Episode 95: Overcoming Erectile Dysfunction

Hi, I'm Suzanne Noble, and you're listening to Sex Advice for Seniors. And today I am with a sexual health coach who lives in a town in Massachusetts that nobody knows, so we don't even have to mention what it is. It's just a mysterious town in somewhere in Massachusetts. His name is Ken Shaffer, and we're talking today about a subject that I know is of interest to lots of people, which is erectile dysfunction. I know, how sexy and horny is that? Anyway, welcome Ken. Welcome Ken from mysterious place in Massachusetts.

Hey, thank you for having me.

And you said to me just earlier like a few minutes ago, but you've only been a sexual health coach for the past couple of years, which is in my world relatively recently. So tell me, what was it that prompted you to get into this exciting world of sexual health, and especially regarding men?

Yeah, so I, I got ED many, many years ago, and I did what most men do, at least here in the US. I know the healthcare system is different in the UK, but here in the US you go to your primary care doctor and, and they proceed. You know, I went to a couple specialists and they proceeded to treat my symptoms without ever really trying to understand what was causing it, which is a problem here in the US, at least with our healthcare system, that they've just started to manage symptoms rather than trying to find the underlying cause. So, you know, they threw Viagra and other pills at me. And at first they work great, you know, and I thought, well, you know, this is just how it's treated. This is how you do things. But then they stopped working. And that's also a very common experience for men because the underlying condition is not going treated. And so eventually you can't outrun the problem.

Yeah.

So I, that started me on a long— I got really frightened. I thought, you know, I was in my mid-50s at that point. And I was like, I'm not ready to give up on my sex life, just, you know, so I started pouring myself into trying to find doctors who were competent. And I was going through doctors like candy. Were you like, what? Yeah, it's because everybody is conditioned to throw pills at you. And so I eventually had to go out of pocket. And again, I know the healthcare system over there is different, but over here we have mostly employer-provided insurance. And you can go out of pocket, but it's expensive. And eventually I found doctors who were competent, but in order to practice medicine the way they want to practice it, they had to stop taking insurance. So, you know, it was a— it was a compromise. Competence, you know, the money for the competence. So I finally found a doctor who really knew what she was doing. And she's actually a minor celebrity. She was on a talk show here in the US for a while. And I started working with her. And it was, you know, it was a lot of work. But I learned a lot in the process. She also runs a school for clinical sexuality coaching. And I attended her school and became a certified clinical sexuality coach. And I decided to, for obvious reasons, decided to focus on men with ED because that's what I do.

Yeah.

So this— so, you know, once I got the certification and started building my business, that was a couple years ago, and it's still in the building process at this this point.

So I'm curious to know, when you went initially to see your doctor before they gave you the little blue pills, did they ask or check for your vascular health?

You know, kind of. So what, what happened was I went to my primary care doctor and, you know, that's not his specialty. So he sent me off I did see an endocrinologist and I saw a urologist. The endocrinologist, I went back and looked at the test he gave me and was shocked to find out he didn't even give me all the right tests. And the, the urologist gave me what's called a Trimix injection to see if I could get an erection. And that's a very fast and easy test, basic test for vascular, to make sure your vasculature can get blood in there.

Yeah.

And I got an erection. And then he just threw pills at me.

Oh, right. So, yeah, so it was kind of a little bit like, oh, we'll do these little quick tests. And then, and then, oh, you can get it up. Oh, well done, you. 'Here's some blue pills.' No, no, no conversation around any of the psychological factors that were going on in your life that might have impacted upon this?

No, actually, that never came up. Basically, the conversation with the urologist I went to was, 'Take these pills. When they stop working, we'll give you an implant.' Bloody hell. And I'm— look, as shocked as I was, I just nodded my head and kind of walked out in shock.

Wow.

You know, and it worked. It worked for a while, you know. So I thought, well, this is, this is fine. You know, I just have to take a pill every time I want to have sex. But then I discovered through working with a doctor who knew what she was doing that You know, basic health plays a huge role in ED. Sure, you have to— diet is very important. And here in the US, people have a very terrible diet. And from what I've seen in Britain, it's not a whole lot better.

No, no, it's really not. You keep talking about the UK as if it's like some sort of like amazing place where transformational things are happening. But clearly you haven't been here for a long time. So I can tell you, I can tell you that is definitely not the case. We are able, our pharmacies here are able to distribute blue pills just on to anyone who walks into the pharmacy. They, they can just fill in a form. I'm providing everything stacks up. They just get blue pills. So like there's, there's even less attention to what the underlying problem is. It's just a, it's just an easy. Thing to just throw at somebody, right? And the fun— and the other thing, of course, is that what nobody tells a lot of these people is that blue pills only work if you're actually aroused, right? So if you, if you're not aroused, like, the blue pills just going, well, where's the, you know, where's the supermodel turning off? Or, or whatever you got hooked on, porn, or whatever, whatever is your little trigger to make your dick go hard. They just— if that's not there, like, the blue pills just kind of just doesn't necessarily have to work. And as you say, like, the blue pill may work for a certain amount of time and then it may stop working. So then you're back to the same old place going, oh shit, now I had the blue pill that was supposed to be the solution. The blue pill doesn't work anymore. Oh crap, what do I do now? Right?

Exactly. Those were my words exactly.

And I'm a woman, so I get that. I have Viagra parties with, uh, somebody, but they don't take it all the time just because, you know, they don't, they don't need to take it. But when it, when they want to just stay hard the whole time without thinking about it, then yeah, it's easy. But that's somebody who doesn't actually really need it. So yeah, it's a whole different ball game if it's actually a real issue.

So right, and, and a lot of people don't realize that One of the reasons why it stops working, as we age, we lose the ability to make a very important substance for the body called nitric oxide. And, and so nitric oxide, if you're not producing enough, it's impossible to get an erection.

Oh, really? Wow.

And so Viagra kind of works on what it does is it inhibits an enzyme that makes your erection go away. So you still have to be able to get an erection, but maintaining it is easier.

Yeah, yeah.

But without the nitric oxide there, it— nothing's going to happen. And as we get older, there's less and less there. And so that's where the nutrition comes in. A big part of nutrition is eating lots of vegetables with nitrates.

Yeah, yeah, it's funny. I did a little TikTok video about foods to avoid if you want to maintain an erection. And being a woman, and being that it's TikTok and most people don't have much intelligence, there was, there was a huge outcry from people going, you know, who are you to tell me that I should eat green vegetables? And who are you to tell me that I should eat healthy foods and reduce my fats and stuff? And I was just like, well, I'm just a person who's done a bit of Google research. That's all. I mean, it's not rocket science, this stuff, honestly. But yeah. So, so you went to see this woman and primarily was her focus on moving you more into a healthy lifestyle, or was it more in terms of thinking about some of the underlying, perhaps psychological causes that may have created, you know, the challenge?

Well, you know, she— not directly on the psychological part. She did give me a lot of support. She, she is a therapist of sorts. She's a— she has a PhD in sexology, and she does counsel people on sexual issues. And she did give me a lot of that kind of support, but the focus there were two primary focuses. One was getting a healthy lifestyle. And again, that's not rocket science, but there is something that a lot of people don't know about that. And this is worse in the US than it is in the UK. We are getting exposed to massive amounts of toxins.

Yeah.

Government is not regulating them. And this, this is, this is a part that a lot of people don't know about. And then the other aspect was doing therapeutic things. So men who cannot get an erection at night, a nocturnal erection.

Yeah.

They're— the reason why you get them is to get blood in there to feed those tissues.

Yeah, sure.

And so if you're not getting that nighttime erections, you need to replace it with something. And so men with ED really should be using a pump therapeutically to draw in the blood, to help nourish those tissues and help things— help the repair process. There's, there's other therapeutic things you can do, but that's one that if you're a man, you have ED, you really need to get a pump and start using it regularly.

And did you— I've just had a big discussion with somebody else about this whole pump thing because it's not clinically proven, but there is a lot of people saying that it's, you know, you should use it, but there's been no, no actual clinical studies about this.

That's not true. Exactly. There's been clinical studies on men who have had prostate removal.

Yeah.

And they can't get an erection. And so in order to maintain the health of the tissue, well, their body is, is their, their nerves are, are, are down.

Yeah.

And they found that guys who did pump were able to return to normal sexual function, and those who didn't pump weren't able to. So they're kind of extrapolating from that.

Yeah, yeah. I mean, yeah, there's still some— there's still people on the fence. I mean, I, you know, personally, I think it makes sense to pump. Because it would seem like it is creating, you know, it is increasing the blood flow, right? And increasing the blood flow is honest, is would seem obvious that it's doing, you know, that it's that's repairing some of those damaged nerves and it's getting the blood circulating again in that area that may have been damaged. So I'm not, I'm not completely disputing it. I think it is definitely one aspect. That seems to be something that people are doing. And I've done stuff about pumps and I bought a pump just myself just because I was like, oh, I'm curious to know what this feels like. And it's kind of— and it's supposed to do the same thing for women, by the way, although there's not really any evidence or, you know, again, clinical evidence around it. But I quite— I thought if you're an older woman, surely a lot of the same things going on and what the pump's doing is it's drawing all that blood into that area. And it's maintaining it there. And, you know, it may have some restorative effect. I don't use it often enough because I use it more as a kind of a bit of a turn-on. But, but yeah, I'm willing to, I'm willing to kind of think it could be. I've been speaking to somebody and there is, they are going to start doing some studies, some actual proper studies on it because there is, there is certainly enough evidence to suggest that it could be something that would work. I think not all— the other thing about it, of course, is a friend of mine who's also got— he's got Parkinson's actually, but we were talking about using it for that. And I think the other thing about pumps is they're not all the same. So you need to try different ones out and there's some cheap ones and there's really expensive ones and there's ones filled with water, which people seem to really like. So I don't know if you have any preference or suggestions. I know people have asked me a lot about if I could recommend one, which one would I recommend?

Well, I recommend to guys have it, have at least a simple air pump because they travel well and you can use them anywhere. Now, if you prefer a water pump and you're right, a lot of guys do.

Yeah.

Have that for your home. And one of the best water pumps is made there in the UK. Backsade and Bathmate is same.

Yeah.

Yeah. The same company, but two different brands. Same, basically the same pump. It's considered like the Rolls-Royce of water pumps. Yeah. But I encourage guys, start with a simple pump that's cheap. That way if it doesn't work out, you're not out of a lot of money because if you go for, for an expensive pump, you know, that's $300 or $400.

Yeah. Yeah. It's really expensive.

Yeah. So you definitely want to work your way up from cheaper to more expensive. And there's, there's a lot of crappy pumps out there. So there's going to be trial and error. There's no question.

And would you say it's something like, did you see that it took a certain period of time before the ED started to dissipate? Was it like using it every day? Like, from a practical point of view, if somebody's listening and goes, okay, I'm willing to give this a shot, I've got ED, I'm willing to— I want to get a pump, like, what is the recommended frequency?

It varies because you're right, no one has, has any protocols that have been tested.

No.

So I know one doctor who is like, 10 minutes, use it for 10 minutes, rest for a few minutes and use it for another 10 minutes. Another doctor is use it for a minute, rest for 30 seconds, use it for a minute, do that multiple times. And you know, everything in between.

Yeah.

I think no one really knows what the best protocol is. Most doctors will recommend a minimum minimum of 3 days a week, and some will recommend every day. And I, I say, you know, at least split the difference, 5 days a week. You have nothing to lose but a few minutes of time. And yeah.

Yeah, yeah. No, I mean, I think not enough people. I just, I don't even know how I found out about it. Somebody told me about it. I told a partner, he was like, oh, that could be quite fun. And then he did, and he was like, it's quite hot. It's just aside from it from a medical point of view, if you're into that kind of thing, it can be quite hot. And so can the one for the women, frankly. But also, you know, clearly some people do actually see some real benefit to it. And so I think you're right. It's worth giving it a go. Did you find that when you were doing that, that you didn't use the blue pill anymore?

I stopped using the blue pill. I eventually went on to get what's called sonic wave therapy. All right. That, that was a turning point for me. Yeah, because I— it had been so long and my tissues had, had degenerated enough where I was going to need more than just getting healthy and doing therapeutic exercise. So I went to a— my female doctor sent me to a urologist that she really expected. He did the sonic wave therapy on me and everything turned around at that point.

Wow. Really?

Yeah. Yeah, it was pretty amazing. And it doesn't work for everybody. But it worked great for me. And so I'm very careful to tell guys that, you know, it's worth trying, but for some guys it's gonna be magic, and for other guys it's, there's nothing that's gonna happen.

And what's involved in that? I don't know anything about sonic wave therapy. After 92 episodes, no one's ever mentioned it to me.

Oh, really? Well, it's basically, they use, sound to— and it's a very high frequency, uh, it actually feels like, uh, it almost feels like there's electricity at the end of the, uh, the wand that they use. And, and so it's, it's supposed to create microtraumas and stimulate, uh, the nerves and a bunch of other things. And so by creating the microtraumas then your body heals that. You got new vasculature forming. And it's, it's actually fairly popular here in the US. I don't know if it's practiced outside of the US, but it's fairly popular here.

And would you say that this works to some extent as well for men who have had prostate operations? Or not?

Yes, I don't have a definitive answer for you because prostate surgery can be vastly different from man to man. Some men will never be able, you know, the nerves will be so badly damaged, there's no chance of. As long as the nerves are intact and You know, and they work on maintaining the healthy tissue. I don't see any reason why it wouldn't help.

Wow. So now when you work with men and they come to you with ED, do you, do you put together like a protocol for them of all the things that they would need to do to be able to, to have a healthy erection? And is there a psychological component to that, or is it mainly kind of nutritional, you know, using a pump, whatever. Like, how does the— how, how— what is involved when, when a guy comes to you? How do you, how do you assess them?

Okay, well, first of all, I, I try to figure out if it is potentially a psychological issue, and that is usually determined, or a very accurate determination for that is, are they getting nocturnal erections? Yeah, if they're getting nocturnal erections, it's probably not physical.

Yeah.

And so I would— I'm certainly not qualified to treat the psychological elements, and I wouldn't try to. So I would refer them to someone else. Okay. Then what I do is I do two things. I try to help them find the best doctor available to them based on their resources. And, you know, frankly, that means that a lot of guys are going to have to compromise and have a less than stellar doctor because that's what they can afford. And then I, and then I work with them on developing the lifestyle they need to support having erections and maintaining erections.

And similar to your own experience, does that mean generally that most of the people that you're going to refer them to are, as you say, out of plan? So, you know, have you found that there's anybody that's— I know this is really difficult, right? Because we've got, you know, we've got similar challenges with our national health system of massive cuts in funding and just not enough resources, right, to be able to deal with this stuff. So they're treating the symptoms and they're just doing something really quick so that they can just get them out of the waiting room and just, and just put, park them somewhere, right? And, and so I suspect that, you know, part, sadly, part of dealing with ED is, is around how much privilege you have, honestly, right?

Absolutely.

Because if you don't have the re— the money and you can't afford to see these people, and let's face it, medical care in America, unlike here, private medical care is a fortune, then you're like, well, what's the best— what's the best you're gonna get, right?

And you— I think you've hit the nail on the head with the privilege part. Now, when I had ED, I had the resources to go out of pocket. Most guys do not. No. If they do have the resources, I have plenty of doctors I can refer them to. If they don't, Then, then I work with them. You know, I help them vet the doctors and help them to find the best one. For some, some guys, they don't even have any choice. No, you know, the insurance company determines who their doctor is.

Yeah, sure.

Yeah. So that, that's a struggle. But for a lot of guys, ED is a lifestyle issue. Yeah, a large number of cases, especially if, if it's early in the process. Like, if, if I knew now— if I knew when I was, uh, getting ED, if I, I knew then what I know now, it would have been a completely different story. Um, but I didn't, and I didn't have good doctors, and so it was much harder.

Yeah, well, tonight, you know, my— as I told you before we started speaking, I've just been to a little Summit on marketing to the over 50s, and I was on a panel talking about sex and intimacy and relationships and stuff. And, and, you know, it was about all the joyful things about having sex in later life and how wonderful it can be, and we should just celebrate the fact that we're older people. And I was like, you know, honestly, after doing this for this podcast for a while, I recognize that not everybody's got it so easy. It's like there's a lot of people out there who are really struggling. They don't know who to speak to. They don't have any vernacular around around their own sex life and how to articulate what's going on with their intimacy issues. Nothing. And so, like, I talk to these people and it's like I'm saying stuff they've never heard before. They've never heard it before. Like, somebody's talking to them just straight up about, oh, so what's happening with you? If you're a woman, like, oh, you know, are you finding things are a bit dry down there? Oh yes, I am. Oh, did you know there's something you could do about that? No, I didn't. Right? Like, like, for a lot of these people, it sounds to me like you have, you've kind of created a space to sit in the middle of a person who's identified they have an issue, doesn't know who to talk to, and you're sort of sitting in the middle there going, okay, what are your financial resources? What's going on with you? What— let's look at what you can actually afford and what's available to you. It's quite a unique little job that you've identified. I've never actually met somebody who's like either not solving the problem directly or, you know, just like a normal kind of counselor, right? It seems like, it seems like you're almost, I don't even know how to describe your job. It's quite—

Well, if you, if you figure out how to describe it, please forward that information to me because I'm struggling to describe it.

It's like you're a gateway. It's like you're, you're, you're like a sexual— I don't know how to describe that. Like you're a gatekeeper, right? You're kind of like this person that sits in, in the midst of all of this. It's quite a unique little job.

What I tell men is like, look, I spent 10 years, tens of thousands of dollars, and went through dozens of doctors and was— I mean, I was on the verge of giving up.

Yeah. Yeah.

And I said, there's no reason why you have to go through that.

Yeah.

And I can guide you through the process. And, you know, I can't guarantee that you're going to get results. There's no guarantees. But I can guarantee if you do nothing, it's not going to get better on its own.

No, no. And, and, and, and a question that I didn't ask before is that, you know, I know that sometimes ED is caused by just, um, overusing porn. Um, is that a question that you ask at the beginning before you get into any of this? Because obviously it's a huge factor, not just with older people but with younger people as well. It's just like overuse of porn and just getting completely desensitized, and then, you know, when they're in a real relationship, their dick just doesn't behave.

I do discuss that with the men. I actually— I wrote a book called The Practical Guide to Managing Erectile Dysfunction. I have a whole chapter devoted to that because it's, it's all tied in with your dopamine system.

Yeah, exactly.

And these guys are watching so much porn that they— to get that dopamine level up, it just requires harder and harder versions of pornography. Yeah, that is definitely an issue, especially for younger guys.

Yeah, and so if that's one of the things, because, you know, I've spoken to people and they're just like, you just have to go cold turkey, which of course is not that easy, but is— but at least is a way to kind of figure out, like, if you just take that away, can you, can you get them onto a different track, you know. But yeah, I realized that's, that's a tough one. God, Ken, you're gonna make me think here about what I should— what your title should be. Now I'm like, oh, it's not— he is a sexual health coach, but it's not completely— there's got to be a better word for you that we've got to come up with. Maybe one of our listeners, having listened to this, will, will write to me and go, I know what this guy can call himself, and not that, right? Because it is, it is something.

I'm definitely open to suggestions. So if someone does, if someone out there, hello, if, if you can give me a better title, please contact me and let me know, because what, what I'm using now isn't, isn't working very well.

Well, as you said, you just got started, right? And, and my other side of my life is that I'm a business coach, so I'm always I'm always, you know, and help people to start businesses. And 2 years is generally the time that things start clicking into place. So typically after 2 years, you will start to see like, oh, why do people come to me? Oh, what's the problem that I'm solving for them? Oh, the problem is they don't know how to deal with this. They've, you know, they've got a number of different kinds of symptoms and And they don't want to, like you say, it's like you don't want to waste thousands of dollars just barking up the wrong tree when somebody can tell you like, look, that's not going to work for you. So let's figure out what will work for you. And that is, yeah, that's the thing. I mean, the only thing I would say being a business coach, Ken, is that probably the— you need to get paid referrals from the people that you send people to, because otherwise it's a kind of one-off service, right? And they go off and they spend a bunch of money with somebody and you don't see any of that. So all I would say, it's like you need to figure out some recurring revenue stream here, but the book could be that or, or something else. We can all have a think about that.

Actually, I'm coming to that conclusion. So it's funny that you would mention that.

Yeah, yeah. No, I'm very astute when it comes to this kind of shit. Anyway, we've reached the end of our— actually, it's 32 minutes. I normally stop at 30, but I was having fun. So no, thanks very much. Really, really, really interesting. And, you know, I think it's always It's always great to hear from people who are trying to solve a problem that they've experienced themselves. I mean, those are the best kind of business people, to be honest, because you have firsthand experience. You can talk with genuine knowledge and honesty. And I think you've been incredibly honest with us about your own challenges with this. And I, and I really do value that. So, so thank you very much.

Well, thank you. And I really appreciated the opportunity to appear on your podcast.

Thank you. And I'll, and I'll put, like I always do, all the social media stuff. And if anybody comes up with a really great name for your profession, then we're totally going to let you know.

Okay, great. Thank you.