October 26, 2024 • 47 mins
In this episode of Love Matters, Dr. Karan Rajan, NHS surgeon and the internet’s favourite doctor, joins host Leeza Mangaldas to tackle men’s sexual health myths head-on. From masturbation and penis size to erectile dysfunction, Dr. Karan debunks pervasive misinformation. They dive deep into the psychological and cultural pressures men face around body image, performance pressure and masculinity. Plus, they discuss the rise of Viagra misuse among young men and the vital link between mental health and sexual well-being. Don’t miss this candid and insightful conversation!
Leeza Mangaldas’ Instagram:
https://www.instagram.com/leezamangaldas/
Dr. Karan Rajan's Social handles:
Instagram - https://www.instagram.com/drkaranrajan/
Facebook - https://www.facebook.com/DrKaranR/
X- https://x.com/drkaranrajan
YouTube - https://www.youtube.com/DrKaran
Website - https://www.drkaranrajan.com/
Credits:
Produced by:
Patricia Szilagyi (DW)
Charulata Biswas (IE)
Khyati Rajvanshi (IE)
Researcher & Editor:
Sana Rizvi (DW)
Video Editor:
Praveen Kumar (IE)
Project Manager:
Patricia Szilagyi (DW)
Executive Producer:
Melanie von Marschalck (DW Life & Style)
Anant Nath Sharma (IE)
Love Matters with Leeza Mangaldas is a cooperation between The Indian Express and DW, Germany’s international broadcaster.
Learn more about DW:
https://www.dw.com
Get in touch lovematters@dw.com
Leeza Mangaldas’ Instagram:
https://www.instagram.com/leezamangaldas/
Dr. Karan Rajan's Social handles:
Instagram - https://www.instagram.com/drkaranrajan/
Facebook - https://www.facebook.com/DrKaranR/
X- https://x.com/drkaranrajan
YouTube - https://www.youtube.com/DrKaran
Website - https://www.drkaranrajan.com/
Credits:
Produced by:
Patricia Szilagyi (DW)
Charulata Biswas (IE)
Khyati Rajvanshi (IE)
Researcher & Editor:
Sana Rizvi (DW)
Video Editor:
Praveen Kumar (IE)
Project Manager:
Patricia Szilagyi (DW)
Executive Producer:
Melanie von Marschalck (DW Life & Style)
Anant Nath Sharma (IE)
Love Matters with Leeza Mangaldas is a cooperation between The Indian Express and DW, Germany’s international broadcaster.
Learn more about DW:
https://www.dw.com
Get in touch lovematters@dw.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:04):
Hello, and welcome to Love Matters. I'm your host, please,
I'm Angolas, and today we're tackling an important but often
overlooked topic, men's sexual health. Our guest today is doctor
Karen Rajan. Karen is an any jest surgeon and the
Internet's most popular doctor, with over eight million followers across
social channels. His brilliant approach to debunking medical myths and
(00:25):
sharing accurate health information with his raisers, sharp wit and
dark humor, has audiences across the world, including myself, tuning
in every day to become better informed about their health
and their bodies. He's also the author of the recent
bestseller This Book May Save Your Life. Doctor Karen, I've
been wanting to talk to you for so long, and
(00:46):
I am so glad to have you on the show today.
Thank you for joining us.
Speaker 2 (00:49):
Thank you so much for having me. It's pleasure to
be here.
Speaker 1 (00:51):
To start off, can you share with us one of
the most striking or memorable questions you've been asked regarding
men's sexual health.
Speaker 3 (00:59):
Yeah, I mean one of the most pervasive myths and
a question you get a lot. Is this whole issue
about masturbating more reduces the risk of prostate cancer.
Speaker 2 (01:12):
And all of this.
Speaker 3 (01:13):
Is based on one study done, a survey based study
where they looked at men and they surveyed them and
saw the frequency of their masturbation and compared it with
prostate cancer rates. And based on that, a lot of
people make recommendations saying twenty one times a month of
(01:33):
masturbation frequency equals a reduction in prostate cancer. And actually,
mechanistically we don't even know if that's true. There's nothing
to suggest that that is the evidence that makes the case.
And that's just the tip of the iceberg with all
sorts of myths, and that's not the I guess cleaner
and safer end of the spectrum. No one's going to
really come to harm by masturbating twenty one times a month.
(01:57):
But you can just see how pervasive men sexual health
myths are just based on that little sample totally.
Speaker 1 (02:04):
I also received so many questions, and you just think, like,
how could somebody be an adult and not know this
about their body, Like don't we deserve better? And so
I'm just curious to ask how you felt growing up?
Did you feel well informed about your own body, about
your genitals? I remember when the book you Know you
talk about how nobody told you to play with your balls,
for example, that Yeah, I just love to hear your thoughts.
(02:28):
Since you grew up in India but then live in
England now you might have a good sense of the
state of sex education in different parts.
Speaker 2 (02:35):
Of the world.
Speaker 3 (02:36):
Yeah, I would say, you know, growing up in a
daycy household with Indian parents, it was never really at
the forefront of my upbringing or cultural education to really
talk about sex, talk about relationships, talk about intimate hygiene,
health when it comes to genitals or anything like that.
(02:57):
And that's not something that my parents refused to talk about,
but neither did they overtly acknowledge it and explain that
this is something that needs to be done growing up.
I think that is just a vestige of the kind
of Indian culture I think most Indian parents probably and
in other countries as well, potentially, you know, Africa, other
(03:19):
countries in Asia is a slightly taboo subject still and
it has some stigma when you're talking about that, and
I don't think the stigma's completely removed in the Western world.
When I came to the UK when I was five
years old. Growing up in school biology class, you know,
any minimal sex health education classes that we had once
(03:40):
a year or whatever it was, we never really spoke
about that.
Speaker 2 (03:43):
The only thing I can remember.
Speaker 3 (03:45):
From sex health education when I was I think thirteen
or fourteen years old, it was actually the chemistry teacher
during a chemistry class said this is a sex health
education we need to do, and the guy literally got
a qq wera and showed us how to put on
condoms on a cucumber. And by that time, people are
already having sex and all sorts of things, and sort
(04:07):
of I think a lot of people knew that. But yeah,
I mean I certainly had very little information to go on,
and most of my information actually came from online sources,
from talking to friends. And this is when I was thirteen,
fourteen fifteen. Nowadays, when you've got those same thirteen fourteen
fifteen year olds having exposure to TikTok, Instagram, YouTube, and
(04:29):
Google in a way that we didn't twenty years ago,
I think the potential there is to really accelerate knowledge
from a young age, which is important, but also to
prevent misinformation.
Speaker 1 (04:40):
Absolutely, And you do that so well. How would you
define men's sexual health? Like what I indicators a good
sexual health. What for you does that encompass the word
sexual health.
Speaker 3 (04:52):
It's hard to extracreate men's sexual health from erections. I
mean that's kind of like the most obvious thing that
someone thinks about when they think about men's sexual health.
You know, how does a man use a penis and
how functional is it? How well can they use it?
Because not only is it an organ for pleasure, but
it's actually also could be an indication that could signify
(05:15):
heart health as well. So you know, your coronary arteries,
the arteries that supply your heart itself, are maybe only
two or three millimeters in diameter. The arteries that supply
the penis, the penile arteries, they're about one millimeter in diameter,
so far smaller than the coronary arteries.
Speaker 2 (05:34):
Now, if a man.
Speaker 3 (05:35):
Stops achieving erections in the morning, for example, or stops
achieving erections forty to fifty, et cetera as a natural
phenomenon when they wake up in the morning during night,
then that could be an indication of something going on
potentially with the heart, an early warning signal of some
impending heart issue. So when I think about men's sexual health,
(05:58):
I think it's tied not only to just pleasure, sex
and reproduction, but it's linked to mental health, heart health
and beyond, as well as a general marker of a
person's fitness, which is.
Speaker 1 (06:10):
Why it's so important we eradicate the stigma and people
be able to feel more free accessing those health services.
Right in India at least, it still remains a huge taboo,
like if you have a sexual health issue, you're unlikely
to feel empowered or sufficiently unashamed to actually get help.
And I think also many people have a lot of
(06:31):
confusion around what qualifies as a dysfunction. Like, you know,
there's diversity. Everybody doesn't have the same size or a
sort of duration or whatever it is, and might not
match up to what they see in port for example,
which is so easily available. So what are some indicators
that a man might need help regarding as sexual health
(06:52):
and at what point does something become a dysfunction?
Speaker 3 (06:56):
Yeah, I mean there's really so many factors here, because
men's sexual health can not only have a root in
physical conditions. For example, there may be some medication which
can have side effects which can compromise the sexual health.
There are a lot of antipsychotic and antidepressive medication, and
mental health medication which could have, you know, a role
(07:18):
in increasing sexual dysfunction. There's lots of surgery complications. If
someone has pelvic surgery or bal cancer surgery, sometimes the
nerves which supply.
Speaker 2 (07:29):
The penis can be compromised.
Speaker 3 (07:31):
Prostate surgery is commonly linked with erptile dysfunction and.
Speaker 2 (07:35):
Reduce libidos sometimes.
Speaker 3 (07:36):
So there's lots of physical causes which can lead to that,
but also psychological causes stress, anxiety, certain mental health conditions,
and various stressors can also impact a man achieving in
erection ejaculating either delayed ejaculation premature ejaculation. So there's a
number of things, and I think actually sexual health and
(07:57):
sex is you know, predominantly an enjoyable act. So I
guess the most basic thing to say is if a
man is not enjoying himself in the bedroom and not
taking pleasure in activities, or there's any pain associated with
those activities and it's causing either physical distress or psychological
(08:18):
distress to the point of it's really impacting quality of life.
For example, you know a person is in a relationship
with a partner and can't get an erection or can't
you know, go through to orgasm and that's really having
a psychological effect and you know, beyond physical causes, that's
also enough of reason to seek professional medical advice.
Speaker 1 (08:39):
Thank you for sharing that. What I find sort of
a bit of a conundrum, at least in the Indian
cultural context as a sexuality educator online and with lots
of men reaching out to me privately in my DM
sharing that you know, insecurity is even around their ability
to perform, and there seems to be this tendency for
(09:00):
many men also to imagine that they have a problem
even if actually it sounds like things are going just fine.
You know, where you I think internalize these standards around
what it means to be masculine, having a big penis
lasting for hours, being able to do certain things as
I mentioned earlier with regard to what you might have
(09:21):
seen in poant. And there's also all this guilt around masturbation.
I think culturally we inherit a lot of guilt and
shame from adults and religious figures and people like that,
giving completely you know, unscientific and often fear and punishment
laden explanations for things like nightfall or you know, all
(09:41):
these bad things going to happen to if you masturbate
and stuff. So a lot of young men will at
least right to me with all of these insecurities about
their sexual function, even though it actually is being described
sounds just like normal sexual function. And I think that
men are still really unable to open up about this
stuff with even each other. There's a sphere I think
(10:02):
of men openly admitting to being insecure about let's say,
their penis size. Like I can go on the internet
and be like, I have small boots. I grew up
with these insecurities around my body, and now at thirty four,
I feel comfortable in my skin and I'm so grateful
I was able to make that journey. And you know,
women in the comments, yes, queen, but I have yet
to see a man be like I have a small
(10:23):
penis and I'm okay with it. You know. So, what
are the most common pressures you think that men face
that are connected to sex and the body based property,
even on your own experience as a man, but also
as a.
Speaker 3 (10:36):
Doctor, Yeah, I think you know you've hit the nail
on the head there, and there is this dichostomy between
you know, body positivity in kind of the female space
online and then the manosphere online, where actually there can
be a little bit more toxicity. And we've seen the
rise of various influencers who kind of really lean into
that sort of ultra macho, alpha male stereotype. And actually
(10:59):
that can be positive in some senses and empower people,
but actually there's also a lot of negative connotations of
that sort of ideology, where men can feel ashamed of
their body if they don't have a six pack, if
they don't have you know, twenty five inch biceps or
whatever they're aiming for, they can feel less than rather
than focusing on the qualities that they do have. And yeah,
(11:22):
I think the problem is not only that online spaces
and people trying to compare themselves to things that they
see online, you know, and we always say that the
online space is a highlight reelist snapshot, and it's not,
you know, it can't be compared to reality. The average
person you see on the street is not going to
(11:43):
be a fitness influencer a bodybuilder, so it's unfair to
compare yourselves to those sort of matchostereotypes.
Speaker 2 (11:49):
And also I.
Speaker 3 (11:50):
Think there's some sort of you know, misconception of what
it is to be of average size.
Speaker 2 (11:57):
For example.
Speaker 3 (11:57):
You know, I think most people would be surprised if
they actually knew, based on evidence, what the average penis
size was, and they'd find themselves probably at average or
beyond average. And I think, you know, people put too
much emphasis on size, and I don't know what that is.
That still again a relic of this phallic centric ideology
(12:18):
that we had from you know, a millionaire ago, where
you know, certain tribes or religious groups would almost focus
on the penis and that kind of phallic ideology as
the focus of their culture. And maybe we're still suffering from,
you know, the hangover of some of those things.
Speaker 1 (12:34):
I could not agree more. I always like to say that,
you know, studies globally sort of show this massive gap
in access to pleasure where straight women are the least
likely to be able to report frequently always experiencing orgasm
during sex compared to let's say, lesbian women who report
that more frequently, and there's no penis even present. Right,
So I wonder how do you think we can reframe
(12:58):
our perspectives on sort of sexual success, Like could we
perhaps prioritize pleasure and connection over things like performance and
stamina and size, you know, because I think for many
men that is still how they think of sexual success
in this masculine sort of configuration.
Speaker 2 (13:16):
Yeah, it's a very interesting one. You know.
Speaker 3 (13:18):
Last year I actually spoke to a sex therapist on
my podcast and it was really an enlightening and interesting conversation.
And I think, yes, generally, on average, men are fixated
with achieving an outcome, and that outcome is usually pleasure
in terms of, you know, an orgasm for the man,
and more often than not, the man orgasms and then
(13:41):
that's the end of the sexual encounter. The woman is
still left wanting more. And I think that is the
where the goalpost could be changed slightly. And I think
actually sex doesn't have to be just about an outcome.
It can be about the you know, it sounds maybe corny,
but the whole journey, the experience. You know, how can
you actually form some sort of bond or relationship with
(14:02):
your partner, so whether that's you know, having something romantic
and I guess almost stimulating other senses apart from just
the genital organs. You know, the skin is the largest
eerrogenist organ in the body, So how can you stimulate that?
How can you use your visual sensors, your auditory sensors,
your sense of smell. There's so many other aspects to
(14:23):
sex and having some sort of excitement in that relationship
beyond just orgasm, because you know, that is really, if
you think about it, such a small percentage of the
whole thing. You know, for play and then they're sort
of cuddling afterwards, and there's just so many things. And
you know, speaking to this sex therapist just really highlighted how,
(14:44):
certainly from a female perspective, as what she was saying
that the orgasm is not the main component, but for
men it is. So how can we, I guess, flip
the script and rearrange that narrative and that it's actually
exploring other things as well, because that, I think is
more sustainable in a long term relationship beyond just the
physical climax orgasm side of things.
Speaker 1 (15:07):
It's funny how those pressures become something you sort of
perceive of at such a young age, almost like women
feel around, you know, how thin they are, or something
men feel that about penis size or seamen volume, or
it becomes just sort of in pop culture almost synonymous
with desirability. And I think we really have to dismantle
(15:27):
those and also provide alternative sort of visions for what
good sex and pleasure and connection can look like. So
at least I'm trying to do a bit of that,
and I'm really grateful for the work you do to
that end as well. I also think though, that when
a man has a sexual health concern, too often he
doesn't actually know where to go. So coming back to
(15:49):
the sort of medical physiological stuff for a second, what
kind of doctor should a man consult when he feels
he has a sexual health concern? To go to his GP,
A sexology a urologist. Could you break that down for us,
because so many people don't quite know where to start.
Speaker 3 (16:06):
Yeah, I think probably, you know, casting the net wide
and going to your family doctor or a GPS probably
the ideal place to start, because again you need to
pick apart what is the root cause, what is the
underlying cause of the complaint. You know that a man
could be suffering, for example, with erectile dysfunction, and it
(16:26):
would be easy to suggest that eurologists would be the
right person to see, and a urologist may end up
being the right person to see if the cause is
rooted in something physical you know, is there some nerve dysfunction,
Is it a complication of surgery, etc.
Speaker 2 (16:40):
Etc.
Speaker 3 (16:41):
Or is it because of trauma related injury and scar tissue? Fine,
but actually, you know, you may be more appropriately referred
to a psychologist or a psychiatrist if there is a
psychological or sort of mental health cause for the erector dysfunction.
So I think seeing your GP so you can be
triage appropriately would be the right way. All of those
answers could be the right thing. Maybe a sex therapist,
(17:03):
maybe you know, a couples counseling therapist, maybe a urologist.
Maybe your GP can just sort it out. And maybe
because it's just a side effect of a medication they
recently started you on, and that's quite a quick reversal
for that. For example, a lot of men these days
are concerned with hair loss and they take various things
(17:23):
for hair loss, and many of those things can have
the side effect of causing some issues with you know,
erectile function.
Speaker 1 (17:32):
Okay, so let's look a little bit more or at
these sort of common sexual health concerns. You already mentioned
erectile dysfunction and did want to ask more about that
because it is something that a lot of men seem
concerned about I think. You know, what I think is
quite sort of interesting is that erectal dysfunction medication is
(17:52):
now being marketed to younger and younger men. When I
was a kid, I feel like ads for viagra had
like men forty years or about, and it always almost
seemed like this thing for older people. Your cardiovascular health
is likely to decline as well, and therefore, like older
men might need viagra or something. But now it's almost
like Viagra's cool, Like, get this blue chewing gum. You know,
(18:14):
you're like twenty years old, you need this. And while
I understand that it's extremely important for people to feel
unashamed and it's great to destigmatize sexual health products and
things like that, I also think there's a danger of
like overmedicalizing or making people feel like they have a
problem when they don't, like is your descarde enough, are
(18:36):
your erections powerful enough? Are they you know, pick these
blue bills? So I wonder where you stand on that
as a doctor, because so many young men are right
into me asking about viagra, asking I'm not a doctor,
so I kind of don't talk about medication on my page.
But since I have you today, I'd love you to
tell us what erectile dysfunction is and what some of
(18:58):
the possible causes are, you know, both physical and psychological,
as well as addressed this aspect of like popularization of
erectal dysfunction medication now even on social media, it's being
overmarketed sometimes and what people should be where we are.
Speaker 3 (19:15):
Yeah, I mean, you know, I've seen all of those
adverts and posts on social media with run viercing leading
the charge and you know, promoting this viagra almost Yeah,
I guess pathologizing something that's very normal, and you know
it doesn't mean a man has to get an erection
(19:35):
fifty times a day, I mean, and then making that
a concern so people buy products, And I think it's
a weird way to advertise things for consumers. And you know,
I guess it's not weird in the farm of industry
where people want to overpathologize things. You know, we've seen
that with various things fifty years ago, with you know,
seventy years ago with tobacco products. You know, with doctors,
(19:58):
they're using doctors and adverts to promote tobacco products. Is
being healthy for you and healthy for your lungs, which
we found out was not a now similar way with
kind of viagra now viagra, you know also I dentifhil,
the kind of generic name can be great for men
who need it, who require it on a medical physiological basis,
(20:18):
to maintain erection, to maintain their sex life, thus to
improve their quality of life, whether they've after surgery or
hitting a certain age, lotusosterone related whatever, It can be
great to maintain sexual function or at least mitigate the
loss of sexual function. Fine, but I think there are,
like you said, too many young men using it unnecessarily
(20:40):
and it's not needed, and I think there's multiple ways
to think about it. There are young men who certainly
do not need it at all, and who are using
it to almost get a super physiological you know, dose
of erections essentially, which is kind of not required. But
you know, each to their own, they can do what
they want, but they should be informed that viagra was
(21:03):
initially created as a medication to lower blood pressure for hypertension.
The side effect was erections. It was a very fun
side effect, and it was marketed as now a viagral
to give you erections, but ultimately it still does lower
your blood.
Speaker 2 (21:19):
Pressure as well.
Speaker 3 (21:20):
So if someone is taking heart medication, there is a contraindication,
they shouldn't willing nearly just you know, pardon the pun.
Take viagra, for example, because it can lower the bloo pressure,
can lead to headaches, it can lead to syncope and collapse,
et cetera, blackouts. So you know, if someone is taking
a couple of viagraers popping it, you know, and then
(21:41):
you're driving, it's not inconceivable. But someone just faints because
of low bloo pressure while they're driving and gets into
an accident. That's something that you know, I have seen
before in a person who's come to the emergency room
with major trauma because they had taken a couple of viagra.
Sixty five year old man also had taking blood pressure medications,
collapsed while driving, hit a tree. Now that's not going
(22:02):
to happen to every single person, but for example, there
are side effects with those things. And I also need
to caution against the use of viagra to potentially paper
over cracks in the medical condition. Maybe you've got a
treatable cause of erectile dysfunction or some psychological issue or
physical issue which can be dealt with quite easily. If
(22:25):
you sought medical attention, and maybe your problems with erections
are just being papered over by you consistently using viagra.
And I also feel that if you consistently chronically use viagra,
your body will probably become reliant on that end of
the day. It is a drug, and you can build
up some degree of tolerance to the drug where you
might need more doses. And actually without viagra, maybe you
(22:49):
can't sustain erections. So I really think it's worth a
man exploring all of those conservative options, so to say,
to explore what's the underlying cause for this problem. And
if there is no course found and it's just idiopathic
and so the medical term for we don't know the cause,
then maybe after failing other options, yeah, you can maybe
(23:11):
try vragrant. But even then I guess be cautious, you know,
go slow, speak to the medical doctor to make sure
there's no contra indications with other medications you're taking or
giving you other medical conditions, and if it's safe, go
ahead and see how it goes.
Speaker 1 (23:26):
And would you like to caution also people against calling
for these sort of quick fixed solutions of an advertiser
on places like pond site, like let's get them when
they're the most vulnerable, right with a picture of a
massive penis, and it'll be like, get this snake oil,
you know, get this lotion, this magic potion or tablet
or cream or something, and you're going to have this
(23:48):
massive penis. And I find in India particularly, there's like,
you know, there's children's and sort of jerty Booty Baba's
kind of marketing. This, you know, almost fantastical, Like the
marketing itself is so over the top that you should
be able to see through it. But I think it
plays into this very sort of fundamental insecurity for many
(24:12):
men that it's sometimes hard to resist. But no cream
will ever make your penis big, right, I mean, can
we demystify some of this?
Speaker 3 (24:22):
Yeah, I mean it's so ridiculous that there are so
many scams and promises and hyperboles out there with regards
to increasing a man's penis size. And I get how
men are allured by these quick fixes because they think, hey, yeah,
if I can do that, great, I'll be more powerful,
I'll be more virile and whatever. But I think the
(24:44):
problem is, no matter how crazy and far fetched these sound,
some people just still believe them because they have this
insecurity about the penis size, because they correlate that with
being less than or less of a man, which is unfortunate.
And some of these things can actually have quite dangerous consequences.
A lot of these unregulated supplements that people could be
(25:05):
taking again that could have some seriously you know, negative outcomes.
There are these penis extension devices where essentially, for you know,
simplistic term, it's hanging await at the end of your
penis to try and stretch it out. You know, these
things don't really have safe outcomes in most cases.
Speaker 1 (25:24):
On a light or note, you had made this post
called how to get rid of an unwanted boner in
thirty seconds? Could you share your scientifically back method or
with us?
Speaker 2 (25:36):
Yeah, I mean, you know, I think.
Speaker 3 (25:39):
Men will get you know, unwanted random bonus throughout the day,
and that's just in line with a normal twenty four
hour fluctuation after software and levels. The probably highest frequency
is during the night and early morning nocturnal penaltre messlence
it's called, and it's usually about six to seven times
a night that man would get these directions, but it
(26:01):
may be during the day as well, when they're out
and about and it can be a little bit embarrassing
potentially so counteracting that there's sort of ways you can
think about it. Again, we alluded to the fact that
there's kind of physiological and psychological causes for you know,
linking to the penis and erections, so looking at the
kind of psychological side of things, actually distracting yourself with
(26:22):
something else. And you know, men may find this useful
to almost delay ejaculation or climax, similar to how they
can almost get rid of a boner as well. So
if you're thinking about something not sexy at all, you know,
I don't know, like a cricket match, for example, that
may help in some way to distract you and reduce
(26:43):
your bono produce your erection other ways physically, I'm.
Speaker 1 (26:48):
Thinking more like climate change. Yeah, yeah, THEIA might actually induce.
Speaker 2 (26:53):
A bone bona.
Speaker 3 (26:55):
Yeah, you're right, maybe something like yeah, maybe something which
doesn't involve bat in because I guess that has you know,
quite yeah, exactly, So maybe nothing ball or racket related.
Speaker 2 (27:09):
So yeah, maybe climate change.
Speaker 3 (27:10):
But then again, climate change can make people hot and sweaty,
you know, so maybe that's not right either, Like I
don't know.
Speaker 2 (27:17):
Like maybe I guess, you know, anything can be.
Speaker 3 (27:20):
Trainers for example, think about trainers, dirty trainers or whatever
it is, and that can be distracting that.
Speaker 1 (27:26):
Will do less than thirty seconds.
Speaker 3 (27:28):
You know, I think physiological causes. Again, it's a blood
flow redirection issue here, So can you do something to
redirect your blood flow? So maybe I don't know, just
like lifting something and kind of flexing your biceps or
something like that, there may be more focus of the
blood being redistributed to other areas.
Speaker 2 (27:47):
You know. Also, you know cold showers.
Speaker 3 (27:50):
Again, in a cold shower, your blood flow is redistributed
to kind of the main other organs or your heart,
your kidneys, your liver, et cetera, so it will take
it away from the penis. So those are some quick
things you can do at a pinch to get rid
of your embarrassing, awkward public bonus.
Speaker 1 (28:07):
Thank you for sharing that. I wanted next to talk
about premature ejaculation, because I would say, after rectilis function,
that's the other perhaps most common concernment seem to have.
Do I last longer? How can I last? I mean,
do I last long enough? How can I last longer? So?
How soon is too soon? You know medically what is
(28:29):
premature ejaculation.
Speaker 3 (28:31):
I think it comes ultimately down to the issue of
the individual and the partnership. If they feel that early
ejaculation is potentially ruining the sexual encounter or actually having
some sort of negative impact on quality of life, that
is worth potentially you seeing a medical provider, and in
this case, certainly a urologist would be helpful.
Speaker 2 (28:55):
In that situation.
Speaker 3 (28:56):
And there could be a number of causes from this
from my home no perspective, you know, doing a blood
screen to see if there's certain hormones.
Speaker 2 (29:05):
That are abnormally raised.
Speaker 3 (29:07):
Or the testosterone is abnormally low, various other things like that,
and again psychological causes. Is there some degree of anxiety
which is causing that or some sensitivity issue in the
actual penis itself. So yeah, I think it is. Again
it's not a one size fits or blanket rule, and
it'll be down to the individual and the couple as well.
Speaker 1 (29:29):
And since we're on the topic of ejaculation, there also
seems to be a lot of misinformation around whether or
not it's good for you to ejaculate. Like there's one
corner of the internet, particularly popular in India that is
obsessed with semen retention as if it's going to give
you superpowers. Do you want to do you want to
debunk some of.
Speaker 3 (29:49):
That, Yeah, And I think a lot of this myth
comes from kind of the sports industry and specifically boxing. Uh,
there was this kind of of myth historically that before
a big fight, you know, the boxers shouldn't sleep with
their wives or something like that, because the loss of semen,
(30:10):
almost like Samson's.
Speaker 2 (30:11):
Loss of hair, would result.
Speaker 3 (30:13):
In losing all of their strength and powers and virility
and they'd lose the fight. And I think that is
where the myth propagated. But there is no medical evidence
to suggest that ejaculation or sex lowest testosterone at all,
So that myth can be you know, put in bed
(30:35):
and semen retention as well. And you know, in the
way that I think of semen retention, it's not just
no fap and not ejaculating, it's actually climaxing and holding
in the semen which should come out, but actually some
way you're contracting your muscles to hold it in. Now,
(30:55):
that can actually be quite harmful because that can result
in retrograde ejaculation, where your semen instead of going out
viya urethra actually refluxes retrograde so backwards into your bladder,
which is not something that you want, which can increase
(31:16):
the rate of irritation, UTIs and all sorts of things
like that which you don't want. You don't want to
retain your semen or shoot it backwards. That is something
you want to absolutely avoid.
Speaker 1 (31:27):
And finally, I want to before I move on to
a little rapid fire around with you, let's talk about
sperm quality. Since we touched on one spam, how would
you define sperm quality? And as a man, how do
you know if you have a healthy sperm count. The
fertility industry is booming in India right now as people
delay childbirth, and I think men too want to sort
of understand a bit more about the fertility.
Speaker 3 (31:49):
Yeah, I don't think there's any real way, And similar
to women's health, there's no real way without some sort
of medical test to determine your sperm quality because swerberm
quality is based on a number of things, you know,
looking at the volume, the quality of the actual sperm itself,
the volume of the ejaculate, the quality of the sperm
(32:10):
itself in terms of their motility, So how well they're moving,
the actual shape of the sperm, do they look mutated
or not. So there's a number of factors with regards
to that which can only be seen under a microscope
and doing blood tests to check all of these various
levels of.
Speaker 2 (32:27):
Hormones et cetera.
Speaker 3 (32:29):
And similar to women's health as well, you need certain
you know, scans and images and blood tests to determine
the actual you know, your varian reserve and your you know,
egg health, et cetera. Same for men. There's no way
that I can just do some at home measurement to
test that.
Speaker 2 (32:44):
You know, that's that's not possible.
Speaker 3 (32:45):
So even the fittest person on earth with a six
pack and able to run ten miles a day and
you know, really healthy, good sleep, et cetera, Yeah, maybe
they are likely to have good quality sperm because of
all of these extra facets in their life which are
you know, good behaviors. But if you analyze their sperm
under microscope, it could be very you know, borderline infertile potentially.
(33:09):
So actually there's no way just externally to assess sperm quality.
You could extrapolate if someone is living a very unhealthy lifestyle,
they're vaping or they're smoking, or they're drinking lots of alcohol,
and they're working in a job which exposes them to
high levels of pollution for example. We know that there
are certain environmental factors, these modifiable factors, which can influence
(33:32):
sperm quality, but just based on someone's appearance, it's not
possible to tell about their sexual health or sperm health.
Speaker 1 (33:41):
So what would you advise that couples both get tested
on these various indices of fertility, shouldn't they have trouble conceiving?
I think often only the woman is sent for the test,
you know, when in fact it could be either party's
fertility that's causing the difficulty in conception.
Speaker 3 (34:00):
Right, Yeah, absolutely, I think you know, there's probably no
need to routinely get yourself tested before trying. And I
think you know, still just trying to conceive, and you know,
if there's a consistent failure over a number of months
and maybe years, then it is definitely time to explore
is there any medical factors which can be modified which
(34:20):
is actually affecting the point of conception, both on the
male and female side, as who suggested, And yeah, I
think that's a very fair thing to do, especially these days.
You know you hear these claims about sperm counts dropping,
et cetera, et cetera. It's probably something to think about
earlier rather than later if there is a long term
issue with you know, trying for a child and it's failing.
Speaker 1 (34:43):
All right, let us move on to a little mythbusting
rapid fire style. The pull out method is a reliable
form of contraception. No, do you want to quickly tell
us why? Why not?
Speaker 3 (34:58):
Rather, well, if you don't know, you know exactly the
timing of the pullout, whether there's any residual sperm being
left in the vaginal cavity, in the vaginal cadal. So
I think it's a very unreliable, unscientific method of contraception.
Speaker 1 (35:12):
I'm durant, Okay, men cannot get sexually transmitted infections from
oral sex.
Speaker 2 (35:21):
Oh, also false?
Speaker 3 (35:22):
Yeah, I mean there is consistent evidence linking oral sex
and the HPV virus with a number of cancers from
oral pharyngeal cancers, throat.
Speaker 2 (35:33):
Cancers, tongue cancers, and beyond.
Speaker 3 (35:36):
So I think, you know, definitely beyond just HPV which
I've mentioned, herpes and beyond can be transmitted orally.
Speaker 1 (35:45):
If you get a vasectomy done, sex won't be the same.
Speaker 3 (35:48):
You know, for me, I don't think that is true
based on the evidence. However, there could be some individual
variants depending on you know, whatever men find with regards
to their sexual function.
Speaker 2 (36:00):
But there should not.
Speaker 3 (36:01):
Be any specific negative impact on sexual function if a
man's had of a sectomy, because the genital organs are
exactly the same. No nerves have been snipped, the actual anatomy,
the hardware on the outside has not really been changed.
It's only the tubes have been tied. For into a
better phrase, So no, that should not affect anything physiologically.
(36:25):
Maybe psychologically there could be some effect there which may
impact a man's perception on in sexual performance.
Speaker 1 (36:33):
All right, a very diplomatic answer that men should certainly
read the side effects of birth control that women have
to endure. Kind of a sectomy is not going to
seem so bad. But okay, one more, one more myth
Men in relationships don't master bit.
Speaker 3 (36:54):
Yeah, I think that's an absolute myth. You know, I've
got tons of friends of mine who are you know,
in relationship and ships. They're married, they've got long term
girlfriends who masturbate. And now I don't think that's something
that needs to be hidden or made it taboo thing.
And I don't think that's an indication of a person
not being in a satisfied relationship either. Everyone has different
(37:14):
sexual needs. If you don't masturbate in a relationship, that's fine.
If you masturbate in a relationship, that's also fine. I
don't think that has any impact on your relationship as
a whole.
Speaker 1 (37:27):
And finally, orgasms and ejaculation are the same thing.
Speaker 3 (37:31):
So I mean physiologically there are two different things. I mean,
one is more of a pleasurable outcome and one is
more of a physiological outcome. So yeah, I think there
should be some discrepancy between the two because you can
orgasm without an ejaculate.
Speaker 1 (37:47):
And you can ejaculate without having an orgasm. Yeah yeah,
all right, Which brings us to the link between mental
health and sexual health, which we did touch upon earlier
a little bit. But I think so often when thinking
about sexual health, people think only about the genitals, genital function, size,
all of that stuff, sort of you know, seeing the
(38:08):
body as disconnected parts rather than a holistic, sort of
very symbiotic relationship. Also, right between the emotional and psychological
and intellectual and the physiological or physical what sort of
links can you know, stress or trauma or self esteem,
let's say, have on sexual function, and what might we
(38:32):
all be sort of better off acknowledging in this regard,
so that we have both the information and the sort
of agency to act on should we detect that we
might not be feeling you know, all that well up here,
I personally am of the opinion that the most significant
sexual organ is the brain.
Speaker 3 (38:51):
Right, yeah, I think you know, one of the main
things is actually if you're low in mood or you know,
depending on on what you're feeling at the time, or
any mental health conditions that can actually impact your libido.
You know, a very common side effect of depression or
a symptom of depression I should say, is reduced libido.
(39:14):
And you also see that with things like lotestosterone. For example,
if a man has a low testosterone, that impacts a
man's mood and thus can impact libido as well the
sexual drive or sexual appetite. So I think that is
the number one thing. But also the mental health can
distort your sensory perception as well. So the same things
(39:35):
that you found enjoyable, enriching and fulfilling experiences can almost
be dull down and kind of the vibrancy of life
in general can be dialed down. So the same experiences
and feelings that you feel can actually be attenuated significantly
because of your mental health. So you know, if you
enjoyed mango milkshakes when you're kind of fine, right, you
(39:59):
really love the taste of that, say you go through
a period of depression, that same mango milkshake may not
taste as sweet and as pleasurable as it did. And
the same can happen with sex as well. It may
not be as preasurable because all the volumes of all
those feelings that dialed down significantly.
Speaker 1 (40:15):
Thanks with that metaphor or analogy. I loved it. I
think it's what everyone can relate to because even on
just a bad day or the day you're feeling sad,
I feel like things don't joy it as and register
as acutely right. And I think it's important that we
seek help, you know, whether it's sexual health or mental
health related. I think those two things still remain significantly
(40:38):
difficult to navigate in India, Difficult to talk to your
family about, difficult to even talk to your partner about
So I want to just take this opportunity to encourage
listeners to know that they can, that they're not alone,
that these are very common issues, and that solutions exist.
So as we close, I did want to get back
to the sort of topic you brought up, but right
(40:59):
at the beginning, around getting your health information from social media. Obviously,
we are all blessed to have you on our feeds
because of the you know, extreme commitment to scientific accuracy
that you have, but unfortunately there are also lots of
people who do not share that commitment, and lots of
people who posit themselves as authorities. Nonetheless, there's gurus and
(41:22):
barbers and you know, people really trying to pursuade you
to see them as experts and somehow worthy of your
respect and the iconography even around these people that, you know,
it's hard for a young person to discern like who
is the authority and who is the quack. So do
you have any tips for just sort of social media literacy,
(41:44):
especially when getting your health information from there, which most
young people it is the starting point if you want
to learn about something that you think you may be facing,
You're going to start at the Internet before you go
to the doctor. You know, I'd love to hear from
you your advice to young people using the internet to
get there to get their medical information.
Speaker 2 (42:04):
Yeah.
Speaker 3 (42:04):
I think I would be wary of anyone claiming one
thing works, and if they're especially linking that to something
that they're selling as well, because there's an inherent financial
bias there as well some incentive that they're using. And
people who generally speak in absolutes scientific languages always could
(42:26):
be likely to be possibly has a higher risk of
chance of it. Sometimes is inherently a little bit vague
and ambiguous, because science can be like that. Science is
usually not in absolutes like this is X Y and Z,
and so I think if someone is speaking in hyperbole,
(42:47):
in absolutes and in very polarizing context, those are usually
red flags for you to think about and thinking, hang on,
is there any evidence behind this? And actually you also
want to do your own research as well. As much
as you might enjoy social media content, if someone is
providing health information online, I think it's worth doing your
(43:07):
own due diligence. Are they a medical professional to be
speaking so confidently about X, Y and z when it
comes to health? And also what they've spoken about can
I find any evidence behind this? So those are things
that actually the owners is also on us as consumers
to do that research as well.
Speaker 1 (43:26):
And I would go one step further in India though
particularly I don't know what it's like elsewhere. But you know, unfortunately,
because religion has such a strong place still in our
cultural and social imagination, what can be very confusing for
young people is that often even medical professionals, you know,
their products of the same society and are practicing with
(43:48):
a certain set of religious beliefs. And I mean there's
doctors on YouTube who say the most unscientific things because
it's coming from their religious beliefs, right, and so they
have the qualification, and they'll still be saying to you
something deeply misogynistic or shame lad and especially when it
comes to things like women's pleasure or you know, I mean,
(44:12):
whether it's something like masturbation or nightfall. There will be
people who have.
Speaker 4 (44:15):
Like various qualifications, whether they're professors or doctors, and unfortunately
they're allowing for their personal religious and other such beliefs
to intervene and cloud the science.
Speaker 1 (44:33):
And I think that and even once parents, you know,
when your own mom and dad tell you that, you know,
there's so much homophobia, for example, even from within the
medical profession and within people's families. I'd love to, yeah,
take that one step further, because I think there's also
some amount of gatekeeping around who gets to talk about
things like you must have these qualifications. But unfortunately, for
example queer people, I think if you have to do
(44:54):
so much work themselves, because the people with the qualifications,
the policy makers like nobody's doing the work for them.
Most healthcare workers in India still have absolutely zero training
and queer affirmative sexual health, sexual and regreactive health services
for example. You know, so I can I like ask
you to take that one step further.
Speaker 3 (45:14):
Yeah, I think you know, there's certainly no restriction on
who should talk about the content. There's likely to be
more misinformation from non medical experts talking about specific medical
issues than medical experts. But again that does not make,
as you suggested, medical experts immune from misinformation and using
their own personal biases towards pushing certain engenders. And for
(45:39):
example in India, Yeah, sometimes religion whether can creep into
the conversation and there can be lots of pseudoscience promoted
as a result of that, I think, yeah, that is
very abundant on the online spaces where someone pushes their
own cognitive biases into the conversation. So, you know, I
(46:00):
really think social media and clips that you see online
use as a stepping stone for you then to do
your own deep dive into a conversation, because there's only
so much nuance and information one can provide in sixty
or ninety seconds. And I don't think any topic can
be given you know it's proper due or you know,
(46:21):
being you can't do justice for any specific topic, certainly
not such a nuanced topic like sexual health in ninety seconds.
So you do need to go away, take the headlines
from whatever you've learned, and then go and do your
own research.
Speaker 1 (46:35):
Thanks for that very important reminder. It's been so wonderful
talking to do tell I guess where they can find.
Speaker 3 (46:41):
You, so everywhere, YouTube, Instagram, TikTok and beyond. I'm doctor
Karen on all these platforms, and you've.
Speaker 1 (46:48):
Got to get doctor Current's book. I so enjoyed reading
it and it's so funny. We had a bit of
a serious talk today, but doctor Karan is such a
pleasure to listen to and watch because he is also
so funny and so funny, so you will definitely have
a laugh both reading this book and consuming his videos.
Thanks so much for tuning in to Love Matters. This
is Lisa Mangolas and Love Matters is produced by Indian
(47:11):
Express and DW, Germany's international broadcaster. If you have a
topic suggestion or guest suggestion question or a story you
want to share, you can write into us at Lovematters
at DW dot com. We'd love it if you read
and review this podcast wherever you're tuning in, and please
do share it with your friends. Un Till next time.
This is me Lisa Mangolas signing off. I believe Love
(47:34):
Matters
Hello, and welcome to Love Matters. I'm your host, please,
I'm Angolas, and today we're tackling an important but often
overlooked topic, men's sexual health. Our guest today is doctor
Karen Rajan. Karen is an any jest surgeon and the
Internet's most popular doctor, with over eight million followers across
social channels. His brilliant approach to debunking medical myths and
(00:25):
sharing accurate health information with his raisers, sharp wit and
dark humor, has audiences across the world, including myself, tuning
in every day to become better informed about their health
and their bodies. He's also the author of the recent
bestseller This Book May Save Your Life. Doctor Karen, I've
been wanting to talk to you for so long, and
(00:46):
I am so glad to have you on the show today.
Thank you for joining us.
Speaker 2 (00:49):
Thank you so much for having me. It's pleasure to
be here.
Speaker 1 (00:51):
To start off, can you share with us one of
the most striking or memorable questions you've been asked regarding
men's sexual health.
Speaker 3 (00:59):
Yeah, I mean one of the most pervasive myths and
a question you get a lot. Is this whole issue
about masturbating more reduces the risk of prostate cancer.
Speaker 2 (01:12):
And all of this.
Speaker 3 (01:13):
Is based on one study done, a survey based study
where they looked at men and they surveyed them and
saw the frequency of their masturbation and compared it with
prostate cancer rates. And based on that, a lot of
people make recommendations saying twenty one times a month of
(01:33):
masturbation frequency equals a reduction in prostate cancer. And actually,
mechanistically we don't even know if that's true. There's nothing
to suggest that that is the evidence that makes the case.
And that's just the tip of the iceberg with all
sorts of myths, and that's not the I guess cleaner
and safer end of the spectrum. No one's going to
really come to harm by masturbating twenty one times a month.
(01:57):
But you can just see how pervasive men sexual health
myths are just based on that little sample totally.
Speaker 1 (02:04):
I also received so many questions, and you just think, like,
how could somebody be an adult and not know this
about their body, Like don't we deserve better? And so
I'm just curious to ask how you felt growing up?
Did you feel well informed about your own body, about
your genitals? I remember when the book you Know you
talk about how nobody told you to play with your balls,
for example, that Yeah, I just love to hear your thoughts.
(02:28):
Since you grew up in India but then live in
England now you might have a good sense of the
state of sex education in different parts.
Speaker 2 (02:35):
Of the world.
Speaker 3 (02:36):
Yeah, I would say, you know, growing up in a
daycy household with Indian parents, it was never really at
the forefront of my upbringing or cultural education to really
talk about sex, talk about relationships, talk about intimate hygiene,
health when it comes to genitals or anything like that.
(02:57):
And that's not something that my parents refused to talk about,
but neither did they overtly acknowledge it and explain that
this is something that needs to be done growing up.
I think that is just a vestige of the kind
of Indian culture I think most Indian parents probably and
in other countries as well, potentially, you know, Africa, other
(03:19):
countries in Asia is a slightly taboo subject still and
it has some stigma when you're talking about that, and
I don't think the stigma's completely removed in the Western world.
When I came to the UK when I was five
years old. Growing up in school biology class, you know,
any minimal sex health education classes that we had once
(03:40):
a year or whatever it was, we never really spoke
about that.
Speaker 2 (03:43):
The only thing I can remember.
Speaker 3 (03:45):
From sex health education when I was I think thirteen
or fourteen years old, it was actually the chemistry teacher
during a chemistry class said this is a sex health
education we need to do, and the guy literally got
a qq wera and showed us how to put on
condoms on a cucumber. And by that time, people are
already having sex and all sorts of things, and sort
(04:07):
of I think a lot of people knew that. But yeah,
I mean I certainly had very little information to go on,
and most of my information actually came from online sources,
from talking to friends. And this is when I was thirteen,
fourteen fifteen. Nowadays, when you've got those same thirteen fourteen
fifteen year olds having exposure to TikTok, Instagram, YouTube, and
(04:29):
Google in a way that we didn't twenty years ago,
I think the potential there is to really accelerate knowledge
from a young age, which is important, but also to
prevent misinformation.
Speaker 1 (04:40):
Absolutely, And you do that so well. How would you
define men's sexual health? Like what I indicators a good
sexual health. What for you does that encompass the word
sexual health.
Speaker 3 (04:52):
It's hard to extracreate men's sexual health from erections. I
mean that's kind of like the most obvious thing that
someone thinks about when they think about men's sexual health.
You know, how does a man use a penis and
how functional is it? How well can they use it?
Because not only is it an organ for pleasure, but
it's actually also could be an indication that could signify
(05:15):
heart health as well. So you know, your coronary arteries,
the arteries that supply your heart itself, are maybe only
two or three millimeters in diameter. The arteries that supply
the penis, the penile arteries, they're about one millimeter in diameter,
so far smaller than the coronary arteries.
Speaker 2 (05:34):
Now, if a man.
Speaker 3 (05:35):
Stops achieving erections in the morning, for example, or stops
achieving erections forty to fifty, et cetera as a natural
phenomenon when they wake up in the morning during night,
then that could be an indication of something going on
potentially with the heart, an early warning signal of some
impending heart issue. So when I think about men's sexual health,
(05:58):
I think it's tied not only to just pleasure, sex
and reproduction, but it's linked to mental health, heart health
and beyond, as well as a general marker of a
person's fitness, which is.
Speaker 1 (06:10):
Why it's so important we eradicate the stigma and people
be able to feel more free accessing those health services.
Right in India at least, it still remains a huge taboo,
like if you have a sexual health issue, you're unlikely
to feel empowered or sufficiently unashamed to actually get help.
And I think also many people have a lot of
(06:31):
confusion around what qualifies as a dysfunction. Like, you know,
there's diversity. Everybody doesn't have the same size or a
sort of duration or whatever it is, and might not
match up to what they see in port for example,
which is so easily available. So what are some indicators
that a man might need help regarding as sexual health
(06:52):
and at what point does something become a dysfunction?
Speaker 3 (06:56):
Yeah, I mean there's really so many factors here, because
men's sexual health can not only have a root in
physical conditions. For example, there may be some medication which
can have side effects which can compromise the sexual health.
There are a lot of antipsychotic and antidepressive medication, and
mental health medication which could have, you know, a role
(07:18):
in increasing sexual dysfunction. There's lots of surgery complications. If
someone has pelvic surgery or bal cancer surgery, sometimes the
nerves which supply.
Speaker 2 (07:29):
The penis can be compromised.
Speaker 3 (07:31):
Prostate surgery is commonly linked with erptile dysfunction and.
Speaker 2 (07:35):
Reduce libidos sometimes.
Speaker 3 (07:36):
So there's lots of physical causes which can lead to that,
but also psychological causes stress, anxiety, certain mental health conditions,
and various stressors can also impact a man achieving in
erection ejaculating either delayed ejaculation premature ejaculation. So there's a
number of things, and I think actually sexual health and
(07:57):
sex is you know, predominantly an enjoyable act. So I
guess the most basic thing to say is if a
man is not enjoying himself in the bedroom and not
taking pleasure in activities, or there's any pain associated with
those activities and it's causing either physical distress or psychological
(08:18):
distress to the point of it's really impacting quality of life.
For example, you know a person is in a relationship
with a partner and can't get an erection or can't
you know, go through to orgasm and that's really having
a psychological effect and you know, beyond physical causes, that's
also enough of reason to seek professional medical advice.
Speaker 1 (08:39):
Thank you for sharing that. What I find sort of
a bit of a conundrum, at least in the Indian
cultural context as a sexuality educator online and with lots
of men reaching out to me privately in my DM
sharing that you know, insecurity is even around their ability
to perform, and there seems to be this tendency for
(09:00):
many men also to imagine that they have a problem
even if actually it sounds like things are going just fine.
You know, where you I think internalize these standards around
what it means to be masculine, having a big penis
lasting for hours, being able to do certain things as
I mentioned earlier with regard to what you might have
(09:21):
seen in poant. And there's also all this guilt around masturbation.
I think culturally we inherit a lot of guilt and
shame from adults and religious figures and people like that,
giving completely you know, unscientific and often fear and punishment
laden explanations for things like nightfall or you know, all
(09:41):
these bad things going to happen to if you masturbate
and stuff. So a lot of young men will at
least right to me with all of these insecurities about
their sexual function, even though it actually is being described
sounds just like normal sexual function. And I think that
men are still really unable to open up about this
stuff with even each other. There's a sphere I think
(10:02):
of men openly admitting to being insecure about let's say,
their penis size. Like I can go on the internet
and be like, I have small boots. I grew up
with these insecurities around my body, and now at thirty four,
I feel comfortable in my skin and I'm so grateful
I was able to make that journey. And you know,
women in the comments, yes, queen, but I have yet
to see a man be like I have a small
(10:23):
penis and I'm okay with it. You know. So, what
are the most common pressures you think that men face
that are connected to sex and the body based property,
even on your own experience as a man, but also
as a.
Speaker 3 (10:36):
Doctor, Yeah, I think you know you've hit the nail
on the head there, and there is this dichostomy between
you know, body positivity in kind of the female space
online and then the manosphere online, where actually there can
be a little bit more toxicity. And we've seen the
rise of various influencers who kind of really lean into
that sort of ultra macho, alpha male stereotype. And actually
(10:59):
that can be positive in some senses and empower people,
but actually there's also a lot of negative connotations of
that sort of ideology, where men can feel ashamed of
their body if they don't have a six pack, if
they don't have you know, twenty five inch biceps or
whatever they're aiming for, they can feel less than rather
than focusing on the qualities that they do have. And yeah,
(11:22):
I think the problem is not only that online spaces
and people trying to compare themselves to things that they
see online, you know, and we always say that the
online space is a highlight reelist snapshot, and it's not,
you know, it can't be compared to reality. The average
person you see on the street is not going to
(11:43):
be a fitness influencer a bodybuilder, so it's unfair to
compare yourselves to those sort of matchostereotypes.
Speaker 2 (11:49):
And also I.
Speaker 3 (11:50):
Think there's some sort of you know, misconception of what
it is to be of average size.
Speaker 2 (11:57):
For example.
Speaker 3 (11:57):
You know, I think most people would be surprised if
they actually knew, based on evidence, what the average penis
size was, and they'd find themselves probably at average or
beyond average. And I think, you know, people put too
much emphasis on size, and I don't know what that is.
That still again a relic of this phallic centric ideology
(12:18):
that we had from you know, a millionaire ago, where
you know, certain tribes or religious groups would almost focus
on the penis and that kind of phallic ideology as
the focus of their culture. And maybe we're still suffering from,
you know, the hangover of some of those things.
Speaker 1 (12:34):
I could not agree more. I always like to say that,
you know, studies globally sort of show this massive gap
in access to pleasure where straight women are the least
likely to be able to report frequently always experiencing orgasm
during sex compared to let's say, lesbian women who report
that more frequently, and there's no penis even present. Right,
So I wonder how do you think we can reframe
(12:58):
our perspectives on sort of sexual success, Like could we
perhaps prioritize pleasure and connection over things like performance and
stamina and size, you know, because I think for many
men that is still how they think of sexual success
in this masculine sort of configuration.
Speaker 2 (13:16):
Yeah, it's a very interesting one. You know.
Speaker 3 (13:18):
Last year I actually spoke to a sex therapist on
my podcast and it was really an enlightening and interesting conversation.
And I think, yes, generally, on average, men are fixated
with achieving an outcome, and that outcome is usually pleasure
in terms of, you know, an orgasm for the man,
and more often than not, the man orgasms and then
(13:41):
that's the end of the sexual encounter. The woman is
still left wanting more. And I think that is the
where the goalpost could be changed slightly. And I think
actually sex doesn't have to be just about an outcome.
It can be about the you know, it sounds maybe corny,
but the whole journey, the experience. You know, how can
you actually form some sort of bond or relationship with
(14:02):
your partner, so whether that's you know, having something romantic
and I guess almost stimulating other senses apart from just
the genital organs. You know, the skin is the largest
eerrogenist organ in the body, So how can you stimulate that?
How can you use your visual sensors, your auditory sensors,
your sense of smell. There's so many other aspects to
(14:23):
sex and having some sort of excitement in that relationship
beyond just orgasm, because you know, that is really, if
you think about it, such a small percentage of the
whole thing. You know, for play and then they're sort
of cuddling afterwards, and there's just so many things. And
you know, speaking to this sex therapist just really highlighted how,
(14:44):
certainly from a female perspective, as what she was saying
that the orgasm is not the main component, but for
men it is. So how can we, I guess, flip
the script and rearrange that narrative and that it's actually
exploring other things as well, because that, I think is
more sustainable in a long term relationship beyond just the
physical climax orgasm side of things.
Speaker 1 (15:07):
It's funny how those pressures become something you sort of
perceive of at such a young age, almost like women
feel around, you know, how thin they are, or something
men feel that about penis size or seamen volume, or
it becomes just sort of in pop culture almost synonymous
with desirability. And I think we really have to dismantle
(15:27):
those and also provide alternative sort of visions for what
good sex and pleasure and connection can look like. So
at least I'm trying to do a bit of that,
and I'm really grateful for the work you do to
that end as well. I also think though, that when
a man has a sexual health concern, too often he
doesn't actually know where to go. So coming back to
(15:49):
the sort of medical physiological stuff for a second, what
kind of doctor should a man consult when he feels
he has a sexual health concern? To go to his GP,
A sexology a urologist. Could you break that down for us,
because so many people don't quite know where to start.
Speaker 3 (16:06):
Yeah, I think probably, you know, casting the net wide
and going to your family doctor or a GPS probably
the ideal place to start, because again you need to
pick apart what is the root cause, what is the
underlying cause of the complaint. You know that a man
could be suffering, for example, with erectile dysfunction, and it
(16:26):
would be easy to suggest that eurologists would be the
right person to see, and a urologist may end up
being the right person to see if the cause is
rooted in something physical you know, is there some nerve dysfunction,
Is it a complication of surgery, etc.
Speaker 2 (16:40):
Etc.
Speaker 3 (16:41):
Or is it because of trauma related injury and scar tissue? Fine,
but actually, you know, you may be more appropriately referred
to a psychologist or a psychiatrist if there is a
psychological or sort of mental health cause for the erector dysfunction.
So I think seeing your GP so you can be
triage appropriately would be the right way. All of those
answers could be the right thing. Maybe a sex therapist,
(17:03):
maybe you know, a couples counseling therapist, maybe a urologist.
Maybe your GP can just sort it out. And maybe
because it's just a side effect of a medication they
recently started you on, and that's quite a quick reversal
for that. For example, a lot of men these days
are concerned with hair loss and they take various things
(17:23):
for hair loss, and many of those things can have
the side effect of causing some issues with you know,
erectile function.
Speaker 1 (17:32):
Okay, so let's look a little bit more or at
these sort of common sexual health concerns. You already mentioned
erectile dysfunction and did want to ask more about that
because it is something that a lot of men seem
concerned about I think. You know, what I think is
quite sort of interesting is that erectal dysfunction medication is
(17:52):
now being marketed to younger and younger men. When I
was a kid, I feel like ads for viagra had
like men forty years or about, and it always almost
seemed like this thing for older people. Your cardiovascular health
is likely to decline as well, and therefore, like older
men might need viagra or something. But now it's almost
like Viagra's cool, Like, get this blue chewing gum. You know,
(18:14):
you're like twenty years old, you need this. And while
I understand that it's extremely important for people to feel
unashamed and it's great to destigmatize sexual health products and
things like that, I also think there's a danger of
like overmedicalizing or making people feel like they have a
problem when they don't, like is your descarde enough, are
(18:36):
your erections powerful enough? Are they you know, pick these
blue bills? So I wonder where you stand on that
as a doctor, because so many young men are right
into me asking about viagra, asking I'm not a doctor,
so I kind of don't talk about medication on my page.
But since I have you today, I'd love you to
tell us what erectile dysfunction is and what some of
(18:58):
the possible causes are, you know, both physical and psychological,
as well as addressed this aspect of like popularization of
erectal dysfunction medication now even on social media, it's being
overmarketed sometimes and what people should be where we are.
Speaker 3 (19:15):
Yeah, I mean, you know, I've seen all of those
adverts and posts on social media with run viercing leading
the charge and you know, promoting this viagra almost Yeah,
I guess pathologizing something that's very normal, and you know
it doesn't mean a man has to get an erection
(19:35):
fifty times a day, I mean, and then making that
a concern so people buy products, And I think it's
a weird way to advertise things for consumers. And you know,
I guess it's not weird in the farm of industry
where people want to overpathologize things. You know, we've seen
that with various things fifty years ago, with you know,
seventy years ago with tobacco products. You know, with doctors,
(19:58):
they're using doctors and adverts to promote tobacco products. Is
being healthy for you and healthy for your lungs, which
we found out was not a now similar way with
kind of viagra now viagra, you know also I dentifhil,
the kind of generic name can be great for men
who need it, who require it on a medical physiological basis,
(20:18):
to maintain erection, to maintain their sex life, thus to
improve their quality of life, whether they've after surgery or
hitting a certain age, lotusosterone related whatever, It can be
great to maintain sexual function or at least mitigate the
loss of sexual function. Fine, but I think there are,
like you said, too many young men using it unnecessarily
(20:40):
and it's not needed, and I think there's multiple ways
to think about it. There are young men who certainly
do not need it at all, and who are using
it to almost get a super physiological you know, dose
of erections essentially, which is kind of not required. But
you know, each to their own, they can do what
they want, but they should be informed that viagra was
(21:03):
initially created as a medication to lower blood pressure for hypertension.
The side effect was erections. It was a very fun
side effect, and it was marketed as now a viagral
to give you erections, but ultimately it still does lower
your blood.
Speaker 2 (21:19):
Pressure as well.
Speaker 3 (21:20):
So if someone is taking heart medication, there is a contraindication,
they shouldn't willing nearly just you know, pardon the pun.
Take viagra, for example, because it can lower the bloo pressure,
can lead to headaches, it can lead to syncope and collapse,
et cetera, blackouts. So you know, if someone is taking
a couple of viagraers popping it, you know, and then
(21:41):
you're driving, it's not inconceivable. But someone just faints because
of low bloo pressure while they're driving and gets into
an accident. That's something that you know, I have seen
before in a person who's come to the emergency room
with major trauma because they had taken a couple of viagra.
Sixty five year old man also had taking blood pressure medications,
collapsed while driving, hit a tree. Now that's not going
(22:02):
to happen to every single person, but for example, there
are side effects with those things. And I also need
to caution against the use of viagra to potentially paper
over cracks in the medical condition. Maybe you've got a
treatable cause of erectile dysfunction or some psychological issue or
physical issue which can be dealt with quite easily. If
(22:25):
you sought medical attention, and maybe your problems with erections
are just being papered over by you consistently using viagra.
And I also feel that if you consistently chronically use viagra,
your body will probably become reliant on that end of
the day. It is a drug, and you can build
up some degree of tolerance to the drug where you
might need more doses. And actually without viagra, maybe you
(22:49):
can't sustain erections. So I really think it's worth a
man exploring all of those conservative options, so to say,
to explore what's the underlying cause for this problem. And
if there is no course found and it's just idiopathic
and so the medical term for we don't know the cause,
then maybe after failing other options, yeah, you can maybe
(23:11):
try vragrant. But even then I guess be cautious, you know,
go slow, speak to the medical doctor to make sure
there's no contra indications with other medications you're taking or
giving you other medical conditions, and if it's safe, go
ahead and see how it goes.
Speaker 1 (23:26):
And would you like to caution also people against calling
for these sort of quick fixed solutions of an advertiser
on places like pond site, like let's get them when
they're the most vulnerable, right with a picture of a
massive penis, and it'll be like, get this snake oil,
you know, get this lotion, this magic potion or tablet
or cream or something, and you're going to have this
(23:48):
massive penis. And I find in India particularly, there's like,
you know, there's children's and sort of jerty Booty Baba's
kind of marketing. This, you know, almost fantastical, Like the
marketing itself is so over the top that you should
be able to see through it. But I think it
plays into this very sort of fundamental insecurity for many
(24:12):
men that it's sometimes hard to resist. But no cream
will ever make your penis big, right, I mean, can
we demystify some of this?
Speaker 3 (24:22):
Yeah, I mean it's so ridiculous that there are so
many scams and promises and hyperboles out there with regards
to increasing a man's penis size. And I get how
men are allured by these quick fixes because they think, hey, yeah,
if I can do that, great, I'll be more powerful,
I'll be more virile and whatever. But I think the
(24:44):
problem is, no matter how crazy and far fetched these sound,
some people just still believe them because they have this
insecurity about the penis size, because they correlate that with
being less than or less of a man, which is unfortunate.
And some of these things can actually have quite dangerous consequences.
A lot of these unregulated supplements that people could be
(25:05):
taking again that could have some seriously you know, negative outcomes.
There are these penis extension devices where essentially, for you know,
simplistic term, it's hanging await at the end of your
penis to try and stretch it out. You know, these
things don't really have safe outcomes in most cases.
Speaker 1 (25:24):
On a light or note, you had made this post
called how to get rid of an unwanted boner in
thirty seconds? Could you share your scientifically back method or
with us?
Speaker 2 (25:36):
Yeah, I mean, you know, I think.
Speaker 3 (25:39):
Men will get you know, unwanted random bonus throughout the day,
and that's just in line with a normal twenty four
hour fluctuation after software and levels. The probably highest frequency
is during the night and early morning nocturnal penaltre messlence
it's called, and it's usually about six to seven times
a night that man would get these directions, but it
(26:01):
may be during the day as well, when they're out
and about and it can be a little bit embarrassing
potentially so counteracting that there's sort of ways you can
think about it. Again, we alluded to the fact that
there's kind of physiological and psychological causes for you know,
linking to the penis and erections, so looking at the
kind of psychological side of things, actually distracting yourself with
(26:22):
something else. And you know, men may find this useful
to almost delay ejaculation or climax, similar to how they
can almost get rid of a boner as well. So
if you're thinking about something not sexy at all, you know,
I don't know, like a cricket match, for example, that
may help in some way to distract you and reduce
(26:43):
your bono produce your erection other ways physically, I'm.
Speaker 1 (26:48):
Thinking more like climate change. Yeah, yeah, THEIA might actually induce.
Speaker 2 (26:53):
A bone bona.
Speaker 3 (26:55):
Yeah, you're right, maybe something like yeah, maybe something which
doesn't involve bat in because I guess that has you know,
quite yeah, exactly, So maybe nothing ball or racket related.
Speaker 2 (27:09):
So yeah, maybe climate change.
Speaker 3 (27:10):
But then again, climate change can make people hot and sweaty,
you know, so maybe that's not right either, Like I
don't know.
Speaker 2 (27:17):
Like maybe I guess, you know, anything can be.
Speaker 3 (27:20):
Trainers for example, think about trainers, dirty trainers or whatever
it is, and that can be distracting that.
Speaker 1 (27:26):
Will do less than thirty seconds.
Speaker 3 (27:28):
You know, I think physiological causes. Again, it's a blood
flow redirection issue here, So can you do something to
redirect your blood flow? So maybe I don't know, just
like lifting something and kind of flexing your biceps or
something like that, there may be more focus of the
blood being redistributed to other areas.
Speaker 2 (27:47):
You know. Also, you know cold showers.
Speaker 3 (27:50):
Again, in a cold shower, your blood flow is redistributed
to kind of the main other organs or your heart,
your kidneys, your liver, et cetera, so it will take
it away from the penis. So those are some quick
things you can do at a pinch to get rid
of your embarrassing, awkward public bonus.
Speaker 1 (28:07):
Thank you for sharing that. I wanted next to talk
about premature ejaculation, because I would say, after rectilis function,
that's the other perhaps most common concernment seem to have.
Do I last longer? How can I last? I mean,
do I last long enough? How can I last longer? So?
How soon is too soon? You know medically what is
(28:29):
premature ejaculation.
Speaker 3 (28:31):
I think it comes ultimately down to the issue of
the individual and the partnership. If they feel that early
ejaculation is potentially ruining the sexual encounter or actually having
some sort of negative impact on quality of life, that
is worth potentially you seeing a medical provider, and in
this case, certainly a urologist would be helpful.
Speaker 2 (28:55):
In that situation.
Speaker 3 (28:56):
And there could be a number of causes from this
from my home no perspective, you know, doing a blood
screen to see if there's certain hormones.
Speaker 2 (29:05):
That are abnormally raised.
Speaker 3 (29:07):
Or the testosterone is abnormally low, various other things like that,
and again psychological causes. Is there some degree of anxiety
which is causing that or some sensitivity issue in the
actual penis itself. So yeah, I think it is. Again
it's not a one size fits or blanket rule, and
it'll be down to the individual and the couple as well.
Speaker 1 (29:29):
And since we're on the topic of ejaculation, there also
seems to be a lot of misinformation around whether or
not it's good for you to ejaculate. Like there's one
corner of the internet, particularly popular in India that is
obsessed with semen retention as if it's going to give
you superpowers. Do you want to do you want to
debunk some of.
Speaker 3 (29:49):
That, Yeah, And I think a lot of this myth
comes from kind of the sports industry and specifically boxing. Uh,
there was this kind of of myth historically that before
a big fight, you know, the boxers shouldn't sleep with
their wives or something like that, because the loss of semen,
(30:10):
almost like Samson's.
Speaker 2 (30:11):
Loss of hair, would result.
Speaker 3 (30:13):
In losing all of their strength and powers and virility
and they'd lose the fight. And I think that is
where the myth propagated. But there is no medical evidence
to suggest that ejaculation or sex lowest testosterone at all,
So that myth can be you know, put in bed
(30:35):
and semen retention as well. And you know, in the
way that I think of semen retention, it's not just
no fap and not ejaculating, it's actually climaxing and holding
in the semen which should come out, but actually some
way you're contracting your muscles to hold it in. Now,
(30:55):
that can actually be quite harmful because that can result
in retrograde ejaculation, where your semen instead of going out
viya urethra actually refluxes retrograde so backwards into your bladder,
which is not something that you want, which can increase
(31:16):
the rate of irritation, UTIs and all sorts of things
like that which you don't want. You don't want to
retain your semen or shoot it backwards. That is something
you want to absolutely avoid.
Speaker 1 (31:27):
And finally, I want to before I move on to
a little rapid fire around with you, let's talk about
sperm quality. Since we touched on one spam, how would
you define sperm quality? And as a man, how do
you know if you have a healthy sperm count. The
fertility industry is booming in India right now as people
delay childbirth, and I think men too want to sort
of understand a bit more about the fertility.
Speaker 3 (31:49):
Yeah, I don't think there's any real way, And similar
to women's health, there's no real way without some sort
of medical test to determine your sperm quality because swerberm
quality is based on a number of things, you know,
looking at the volume, the quality of the actual sperm itself,
the volume of the ejaculate, the quality of the sperm
(32:10):
itself in terms of their motility, So how well they're moving,
the actual shape of the sperm, do they look mutated
or not. So there's a number of factors with regards
to that which can only be seen under a microscope
and doing blood tests to check all of these various
levels of.
Speaker 2 (32:27):
Hormones et cetera.
Speaker 3 (32:29):
And similar to women's health as well, you need certain
you know, scans and images and blood tests to determine
the actual you know, your varian reserve and your you know,
egg health, et cetera. Same for men. There's no way
that I can just do some at home measurement to
test that.
Speaker 2 (32:44):
You know, that's that's not possible.
Speaker 3 (32:45):
So even the fittest person on earth with a six
pack and able to run ten miles a day and
you know, really healthy, good sleep, et cetera, Yeah, maybe
they are likely to have good quality sperm because of
all of these extra facets in their life which are
you know, good behaviors. But if you analyze their sperm
under microscope, it could be very you know, borderline infertile potentially.
(33:09):
So actually there's no way just externally to assess sperm quality.
You could extrapolate if someone is living a very unhealthy lifestyle,
they're vaping or they're smoking, or they're drinking lots of alcohol,
and they're working in a job which exposes them to
high levels of pollution for example. We know that there
are certain environmental factors, these modifiable factors, which can influence
(33:32):
sperm quality, but just based on someone's appearance, it's not
possible to tell about their sexual health or sperm health.
Speaker 1 (33:41):
So what would you advise that couples both get tested
on these various indices of fertility, shouldn't they have trouble conceiving?
I think often only the woman is sent for the test,
you know, when in fact it could be either party's
fertility that's causing the difficulty in conception.
Speaker 3 (34:00):
Right, Yeah, absolutely, I think you know, there's probably no
need to routinely get yourself tested before trying. And I
think you know, still just trying to conceive, and you know,
if there's a consistent failure over a number of months
and maybe years, then it is definitely time to explore
is there any medical factors which can be modified which
(34:20):
is actually affecting the point of conception, both on the
male and female side, as who suggested, And yeah, I
think that's a very fair thing to do, especially these days.
You know you hear these claims about sperm counts dropping,
et cetera, et cetera. It's probably something to think about
earlier rather than later if there is a long term
issue with you know, trying for a child and it's failing.
Speaker 1 (34:43):
All right, let us move on to a little mythbusting
rapid fire style. The pull out method is a reliable
form of contraception. No, do you want to quickly tell
us why? Why not?
Speaker 3 (34:58):
Rather, well, if you don't know, you know exactly the
timing of the pullout, whether there's any residual sperm being
left in the vaginal cavity, in the vaginal cadal. So
I think it's a very unreliable, unscientific method of contraception.
Speaker 1 (35:12):
I'm durant, Okay, men cannot get sexually transmitted infections from
oral sex.
Speaker 2 (35:21):
Oh, also false?
Speaker 3 (35:22):
Yeah, I mean there is consistent evidence linking oral sex
and the HPV virus with a number of cancers from
oral pharyngeal cancers, throat.
Speaker 2 (35:33):
Cancers, tongue cancers, and beyond.
Speaker 3 (35:36):
So I think, you know, definitely beyond just HPV which
I've mentioned, herpes and beyond can be transmitted orally.
Speaker 1 (35:45):
If you get a vasectomy done, sex won't be the same.
Speaker 3 (35:48):
You know, for me, I don't think that is true
based on the evidence. However, there could be some individual
variants depending on you know, whatever men find with regards
to their sexual function.
Speaker 2 (36:00):
But there should not.
Speaker 3 (36:01):
Be any specific negative impact on sexual function if a
man's had of a sectomy, because the genital organs are
exactly the same. No nerves have been snipped, the actual anatomy,
the hardware on the outside has not really been changed.
It's only the tubes have been tied. For into a
better phrase, So no, that should not affect anything physiologically.
(36:25):
Maybe psychologically there could be some effect there which may
impact a man's perception on in sexual performance.
Speaker 1 (36:33):
All right, a very diplomatic answer that men should certainly
read the side effects of birth control that women have
to endure. Kind of a sectomy is not going to
seem so bad. But okay, one more, one more myth
Men in relationships don't master bit.
Speaker 3 (36:54):
Yeah, I think that's an absolute myth. You know, I've
got tons of friends of mine who are you know,
in relationship and ships. They're married, they've got long term
girlfriends who masturbate. And now I don't think that's something
that needs to be hidden or made it taboo thing.
And I don't think that's an indication of a person
not being in a satisfied relationship either. Everyone has different
(37:14):
sexual needs. If you don't masturbate in a relationship, that's fine.
If you masturbate in a relationship, that's also fine. I
don't think that has any impact on your relationship as
a whole.
Speaker 1 (37:27):
And finally, orgasms and ejaculation are the same thing.
Speaker 3 (37:31):
So I mean physiologically there are two different things. I mean,
one is more of a pleasurable outcome and one is
more of a physiological outcome. So yeah, I think there
should be some discrepancy between the two because you can
orgasm without an ejaculate.
Speaker 1 (37:47):
And you can ejaculate without having an orgasm. Yeah yeah,
all right, Which brings us to the link between mental
health and sexual health, which we did touch upon earlier
a little bit. But I think so often when thinking
about sexual health, people think only about the genitals, genital function, size,
all of that stuff, sort of you know, seeing the
(38:08):
body as disconnected parts rather than a holistic, sort of
very symbiotic relationship. Also, right between the emotional and psychological
and intellectual and the physiological or physical what sort of
links can you know, stress or trauma or self esteem,
let's say, have on sexual function, and what might we
(38:32):
all be sort of better off acknowledging in this regard,
so that we have both the information and the sort
of agency to act on should we detect that we
might not be feeling you know, all that well up here,
I personally am of the opinion that the most significant
sexual organ is the brain.
Speaker 3 (38:51):
Right, yeah, I think you know, one of the main
things is actually if you're low in mood or you know,
depending on on what you're feeling at the time, or
any mental health conditions that can actually impact your libido.
You know, a very common side effect of depression or
a symptom of depression I should say, is reduced libido.
(39:14):
And you also see that with things like lotestosterone. For example,
if a man has a low testosterone, that impacts a
man's mood and thus can impact libido as well the
sexual drive or sexual appetite. So I think that is
the number one thing. But also the mental health can
distort your sensory perception as well. So the same things
(39:35):
that you found enjoyable, enriching and fulfilling experiences can almost
be dull down and kind of the vibrancy of life
in general can be dialed down. So the same experiences
and feelings that you feel can actually be attenuated significantly
because of your mental health. So you know, if you
enjoyed mango milkshakes when you're kind of fine, right, you
(39:59):
really love the taste of that, say you go through
a period of depression, that same mango milkshake may not
taste as sweet and as pleasurable as it did. And
the same can happen with sex as well. It may
not be as preasurable because all the volumes of all
those feelings that dialed down significantly.
Speaker 1 (40:15):
Thanks with that metaphor or analogy. I loved it. I
think it's what everyone can relate to because even on
just a bad day or the day you're feeling sad,
I feel like things don't joy it as and register
as acutely right. And I think it's important that we
seek help, you know, whether it's sexual health or mental
health related. I think those two things still remain significantly
(40:38):
difficult to navigate in India, Difficult to talk to your
family about, difficult to even talk to your partner about
So I want to just take this opportunity to encourage
listeners to know that they can, that they're not alone,
that these are very common issues, and that solutions exist.
So as we close, I did want to get back
to the sort of topic you brought up, but right
(40:59):
at the beginning, around getting your health information from social media. Obviously,
we are all blessed to have you on our feeds
because of the you know, extreme commitment to scientific accuracy
that you have, but unfortunately there are also lots of
people who do not share that commitment, and lots of
people who posit themselves as authorities. Nonetheless, there's gurus and
(41:22):
barbers and you know, people really trying to pursuade you
to see them as experts and somehow worthy of your
respect and the iconography even around these people that, you know,
it's hard for a young person to discern like who
is the authority and who is the quack. So do
you have any tips for just sort of social media literacy,
(41:44):
especially when getting your health information from there, which most
young people it is the starting point if you want
to learn about something that you think you may be facing,
You're going to start at the Internet before you go
to the doctor. You know, I'd love to hear from
you your advice to young people using the internet to
get there to get their medical information.
Speaker 2 (42:04):
Yeah.
Speaker 3 (42:04):
I think I would be wary of anyone claiming one
thing works, and if they're especially linking that to something
that they're selling as well, because there's an inherent financial
bias there as well some incentive that they're using. And
people who generally speak in absolutes scientific languages always could
(42:26):
be likely to be possibly has a higher risk of
chance of it. Sometimes is inherently a little bit vague
and ambiguous, because science can be like that. Science is
usually not in absolutes like this is X Y and Z,
and so I think if someone is speaking in hyperbole,
(42:47):
in absolutes and in very polarizing context, those are usually
red flags for you to think about and thinking, hang on,
is there any evidence behind this? And actually you also
want to do your own research as well. As much
as you might enjoy social media content, if someone is
providing health information online, I think it's worth doing your
(43:07):
own due diligence. Are they a medical professional to be
speaking so confidently about X, Y and z when it
comes to health? And also what they've spoken about can
I find any evidence behind this? So those are things
that actually the owners is also on us as consumers
to do that research as well.
Speaker 1 (43:26):
And I would go one step further in India though
particularly I don't know what it's like elsewhere. But you know, unfortunately,
because religion has such a strong place still in our
cultural and social imagination, what can be very confusing for
young people is that often even medical professionals, you know,
their products of the same society and are practicing with
(43:48):
a certain set of religious beliefs. And I mean there's
doctors on YouTube who say the most unscientific things because
it's coming from their religious beliefs, right, and so they
have the qualification, and they'll still be saying to you
something deeply misogynistic or shame lad and especially when it
comes to things like women's pleasure or you know, I mean,
(44:12):
whether it's something like masturbation or nightfall. There will be
people who have.
Speaker 4 (44:15):
Like various qualifications, whether they're professors or doctors, and unfortunately
they're allowing for their personal religious and other such beliefs
to intervene and cloud the science.
Speaker 1 (44:33):
And I think that and even once parents, you know,
when your own mom and dad tell you that, you know,
there's so much homophobia, for example, even from within the
medical profession and within people's families. I'd love to, yeah,
take that one step further, because I think there's also
some amount of gatekeeping around who gets to talk about
things like you must have these qualifications. But unfortunately, for
example queer people, I think if you have to do
(44:54):
so much work themselves, because the people with the qualifications,
the policy makers like nobody's doing the work for them.
Most healthcare workers in India still have absolutely zero training
and queer affirmative sexual health, sexual and regreactive health services
for example. You know, so I can I like ask
you to take that one step further.
Speaker 3 (45:14):
Yeah, I think you know, there's certainly no restriction on
who should talk about the content. There's likely to be
more misinformation from non medical experts talking about specific medical
issues than medical experts. But again that does not make,
as you suggested, medical experts immune from misinformation and using
their own personal biases towards pushing certain engenders. And for
(45:39):
example in India, Yeah, sometimes religion whether can creep into
the conversation and there can be lots of pseudoscience promoted
as a result of that, I think, yeah, that is
very abundant on the online spaces where someone pushes their
own cognitive biases into the conversation. So, you know, I
(46:00):
really think social media and clips that you see online
use as a stepping stone for you then to do
your own deep dive into a conversation, because there's only
so much nuance and information one can provide in sixty
or ninety seconds. And I don't think any topic can
be given you know it's proper due or you know,
(46:21):
being you can't do justice for any specific topic, certainly
not such a nuanced topic like sexual health in ninety seconds.
So you do need to go away, take the headlines
from whatever you've learned, and then go and do your
own research.
Speaker 1 (46:35):
Thanks for that very important reminder. It's been so wonderful
talking to do tell I guess where they can find.
Speaker 3 (46:41):
You, so everywhere, YouTube, Instagram, TikTok and beyond. I'm doctor
Karen on all these platforms, and you've.
Speaker 1 (46:48):
Got to get doctor Current's book. I so enjoyed reading
it and it's so funny. We had a bit of
a serious talk today, but doctor Karan is such a
pleasure to listen to and watch because he is also
so funny and so funny, so you will definitely have
a laugh both reading this book and consuming his videos.
Thanks so much for tuning in to Love Matters. This
is Lisa Mangolas and Love Matters is produced by Indian
(47:11):
Express and DW, Germany's international broadcaster. If you have a
topic suggestion or guest suggestion question or a story you
want to share, you can write into us at Lovematters
at DW dot com. We'd love it if you read
and review this podcast wherever you're tuning in, and please
do share it with your friends. Un Till next time.
This is me Lisa Mangolas signing off. I believe Love
(47:34):
Matters
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