Episode 130: Sex after Recovering from Breast Cancer

Suzanne Noble: I'm very excited to welcome our new sponsor, Higher Nature, who have created Rekindle, which I'm currently trying out and is working a treat. A 100% natural libido-enhancing supplement for women, which contains clinically backed ingredients to give your sex life a boost. And who doesn't want that?

Hi there.

Hi there.

How are you?

I'm good. I forgot we were meeting over Zoom because normally I do Riverside, but then I remembered you had some issue with Riverside, I think, or something before, didn't you? I think so.

Yeah, I couldn't get onto it properly.

Yeah, that would be it then.

How are you? Did you have a good, uh, Christmas?

Uh, it was a bit, it was a bit eventful because my, uh, my son took umbrage at a, uh, a magazine article that was published about me in relation to my sex life. And, and the— they, they, they did a real clickbait sort of headline that was really shit, and I, and I was really not happy about that. And then he was like, I'm not coming for Christmas and we gotta sort our shit out. So that wasn't, that Oh, goodness me. I know. And it was all a bit dramatic. But anyway, yeah, so it'll be— it's okay. It's, you know, sometimes these things happen for a reason, right? And, and they just are the way they are. But yeah, aside from that, it was nice. And I'm living in the Grand Canaries now for 3 months, so I really, I really can't complain about anything.

So, no, you're nice and warm.

I am. I am. I'm wearing—

I'm wearing this jumper.

The sun is streaming in. The sun is streaming in. So anyway, yeah.

Oh, fabulous.

And I just read your PowerPoint presentation. How bloody exciting is that?

Really exciting. I can't tell you how good it is to feel relatively normal.

Amazing. Well, we're gonna talk about that and we're gonna talk about it without talking about it now, cuz I just think that, that yeah, we should do that. And so I'm, I'm gonna do what I normally do, which is my little hi, welcome to Startup School for Seniors. Start of Sex Advice for Seniors and then introduce you. And, um, yeah, you're the title, Sexual Health Advisor. Advisor.

Advisor.

You know, Sexual Health Advisor. All right, let's go for it. Let's just go for it and see what happens. So I'm just gonna do my fake countdown in my head. Hi, this is Suzanne Noble, and you're listening to Sex Advice for Seniors. And today we are welcoming back onto the show somebody that I really enjoyed talking to last year, and I actually think is— the more I speak to women about, um, Darlene's specialty, the more I realize that there's just so much going on around breast cancer specifically that so few women are told about, especially when it comes to understanding how it's going to impact on their sexual health. So welcome, Darlene, honey, back onto the program. So nice to see you again, looking so lovely and red against my red background. So yeah, welcome. So what, what have you discovered? The last time we spoke, we sort of just touched on the subject of your own journey um, as someone who's experienced breast cancer and how it impacted on your sexual health. And I know since then there's been some real revelations.

Yeah, I have been just toying because at work we've got a lab and I can use the microscopy, um, facilities there. So, um, I've been toying with different things for about 2 years now, on and off, try things, stop things, try things, stop things. And then I came across a product, it's a probiotic product, and I'm quite a skeptical person, so I looked at it and I thought, well, okay, you can say this works, but you know, I'm never going to say do that unless I've tried it myself. Um, so I think it was about July last year I started to take this, um, product, um, and then monitored my own vaginal pH. So I did a whole month of a baseline test every week because obviously everybody's different. And we all fluctuate in day to day really quite often and through different hormones and cycles. So I did a whole month of just testing my microbiome inside and reading it and seeing what was happening. And then I started taking this product. And so for many women, we have this kind of like weird feeling of kind of itchy but not itchy, just prickly, I'd say, like cracked pepper. Feeling where you're not scratching, but you're just not comfortable. And then the dryness fits in with that as well, makes it worse. So you can use your lubes, and you can use your dilators and moisturizers. That's great, as long as they're not containing any bad things like parabens and glycerines. But then if you still— you're uncomfortable, and the lubes will make a difference, absolutely, and estrogen creams make a difference, but we don't all get prescribed those. Those of us who were taking aromatase inhibitors were less likely to be prescribed, because there's a lot of holding back from GPs. They get a little bit anxious, and the amount of oestrogen in those creams is very minimal. So, but also, there are a lot of women who don't want to take that risk, because breast cancer is so awful, fearful. They don't want to take the risk, and I get that. So there was me trying to work out what else could be done, and could you get yourself better by 10, 15, 20, 30? At the moment, I'd say it was 80%. So that's quite amazing. And that happened in the first month for me, that happened. So what I was reading on, on those slides in, in the baseline moments I was doing was there was a— there's a pH imbalance because your oestrogen actually supports the flora in your vagina. And so if you don't have oestrogen there, there's no support for it to carry on, and then the pH balance goes astray, and then it all goes wrong. So when I was looking at my baseline slide, it was like looking at a male slide because there's no flora, no epithelial cells, there's just nothing there. It just looks like a weird little pattern on there. And after a month I had all of that back again to a certain degree. It will never be 100%, but it was back enough to make me feel much more comfortable, not needing to, um, keep checking after that. But I've been checking because I've been looking at this now since October last year. So every week I go in and check what's happening with this product, and it's working, and it's working really well because it actually does put the lactobacilli, which we need to keep the balance right, back into my vagina.

And so does that mean that you don't need to use as much lube as well?

I'm still using that, obviously, because you know, you, you need all the help you can get. But actually we need to start with every single basic thing that we are doing. We need to start with personal hygiene. That needs to be really important to most people. So without using soaps, gels, bath bombs, and all the rubbish that gives you itchy, sore, and everything else.

Yeah.

You just need to make sure that you stay relatively clean, and at least once a day you're washing or showering. Twice is even more helpful. But the worst thing I found while I was looking at this is most UTIs are actually E. coli based. So E. coli usually comes from your back passage, um, on your rectum. So because our openings are very close to each other, and it's usually moist, you can get this moving around a lot more easier. And when you're older without oestrogen, your labia shrink back, so they're not really protecting that area very well. So it's got more chance of moving into that area and causing a problem.

Yeah, yeah, yeah.

And another thing that I was thinking is we all pass wind, and if you pass it sitting down, it kind of rolls forward. So when it kind of pops open, it's kind of right in the right area to cause you distress.

Yeah.

So what I found with this product that I'm using is that it seems to be on, you know, it seems to be keeping this under control. Yeah.

And did you just— were you approached to try it out? It's called something with a V. What's it called?

It's called VJJ. Um, Pelvic Relief actually, um, supply this stuff. Um, I think you might be able to get it on Amazon as well, I'm not too sure. And so when I tried this and I was really pleased, and I, I emailed the guy and I said, oh my gosh, this is great. And the guy who was actually started this company up, he, um, did it for his wife and his two girls because his two girls were having lots of friends that were having thrush and BV and stuff like that. And, you know, you don't get told when you're younger, don't use products with this in, don't use products with that in, keep everything natural, organic, and, you know, you know, no parabens. People are using lubes and they're using ones with glycerin in, and it's just not a good idea because some people are sensitive, but others, you know, it just makes it worse. And then we see girls in the clinic, young girls with BV, and they're just using bath bombs and very highly scented douches that they're— but they're not, they're not addressing the fact that we have a natural smell. We don't need to smell like a perfume shop in our vagina. It's, it's a bit, um, it's a bit hard to tell girls that because obviously they— the fashion is for your vagina to look and be fashionable. So it kind of— it's just going along with the trend. But since I've done this product, been using this product, I'm not having any problems. Now, this doesn't to say that it wouldn't happen to everybody or it would be great for everybody. But I think that if you're in the situation where you actually were thinking, I'm not feeling comfortable, I need to try something, that would be something good to try. So at first I noticed that my sample was kind of wavering between BV and not BV. It wasn't BV because it wasn't full-on, but it was really kind of that scratchy feeling that a lot of women that I've spoken to have experienced. And, um, I've got a couple of people now using this stuff and they're not feeling that anymore. So it, it's gotta be doing some people some good.

Yeah. And I know that you, I was reading in the presentation that you sent me that tamoxifen, which is the drug that you get put on when you've got breast cancer, actually in conjunction with vaginal estrogen, it reduces its effectiveness by something like 99%. Did I get that right?

I've not heard of that, no. With aromatase inhibitors—

Oh, that's one. That was the one. Sorry, that was the one.

Yeah, so aromatase inhibitors, they don't actually have much research done into a level which is acceptable yet. Right. So I don't think— I think I said it on my presentation that there isn't a level which everybody has agreed is ideal or acceptable for women with breast cancer. So, you kind of have to assume some women with breast cancer will be taking aromatase inhibitors, and they will be older, probably post-menopausal, because that's a different way of dealing with the oestrogen. Tamoxifen is usually for younger women. And I've just gone on to tamoxifen so that I can just have a change of regime, because the pain that you get sometimes, some women, from, Having no estrogen is risks both bound up. Oh, wow. Because, um, the pain in your joints is so awful.

Yeah, yeah, yeah. Oh, that sounds terrible. Yeah. I mean, I, you know, the thing is we hear so much about, in fact, I was just reading the other day and I've done some work with a supplement company called Higher Nature. And I do think that, you know, as you've demonstrated, I mean, obviously you did it in an incredibly scientific way. But some of these supplements do nothing, right? And, and then some of them actually, and actually do do something. And sometimes it's very difficult to know when you're reading all of this whether or not this is actually going to work. And as you've demonstrated, you did the research, you set a baseline, you actually looked at the, the outcomes and went, well, I mean, the results speak for themselves, you know. It has worked, really.

Yeah, they are working. It's working for me, and it would, you know, it's up to people to try whether they wanted to try it or not. But you have to, you know, go with the basic rules. You have to make sure you've showered and then you shower again. And when you're careful when you're passing wind, that you don't pass it sitting in the car or sitting on the couch, you know, those kind of things. And you know that you're moisturizing, because when you put moisturizer on your face, but a lot of people don't put it on their, on their vaginal area or their genitals. And you do need to do that. Um, there's a lot of things that change with, um, it's not just atrophy, which obviously happens when you don't have estrogen, but you know, your labia shrinking back is one thing, but also your clitoris shrinks back as well. And, and it's kind of making sure that you're keeping an eye on all what's going on if you want to continue to be sexually active or use the equipment that you have.

Yeah, yeah. And, um, is there anything else that you've discovered since I last spoke to you? Because I, I think you were just generally researching this area of, you know, how do we deal with the effects of breast cancer? What are some of the ways that women can be supported? As we said, they don't get told anything, it seems to me, mostly. And in fact, just related to bath bombs, I was, um, I read a little post from somebody that's quite a well-known author saying, oh, I just got my bath bomb from this company and I'm so excited and it was in this really pretty little package and I said, I don't want to burst your bath bomb bubble, but you know, you shouldn't get that anywhere near your, your intimate areas because that's really not going to be good for you. And I didn't look to see what I felt kind of like really bad saying that. But I mean, people just don't know. They just don't know. That they put that crap in their baths, you know?

Yeah, yeah. Why would they know? Because these things are sold, um, to make us feel like there's something actually wrong, you know? Um, there's another couple of feminine washes and douches and stuff like that, and they're sold to, to, to make you feel attractive and that you're worth sleeping with because your vagina smells like a hyacinth or whatever you'd like, but It's not helpful because it does really affect and irritate. I mean, there are people that they get away with it and it doesn't, but it's really not the best thing to do. I mean, anybody who's ever accidentally used a certain shower gel with a very strong mint without knowing it will actually tell you how much that stings. Yeah, it's not until a week later that you actually realize that this irritant is causing your problem.

And I've spoken to a number of people that when I just say just use water, they look at me like, 'Ick.' So like you said, there's a huge amount of taboo around natural smelling vaginas and, and that the fact that they're supposed to be floral scented. And I know that when I was a younger woman, look, when I reflect back on the amount of thrush I used to get as a younger woman. I barely went a week without encountering something. No one during probably at least 2 to 3 decades of my life until actually, if I, if I think about it, relatively recently said, you know, all those scented products are just contributing to what's going on down there, whether it's BV or thrush or, you know, or, or all the any number of things that can happen as a result of of using these. And of course, now we've got the lovely company like Boots who are promoting menopausal products under their— I think it's M+ range or something like that. They've, they've created a whole display now of menopause-safe products, which, guess what, happen to include feminine washes. Like, in what world did a big company like that decide they're going to launch a bunch of menopausal products and think that that was appropriate? But that— we're still dealing with that, you know.

Yeah, but that's what makes money, isn't it? To make, make you feel like you're kind of slightly inadequate because you, you may have a strong-smelling vagina. Everybody's vagina smells differently. Um, and you know, my recommendation to the younger population that I see is that, you know, if you if you're washing properly, if you really need to have that smell, put something on the inside of your thighs. And then when you sit down to go to the toilet, you won't be thinking, "Oh, I don't like the smell of my natural smell," you know, because you'd smell the perfume on the inside of your thigh. And that might help. But it's to look at the ingredients, even in the products that they say are specialist. You should look in the ingredients I think you are friends with Sam from Jo Divine as well, aren't you? Yeah, yeah, yeah, yeah, yeah. And she is the best person to ask for these things because she knows all the ingredients in every single thing because she had the problems herself.

I know.

And so, you know, if there's any doubt at all, just get onto Sam because she will, um, help you with any of the ingredients that are listed. Um, you shouldn't be having those ingredients in there.

No, I mean, I took her li— it was in fact, I took her list and I, and I, you know, and I, and I attributed it to her, but I just said, you know, if you find any of these in your lube, walk away. And, you know, one of the interesting things I discovered the other day about all of this was that I've become a little bit obsessed with this app called Yuka. So it's this app that tells you whether or not things are safe. And my friend who got breast cancer is now addicted again, as well as me, to this app. And she stopped using certain hair dyes and all sorts sorts of things because she's seen how toxic they are. And of course, these chemicals can enter our scalp, and, you know, we just don't know what's happening, right? We don't know where this has all come from. So she's become really concerned, quite rightly, about the products that she uses and making sure everything that she puts on her skin is safe. Um, and so I just decided, just out of interest, I thought, I'm gonna go to the L'Oréal counter and I'm gonna yaka all the products in the— in Boots. And you know what? They came up as safe and they're not. They're not safe. So that's the other thing, of course, is like you have to do your own research because even apps that propose, you know, that say we're going to tell you what's safe or not, the reality is that I wrote to them and I said, 'Direct sleeves have got parabens in them and glycerin.' Okay, they're not safe. Like, that's not going near my vagina. So can you please remove them from this app as being safe? Because they're not, you know.

So a lot of things with breast cancer as well. There's a lot of things that people are saying that you get cancer because you drink too much, you don't do enough exercise, you're fat, you don't eat something, you don't eat this, you don't eat that. But there's not enough attention paid to the environmental factors, the cosmetics, the lotions, the hair dyes, all of these, the, the tampax, you know, the bleaches in the sanitary towels. There's all these things that you actually do need to be thinking about as well. It's not just diet, exercise, and alcohol. I mean, they do play a part obviously, but it's not just that. It's everything around you. Plastic bottles contain estrogen.

Yeah. Yeah. No, I know. I mean, it's horrifying when you actually start looking at it. I mean, the thing is, if you're an, naturally anxious person, unfortunately it just makes you more anxious because—

oh yeah, yeah. And I really do feel for women because you're, you're given this diagnosis and you're sitting there and you're thinking, right, okay, this is a bit of a shit show, but, um, let me see what I can do with it. And then you've got all this information from the people that give you this info, and they dribble it out to you because they don't want to give you the hard sell straight away. And that's fair because you've just gone into like some sort of netherworld, and you're thinking, what the hell am I going to do now? So you get all this information bit by bit, and then some people just go with that and they don't go any further. But people like me, I just— I'm kind of looking for every single piece of information I can find. So that— because you do have to really advocate for yourself. Um, there's not really a lot of talk about how to have sex. There's not a lot of talk about moisturizing your vagina to make sure it stays— the skin stays supple. There's not any talk about which lubes to use or glycerins or any of the products that are in them. It's just not there. And it's not really their fault because they just don't have the time. They've got to see so many people in the clinics that they don't have that time to sit down afterwards and kind of go, well, you know, this might help or that might help. So everybody's got something that helps. We need a central point where everybody could put something that may have helped them. And so this has helped me and it's great. It might not help my friend, but it might help her friend.

So yeah, but I'm assuming even if you don't have breast cancer, that using this particular supplement, if you're experiencing vaginal atrophy or just— Suzanne Noble is still going to benefit you just as an, as an add-on to your, your supplement regime if you've got one, or just, you know, just, or just your genital health. Exactly.

Yeah, yeah, yeah. Because you don't want to be taking antibiotics for, for BV really, because, you know, it's, it's quite a harsh antibiotic and it's going to come back if you continue your old practices. And they don't happen overnight, you have to change gradually. And the one thing that I found over the Christmas period where I probably have had one or two more glasses of wine and chocolate, so that's put my sugar intake up All right, which is slightly giving me a bit of an effect, which is settled now Christmas is over. But at the time I was thinking, oh, I wonder if this is to do with the amount of sugar and alcohol I've had over Christmas. So you have to kind of look at your diet as well. I'll be looking to be, you know, changing a few things. I'm not saying change everything, but, you know, little and often and a bit here and there is not bad. Yeah.

And look, I mean, I think once we recognize the impact that what we eat and what we drink and our lifestyle choices and all that, I've been doing a lot of work with a company around erectile dysfunction. And of course, there's a lot around having a healthy lifestyle as a man that contributes to whether or not you've, you know, your ED can get better or not. And because it is a cardiovascular issue. And so, you know, if you sort out your diet and you eat less red meat and you exercise more and you lose weight, chances are that you're going to improve your erectile function. Right. And internally, women work in a very similar way. Like, if we eat a load of shit and the flora in our vagina starts getting a bit like, hey, what's going on here? Where is all this crap coming from? Then it reacts and it goes, yeah, there's definitely a change. Yeah. You know, I— but we don't. I think the thing— what I've noticed since I've started doing this is that we don't make those correlations, right? We think that this is something— either we've got something because we use some, like you said, some shampoo, some shower gel, we use something on it and it possibly contributed to this, which it almost inevitably will. Like, there's no way, as you say, that you're going to use crap shower gel consistently down there without some sort of eruption of some description. I mean, I think you'd be incredibly lucky if you didn't. But then we don't look at what, you know, just what we generally eat, and we don't look at the stuff that we put on our hair and in the environment and all the other stuff that contributes to, you know, having either chronic health conditions or just recurring things. Like, you know, I— thankfully I've stopped having problems down there, and I think that is because I've become so aware aware of all the different ways that I didn't look after that for so long. And I look back at my previous history of products I used and bad choices I made about my diet and all sorts of things. And I think, no wonder I spent years when I was a young person with, like, either BB or thrush or something, right? Because I wasn't told, and no one— I just didn't I just didn't know, you know.

So I mean, we kind of all did it, didn't we? Because nobody told us. Nobody said this will cause this irritation or that irritation. And this is still going on now because nobody tells these young people that this is— this may cause you irritation and this may cause— and you know, people are coming back and back and back for more metronidazole and things like that to cure their BV. And you think, well, actually everything is a quick fix for everybody, and actually you need to work on the whole thing, the the whole thing is, is actually more important. But it actually takes too long, and I don't think a lot of people want to do that. I'm older, so I've got the luxury of actually trying to work out and sit still and work out what actually is going to work and help, rather than battle my way through every day thinking, oh my God, that feels uncomfortable.

Yeah. And I think when it comes to being older, you know, the response that I get, especially if people haven't had penetrative sex for a while is, well, I'm all over that, you know, I'm not going to do that anymore, or I'm— I don't know what would happen, it's been so long. And if there's not some consistent attention being paid to that area— the thing is, you know, somebody I know recently hasn't had sex for years, and I said, well, you know, you might want to do some stuff down there, like, absolutely. Oh, because I said you might be very surprised as an older woman having not had sex for a few years that it's not all suddenly gonna go like, oh, the lights are on, great. You know, it might be quite a big—

yeah. And, and to have a, a good check around 'cause your labia might not be there, your clitoris might not be there. You know, it may be that you need extra stimulation or extra thought to have sex a different way. Because these things are changing. And if you're not moisturizing your vagina, is the skin really, you know, going to be stretched and harsh? You know, and have you got the right lube? But, you know, Sutil do one that's an extra one for menopausal women, it's slightly thicker, and that works much better for sex in older people. So there's all these kind of things that you have to think of. But if we've gone through our younger life not thinking we had to do that, it comes as a bit of a surprise now that you have to really think about what's going on.

Yeah, well, we don't look down there for a start, so really it's unlikely. I mean, the other thing I was going to say is I had a discussion in a chat recently, and this is all older people, right? We're not, we're not talking about, you know, kids. We're talking about older people talking about the whole waxing, shaving, and all that sort of stuff. And I said, oh, you know, that whole waxing thing, I just can't deal with any more of that pain. That's just— I, I can't stand that anymore. But again, when I think back to all of that, I think that I said, you know, even when you look at old porn movies, there was— women had hair down there, men, you know, and there was a reason, there was a reason why they had a forest. Yes, because it protected all of that area. From a lot of the stuff that now just gets in there because there's no— there's nothing there to stop it. Yeah.

And until you're older, you've got probably your inner labia is slightly more protective as well because, you know, you have that there. But then all of a sudden that disappears and you're out in the open.

Yeah, literally your vagina is out in the open.

It's out in the open.

What a thought that is. But yeah, I mean, I'm trying to get— I'm, I'm probably going to call Sam up at some point because I'm trying to work. I know she already does it, but I'm trying to get more involved as well in how do we get, you know, doctors, GPs, more of the primary care people to understand how to talk with older people about intimate health issues. Right. Because, because I can't, I don't see that happening. And I'm getting all my information from people like Sam and people like you and people that I speak to. But when I speak to just the general public, they're like, nobody tells us this. And I said, no, it's a big, massive problem. Yeah.

Nobody does tell you. But I think also, and I'm speaking from experience in the NHS, is that there's a set of guidelines you follow and you, you just do that blindly. Unless you're me and you don't. But you just kind of do what you have to do because that's what you're told that is within your remit. So you do that, and then we're timed for certain things as well. So there's always a time pressure on things to do. But it would be good if NICE and people who govern that kind of thing actually recognize that there needs to be more added to the menopause side of things, and it needs to include this sexual health side. And intimacy side, um, to, to do this. Um, the Breast Cancer Now survey that mentioned in my PowerPoint there found so many women— like, over 90% of women were dissatisfied with their intimacy because then they can't do it, or they haven't got it, or, you know, they've just been given— sent away with dilators and lube, and they found it hasn't helped. And I think what experience I've had from women when I'm talking to them about actually having the sex again is that they're fearful, even though their partners are great, they're fearful of the Geronimo moment. Because when somebody's about to orgasm and they start to go faster and quicker, and, and then the control is gone from the woman who actually is thinking, God, that really hurts, and I need you to stop.

Yeah, yeah, yeah. And I mean, you know, that's, that is a, that's, that's a really clear problem, right? I mean, it's, it's a clear problem. Like you said on your PowerPoint, there's things I only just discovered when I was at an event, like the Onut, you know, which is a sort of rubber thing that goes around the penis to stop, um, to stop really deep penetration, which I was like, wow, I never knew that existed before, which was really interesting. But again, there's just very, very little information out there about any of the stuff that can support you to have better sex and just generally feel more comfortable.

Yeah, I think that product works very well. I gave it to the psychosexual therapist at work to try out with people in her gym, and most of the guys were really against it. And I think maybe the color was the thing, although it's a nice color. Yeah, and I think Yeah, they said, oh no, I wouldn't use that. No, I wouldn't use that. But then they probably didn't have women that have breast cancer, so, you know, it would be a difficult thing. But they weren't excited about using something like that if their partner was having painful sex.

Yeah, it's interesting because I know that, again, with my other hat on, when I talk to people about just cock rings, they go, oh, isn't— aren't those just for gay people? And, you know, so there's a whole, there's a whole taboo and a whole education piece that needs to be out there around these products are not aimed at specific types of people. These are actually for use by, you know, like pretty much all older guys or all men who, who find that they're a little bit too big and maybe this is going to help them and their partner. You know, anything that looks like a ring, I think, is one of these things, right? There's a bunch of people who just don't have a problem with it at all. And then there's another bunch that say, I'm not putting a ring around it because that's—

I think it's significantly subconsciously in the background is that the ring is going to tighten. They won't get it off.

Oh right, oh maybe I hadn't thought about that, although that was a very stretchy rubber thing.

That, uh, that was a stretchy rubber thing, but if it was a metal ring, they'd be thinking, what if it gets stuck? That won't come off. Trying to get a wedding band off that you couldn't. Yeah, yeah, and then you'd have to go to the hospital and explain that.

Yeah, I mean, look, if you've never used a ring before, the nice thing about the Firmtech ones is that they're stretchy and there's a So you can't— it's very, you know, you, it's, you just pop it off. It's no big deal. But yeah, I can see why anything that also that I think there's probably something about constricting blood flow. There's probably a bunch of stuff that goes on. I have no idea. But anyway, it's been great to talk to you and like usual, I always learn something when we have these conversations.

Can I just add actually on that Cochrane conversation? A lot of men still think they come, they don't want to come to the clinic. And I think this is part of their penis and ideas in their head. They think we put down this metal rod with an umbrella, open it, and then pull it up. They still think that happens. Oh. They don't realize it's a cotton tip. So I can understand the cock ring thing. Yeah.

Yeah, yeah, yeah. Yeah.

Anyway, it's great to talk to you again. I'm dead jealous that you are in the Canary Islands and I'm in England in a jumper.

Um, well, you know what, I come here for 3 months, so, you know, I don't blame you. And I've got 2 bedrooms and I've got a spare room. So, you know, I always say to people if they just wanna come for a few days, just drop in, stay in my spare bedroom. I have friends that come and stay and it's all very nice.

Oh, that's fabulous. Yeah.

And all you have to do is buy me cheap glasses of wine and the occasional meal and it's fine.

Oh, that's fabulous. That sounds good.