very true.

Ego thing. Yeah. Okay, well, you know, so. All right.

Okay.

Our work here is done with you, Rick. Thank you very much. Anything new? Penis issues that I haven't. I don't know about?

You want to hear the weirdest requests I ever got?

Yes, please.

So I had a guy call me and ask me if I could split his penis into two.

Okay, you've got me. What?

So the penis actually has two chambers, two corporal bodies. There's just one of these fetishes or paraphilias that people have. And this is. I think we talked about this last time, and I said this to you. There's no way to train and prepare for this kind of stuff because I could not find that in textbook anywhere. And I was. I had to. Actually I heard from one of my colleagues who is. Does a lot of this stuff also. And he told me once a long time ago that he had a patient that actually asked him to do that, and he did it. And when this guy called me, I said, oh, my God, I wouldn't even know where to turn to. But thank God. I remember my buddies told me this story and we were like, I think it Was like, just one of those conversations you have at a bar and you say, you'll never believe what I did. And I had to call him and ask him, how do you do this?

Where do you put the other? Like, I'm confused. Split it in half. So it's two penises.

You could have two horns coming out, like double penetration. There's actually two chambers, and theoretically, you can split them in half, and then you have two erectile bodies. And whether it's a forked penis you want to call it, or a forked tongue, something like that, I don't know what you do with it, but.

So did you do the surgery on him? You did it?

He never followed through with it. My friend who did it, when I was talking to him, he told me that the person he did it on actually changed his mind, and then he put them back together.

Oh, God.

But it's not gonna be the same, right? It's not gonna be the same.

Oh, right. Exactly. Wow. Manny talks about penises as much as I do. It's so good to have you here, Dr. Cartman. We're gonna take a break, but stick around afterwards. From our sponsors, I'll be talking all about the penis and premature ejaculation with Jeff Abraham.

Jeff Abraham is the CEO of Promescent, the iconic delay spray company empowering penis owners to last longer in bed. As an innovator and a visionary, Jeff and his company have been featured on Dr. Oz, the Chicago Sun Times, CNN, and, of course, Sex with Emily. Find more jeff@promescent.com or on Instagram and Twitter messin, or at jeffabraham111. How's your journey been? Tell me.

I think it's been gratifying to grow and have success from a business standpoint is obviously, as a CEO, it's my fiduciary responsibility to my shareholders and my employees to do that. But I don't think anyone could ever truly understand. But you understand, because what you do for a living, when you get emails from people saying, I was celibate for five years, I literally was tired of being in disappointing sexual relationships. I quit being intimate. I was so disappointed. I saw these ads or these products, they didn't work for some reason. I saw the medical credibility. I heard Emily. I heard Dr. Ian Kerner. I heard, you know, urologists on a certain show, and I decided to give it a chance. It's revitalized my life. When you get an email from a couple who says, you know, we had been going through the motions literally for the Last three years, five years. We were intimate on his birthday, Christmas and you know, our anniversary. Other than that, we weren't really excited. When you hear people and they get emotional and they go, do you know what it's like to have my self esteem back? Do you know what it's like to feel like a man again? And you don't realize until you do this? Something like this. Because the average person doesn't, like, you sit here all day and like I do in my job, sit there all day and talk to people. They don't realize how much of a person's self esteem is wrapped up in their sexuality.

Absolutely.

And unfortunately, we wrap it up in religion. And you know, it's this taboo subject that people can't talk about. People are uncomfortable. Oh, my kids are here. Let me tell you something. The fact that your kids are there is something you should talk about so they don't grow up thinking that it's the forbidden fruit, that they don't get all completely caught up and this is wrong. I can't talk about it. I want us as a society to not feel the taboo, to not feel the shame, to not feel like, oh, this is a naughty thing. Are you kidding me? When I took over this company, I think I've told you this before, it's very important to me, if you're going to run a company, be the CEO and you have to know what you're competing against, what people's other options are. How can you properly position your product? So I said to Ron, he was a urologist, the guy who invented and founded Promescent. I'm going to try all the other products. So the stud one hundreds and the man delays and risers. I used them and they completely numb me.

Like seven or eight.

Yeah, exactly. My partner, I was like, well, I think we're being intimate because I know we're moving, but I can't feel anything and she can't feel anything. The whole objective is to feel pleasure. I mean, you could have dropped a cinder blanc on my penis.

I could have felt it.

Okay. It was like I could have lasted for two days.

Thank you very much.

Exactly. That's a bad visual for me too, because you can't feel anything. So I said to Ron, you know, a lot of doctors prescribe antidepressants because SSRIs, which is selective serotonin reuptake inhibitors. One of the side effects of that drug is they allow you to last a lot longer. So I said, give me whatever dosage you give to people for pe. That aren't depressed or whatever says, okay, great. So it was something called Zoloft. So he gave me this low dose Zoloft. So the first two, three days, I'm like, wow, this does allow you to last forever. By the third or fourth day, I'm like, hey, wait a second. I have dry mouth, nausea. I swear to God, my eyes were all dry. It felt like someone took my libido, put it in a garment bag and threw it in the back of the closet somewhere. I mean, literally, like, take your fantasy person. For me, it's Emmanuel Shariki. Remember, she used to be like, oh, my God. I mean, seriously, I get weak in the knees. I even think about her. She could have walked in right now, laid on this table naked, went, let's go. I go, I'd rather have a ham sandwich. You know what I mean? It was like. And I'm normally, even for my age, I have a really active libido. It was like, I'm not kidding you. I'm like, ron, get me off of this stuff right now. He's like, well, because it has a half life and everything. You can't just get on and get right off. He goes, what we'll do is we'll start tapering down. I go, take me down right now. Get me off of this stuff. Because in my mind, I'm thinking, what if this is, like, permanent? What if this stuff doesn't go back away? So it took about another four or five days. And I go, how could anyone take those? Dry mouth, nausea, vomiting, loss of libido. I go, excuse me, I'll take pe. Okay? I'll deal with it. I'll get all kinds of vibrators. I'll get a simian. I'll get every toy known to mankind. As long as I don't feel like that. Okay? And that's what people with physicians were referring people to.

Yeah, they were getting. Yeah, they're giving. And they also do that for. Yeah. And a lot of people don't understand the hidden side effects of antidepressants.

Those aren't even hidden.

No, I mean, it was, right? They're not hidden. Sorry. No, But I'm saying women call in. They're like, I can't orgasm. Like, what do you want? They're like, ssri. I guess their doctors don't often tell them. Or maybe they forget. They don't think it's gonna happen for men, too. It's ridiculous.

Using an SSRI for PE is like putting out a candle with a fire hose. Okay? It's a little too strong. You know what I mean? It was insane.

That's a good way to put it.

Yeah.

And we also. So I promised everyone we were gonna close the orgasm gap tonight. And I think you've been doing that with Promescent. But let's talk about it, like, the orgasm gap. When I say that, it's like, we know that women take longer to orgasm than men. There's just gonna be a gap.

The clinical trials, when you look at. And it's funny because I went to some of the clinics. So I went to some of these clinics because, you know, we do.

He does his work, I do my work.

Exactly. It also satisfies the perv aspect. You go in there, go. I wonder how this works. You know, you go in there, I swear, you go in there. I'm not kidding you.

He doesn't look like a perv.

And they have. I'm a pretty normal dude.

I say that jokes.

I do have a little bit of adventurous inside, which a lot of people do. I think it comes from being a single dad and raising my son all those years. I had to kind of suppress things, and I'm living out this fantasy.

I love your life, Jeff.

Yeah, I kind of enjoy it, too. But you go in, and this is the craziest thing. They have a thing where they wire people up and they monitor them so they know when they're having orgasm. They have a stopwatch. If you have pe, can you imagine something standing with a stopwatch? You know what I mean? Like, excuse me, that's putting a little more anxiety here. But they determined that the average. This isn't people with pe. These are normal, healthy people. The average woman without excessive stimulation takes 18 minutes of thrusting to achieve climax. The average man, actual penetration or thrusting.

If she can even get there.

If she can even get there. If she can. The actual man, healthy male, not someone pee, lasts 5 minutes and 20 seconds. That's the arousal gap. So even in healthy couples, you have this giant disparity of good intimacy. That's why there's 18 trillion vibrators in the world. Guys, stop. Start. Switch positions. Think about baseball scores. Think about their grandmother naked. All these crazy things going on. I can't feel the pleasure and go over the edge. I have to disassociate. Intimacy is about connecting. It's about passion and emotion. Not sitting there going, dead skunks on a soccer field. Oh, whatever. I just can't think of what I'm doing so that, you know, that just. It's so crazy. These methods that people use to last long enough. So we recommend. And one of the things we always tell people, if you look at our product, it's a great product, it works. But also learn to be more into foreplay. Learn. Get yourself a vibrator. You know, I was shocked because I've always been a little bit on the adventuresome side. How many people go, oh, I would never buy a vibrator. I go, why? Well, it would mean I can't satisfy my wife. I go, no. How about if you think of it as a way to satisfy your wife to a higher degree? Okay, how about if it get out of this puritan mindset that having toys and vibrators, for God's sakes, you can get them at Target now. You can walk anywhere. It's not like you have to go to some seedy sex shop on the end of the street. There's 47,000 websites. Regular grocery stores have a section with, you know, condoms and lubes and vibrators. Open up your sexuality. Connect with your partner. To me, there's nothing wrong with people in any relationship is being open with one another and sharing things and go, what is it that I can use to bring you to a higher level of passion or intimacy or pleasure?

Exactly. I mean, that's immediately just saying that we are going to connect. Because if you find that you are in your head during sex, you're worried that you're gonna orgasm too quickly. You're women out here. You're not gonna. You're worried you're not gonna orgasm at all. Then you know, if that is happening. If you are having thoughts like that during sex, you're not as connected as you can be.

Think about it. If you inject anxiety into anything, are you ever fully enjoying it? If you're having a meal and you are anxious about something, are you really enjoying the flavors of that meal? Are you sitting it, letting it seep in and getting every bit of pleasure out of it? Of course not. No matter what you're doing. And if there's anything more important in your life than intimacy, I'd like to know what it is.

Right? And that's what we all crave. We crave that connection, but yet we're in our heads worrying about how to do it right. And then we're missing the whole experience. And then life goes by.

One of the things that I have found.

And then you die.

I'm a big believer in it. I have no objection to porn whatsoever. But people start measuring themselves to porn. A woman goes, if I Don't have an orgasm where I'm flopping around like a fish, you know what I mean, and going insane. Or if a guy goes, you know, I don't shoot across the room and hit someone in the forehead, you know, across the other end of the thing, you know, I don't have a 14 inch penis and I last an hour and a half, then I'm insufficient.

Exactly.

You know, it's like you, you don't watch the NFL and go, I should run as fast as the fastest running back. Why is it that people watch porn and go, that's the deal.

Because they think it's real. For some reason, people think, oh, well, it's the first time I've ever seen sex. For many people, yes, they've seen the sexual act and they think, oh well, then it must be real. Like, because they have nothing because their parents didn't talk to them about it.

Exactly.

They've never seen anything else. They never came across by podcast and they think it's real. And then they get disappointed during sex or they're worried they're not performing. And it starts at a young age. That's why you gotta talk to your kid and say, I know you might find porn, son, daughter, but here's the thing, it's not real. They're not actually really having orgasms. He was casted for his penis.

Yeah. That 12 inch penis with the girth of a coke hand isn't the norm. You know what I mean? Don't get upset if that's not you.

Exactly. Yeah. And I love what you're saying about vibrators too, all the things. But if you, if you're listening to this, we're talking about like, how can you satisfy yourself and your partner? So if you're tripping about your, maybe you're lasting too long, not long enough. Some people last too long. You must hear everything. Right? Like you, first of all, I mean, because people don't get the difference between like ED and pe People going, well.

This helped me get an erection. I go, what part of our website did you ever get that impression? It's not, it's not Viagra, it's not Viagra. It's totally separate. So we have to literally educate people and talk to them and go, if that's your expectation, you're going to be disappointed. That is not what we do. We have people that go, well, I have trouble orgasming. Will this help me? I go, if you're having trouble orgasming before putting this on, okay, I get news for you. You're gonna have to have make love to your woman, or man, whoever you're making love to, for two weeks before you're gonna. If you're already having issues, this is gonna only accentuate that.

So people who use Probiotic, what have you found? Is there a certain, like, demographic? Has it surprised you? Same sex couples like men.

I'll give you the typical. But then I'll give you the ranges. Okay? The typical promescent user is a man between 33 and 50 years old. And you have to understand there's two.

People, 33 and 50.

33 and 50 is the.

Absolutely. A lot more younger. But maybe they don't find you at a young age when they need you.

Here's the thing. They don't find us. And I call this the machine gun theory. Okay? When men are 18 to 33 or 16 to 33, when they'll become intimate, they literally have a machine gun. They can fire bullets every day.

I don't care if I came in two seconds.

That's exactly because I know I'm going to go again. When you get to be my age, it's. I say when you're in your 50s, it becomes a rifle. I'm like a musket. Okay? You gotta like put the powder in, but it takes like a half hour to reload. You know, the whole thing. So men that aren't. You're laughing over here. It's one of those things that if you go, I can have sex again in two minutes. Who cares?

Yeah, we didn't even notice.

The second time. I'll last longer. When you're like me, I'm like, I need a meal, I need to sleep, I need to work out the next day before I'm ready. I gotta make every shot count. So I have a gun. Every. Every shot has to be right in the forehead, okay? They look at this machine gun, they're spraying bullet. I'll hit him with something, you know what I mean? So younger men, unless they're extremely, you know, wealthy, and they have all this discretionary income and they're going, I'm trying to optimize every area of my life. They're like, hey, I'll just do it again. You know, it's like, true.

Yeah. My boyfriend at 25, he could come three, four times. I'd never seen that since I was like, oh, wow. I don't know if I remember how fast the first one was. Just kept coming.

Exactly. Yeah. Not anymore. Trust me. Not because people my age. I'm about to turn 62. And it's like one of the things that blows me away is they'll go, oh, I've been married 20 years. We have sex literally three times a year. Like what? They go, no, we're just both kind of over it. And I go, dude, you need to re examine your relationship. Take a vacation, you know, get back into it, you know, that kind of a thing. But for us, it's about if your performance starts waning, then your enthusiasm is going to wane. Then you get into the spiral where you forget about it. Think about if you have a favorite food you eat all the time, you love it, you cook it, and all of a sudden you just kind of quit eating it a year later, you kind of forget about it.

Yeah, you do.

But then someone weighs it in front of you, go, hey, wait a second, that's good.

You know, people forget they like sex. They forget they connected because there was a problem. And they're like, I don't really need it. And I feel like a lot of you have called in and said that. I'm like, no, you just forget. You have forgotten what it feels like to be a sexual being on the planet.

And you know what I find too, and everyone gets into this is when you get into a relationship, I don't care how explosive it is to begin with. I don't care how magical it is the first year or two years, if you pass at three, four, five year mark, you get into a routine. Once you get into routine, the excitement begins to wane. It's something you truly have to work at. It will happen. It's just like, think about your favorite meal. If you eat it every single day, after five years, you go, I want anything but that. Okay, give me anything but a sirloin steak after all these years of loving it. So you have to go, I need to find different ways to make that steak. I need different sauces, I need different presentations, different side dishes to get it a little bit of a flavor, different flavor so that I still crave it. Sex is the same thing.

Same exact thing. It's the one thing in our life that we think it should just work without having any effort at all. Because it did in the beginning. And no one tells you that it changes over time. Except for I do and you do, Jeff, which I appreciate.

Part of it is we have the benefit of seeing so many people that lose touch and then it shocks you and scares you into going, I'm not letting that happen to me. I've seen that. I don't want that to happen in my life.

But I started the show because people were saying, God, sex is so amazing. I'm like, okay, I want to figure out what great sex scene. But also, I saw that so many people were not having greats, that sex was a culprit. Where people were ending relationships. They're like, oh, yeah, the sex wasn't great. Or then I saw that couple that sitting at the restaurant. Or you tell them, married for 20 years, and they weren't talking to each other. And I say, never want to be that couple. I never want to be in a relationship where the sex dies, you know? And so, because I knew, and I'm like, well, I'm gonna figure out how to prevent that.

And you're doing a great job of it. You go in a restaurant and you see a couple, and the woman's texting, the guy's reading the paper, and then you start staring at him. And 20 minutes go by, and there's no interaction with them. Zero. And you know what I think now, from having been in the business, I go, those people are having horrible sex.

They're not connected.

And if I go into a restaurant and you see people and they're holding hands and they're joking, and you see this banter back and forth, I literally say to myself, those people have good intimacy. Because it's not just. It doesn't stop in the bedroom. It doesn't start in the bedroom, and it doesn't stop in the bedroom. For you to have good intimacy, you literally have to be anticipating it during the day. You have to make that person feel special. And even afterwards, you can't roll over and go, I'm done. Boom. Go to sleep.

Aftercare is a big part of sex.

After care is just feeling that connection. And everyone's felt this. You ever get that feeling? Like, you go, I don't know where I end, and she begins. Vice versa. It's just like, you feel like you're laying there, and it's just one giant connection. There's no beginning, there's no end, and you're just totally comfortable. And that you can only achieve that through intimacy. And intimacy doesn't mean good intimacy doesn't mean lasting 45 minutes. It doesn't mean, because there are certain couples that go, we have a great sexual relationship, and the guy lasts three minutes, but it only takes three minutes for the woman.

It's fine if it's not a problem. If it's not a problem, it's not a problem. It's not a problem for either one of you. It's not a problem.

You know what I tell people? Because sometimes people say to me, well, because of what you do, define how long good sex is. I go, there's no such thing to define it in a time frame. It's when both couples generally are mutually satisfied and they're both comfortable, and they both say, I'm happy with the intimacy we have. It can be three minutes, it can be 30 minutes, it can be 40, it can be whatever. That's the most important thing. Are your expectations being met? Are you comfortable? Do you look forward to it? Do you want to do it again? Do you want to be in a situation that you just can't. Can't distance yourself from that person? You just love feeling close to that person.

Exactly. It's intimacy. I think a lot of people don't understand that, which is why we're here and why we do what we do. Look at you, Jeff. You've been doing this now for eight years. Like, half the time you're, like, out there too, being the sex expert.

Well, here's the funny part.

I love it, Jeff.

I was a semiconductor engineer and I retired after I sold my business and my next door neighbor develops a product. And the next thing you know, I feel like I'm Dr. Oz. You know what I mean? It's like, you're the best people that knew me from the semiconductor day goes, what? How did you make that transition? I go, it's a long story.

Because you're like, hey, what's going on with your sex life? They're like, what? Okay, Jeff Abraham, he's the CEO of Promescent, the only FDA approved treatment to help you last longer in bed, Correct? Just say that.

That's it for today's episode. See you on Tuesday. Thanks for listening to Sex with Emily. Be sure to, like, subscribe and give us a review. Wherever you listen to the podcast and share this with a friend or partner, you can find me on YouTube, Instagram, Facebook, and Twitter. Exwithemily. Oh, I've been told I give really good email, so sign up@sexwithemily.com and while you're there, check out my free guides and articles for more ways to prioritize your pleasure. If you'd like to ask me about your sex life, dating or relationships, call my hotline 559TALK SEX. That's 559-825-5739. Or go to sexwithemily.com askemily Special thanks to Acast for powering this. The Sex with Emily podcast. Was it Good for you. Email me feedbackexwithemily.com.

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