Too Small, Too Soft, Too Soon? Dr. Rena Malik Fixes Your Sex Life

Board-certified urologist and sexual health expert Dr. Rena Malik joins Holly to answer the questions most people are too embarrassed to ask. From erectile dysfunction and “porn addiction” fears to low libido, squirting, semen retention, and what good sex actually looks like, she cuts through shame with science, compassion, and real-world advice for both men and women.

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Episode Transcript

Speaker 1 (00:00):
You were listening to a pleasure podcast. For more from
our sex podcast collective, visit pleasure Podcasts dot com.

Speaker 2 (00:25):
Hello everybody, Welcome back to Holly Randall Unfiltered. I am
over the moon about today's guests because she's somebody that
I have been stalking on the Internet for quite a while,
and if you're a man who has any interest in
having your sexual health questions answered, you may have been
as well. She is a certified sexpert, a board certified urologist,

(00:49):
pelvic surgeon, and one of the most trusted voices in
sexual health. I am, of course talking about doctor Rena Malick.
She specializes in sexual wellness for both men and women,
but she's an invaluable resource specifically for men who have
questions are too embarrassed to ask anywhere else. And despite
her busy medical practice, she's built a massive YouTube following

(01:12):
of over two point five million subscribers where she breaks
down everything from a rectile dysfunction to pelvic pain to
porn myths. No judgment, just facts, and today I'm so
privileged to have her here to answer all of your
questions about what does good sex actually look like?

Speaker 3 (01:28):
Is porn addiction real?

Speaker 2 (01:30):
How do you get hard and stay hard if you're
having problems in that department. I'm so excited to have
her here to set the record straight, inspire better conversations,
and take the shame out of sexual health. So let's
welcome doctor Arina Melick. Hi, thanks so much for having me.

Speaker 3 (01:46):
Of course, I'm truly very excited to have you on.

Speaker 2 (01:50):
And when Keeley Rankin told me, she was like, you know,
you should really have her on, I'm like, how did
you know I was talking her?

Speaker 3 (01:58):
Are you looking at my surch history?

Speaker 2 (02:01):
Because you really do, like have a massive following, and
I feel like it kind of speaks to the fact
that men do have so many questions about sexual health
and there is such a need exactly like you just said,
and they you know, don't have resources for that or
they're too ashamed to ask it, and you really like
break it down in a very, like I said, non

(02:23):
judgmental way that really provides the information that I think
is so incredibly helpful. So I guess let's just start
from the beginning. How did you become interested in this
area of medicine.

Speaker 4 (02:34):
Yeah, so when I went to medical school, I didn't
ever even know what urology was I did rot I
did my medical first two years, you just do like bookwork,
and I thought I'd be like a critiologist or something.
That I went to rotations and realized that I liked
surgery and I really enjoyed doing things with my hands.
I enjoyed the idea of taking somebody and fixing them
and leaving them right and being able to do that.

(02:55):
But I also liked the idea of having a long
term relationship with your patient. And so there's only a
few fields in medicine where you can manage a patient
over a long period of time and operate, and so
urology was one of them. And when I found urology,
I realized, like, there's the people in urology are just
really great when they're super smart, they're innovative, but they

(03:16):
also don't take themselves too seriously because they're taking care
of genitalia all day. And so I was like, oh,
I found my tribe. These are really smart, really fun
people who love their jobs.

Speaker 3 (03:26):
And I took a chance.

Speaker 4 (03:27):
Because in medical school you only get so much exposure,
and I realized I actually loved eurology. I was so
grateful that I made the right choice. I love operating.
I love taking care of patients, and then sexual medicine
I actually became more of a passion project of mine
as I started seeing patients, and I just saw how
desperate people were to get better, and how long they

(03:48):
had hid in shame or in fear or with anxiety
before they actually came to see me, And they had
struggled for years. Some of them have had divorces, some
of them have just been like avoiding sex, and they
became a shell of themselves. And I realized this was
such an important part of people's health that they were
just ignoring, and so I wanted to be able to

(04:09):
help people learn about their bodies.

Speaker 3 (04:11):
Yeah, I mean I think like that.

Speaker 2 (04:13):
You know, that need for intimacy is such an incredibly
important part of the human experience, and I think that
we tend to sweep that under the rug a lot,
especially in this country. And you know, obviously we you know,
I'm constantly lamenting the lack of sex education as well
in this country, which you must run into that gap
all the time.

Speaker 3 (04:34):
I mean, it's crazy.

Speaker 4 (04:35):
In the US, it's bad, but around the world it's
really lacking, except for like some of the European countries, right,
which have a little bit more sex education than we do.
But for the most part, people don't know anything about
their bodies. So when something goes wrong or they think
something is wrong, they're like, oh my god, I'm broken.
And sometimes it's just normal physiology and they weren't taught.

Speaker 3 (04:54):
What is the most common problem that people come to
you with.

Speaker 4 (04:57):
So for men, it's a rectile dysfunction and for women,
and it's low libido when you're talking about and now
menopause and those sorts of changes. But oftentimes with men,
you know, fifty two percent of men over fifty will
have a rectile dysfunction, so it's exceedingly common, and it's
probably increasing in prevalence as we see more comorbid conditions
like high blood pressure, diabetes, all those things. And then

(05:20):
for women, about forty percent of women experience low libido,
so it's very very common, and twelve percent are bothered
by it. But that's still a lot of women who
feel like they've lost a part of what they used
to be.

Speaker 2 (05:31):
So I'm interested about the low libido, you know thing
in women. I mean, I know that my audience is
mostly men. We're probably going to talk a lot about
men's sexual health issues. But you know, I think that
there's just a sense and this is obviously like a
bias that I see a lot working in the adult
industry and the way that men view women in the
adult industry, And the idea is that women are just
generally not sexual beings, right, that women are there to

(05:55):
provide a service and pro create and let like all
they're therefore, so this idea that women have a low
sexual libido, probably a lot of people think, like, well,
women don't really have a sexual libido? Is that something
that you encounter.

Speaker 4 (06:08):
I think more so it's that they expect it to
go away. So I think when you're younger, everyone assumes
that women want to have sex, or they're interested in sex,
or they have a sex drive. But it's very common
that sex drive changes over a lifetime, especially after babies,
especially when you're going through hormonal changes, and so very
often women will at least have periods of time where

(06:29):
the libido waxes and wanes, and they may change in
terms of how they respond to desire. Their desire will
change in terms of it won't be spontaneous. They won't
just see their partner and be like, oh my god,
I want to jump them. It will be more like
I need to be open and receptive and close and
intimate with my partner, and then oh, there is a
desire after I've allowed some arousal to happen, right, I've

(06:51):
allowed myself to get turned on a little bit. Now
I'm like, oh, yeah, I like that. I describe it
like going to the gym. When you go to the gym,
A lot of times you don't want to go, but
once you're there, you glad you did. It's sort of
like that, and that's not abnormal. That's a normal variation.
It's very common. But the thing is that no one
knows that. So they're like, oh, I never feel desire anymore,
so I'm broken. And then they're not receptive to trying

(07:14):
to become aroused because they're like, well, I don't feel
like I want it, and that's where the breakdown happens.
But really, I think a lot of women, to your point,
is they are sexual beings. They miss feeling sexual, feeling desired.
That's a big part of it is they don't feel desired,
they don't feel desirable, and so they start feeling like
they're not themselves. But like, how dare they bring that

(07:35):
up when they have so many other things to do, right, Like, oh,
I've got to take care of my kids, they go
to take care of my aging parents. I've got so
much else going on, Like that's not a priority. And
I think that's a huge thing. I wish would die
swift death. Like sex is a priority. It is something
that if you enjoy, if you feel pleasure from, you
should hang on to as long as you can. It

(07:56):
is a marker of longevity, being able to be intimate
with another human being, to have sex, to feel that
connection with someone else. It makes you live longer. It
makes you happier, and it is a sign that things
are working. That there's good blood flow, there's good nervous function,
there's good hormones. All those things are working well. So
it's a sign of good health. So if you enjoy
sexual activity and you start feeling like something is changing,

(08:19):
you should investigate that and you should figure out what's
going on and you and sometimes it could be, like
I said, a normal variation. You just have to work
through that. But the worst thing someone can do is
just like close the door and say I'm just going
to deal with it. And sex is just going to
dwindle away, and that's okay.

Speaker 2 (08:34):
Do you think a lot of that has to do
with and this is of course, like speaking from experience
as a woman who you know, has had a child
and who's you know, sexual libido has waxed and waned,
you know, depending on what's going on in my life.
You know, I feel a lot more confident in my
body now than I used to because I've actually taken
a lot of measures to like take care of myself.

(08:55):
But I know that a lot of women don't have
that luxury, right. Do you think that a lot of
that comes from like and feeling you said, they don't
feel desirable. Do you think that a lot of that
has to do with the fact that, like we in
society have this ridiculous standard that like women need to
look like and need to like appear a certain way
to be desirable, and that's a really hard thing to
achieve after you have a child.

Speaker 4 (09:16):
Absolutely, I mean one of the biggest reasons the biggest
sexual insecurities for women is body image, right, And I
think especially after you've had children and maybe you're going
through menopause, maybe you've gained a few pounds, it can
feel very sort of not sexy in your body because
we see these images of like these perfectly fit women
even in their postmenopausal years, looking great exercising, you know,

(09:40):
and sometimes it's difficult, and I think the reality is
that everyone's body changes and.

Speaker 3 (09:46):
It's sort of like we have to go.

Speaker 4 (09:48):
This is where like self talk, sex therapy, those things
can be really helpful in sort of one getting rid
of those negative thoughts, but also when you're with your partner,
focus on what feels good, not thing about how does
my body look like in this light? How does it
look like when I am in this position? More so like,
look is this pleasurable? Let me enjoy the sensations that

(10:09):
are happening. Let me focus on those things rather than
all the other thoughts in my head. And that's when
you can really sort of let go and enjoy. And
I think for women that's really difficult. They've actually done
studies where women will practice mindfulness and they've seen an
improvement in desire arousal orgasm like all the sexual domains
just from practicing a twenty minute mindfulness meditation daily because

(10:33):
they're now able to be more present in the moment
with their partner. And men men deal with this too, right,
Men are worried about when they have trouble with erections,
the next time they have sex, they're now worried about
their erections. They're not focused on what's happening, like is
my erection gonna last?

Speaker 3 (10:46):
Is it going to come?

Speaker 4 (10:47):
And it can be the same thing with ejaculation. Am
I going to come too soon? Am I going to
come at all? I mean, there's a variety of different things.
And men have body image issues, right. They worry about
the size of their genitalia and if they're doing the
right thing, and they just not vocal about it, but
they still, you know, feel these anxieties and they can
absolutely play a negative role in their sexual relationships.

Speaker 2 (11:07):
I want to talk about penis size. Obviously, that is
probably like the question that comes up like the most
from my audience. I'm sure you get a lot of this,
and you know obviously working in the adult industry where
you know we I mean, look, it's a caricature of
real life, right, and you see these large penises that

(11:29):
are much bigger than the average dick. And unfortunately, I
feel like a lot of people do get sex education
from porn and they don't separate fantasy from reality, which
I think honestly happens in all.

Speaker 3 (11:42):
Forms of media.

Speaker 2 (11:44):
And they think like, I could never be a good lover,
I could never be a good partner because I don't
have a penis like Johnny Sin's. So how do you
address those insecurities? Well, one, we are really bad at
estimating size. We know the AP size is summer between
five point one and five point six inches. Most people
think it's six inches or larger. And then when you

(12:06):
ask someone what is six inches, they're like, you know,
their idea of what it is is much larger than
it actually is. So they've done stays where they've actually
shown people different sized fallacies, and they've said, what size
do you think this is?

Speaker 3 (12:18):
And when they are average.

Speaker 4 (12:20):
They are usually bigger than average, is what they'll say. Sorry,
When they're slightly bigger than average, they will think they're
a lot bigger than they are. When they're slightly smaller
than average, they think they're the accurate size. And then
average is sort of somewhere in between. And so the
realit is, we don't nobody knows what reality is. And
I think the most important part is that you don't
need a large penis to satisfy a partner, because for women,

(12:44):
the most important organ of pleasure is the clitterists. The
clitterist doesn't require you to have a long penis. The
clitterists can be stimulated by your fingers, by your mouth,
by a toy, and that is the homelogue of the penis.
So for guys, I'm like, look, you guys enjoy someone
stumilating your penis, The same thing is what a female
person is going to enjoy when you stimulate their clitteris.

Speaker 3 (13:04):
And so you don't need like.

Speaker 4 (13:05):
A large penis that's reaching the cervix to provide pleasure
for a partner. And so I think focusing on communicating
with your partner, finding out what they like and that
it's an exploration that can be very very fun and
sort of like applying that is going to be way
more valuable than focusing on the size of your organ.

Speaker 2 (13:25):
I mean. And there's a lot of women who can't
come from penetration. I'm actually one of those. Yeah, it's
very common.

Speaker 4 (13:30):
So eighty five percent need clitoral stimulation, and only a
small percentage of them will climb A very small of
women will climax through vaginal penetration, and likely it's because
of the anatomical variations, right, Like some people have a
thicker space between the clitoris and the vagina and some
have a thinner one, And that's just variable person to person,
And so I suspect that when people have a little

(13:52):
bit less space that they're more likely to climax because
the penis is closer to the clitteris the clitteral shaft.
So again it's variable, but it doesn't mean there's something
wrong with the person or wrong with you. Everyone is
individual and that's where the communication is so important.

Speaker 2 (14:07):
Do you think that people focus too much on like
the physical aspects of sex, like what you said, like
just the large penis size, body image, and less around
like the cerebral parts of sex. That's I was once
in a like an S and M relationship for a
brief amount of time, and what I enjoyed about that
was there was a lot of mind play in that.

(14:29):
It was like the most actually cerebral relationship that I
had been in, because it wasn't just about this that
makes a lot of sense, It was a lot more
around it, and that for me was really interesting me.
I think we can learn a lot from BDSM practitioners
because they communicate right before they have sex. They have
like a contract and they go through right, you go
through what's okay, what's not okay with my zoyfriend.

Speaker 3 (14:51):
Did that with me. He gave me a boundary checklist.
And this was years ago.

Speaker 2 (14:54):
I had never seen one like this before in my life,
and I was like, what is this And he's like,
I want you to check off what you're okay and
what you're not okay with And I was so uncomfortable
with this level of communication.

Speaker 4 (15:03):
But it's so great right now now you know like
what you're into and what you're not into, and it
doesn't need to be that like concrete, but it's great
if you're open to that. I mean, I think, like
I tell my patients sometimes, I'm like, write down your
fantasies and you don't have to share them right away,
but it's good for you to know what they are
and encourage your partner to do the same. And maybe
as you start talking about sex, you can share one

(15:26):
and then see how you react to it and sort
of like slowly think about the things that you're open
to and not open to. Because we don't really take
time for that exercise. But I think the bottom line is, yeah,
we don't talk about sex. We just were never and
this is no one's fault. No one taught us how
to talk about sex. Right in my household, we didn't
talk about sex. It was like, don't have sex. That
was the entire conversation. Boys only want sex, don't have sex.

(15:47):
That was the whole conversation I had growing up, And
many people who knew had very similar conversations. And so,
how are you going to know how to talk about it?
How are you going to know how to communicate with
your partner to find out what they like? It is
such a foreign concept. It's so uncomfortable for so many
people because we've had no practice doing it, and so
realizing that everyone you talk to probably has not talked
about sex. So it's okay, you're both going to be awkward,

(16:08):
it's going to be weird, but it's like an ongoing thing.
We're not just going to talk about sex one time.
We're going to keep talking about it and have little
snippets of conversations throughout the relationship and really open up
over time.

Speaker 2 (16:20):
If you're somebody who's in a relationship and you feel
like your sex life is stagnated. Let's say you're a man,
because like I said, my audience is mostly men, and
you want to start talking to your wife about sex
and about maybe trying different things. How do you even
start that conversation? Because I know so many men that
are afraid to even broach the topic.

Speaker 4 (16:37):
So one, I would say, give them a little prep
so say, look, I love being intimate with you, or
if you haven't been intimately, like I miss being intimate
with you, and I'd love to talk about it. Let's
set aside in time to talk about it when you're ready.
So one, it's not like let's just try to have
the conversation, give them a little moment to like process
and think about, and then pick a time and a
place not near sex, so like not right after sex,
not right before sex, like in kitchen on when you're

(17:02):
sitting at the kitchen, when you're going for a walk,
when you're in the car. I do that you don't
have to look each other in the face because obviously
it's an uncomfortable conversation, so not.

Speaker 3 (17:09):
Like a kitchen table, like sit down and see.

Speaker 4 (17:11):
Yeah, yeah and so and realize like look, she might say,
oh no, I don't want to have that conversation and
be like, look, it really means a lot to me,
think about it, and just and just leave it there,
like you don't need to It doesn't need to be
a yes right away, but sort of just like broach
it gently, carefully and realize that she might be like, oh, no,
I'm worried that you're going to say I did something wrong,

(17:32):
I did something bad, you don't love me anymore, you
don't find me sexy, whatever is she's ruminating in her head, Like,
just realize, like she's probably not worried that you're about
what you're thinking in terms of like wanting to make
it better. She's probably just worried about the negative things
that could come of the conversation. And just keep trying
right and like it is. It is going to be
difficult for someone who's never had this conversation. In the beginning,

(17:53):
will be awkward. It might be awkward ten times fifteen
times before you start feeling more comfortable with it, But
it's worth it. I think we really feel like we
should never work on sex, but anything in life that's
worth working, that's worth having, you have to work for,
and so you should work for having a great sex life,
you should keep trying to make it better and trying

(18:15):
to connect because a lot of times we just do
one thing and we're like, Okay, this works, we both
get off, we're super happy, and we're going to keep
doing this thing. But in the day, you can't keep
doing the same thing because you'll get bored. And there's
comfort and routine, but there's also importance of having novelty.
And to have novelty, you probably have to talk about it, right.
I mean, you can do things like try different rooms
or try you know, a different time of day, and

(18:37):
that's easy enough, but if you want to have different
types of novelty, you're going to have to communicate about it.

Speaker 2 (18:42):
So you obviously have an incredibly strong presence on social media.
You have this huge YouTube following how did that happen?

Speaker 3 (18:51):
Like how did that journey turn into?

Speaker 2 (18:53):
Like being one of the biggest voices on YouTube for
men's sexual health.

Speaker 4 (18:57):
By accident, I started YouTube because I really had a
passion for health literacy, and I knew that in fifteen
minutes when I saw my patients or thirty minutes, I
could not communicate everything I wanted to because it was
just such a short time and they left feeling, you know,
maybe they got some information, but how much are they
really going to remember? And so I knew that video

(19:19):
was a great way for people to remember things, and
so I said, okay, I'm just start making content on YouTube.
And so I started making content. And I remember when
I got like my first I said I'm going to
do it for six months and I'm going to see
what happened. And after six months, I had a thousand
subscribers and I was like, oh ma, oh. This was
in about six years five and a half years ago.
So I was like, okay, I made it. A thousand
subscribers that said I'm going to do this, And so

(19:42):
I just kept doing it, and I just kept listening
to my audience, seeing what they needed, seeing what kind
of information they asked for, and I just kept getting
content around that, and that's sort of grew from there.

Speaker 3 (19:51):
Do you remember the first video that went viral for you? Yeah?

Speaker 4 (19:54):
It was scientifically proven ways to increase penal length?

Speaker 3 (19:58):
Yeah, what is it?

Speaker 4 (19:59):
Rise? I mean there was other ones, but that was
the biggest viral video of course.

Speaker 1 (20:05):
Yeah.

Speaker 2 (20:06):
So okay, so speaking of what are are there any
scientifically proven ways to increase.

Speaker 4 (20:13):
So there are many There are many ways. There are
non surgical ways, and there are surgical ways, and they've
been studied, but I will say there is not an
abundance of data on all of them. So I would
say the surgical techniques have many, many complications. They're not
there's not a lot of people doing high volume penile
enhancement surgery, and so at this point in time, I

(20:33):
would say avoid those things unless you have a doctor
who is really proficient in those surgeries and can give
you clear outcomes, because you only have one penis and
you really don't want to mess it up. So I'd say,
generally speaking, the outcomes are okay, but there's a lot
of downstream potential risk. And then there's non surgical options.
So when you talk about non surgical options in terms

(20:55):
of length, probably the safest thing that has shown benefit
as attraction device. You can buy online, but you do
need to It's like a commitment. You have to sort
of be very disciplined about using attraction device, which sort
of lengthens with stretch over time, and really disciplined at
least a half an hour twice a day, up to
six hours a day depending on the traction device you use,

(21:17):
and then after several months you will see an increased length.
I don't know if it will last over years, right,
Like when you stop using the traction device, will you
maintain that length? I don't know because there's no evidence
on that yet. So that's one. And then for girth
there are some options. Probably the safest option available now

(21:38):
is a penal filler with micro doses of hyonic acid,
so very small doses delivered over multiple times, right, so
you won't go to the doctor once and get a
filler and be done. It's probably going to be overtime
because they don't want it to become lumpy and bumpy
and sort so they want to give these really small
doses and that will also dissolve. So after you know,

(21:59):
about a ten months usually it dissolves and so you'll
need to go through the process again if you still
want it. So those are probably the safest options right now.

Speaker 3 (22:08):
There are other ones.

Speaker 4 (22:09):
There are people always researching, investigating, but this time those
are probably the top two things that are the safest
and of course you know, reasonably effective with obviously everything has.

Speaker 2 (22:19):
A little bit of a risk. What's the like standard
amount of length that people can gain.

Speaker 4 (22:25):
With attraction device about two centimeters. With girth, it just
depends on how much you inject. Most injectors will stop
you at some point because at some point it's not
possible to accommodate that kind of girth and normal vagina. So,
in fact, they did studies where so when they do
transgender surgery, they use a forearm flap to create a

(22:47):
neofallus and they would make the girth of it, and
they were making them too girthy. So they actually had
to do studies to figure out what was the optimal
girth and length. And so there is sort of an
optimal girth. You don't want to go too big because
then you won't be able to fit your partner anymore.

Speaker 2 (23:03):
Yeah, you don't want to be growth master. Yeah, or
maybe you do and you get a contract with browsers.

Speaker 3 (23:08):
I don't know. I mean two centimeters that I don't know.

Speaker 2 (23:13):
To me, that seems like not a huge difference, but
I guess to a guy who's like really obsessing over
his penis size, I guess that would.

Speaker 4 (23:20):
Again, it's very individualized for some people. But I think
the more important thing is if you have something we
call small penis anxiety where you are obsessing over this
and you like are like so fixated on it. You
need to see a psychiatrist to really make sure that
your thoughts are under are managed, because it's not gonna
that's a mental issue, right. A lot of people just
want a longer Peni's just like women want larger boobs,

(23:41):
and that's okay.

Speaker 3 (23:42):
But when it.

Speaker 4 (23:42):
Becomes this compulsion or this sort of obsession where you
are thinking about it all the time, re ruminating about it,
you're feeling like it's so important, that's where we have
to really involve a mental health professional to make sure
that you know you're in It's not a body dysmorphia
where like you're not going to be satisfied with anything, right,
And and that's where also you can harm yourself by
doing really sort of aggressive options and then be dissatisfied

(24:05):
at the end.

Speaker 2 (24:06):
What about guys with micro penises have you ever seen
and what is specifically like, I mean, I know micro
penis is a very small penis, but is there a
specific size that measures.

Speaker 4 (24:18):
About I think it's about two point seventy five inches
or smaller in terms of stretched PNL length, which is
the essentially the enhanced the erect penal length, the surrogate marker.
In terms of those, yeah, there are again that's where
we have all the data. In terms of pen l enhancement,
there are surgeries and other options, but again they're risky.
There's nothing that is like, there's no free lunch, is

(24:39):
what I always tell patients, And like the more aggressive
you are, it's not People will always say, like, well,
women can get boob jobs, why can't I get it enhancements?

Speaker 3 (24:48):
But it's a very different organ right, It's.

Speaker 4 (24:50):
Very vascular, it's very has a lot of nerves, and
like there are you know, we have to be and
your wethrow runs through it, so you pee through there.
There's a lot of things you have to think about.
The anatomy is not as simple as a breast, so
it's more complicated.

Speaker 2 (25:06):
I have a question, actually, do you know a lot
about carve reject? Yeah, yeah, because we see a lot
of that in the adult industry and I know some
guys that have used So for those of you who
don't know, it's a substance that sometimes male performers will
inject into their penis to keep it hard. And I
do know some male performers that have actually kind of
ruined their penis by using it extensively and have had

(25:28):
to get a penis pump to get their well.

Speaker 4 (25:32):
So CAB reject is a it's a class of interracovernocal
injections that we use for a rectile dysfunction. So when
men have severe rectile dysfunction that doesn't respond to medications
or vacuum erection devices, we offer these medications and they
work very well, like eighty percent of guys can get
an erection with an injection. However, the issue is that
there's a high risk of priapism, which is an erection

(25:53):
that lasts longer than four hours. After four hours and
this always sounds so great, but after four hours, you're
not getting any acts need a blood flow into the penis,
and so you start forming scar tissues. So I suspect
what happened in these performers is they injected too much
and then they had an erection that lasted too long,
and they didn't go to the emergency room, which is
what you should do because then we can we can

(26:13):
extract that medication, or we can give you an injection
to try to bring the get the blood flow moving. Again,
and so then after about four to six hours, you
start building up scar tissue in your penis, and then
you've got this permanent scar tissue, which means you can't
get an erection, and so then the only option is
to have a penile implant.

Speaker 3 (26:33):
Yeah, I think that.

Speaker 2 (26:34):
And the problem is too, is that, of course, sometimes
porn sines can last a very long time. Yes, I
mean it's not common that you'll have a scene that
you'll need to be hard for four to six hours,
but I mean sometimes there's been stops and stars, stops
and starts, the light stops working, I don't know, yeah,
whatever happens. And so maybe they keep that erection for

(26:55):
that long because the sort of need it.

Speaker 3 (26:58):
For that long.

Speaker 4 (26:59):
And then I mean it's a known risk, right, Like
if you're having multiple like sexual encounters in your arouse
that's different than having an erection that's just there without arousal.
That's where we see the problem.

Speaker 2 (27:12):
Yeah, yeah, yeah, And I think that it just, you know,
male performers are under so much pressure that and I
think they just become so really they can become so
reliant on it and they use it every all the time.
And if you're working twenty five days out of a
thirty day month.

Speaker 4 (27:30):
I mean using it is using it is fine. I
don't think that it's harmful to use it because a
lot of guys use it, right, But it's really that
ignoring that prolonged direction that's when it becomes a problem.
Otherwise it's safe, Like anyone who has a rectabysfunction uses
it for sex, it's safe to use. But you're supposed
to use it for a normal sexual encounter, which lasts
anywhere from you know, five minutes to at max, like

(27:52):
thirty minutes usually for most people. And so if it's
lasting longer than that, which you obviously need when you're
having you know, performer, that's where it becomes problematic.

Speaker 3 (28:02):
It's not the use of it on a normal way.

Speaker 4 (28:04):
So I want anyone who's using it to understand that
it's safe when used appropriately.

Speaker 2 (28:08):
Okay, So if you are a male performer and you're
using it, and I know, they don't ever talk about it, right,
they never tell you. They go into the bathroom with
their little bag and we kind of know what they're doing,
but they don't tell us. So, say there's a male
performer watching he uses it. He doesn't want to stop
using it because he's afraid it's going to affect his career.
What are some measures that he can take to make

(28:29):
sure that he doesn't have this scar tissue problem.

Speaker 4 (28:32):
Yeah, so one is talking to tell your urologists, because
we can some people who who can really have good
we can actually give them some medication to reverse it
if they're struggling with this iss you're so talk to
you eurolgist about that. But also, if you have an
erection that lasts longer than four hours, go to the er,
Like if you can't reverse it, go to the emergency

(28:53):
room because literally you will save your penis that way.
So that's the biggest thing, right, Otherwise use it. That's
totally fine. If you have an erection last longer than
four hours without stimulation, you need to go to the
r especially if it's painful. That's a sign, right that
like this is dangerous and we need to reverse it immediately.

Speaker 2 (29:11):
I have to say that's probably literally the most helpful
information that like almost any male performers ever are going
to hear, because I've never spoken to a medical professional
about this. Like, we all know what happens in the industry.
We all know that it's like ruined some performers' careers.
But I've never had the opportunity to talk to a
medical professionals.

Speaker 3 (29:30):
Well, I hope if.

Speaker 4 (29:31):
You're listening that you take that home because it's so important, Like,
we want you to have good erectile function. Getting a
penal implant is great when you need it, but it's
not the same.

Speaker 2 (29:40):
Yeah, absolutely, fellas. Let's get real for a second. Confidence
in the bedroom isn't just about charm or technique.

Speaker 3 (29:47):
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(30:21):
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(30:55):
Visit blue choo dot com for more details and important
safety information and a huge thanks to blue Choo for
sponsoring the podcast. Okay, so I wanted to just talk
about your YouTube channel a little bit more because you know, obviously,
like this is actually something that I personally struggle with
a lot, and I wonder if this is something that
you ever deal with. Do you ever have an issue

(31:16):
between like balancing your values as a medical practitioner and
getting the information out there that you need and then
the need to like have thumbnails that like grab people
or you know, titles that are almost on the verge
of being clickbait to bring people in or retain your audience.
Or do you find that, like because of the nature

(31:38):
of your information that like you don't have a problem
getting those views.

Speaker 4 (31:42):
No, you, I mean I would be lying if I
said that I didn't think about titles and thumbnails. Of course,
anyone who is on YouTube, you have to get someone
to click on the content, right, So all of that
is really important, but I try to make it as relevant.
I never make a fake title, right, I never want
to make it till it doesn't isn't relevant to the content.
And you know, you have to think about the kind

(32:03):
of in a way that's like, how can I serve
this to you in a way that's educational, and we'll
answer this question and still be interesting, right because I can.
For example, I just saw an article about how sleep,
apne and a rectil dysfunctional. Really, if I made a
video and said the link between sleep, aap mean, and
a rectail is function, I'm not sure everyone's going.

Speaker 3 (32:21):
To click on it.

Speaker 4 (32:22):
But if I said something like, oh, when you're snoring,
that might mean you're in danger for your erections going away,
Like oh, people would be like, oh, I'm going to
click on that. Right. It's the same information, but it's
how you deliver it. And so that's the way I
sort of sort of manage that.

Speaker 2 (32:35):
What about online censorship, I know that YouTube can be
a tricky place in that world.

Speaker 3 (32:40):
I deal with it a lot. I know that there's
you know, they don't always.

Speaker 2 (32:45):
Love sexual content, but if it's educational, they generally let
a lot of things yes fly.

Speaker 3 (32:51):
How do you find that that's the same.

Speaker 4 (32:54):
I would say for YouTube in particular, they're actually quite
supportive of educational content and they realize like this is
all they have their you know, auto sort of bots
ready that scan content first, and there are some things
that will just get flagged and you just have to
go through the process to unflag them. But I say
other platforms are actually more difficult. I don't know if
you feel this way, but I found that Instagram, TikTok,

(33:18):
those meta and TikTok, they don't really care like who
you are, what you're creating.

Speaker 3 (33:23):
If it gets flagged, it's very difficult.

Speaker 4 (33:25):
I mean, you have a process right to request it,
but I think I mean, I don't know, I don't
have any context there, but I would say that once
you've been flagged a bunch of times, it does negatively
affect your reach and it frustrates me very much so
because people who are posting content where like women are
almost naked but not it's okay, right that is fully

(33:46):
available and not flagged because the bots don't see it.
But like content where I'm trying to educate someone on
their sex life and how to have healthy, safe sex
is flagged, and so that's a bit frustrating.

Speaker 3 (33:57):
But you know, we do what we can. It's interesting
mixed bag for me.

Speaker 2 (34:01):
I will say definitely, YouTube at least has somebody that
you can talk to, right, and that does not exist
on any of the other platforms. There's no like channel
manager or anybody that you can speak to. But I
have found that for myself that YouTube is actually more
restrictive with my content than Instagram is now.

Speaker 3 (34:19):
Interesting, which is crazy.

Speaker 2 (34:20):
TikTok impossible, I know, like impossible once you're flagged.

Speaker 3 (34:24):
Once it's like your TikTok is gone.

Speaker 2 (34:26):
It's just like TikTok just doesn't like anything like sexy.

Speaker 3 (34:30):
Yeah, I mean, I don't even try.

Speaker 2 (34:31):
I'm so there's a lot of content that I'll put
on my Instagram on my YouTube that I will not
put on TikTok because there's just no way they're going
to let it fly.

Speaker 4 (34:38):
Yeah.

Speaker 2 (34:39):
Yeah, yeah, it's but it's it's also difficult, right because
it's like they're pretty opaque and you can't really they
won't give you a straight answer.

Speaker 3 (34:48):
I'm like, what's allowed and what's not You have to
sort of guess.

Speaker 4 (34:51):
So, anyone who's listening, if you want to support us,
share our content when you see it, because that's the
best way that we can get a bigger reach. If
you like what we do, I would just say do
that because it's helped this a lot.

Speaker 3 (35:00):
Yes, yes, yes, sure.

Speaker 2 (35:03):
I never encouraged that I should. Maybe I should say
that more often. It might be a good idea. Okay,
So obviously I would love to talk about porn being
in the porn industry. I have, you know, my view,
my side coming from a medical professional. You know, obviously
there's a lot of activity about porn out there. Give
it to me straight. Do you think porn is unhealthy?
And can you watch too much porn? Okay, So I

(35:26):
don't think there's a yes or no answer here. I
think that and I know it's annoying to be wishy washy,
but I will say that porn is just an entertainment product.
It is fine for adults to watch.

Speaker 4 (35:37):
I do worry that kids are getting access to it
at younger ages. When you and I were kids, it
was very difficult to get access to porn. You'd have
to find a magazine or a VCR and a videotape
and it was not that easy.

Speaker 2 (35:47):
Well, what's funny is, I don't know if you know this,
but my parents were pornographers. Oh really, so I grew
up the daughter of pornographers, so it actually wasn't that
hard for me. However, when I did get access to
like a magazine back then, it was actually soft core
content because they didn't show any sort of penetration in
print at the time. When the Internet came along, everything changed.

(36:08):
So when I was able to steal my parents like
Club magazine, Penthouse magazine when I was younger, I didn't
see all that much, right, compared to what kids are
able to access today, completely different.

Speaker 4 (36:19):
Mong So that's where I would say hard, no, you
should be doing your best to have your children not
access that. Unfortunately, the average age of children accessing is
a ten, which means that eight year olds are seeing
it and it transforms the way they see sex because
their brains are not fully developed and so they think
that's what sex is. And as you know very well,

(36:39):
porn is a curated product. It is not real life sex.
And so that's where I will say, draw the line,
no porn is bad as an adult. Porn is an
entertainment product. If you can separate reality from fantasy, you're
probably fine. It's a great way for people to explore,
to find new things they're interested in, to maybe even
have arousal with their partner, enjoy something together. It is

(37:03):
not harmful for those people. There is a very small
subset of people, I would say, who do have a
problem with porn. So people say porn addiction. There's actually
no medical diagnosis called porn addiction. There's compulsive porn use
now is becoming I don't know if that's the exact term,
but there's an ICD criteria for that, which is also not.

Speaker 3 (37:20):
Really valid in anyway yet.

Speaker 4 (37:22):
It's just sort of they've come up with these criteria
that may be related to compulsive porn consumption or compulsive
sexual disorder.

Speaker 3 (37:28):
It's not about porn specifically.

Speaker 4 (37:31):
And so in those situations, people find that they are
consuming a lot of pornography and they have difficulty doing
other activities, like they just want to watch porn all
the time. They don't want to spend time with their partner,
they don't want to go outside, they don't want to
hang out with friends. That's a clear problem oftentimes, why
is that happening. We suspect that it may be that

(37:53):
they have some underlying mental health disorders also, and they're
trying to cope with those disorders by using porn. And
so yes, there are people who struggle with it. There
are also people who can't separate fantasy from reality, and
then when they do have intercourse, they feel like something
is wrong with them or someone is broken because their
partners not responding the same way that they do on porn,

(38:15):
or they're not responding the same way the porn actor does.
And so I see a lot of that in young guys,
which is why again I say young people. I really
do have an issue with young people saying porn. So
as an adult, yes, there are some people who have
problems with it. And if you like you know search this.
There are many people who feel perceived they have a

(38:35):
problem with porn. The reason we find that this is
when is this more common when you have a moral incongruent.
So this is actually in the data. So when people
feel morally that porn is wrong, they are more likely
to have a problem with porn. And so that's a
lot about society, how you're raised, how you view things,
and so yeah, like if you have if you think

(38:57):
you have a problem with porn, you may, but it's
often times a reason because of the way you're raised
or what you think of porn. And for those people
watching porn once can be bad, well, watching porn like
once a year can make them feel like there's a problem.
And then there's people who can watch it every day
and have no problem with it and it's fine. So
it's a very individual thing. We should not shame people, right,

(39:19):
that's my biggest takeaways, Like we should not shame people
for watching porn in a healthy way, it's really that,
But we should also acknowledge those who struggle with it.

Speaker 2 (39:28):
I think that that's the biggest problem too, is that
like the shame around it in general, Like people don't
even want to admit that they watch porn in the
first place. Yeah, so if they believe that they have
a problem with porn, they don't even want to acknowledge
that they watch it at all, and so then they
don't seek that help, and then the problem just pretic cycle.

Speaker 4 (39:47):
It becomes a cycle. So they feel shame and guilt
around watching porn. Then they want to alleviate their stressor
of shame and guilt, so they watch porn again to
get the dopamine hit basically, and then they feel more
shame and they just keep going in this cycle. So
that's sort of what what happens, you know, and then
they just like they get deeper and deeper into that experience.

Speaker 2 (40:07):
For me, I just and this is actually speaking from
I'm a recovered alcoholic. I have like seven years of sobriety. Congratulations,
thank you. But you know, so I obviously like have
an addictive personality. I'm not addicted to porn. I actually
always joke that the best way to get over a
porn addiction is to work in the industry and you
won't want to watch it anymore because you will know

(40:29):
everybody in the scene and it'll feel weird and then
second you'll just get really.

Speaker 3 (40:32):
Sick of it.

Speaker 2 (40:33):
But you know, I think that, like it's so easy
for me, like my addiction will transfer itself. Work is
the number one thing for me, and like that's thought,
but I've had it transferred to food and other things,
and so I think that, like, you know, anything that
can have a dopamine response hitting people can be addictive, right,
addictive or compulsive.

Speaker 4 (40:55):
Interestingly, when you look at how the brain responds to porn,
So if you look at like the the response of
your brain when you watch porn, of course there's a response, right,
but that response is significantly higher the second you touch yourself.
So it's not the porn, it's that you are masturbating
while you're watching porn. That's what creates that response that's
even higher. And then after that level, if you're with

(41:18):
the person, your response.

Speaker 3 (41:19):
Is even higher.

Speaker 4 (41:20):
So I think people blame porn, but it's actually just
the behaviors that you're associating with porn and then like
you're doing those and you're not. But if you were
to actually have it with a partner, your response will
be even higher.

Speaker 2 (41:33):
What would you say to people who believe that they
have a problem with porn? Where should they go?

Speaker 3 (41:37):
Yeah?

Speaker 4 (41:38):
So I would say the best thing is to find
a you know, a psychologist who is vetted in who
has some sexual education background. So if you go to
a SECTAA, sect dot org, they have a list where
you can look up sex therapists, sex educator psychologists who
have a background who can help you with going through

(41:58):
the process. Often time it's like CBT or acceptance and
sort of thought modeling type things. Actually like cold turkey,
getting rid of porn doesn't work. A lot of people
online who are like coaches and things will say like,
that's what you have to do. But oftentimes it's like
when they relapse, which often they relapse, is not you

(42:18):
know what I mean, when they watch porn again, they
then feel so much shame and it's actually worse right,
and so it's better to actually seek a qualified sexual educator,
sex therapist, psychologists who can actually work with you through
that process, because it's not about just eliminating it. If
it was that easy, then people would be doing it right.

(42:38):
If you could just eliminate it and be done with it,
then there wouldn't be so many people struggling. It's just
that they think that's the right thing to do because
that's what they see online.

Speaker 3 (42:47):
It's just not that easy. It's funny.

Speaker 2 (42:50):
I've actually you know, of course, I have Google ad
Sense turned on on my YouTube videos, and you know,
I monetize my videos like everybody else. And I've definitely
seen ads for like porn addiction, like get rid of
your porn addiction sign up for my program for twenty
nine to ninety nine.

Speaker 3 (43:05):
On my videos. Absolutely, and I'm serious, it's crazy.

Speaker 4 (43:09):
It's you know, it's sad because these you know, it's
such an emotional thing. Porn is such an emotional thing,
porn addiction. But people who feel they've are rightfully so,
I feel like it's ruined their life, right because they
are dealing with like the downstream sequele of whatever they're
struggling with. And so because it's so passionate, it's easy
to be passionate about, it's easy to sell that right

(43:31):
because you're like, oh, like I don't want you to
look what I did, this is what I went through,
this is what i've and now I'm completely stopped.

Speaker 3 (43:37):
Watching my life so monetizable.

Speaker 4 (43:40):
I've transformed my life, And like, that's great. I'm so
happy if you've transformed your life for the better. But
like the reality is, we know from the data it
doesn't work. So it's so much better to find a
like someone who's certified, who has a degree, who can
actually walk you through the actual science behind how we
deal with those types of things.

Speaker 2 (43:59):
If I'm somebody who watches porn, and I'm not sure
if I have a problem, right, I don't know if
maybe it is like the moral background that I grew
up with, and I have that moral congruency that you
talked about, What are maybe some telltale signs that I
actually have a problem rather than I just feel ashamed
about something I was always taught was wrong.

Speaker 4 (44:20):
If you feel like shame and it's pervasive and you
feel negative thoughts about it, then yeah, I think it's
worth exploring, right, Like it's worth figuring out why you
feel that shame over something that isn't likely benign, right, So,
like why are you feeling that shame? It's it's worth exploring.
But I tell people, like, if you think you have
a problem, you probably do, right. Like most people who

(44:42):
use it with no real shame about it.

Speaker 3 (44:46):
They don't think twice about it, Like it's just a thing.
It's just a tool.

Speaker 4 (44:49):
That's why I look at it pornography or a sex
toy or anything.

Speaker 3 (44:52):
It's a tool.

Speaker 4 (44:53):
And if you use it without shame and you're fine,
you don't have a problem. But if you know, like
deep down, you feel some shame or discomfort, or you
literally are like ignoring your partner rather than watching porn,
or you're ignoring your duties to watch porn.

Speaker 3 (45:06):
Yeah, then you have a problem. You know.

Speaker 2 (45:08):
I only just learned about what gooning was this year,
which is kind of crazy considering how long.

Speaker 3 (45:13):
I've heard the word. But remind me what it is again.

Speaker 2 (45:15):
Gooning is somebody who like basically is on the edge
of who edges to a point where they're like on
the edge of an orgasm for like hours.

Speaker 4 (45:25):
I know. That's insane to me, which is crazy to me,
and it's become like a thing. Well, the issue with
that is for me from a medical standpoint, is that
your when you're on the edge, your pelvic floor is tense, right,
and it's it's tight, and it's it's pulled together really tight.
And so then over time you can get dysfunctional pelvic
floor muscles because they don't relax normally like they should.

(45:47):
So that's where I get concerned, is like if people
are doing this and now they've developed pelvic floor dysfunction,
which can then present as weak directions back pain or
urinary symptoms like urgency, frequency constipation, pain with erections, pain
with ejaculation, Like, then you're actually doing yourself harm. And
also if you're doing that for a pro long period

(46:07):
of time when you eventually want to be with a partner,
you may have delayed ejaculation, right because you've trained yourself
to sort of hold off for so long, and that's
not great for any partner.

Speaker 3 (46:19):
You know.

Speaker 4 (46:20):
If you're uncomfortable and there's friction, and there's all sorts
of things and you're like trying really hard to ejaculate
and you can't, that's actually a really challenging issue.

Speaker 3 (46:29):
In your opinion, What does a good healthy sex life look.

Speaker 4 (46:32):
With good healthy sex life is one that makes you
feel good, one where you are intimate with a person,
You are experiencing pleasure.

Speaker 3 (46:41):
You are feeling pleasure.

Speaker 4 (46:43):
If you have an orgasm, that's an added bonus, but
the entire experience should be pleasurable. You should basically just
be feeling that that connection and that pleasure on a
regular basis with yourself or with someone else. If you
have a partner, that's better, But if you don't, it's
okay to self explore and enjoy yourself too.

Speaker 2 (47:04):
You've described good sex before as inducing like a flow state.

Speaker 3 (47:07):
What does that mean? So I will not take credit
for that.

Speaker 4 (47:10):
It's Emily Jimia who wrote the Anatomy of a desire,
but I love the idea.

Speaker 3 (47:14):
So when you're in a flow state, right, you can
you can.

Speaker 4 (47:17):
You know, it seems like things are effortless, right, like
you're doing a lot, but things are sort of effortless
and they're just working in the right way. And to
get in a flow state, you want to sort of
obviously be very present, but also you want things to
be just slightly challenging.

Speaker 3 (47:31):
Right.

Speaker 4 (47:31):
If it's too easy, you can't get in the flow state.
If it's too hard, you can't get in a flow state.
So just a slight challenge that sort of activates your brain.

Speaker 3 (47:39):
And it comes from like the.

Speaker 4 (47:42):
Fitness literature, right, so they get in flow states when
they're performing in athletics, and so that's sort of where
it comes from and where we extrapolate that. But essentially, yeah,
it's that you're totally present in what you're doing, you're
not thinking about anything else, and that it's slightly challenging.

Speaker 2 (47:56):
So you've also talked before about how people get four
things conflated in the sexuality receptiveness, desire, arousal, and consent.

Speaker 3 (48:03):
Can you talk a little bit about.

Speaker 4 (48:04):
Those, yes, So receptiveness essentially is just being open to
like advances of your partner. And I think that that
is something that we struggle with in society, where like
if I don't want sex right now, like I'm going
to just say no. And I think there's a place
to being open and when the time is right right,

(48:26):
And I think part of it is like cultivating the
space of desire where like, hey, like I know that
you've you've sort of told me you think I'm beautiful,
or you've given me a caress on the back, or
you've made me think or sent a flirty text, and
so that you can be more receptive and open because
you're already sort of primed to do that.

Speaker 3 (48:43):
So that's one.

Speaker 4 (48:43):
So desire and arousal get very confusing for people. So
desire is the want, like I want to want, and
arousal is the actual feeling. So for men, it's very
obvious you get an erection. For women, it's that feeling
of like full of feeling like you're getting lubricated. You're
getting that fullness that you feel in the pelvic organ
because there's a lot of blood flowing there and so

(49:04):
lubrication is the most obvious one, but it's not the
easiest one because it can fluctuate based on medications and
based on where you are in your hormonal sist So
for everyone, it's not the be all end on. Sometimes
you can get lubricated when you're not, you know, technically
have any desire. Now, for men, it's often desired than arousal,
And I talked a little bit about this. You know,

(49:25):
that's spontaneous desire. You have desire and then you get
aroused and then you go on to have sex. But
there's also this responsive desire, which means that you get
aroused first and then you feel desire.

Speaker 3 (49:37):
And I think knowing that.

Speaker 4 (49:37):
That's normal and okay is really like giving yourself permission,
like okay, I am allowed to feel arousal and then
the desire will come, and that's not abnormal. That's just different, right,
that's a different variation on normal. And then consent, you know,
I think that's obviously like in today's age, we talk
about consent as being very like like yes, will you

(49:59):
have sex media like, and when we were younger that
was not the case. But I think it is very
important to just be on the same page in general
with your partner. And it doesn't all like obviously it
needs to be very enthusiastic and often that you're seeing
consent from your partner, But every time it doesn't need
to be verbal, right, Like it can be like do
you you know?

Speaker 3 (50:19):
Is this feel good?

Speaker 4 (50:21):
You know?

Speaker 3 (50:21):
It does have to be like is this okay?

Speaker 4 (50:22):
It can be in a sexual way so that you're
kind of getting consent, but also like making sure that
they're on the same page.

Speaker 2 (50:28):
I've heard a statistic that younger people are having less
sex these days than they used to.

Speaker 3 (50:33):
Is that true? Based on the data, we would say yes.

Speaker 4 (50:36):
And I think part of it was COVID, right people,
because young people went through COVID, so there was a
little less of that. I think a lot of it.
There's a couple of reasons. One, I think young people
are just not connecting as well as our generations did prior,
Like they're not finding a match, and that's I think
part of it is because of like dating culture these days,
like there's swipe, like we can swipe till we find

(50:57):
the right person, and we'll just keep swiping until we
find the person that meets our exact criteria, and so
you sort of like they're just not connecting because they're
waiting for the next best thing, and so that's a problem.
And then there's also like we didn't grow up with
all these distractions, right, Like we did have video games
on TV, right, but it was different, Like it's very different.

(51:17):
These things are addictive, and they're meant to be addictive, right,
Like we have reels and these little short videos that
like my son is obsessed with YouTube shorts, like he'll
just watch if I let him, he'll just keep watching, right,
because you can always find something interesting, and so these
distractions are so powerful. I think that's also why people
are having less sex, right because you lie in bed
and you're like, oh, let me look at my phone

(51:38):
and instead of like normally you would lie in ben
big my partner's right next to me, like maybe I'll
just snuggle up and we'll see what happens. Or I'm
a little bored, like let's just try something. And now
there's other distractions that weren't there before. And I think
you have to actually make an effort to be intimate
with another human being and to connect with someone that way.
And so we have to make an effort. And that's

(52:00):
like just another thing that we have to do that
we didn't have to work.

Speaker 3 (52:03):
So hard for before.

Speaker 2 (52:04):
I have a question and this actually has nothing to
do with sex, but just wondering what your opinion is
on this because now everyone is ADD Do people always
have ADD or do people just have Is it more
diagnosed now or is it just because we have so
many distractions.

Speaker 4 (52:19):
That I mean, there's a real diagnosis and there's some
where people just say I have ADD, right, And like
there's a real things where there is neurochemical changes in
your brain that make it difficult for you to focus
and it makes it difficult for you to have attention
on certain things. And I think that's distinct from people
just saying, oh, I think I have ADD because I
have difficulty focusing. But they're also doing ten things at

(52:41):
once and they're like, you know, they're easily distractable. But
part of that is like we have a lot of distractions, right,
I mean, if you think about life pre internet, even
if you worked your nine to five, when you got home,
there was no way to connect besides getting on the
phone and calling someone. And no, you would not call
your business partner in the evening, right.

Speaker 3 (53:00):
That was not normal.

Speaker 2 (53:01):
It's so crazy because like all get like people will
text me, call me, at like eleven o'clock at night.

Speaker 4 (53:07):
Yeah, but that would have never happened. That was like inappropriate,
that was unprofessional, right it appropriate? Well it's not, but
I will say you can get emails at all time
of the night now, right. And so if you are
someone who loves to work, and I love to work.
I love my job, you can find yourself like I
have to be very intentional about turning off my devices
and being I'm not going to work after in the evening,

(53:27):
I'm going to hang out with my kids and I'm
going to go to bed and read a book because
if I don't do that, I will just.

Speaker 3 (53:31):
Have my brain on.

Speaker 4 (53:33):
And so I think part of it is like society
has changed the has the actual diagnosis gone up?

Speaker 3 (53:40):
I don't know.

Speaker 4 (53:41):
Is it that we're just catching more of it because
there's more attention possibly, And that's a good thing, right,
because if people really have neurochemical changes in their brain
that require attention, I'm really happy that they're getting diagnosed.
Or is it that they're just more self diagnosis.

Speaker 3 (53:55):
I don't know. Yeah, it just seems like everyone's on
adder all these days except.

Speaker 2 (53:58):
For me, and sometimes like and I, you know, I
refuse to even consider that I have ADD and I
honestly don't think that I do. But I think it's
just what you said, I'm trying to do a thousand
things at once, because the problem is is that with
all the ability to increase our productivity, what do we do?

(54:18):
We try to do more things at once, And so
now I've got like ten different things going on at
the same time. And sometimes I'll forget to follow through
with this or respond to this email, and then I
beat myself up about it because I'm like, oh my god,
how did I not remember this.

Speaker 3 (54:31):
I wasn't organized in this.

Speaker 2 (54:32):
Area, And I'm just like, but I don't have ADD
But no, we just have a lot on I just
think we just.

Speaker 3 (54:39):
Have, right, Like I think.

Speaker 4 (54:40):
I think it's very it's very distinct, like when you
are when you see like, for example, children who have
ADHD versus don't, it's very like clear right because they're
just going to school, they don't have ten million different
things going on. Now we are seeing a more diagnosis
of adults with ADHD because in girls specifically, it's not
as obvious when they're kids because they have less of

(55:01):
that hyperactivity component. And so I'm not an expert on this,
but like, I know a little bit, and so I think,
you know, I think it's good that we're getting more diagnosis,
but I do think like there is a lot of
self diagnosed it because you're just feeling like, oh my.

Speaker 2 (55:13):
God, I've got a lot on my plate. Yeah, yeah,
that's me.

Speaker 3 (55:19):
Okay.

Speaker 2 (55:19):
I want to close out with kind of like a game.
I'm going to name something and then you tell me
if it's real, and maybe a little bit about it.

Speaker 4 (55:28):
Okay, okay. Number one kegels. They are real, so they're
an exercise that you do. They're named after a gynecologist
to increase pelvic floor strength, so essentially they are a
tensing and relaxing of the pelvic floor musculature in women.
We will describe well in both genders. We will say
it's like when you pee and try to stop the

(55:48):
stream of p I don't want anyone to do it
all the time when they're peeing. It's okay to learn
how to do it when you're peeing, but don't do
it every time you pee, because those are the muscles
that you're squeezing when you try to stop that stream.
You don't want to squeeze your abs, you don't want
to squeeze your butt. For women, I'll often tell them
it's like you're trying to squeeze up a blueberry with
your vagina, Okay, like those little bluebear evers, squeeze it up,

(56:09):
and then you're relaxing and you're letting it go. For men,
I tell them it's like you're trying to lift your
penis up off the ground without touching it, Okay, And
that's kind of a good way in both energs because
they try to hold in a fart. So those are
kind of little cues you can usally sort of help
you understand what a kegel is doing. Them can be healthy,
they can also be if you don't. If you have
a normal public floor, it's healthy to do them. They

(56:30):
can help strengthen your pulvic floor. They can help you
have better orgasms, and they're just like any other muscle.
But if you have a dysfunctional pulvic floor, which we
talked about briefly, you want to see a doctor before
you do them. So if you have any indication that
maybe things are not working correctly because you have pain,
or you have urinary problems or bowel problems.

Speaker 3 (56:50):
See a doctor. Before you start doing them. Got it? Okay?

Speaker 4 (56:52):
G spots So G spots are content are contentious if
they exist or not. But they're basically an area zone
the antier top of the vagina anti your vaginal wall,
where there is a confluence of nerves, the literal shaft
and the scheme's glands, all of which are very sensitive
and can be very pleasurable. I think a lot of
times people think it's like this magic button that they

(57:14):
have to find. There's no button, it's this area. And
some people actually will say like, oh, I do feel
like a little sickness there.

Speaker 3 (57:20):
Like I've heard it's called something like spongy.

Speaker 4 (57:22):
Yeah, but some people won't feel that, right, and so
like I don't don't go looking for it. It's just
an area, and so you can stimulate it, and some
people will find it very erogenous. They will find a
lot of pleasure for it, and they will orgasm from it,
but not everyone will. And I say it it's an
analogous to the male prostate. So if men enjoy prostate
play and like you're massaging their prostate and they enjoy that,

(57:44):
not everyone's going to orgasm from that, right, And so yes,
your partner may like it. They may not orgasm from it.
They might, but it's all about exploring with your partner. Okay,
this is a contentious one, squirting squirting, So squirting exists. Obviously,
not everyone does it. About forty percent of women squirre it.
So if your partner doesn't score, that's okay. And squirting people,

(58:05):
there's like a lot of like is this P Is
this not P?

Speaker 3 (58:08):
Right? That's a big question, and so there's been a
bunch of studies.

Speaker 4 (58:11):
Some have looked at, like, let's put dye in the
bladder and then have women who score it and see
if the blue comes out and lo and behold they
saw blue. There's some people who've studied looking at the
components of squirting, and basically it's like a very dilute
urine and it also has PSA, which is what comes
from the male prostate, but also comes from the female

(58:31):
schemes glands, which is a z G zone, so it's
probably a combination. It's there's some theory that when when
you're like aroused, your kidneys may be diluting urine in
a different way.

Speaker 3 (58:44):
So it's very dilute.

Speaker 4 (58:45):
Because if you've tasted squirt, it's usually colorless, it's usually oldorless.
It's usually a little sweet, doesn't smell or taste like PE.
So I think there's probably something physiologically going on that's
changing the filtration in the kidney. So the fluid is different,
but it's coming from the bladder and the skins gland.
So the skins gland are in that space between the
clitoris and the vagina, and they're these really tiny glands

(59:08):
that create female ejaculate and that also emit PSA.

Speaker 2 (59:12):
Okay, yeah, I've never heard anybody describe it in such
an incredibly clear clinical way. It's like such, I mean,
so it does exist, but it could so.

Speaker 3 (59:23):
It sounds almost like doctors are not one hundred percent.

Speaker 4 (59:26):
I mean there's a lot of like, look, it's it's
a fluid that comes out.

Speaker 3 (59:29):
Is it P? Who cares? Right?

Speaker 1 (59:31):
Like?

Speaker 3 (59:31):
I think that's really like people like is it P?
I'm like, who cares?

Speaker 4 (59:34):
Like?

Speaker 3 (59:34):
It's not hurting you? If you enjoy it, great.

Speaker 4 (59:37):
Some people actually feel shame, they feel embarrassed, like what
is all this fluid coming out?

Speaker 3 (59:41):
And like is it P?

Speaker 4 (59:42):
Some people actually do have what we call coiital and contents,
and they do leak when they of an orgasm because
they're bladder spasms, and like, there's like it doesn't really matter, right,
Are you having pleasure as your partner having pleasure.

Speaker 3 (59:53):
That's what matters, right.

Speaker 4 (59:54):
It is not like you have some amazing superpower just
because you square you might feel that way, and if
you do, great, right, But if you don't, you're not
missing out.

Speaker 3 (01:00:03):
That's what I really want people to know.

Speaker 4 (01:00:04):
And you're not missing out if you can't elicit it
from your partner because she may not be a squirter.

Speaker 3 (01:00:08):
And that's okay.

Speaker 4 (01:00:09):
Blue balls, that's a thing. So we call it epiditimal hypertension. Basically,
when you're aroused, a bunch of blood flow gets into
the testicles and if you don't ejaculate or climax, it
sort of stays there and creates this discomfort. Usually it
goes away with time. Sometimes it's very painful, and there's
been instances reported in the literature of like young boys

(01:00:31):
in the er with like significant pain. Is just blue balls,
that's uncommon, but yes, it is.

Speaker 3 (01:00:37):
A real thing. Okay, pop cherries, it's a real thing.

Speaker 4 (01:00:41):
So when you have sex for the first time, you
can have your your hymen can still be intact. Now
it doesn't always have to be right, Like if you're
a horseback rider or you've done some vigorous sports, like
it might have already been not intact. It doesn't mean
you've had sex before, which used to be like this
big misconception like, oh if you if your hymen is destroyed,
then you've had sex and they were not true.

Speaker 3 (01:01:02):
Ses afterwards for blood.

Speaker 4 (01:01:03):
And that's not true because you can have your hymen
disrupted from a variety of different things. But essentially, when
a fallus enters through the hymenal when the hymen is intact,
it can create bleeding and it can create some discomfort.

Speaker 3 (01:01:17):
So, yes, it's a real thing. What is the purpose
of the hymen?

Speaker 4 (01:01:20):
I believe it's probably protective from like getting like fluid
in or out when you're still developing. I don't really know,
to be honest with you, Okay, semen retention. So it's
a thing that people do now, semen retention. It's November.
I don't know if it's going to air in November, but.

Speaker 3 (01:01:36):
It is no, not November. It is a stupid thing.

Speaker 4 (01:01:40):
Yeah, So semen and retention is like a Taoist principle
that Uh, there was a lot of like thought that like,
retaining your semen is like a life force and it's
good for you in terms of like medically, there is
no medical benefits specifically in terms of testosterone or fertility
to retaining semen.

Speaker 3 (01:01:58):
There's like one study that people love to quote.

Speaker 4 (01:02:00):
It's like a very small number of people who saw
a very small increase in testosteron which would not be
clinically significant, after they retained for twenty one days. I
think it was like ten guys, and so that's the
ones that everyone likes to report. But it's not clinically significant.
It's you know, it's probably anticipatory. These guys knew they

(01:02:22):
were going to ejaculate in twenty one days and they
were really excited about it, and that itself can increase
it's your testosterone. So from a medical standpoint, there's no benefit.
Now for some people because they are like not thinking
about sex, right, they're trying to avoid thinking about sex.
They can find themselves having more focus, more energy, more clarity,
and so for them it works, right, they feel like

(01:02:43):
they feel better.

Speaker 3 (01:02:44):
Because of it.

Speaker 4 (01:02:45):
My problem is when people are shamed about not being
able to retain or feeling like they're missing out or
they're white knuckling it, so they're tensing their pulvic floor
for like a month, and then they create dysfunction. And
so all I want people to know is if you
find benefit by all means, continue, If you are feeling
shame or your white knuckling it, just let it go.

(01:03:05):
And the other big thing is people will have a
nocturnal emission oftentimes when they're abstaining from ejaculation, and then
they'll feel like they failed. It's like a normal physiologic thing.
You will get a wet dream and that's nothing you
can do to prevent that, and so don't feel bad
about it.

Speaker 3 (01:03:20):
Is regular ejaculation good for your prostate health?

Speaker 4 (01:03:24):
Yeah, So there's one very famous study where they ejaculated
twenty one They looked at ejaculation frequency, and they did
it by category, so zero to four, four to seven,
so on and so forth, then twenty one and more times,
and so what they found was that men who ejaculated
twenty one times or more had a lower incidence of
prostate cancer compared to those who ejected four to seven times.

(01:03:44):
And they controlled for a lot of different things that
would be risk factors for prostatec indis. So it's a
pretty well done study. So what does that mean you
should exactly twenty one times? Know what I used it
to say is, like, you know, the theory is that, yeah,
might clean the pipes, you might not have stagnation a fluid,
and might be beneficial because it might prevent like cancer
cells from you know, growing, But well, we don't know

(01:04:05):
that for sure. What I would say is, don't feel
shame about ejaculating however many times a month, Like it's
fine to ejaculate more often. It might be helpful, but
if you're not abjecting twenty one times a month, it's
also not a bad thing.

Speaker 3 (01:04:17):
Like it just just ejaculate as much as you'd like.
And that's okay. I love that.

Speaker 4 (01:04:22):
All right.

Speaker 3 (01:04:22):
Well, those are all my questions. Thank you so much.
You're so welcome.

Speaker 2 (01:04:26):
I do have some more questions for you that we're
going to do in a separate segment for my Patram members,
if that's okay. They've definitely sent in quite a few
for you. I just want to say this has been
one of the most enjoyable and informative interviews I've done
in a long time. I learned a lot and I
know that my audience has benefited enormously from this interview,
So thank you so much for your cust time.

Speaker 3 (01:04:48):
Yeah, can you tell everyone where they can find you on?

Speaker 4 (01:04:51):
Absolutely so. You can find me on YouTube. Rina Malik
MD is the name of my channel. You can find
my podcast Arena Malik MD podcast, and then I'm on
all social media platforms as Rina Malik MD.

Speaker 2 (01:05:00):
You guys can find me on Instagram and on x
at Holly Randall. If you want to watch these interviews
streamed live or get access to bonus Q and A
like We're about to do now, go to Patreon dot
com slash Holly Randall Unfiltered go to hollylinks dot com
for access to all of my platforms. Thank you guys
so much for watching, and I will see you guys
on the next one.